Preventing subsequent suicide attempts one phone call at a time

This story originally aired on KQED Public Radio.

Every day in California, nine people die by suicide. It’s the 10th leading cause of death in the state and nationwide. According to a recent study, More than half a million adults in California seriously thought about killing themselves in 2009. It’s such a big problem that just this past fall, the California Mental Health Services Authority launched a statewide campaign called Know the Signs as part of a larger Suicide Prevention Initiative. 

But, in Sacramento, there’s a unique partnership between Sutter Medical Center and WellSpace Health that takes a hands-on approach to this devastating problem. It’s a suicide prevention arrangement that targets people who have already tried to take their own lives. And it’s all done over the phone.

John describes himself as happy-go-lucky. The 29-year-old is a student in Human Services at American River College in Sacramento. But, last year, he had been let go from two different jobs, was facing bankruptcy and was forced to moved in with friends.

“At that point in time, I knew that I had absolutely nothing left,” he said. “I was emotionally and mentally stripped. My pride was gone.”

And then he got more bad news: he was diagnosed with HIV.

“That took away pretty much the last thing that I had, which I thought was my health.”

John asked that we use his first name only because of the shame he feels is associated with both suicide and HIV.

One day this past August, he thought, “I’m tired of doing this.” That day, he decided to take his own life.

“In my room, I wrote out my note,” he remembered. “I got all my medication out on my bed and I just started taking it. And … All of a sudden, what I just realized is here I am laying here on my floor. And all of a sudden, I think, Oh My God, what am I doing? What am I doing?”

He called out for help and his roommates called 9-1-1.

He woke up in downtown Sacramento at Sutter General’s emergency department with nurses pumping his stomach.

After he woke up, something extraordinary happened. A social worker told him about a unique program that matched John with a suicide prevention specialist. John signed up. That person would give him a call every few days for a month just to check in.

“Ultimately, I knew that I had a cushion for support,” John said about receiving those calls. “I knew that if I was having a hard time, I absolutely had somebody available there.”

The calls to John were made from a room at the back of a WellSpace Health clinic in South Sacramento where people speak in soft, sing-songy voices. It’s Roop Dhillon’s job to call people like John who have recently been to the ER for thinking about suicide or attempting it.

“A lot of times that visit alone could be a pretty overwhelming experience,” said Dhillon. “What we’ve heard from a lot of participants is their hardest part of leaving the emergency room was feeling alone once they got home.”

WellSpace Health (formerly called The Effort) started this Emergency Department Follow Up program with Sutter Medical Center to try to keep people from going back to the hospital or worse. If a patient doesn’t have the financial means, they can go directly to WellSpace Health, for six free counseling sessions. The Follow-Up Program is free, too.

This Emergency Department Follow Up program is unique because it’s proactive. Dhillon calls people who have just gotten out of the emergency room. People who are vulnerable. People who are most likely to try to take their own lives again.

Dhillon calls her clients from the same room where the clinic runs a more traditional 24-hour crisis hotline. So, this clinic has both the well-known hotline and the newer phone call outreach.

The outreach program has served about 300 people so far, and none have died from suicide.

Liseanne Wick, who, manages suicide prevention and crisis services at the clinic, says when volunteers answer the phones, they never know how close the callers are to the edge.

“That being said, we talk to people who aren’t suicidal at all and maybe just need to talk or are a little bit depressed or anxious … or sad,” she said. “But we also talk to people who are standing on the train tracks or have a loaded gun in their hand or who have a noose wrapped around their neck, the whole spectrum.”

If someone makes it to the Emergency Department following an attempt, chances are pretty good that they’ll meet with a social worker. Someone like Joshua Collver, who used to work night shifts at Sutter General.

“Often times, we see people who just lost their jobs, been through a breakup, or had some kind of other crises,” said Collver.  “Now, a patient in the ED could be a lawyer, a doctor, a prostitute … it could be anybody in crisis.”

Studies show that Emergency Departments treat the majority of suicide attempt survivors, increasing the burden on an already taxed system. The CDC reports that suicide costs society approximately $34.6 billion a year in combined medical and work loss costs.

Jonathan Porteus is CEO of WellSpace Health. He says their suicide prevention programs helps reduce hospital readmissions, saving lives and money.

“It saves all elements of the system,” he said. “It saves on associated costs in the mental health system, it saves on associated costs in the coroner office, it saves on associated costs in the health care industry.”

Porteus has seen a big benefit, too, for hospital staff.

“The anxiety you live with when you’re working with persons who are at risk of killing themselves, is pretty immense,” he said. “And … the collateral damage to everyone around, including professionals, when a patient does commit suicide, that’s really bad. … It just really hurts a lot of people.”

It hurts co-workers, friends and family members.  People like the clinic’s Liseanne Wick, who was drawn to suicide prevention over a decade ago after her brother took his own life.

“Personally, it will never bring my brother back, but it really brings meaning to that experience knowing that we’ve affected the lives of thousands, literally, over the last 10 years, probably tens of thousands,” she said.

When asked if she thought the prevention hotline or the Follow-Up program would have potentially helped her brother, Wick said “we do know that people that call the crisis lines are helped. We know that statistically, we  know that anecdotally from our experience....  I can’t speak for my brother, if he would have called or if he had knowledge of suicide hotlines. I wish he would have, though, because I know that it makes a difference and we save lives on a daily basis.”

Indeed, John sounds like a convert when talking about how the follow-up program helped him. He said when he would see the number pop-up on his cell phone, it would remind him to pause. To assess how he was doing. And to realize he wasn’t alone in the world.

“So if you’re at a point where it just makes more sense to end it all because it’s not worth bothering anymore,” he said, speaking to those who may be considering hurting themselves. “Just pick up a phone and reach out to somebody for help. Let them tell you why it’s worth the bother.”

If you or someone you know is in crisis, call the 24-hour national crisis support line at 1-800-273-8255.

More Stories from This Project

Suicide Prevention Resources

US toll-free 24/7 hotline. 1-800-273-8255

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Lauren M. Whaley

Freelance journalist Lauren M. Whaley is a photographer, radio producer and print reporter specializing in topics related to mental illness, reproductive health care and health disparities. She is also a childbirth photographer.This year, She is working on a series about how low-income parents access care for perinatal mental illnesses. The project is funded in part by the Rosalynn Carter Fellowships for Mental Health Journalism.She was a 2016-17 Knight Science Journalism Fellow at the Massachusetts Institute for Technology.Her work has been recognized by the Association of Health Care Journalists, the Scripps Howard Foundation and the Public Radio Exchange (PRX) STEM story project. She has contributed radio, video, photography and written stories to KQED Public Radio, Southern California Public Radio, the San Jose Mercury News, the New York Times and other media outlets. For six years, she worked as the Center for Health Reporting's multimedia journalist. She is a past president of the national organizationJournalism and Women Symposium (JAWS) and spent her early 20s leading canoe expeditions for young women, including a solo-led 45-trip in the Canadian Arctic. She is based in Los Angeles.

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