Wellness

Preventing Suicide

Carrie Arnold

Whenever someone takes his or her own life, it raises more questions than answers. The people left behind find themselves asking what went wrong, why didn’t they notice, why didn’t the person get help. As the number of postdocs and undergrads and grad students who die by suicide increases, universities around the country are starting to ask themselves what they can do to prevent these potential deaths from occurring.

The answers aren’t simple. Learning to recognize the signs that someone might be struggling and also helping students and faculty identify an immediate crisis are all important steps. But effective suicide prevention requires a more comprehensive approach, says Victor Schwartz, Medical Director at the Jed Foundation, which was founded in 2000 to address the issue of suicide on college campuses.

“Waiting to intervene until you see the warning signs of suicide is like waiting to treat someone for heart disease until they have a heart attack. We need to intervene upstream,” Schwartz warns.

Personal, social, academic, and financial problems assault students simultaneously. Although undergrads also face these stressors, their intensity tends to be amplified for postdocs and grad students, who must also navigate their own research, grant writing, teaching, and other responsibilities. The key, notes Schwartz, is to provide graduate students and postdocs with the resources they need to thrive in what is often a pressure cooker situation. Everyone, from grad students and postdocs to PIs and lab managers, can learn how to recognize the signs of everything from a bad day to an urgent crisis and respond appropriately.

If someone struggling with depression, anxiety, or another mental health problem is to get help before everything spirals out of control, that person needs to be able to both identify and access psychological help. Many postdocs have benefits under their university’s employee health plan and can contact a therapist in the community. Undergrads and grad students can usually avail themselves of on-campus assistance through student health services. These services, however, aren’t always available on demand.

Some grad students hesitate to seek counseling because they worry that the students they are teaching will see and recognize them. Furthermore, many grad students and postdocs say that high levels of depression and anxiety are common, which can cause feelings of stress and despair to seem more normal than they should. Others worry that other grad students or their PI might find out they are receiving mental health care, and that the discovery could hinder their work.

“There might not be a formal ranking in most departments, but there is a pecking order, and people generally know where they stand,” says Nick Repak, founder of Grad Resources, a nonprofit serving the emotional needs of graduate students around the country. “There’s often a great concern that letting a weakness be known will affect this order and their work.”

Foreign students may find grad school and postdoctoral work especially challenging. They are frequently a long way from home in a strange country, circumstances that amplify stress while simultaneously decreasing their support network of nearby family and friends. As well, it’s not uncommon for international students to come from countries and cultures where mental health issues are even more stigmatized than in the United States. This makes asking for help even more difficult.

The nature of severe depression and other mental illnesses can make it hard for individuals suffering from these conditions to recognize how bad things are. For some, the conditions may creep up so slowly that they might not notice that their mental health requires urgent action. Sometimes, feelings of despair and hopelessness make seeking help feel pointless. Other times, mental health problems can leave a person completely unaware that there is a problem.

Whether or not someone is aware there is a problem, her or his behavior will noticeably change. The lab’s social butterfly might become introverted and withdrawn, while your friend the early bird won’t show up until well after noon. A change in eating habits is also common. An individual might focus on events that will occur when “I’m no longer here.” Normally meticulous work might become careless for one person, while another with a generally lackadaisical approach may become bogged down in meaningless details.

Schwartz advises, “It’s like they say on those public service ads in the subway: If you see something, say something.”

Casually approaching a friend or labmate may be effective in many situations, but both Schwartz and Repak point out that an actual crisis may require more immediate action. Schwartz uses the mnemonic IS PATH WARM:

Schwartz says if you see these signs in someone, approach the person with your concerns.

As well, studies have shown that asking people whether they are having thoughts of hurting themselves does not make them more likely to do so. Thus, if you are concerned that a friend is at the breaking point, asking him or her directly will not cause harm.

“Many times, people thinking about suicide are looking for someone safe to talk to about their thoughts and feelings, but they’re also worried about freaking people out,” says Mahlet Endale, suicide prevention coordinator at Emory University. Broaching the topic will help create a safe, nonjudgmental environment where someone can share emotions and start seeking help.

If you recognize these signs in yourself, Grad Resources runs the only crisis hotline geared specifically toward graduate students at 1-800-GRAD-HLP (1-800-472-3457). When someone calls, Repak says the person will speak with a counselor who has been trained in issues specific to graduate students, such as academic and financial pressures, department hierarchies, and teaching responsibilities.

Not everyone recognizes the need for and accepts help, even when actively having suicidal thoughts. “You need to ask the right questions to help persuade someone not to harm themselves,” Repak said. Pointing out specific examples of behavior change and asking direct questions in a caring manner can help get the conversation started. Instead of asking, “You’re not thinking of suicide, are you?” Endale recommends something along the lines of, “Many people struggle with depression and have thoughts about hurting themselves. Is this something that is happening to you?”

Continued resistance and denial may mean you need to reach out to trustworthy mutual friends, PIs, and others in the department and ask whether they will also talk to the person about his or her concerns and use additional leverage.

If someone’s life appears to be in imminent danger, Schwartz and Repak say to call 911 and have the person evaluated at the emergency room.

“We are often afraid of intruding and stirring things up, but if you’re feeling in your gut that there’s something wrong, it’s more prudent to overreact than just ignore the problem and assume it’s going to go away,” Schwartz concludes.

Emergency Phone Numbers

If someone’s life appears to be in imminent danger, call 911 and have the person evaluated at the emergency room.

If you recognize the signs discussed in this article in yourself, call 1-800-GRAD-HLP (1-800-472-3457). This will connect you to Grad Resources, which runs the only crisis hotline geared specifically toward graduate students.

Remember: When in doubt, get help.