GPSOLO October - November 2008
IN THE SOLUTION
Preventing Suicide: A Challenge to the Legal Profession
Every American knows that on 9/11 approximately 3,000 Americans were killed by terrorists. What most Americans don’t know is that ten times that many Americans kill themselves every single year, leaving hundreds of thousands of loved ones, colleagues, and friends to grieve.
How many of the approximately 32,000 suicides in the United States each year are lawyers? How many are family members of lawyers? How many are law students? How many are employees, co-workers, clients, or citizens being served by our judicial system?
No one is quite sure. But if the United States has more than 1 million lawyers and law students, and if they experience the same rate of suicide as the general U.S. population (11 suicides per 100,000 people per year), then since 9/11 an estimated 800 lawyers and law students have died by suicide. And it may be worse.
A study of Canadian Bar Association members suggests that the suicide rate among attorneys is actually five to six times higher than the national average, or 55 to 66 per 100,000 per year. If ABA members are like CBA members, the number of U.S. attorneys and law students who have died by suicide since 9/11 could exceed 5,000.
When giving lectures on the subject, the authors often ask audiences the following question: “If you have lost to suicide someone you knew on a first-name basis, would you please raise your hand?” In most adult audiences, 90 percent of people will raise their hands. Our guess is that in your mind you are raising your hand, too.
Why Now? Why Us?
The United States lagged behind other first-world countries in developing a national suicide prevention plan, but now we have one. Because lawyers play a pivotal role in the lives of many distressed people, lawyers were identified as possible “key gatekeepers” in the 2001 Surgeon General’s National Strategy for Suicide Prevention: Goal 6.7: “By 2005, increase the proportion of divorce and family law and criminal defense attorneys who have received training in identifying and responding to persons at risk for suicide.”
Attorneys have unique opportunities to identify and refer potentially suicidal clients, employees, and colleagues. They are often in the thick of stress, loss, and the psychological combat of conflicted relationships. With their enhanced literacy in mental illness and substance abuse, those reading this article are uniquely positioned to act as gatekeepers in the implementation of the first U.S. national suicide prevention effort.
The aim of Goal 6.7 is to address the “missed opportunities” to identify and refer potentially suicidal persons who may otherwise remain undetected and unassisted. Although attorneys may have no medical-legal requirement to intervene in the lives of potentially suicidal persons, many of them feel an ethical, humanitarian, and professional duty to take considered and positive action when they encounter someone suicidal.
No lawyer or judge of our personal acquaintance is unfamiliar with suicide, its awful consequences, and its devastating effects on loved ones and those left behind, and everyone we know has a “suicide story” to tell. It could have been a law school classmate, a college roommate, someone at the firm, a client, or an old friend who died by suicide.
Suicide Prevention Is Also about You
We all know lawyers are not immune to personal crises, mood disorders, and substance abuse problems. We also know that many lawyers, while excellent at referring other distressed people for help, are often loath to seek that same help for themselves.
Unless we are much mistaken, this means you—especially if you are a man. Compared to women, men are boneheads when it comes to asking for help, which may account for a fourfold higher rate of suicide among men compared to women. But smart men make smart choices, and smart choices include taking care of one’s mental health.
Self-referral takes courage. The U.S. Air Force launched a service-wide suicide prevention program in 1996. Asking for help was redefined as a courageous act. As described in the December 2003 issue of the British Medical Journal, the program produced not only a 33 percent reduction in the suicide rate among airmen and women but also brought about significant reductions in homicide (51 percent), accidental death (18 percent), and domestic violence (30 percent to 54 percent).
Suicide Prevention Is Violence Prevention
All members of the bar embrace violence prevention. They see too much of it in their work, and they try hard to prevent it. Just imagine how our communities would look and feel if we could be a part of bringing about the same reductions in violence that the U.S. Air Force was able to produce. Remember that the tragedy of the Virginia Tech shootings and almost all similar mass murders are initiated by seriously mentally ill, suicidal persons who, by their premeditated, self-inflicted deaths, avoid prosecution.
We already know what is needed and what works. We have lawyer assistance programs. We have effective treatments. Recovery is real. We have strategies and interventions that work. Lives can be saved. What we need now is participation and leadership.
Among others, Senator Harry Reid of Nevada, who lost his father to suicide and had the courage to tell his story in the well of the U.S. Senate, and Senator Gordon Smith of Oregon, who lost a son to suicide, have stepped forward and helped pass the Garret Lee Smith Memorial Act, which now funds millions of dollars in suicide prevention programs. These “survivors” of loved one’s suicides are helping to power the national movement with passion, brains, and determination. They are not about to be silenced, they are not about to quit, and they represent millions of our fellow citizens.
A True Story
Some may recall a little-known member of the Illinois bar, a lawyer who suffered from suicidal depressions as a young man. After losing his true love to an early death, he became so despondent he told others he felt like killing himself. Recognizing his despair, his friends and colleagues in the bar rallied to his support, took away his pistols and knives, spent time with him, and even locked him up to protect him from himself.
Thus did Abraham Lincoln survive his suicidal crisis and learn to live with and gain insights from the depressions that revisited him throughout his life. If one life lost to suicide is too many, imagine the cost of not preventing the suicide of our next Abraham Lincoln, who may, right now, be attending law school.
As we say to our colleagues in mental health and the law, to dither or drag our feet about implementing the National Strategy for Suicide Prevention is not just a matter of will, but of ethics. Former surgeon general Dr. David Satcher said, “Suicide is our most preventable form of death.” If true, then we are all in a high-stakes race between education and tragedy.
WHAT YOU CAN DO
Learn the Warning Signs
Worried about someone you know? Look for the following warning signs:
- Threatening to hurt or kill oneself or talking about wanting to hurt or kill oneself
- Looking for ways to kill oneself by seeking access to firearms, available pills, or other means
- Talking or writing about death, dying, or suicide when these actions are out of the ordinary for the person
- Feeling hopeless
- Feeling rage or uncontrolled anger or seeking revenge
- Acting reckless or engaging in risky activities, seemingly without thinking
- Feeling trapped, like there’s no way out
- Increasing alcohol or drug use
- Withdrawing from friends, family, and society
- Feeling anxious or agitated or being unable to sleep or sleeping all the time
- Experiencing dramatic mood changes
- Seeing no reason for living or having no sense of purpose in life
QPR (Question, Persuade, and Refer someone for help) is like CPR, an emergency intervention for those who may be considering suicide. A one-hour training program is available from certified QPR instructors nationwide or online at www.qprinstitute.com. The training takes one hour and can save a life.
Read This Free Book
Dr. Paul Quinnett has donated his best-selling book, Suicide: The Forever Decision, to the public in electronic format. It may be printed, distributed, given away, and shared with anyone who needs it. The book can be downloaded for free at www.qprinstitute.com.
Don't Wait, Get Help Now
The National Suicide Prevention Lifeline is a 24-hour, toll-free suicide prevention service available to anyone in suicidal crisis. If you or someone you know needs help, please dial 1-800-273-TALK (8255) or call a mental health professional you know or your bar’s lawyer assistance program. A listing of lawyer assistance programs and other resources can be found through the ABA Commission on Lawyer Assistance Programs, www.abanet.org/legalservices/colap.
Skip Simpson practices law in Frisco, Texas, where he specializes in handling suicide and other psychiatric and psychological malpractice cases; he may be reached at email@example.com. Dr. Paul Quinnett is president and CEO of the QPR Institute ( www.qprinstitute.com), a suicide-prevention institute in Spokane, Washington; he may be reached at firstname.lastname@example.org.