Transcription:

Melanie Cole (Host): Everyone can feel down at times, however, if you suffer from depression, without the proper treatment, your feelings of despair can become so severe, that you consider taking your own life. My guest today is Dr. Hatim Omar. He is the Chief in the division of adolescent medicine at UK Healthcare and the founder of the Stop Youth Suicide Campaign. Welcome to the show Dr. Omar, do you think that there is still a stigma around mental illness and people are not as willing to talk about it? How common is suicide these days?

Hatim Omar, MD, FAAP (Guest): Thank you for having me. I think it is very important for us all to understand that suicide is one of the biggest problems we face. In 2016, on data just released from the CDC, we have 45,000 lives lost to suicide. That is every twelve minutes, one person every twelve minutes. In another way to put it, that is a 127 people every single day. Just imagine if we have a passenger jet with 127 passengers crashing every single day, you would think we would do something about it. The other fact is that suicide rates have jumped up more than 30 percent just since 1999. And the more important fact in my view is we need to stop thinking of suicide just as a mental health problem. More than half, like 54% of the people who die from suicide never had a known mental health problem. It is more of a public health problem and it is unfortunate that yes, we still have a stigma and we don’t want to talk about it and the less we want to talk about it, the more it’s going to happen.

Melanie: Who is at greatest risk doctor? So, give us some of the parameters that you look for whether it’s youth or adults. Who do you think is at the greatest risk?

Dr. Omar: I think the simplest way to look at this is who gets to a point where I think I’m hopeless. I don’t think my life is going to get better. From that, one of the largest risks for suicide would be youth, ages 10-24, in part, because they don’t understand that things can change. They don’t understand that if I am feeling bad today, maybe things will be better tomorrow. So, they are at much higher risk with what we call same day suicide. These are kids who don’t have a problem, never had a health care problem but they get bullied or broken relationship or something that happens that day and they don’t have any other source or a support system that they can rely on or somebody to talk to and they end up taking their life that same day. That’s roughly 25 – 30% of all suicides in that age group. The second group is the older people, the 65 and up especially single males 65 and up who don’t have or lose all support systems and realize that they really don’t have anybody to be with them or help them.

So, from the reality is for us to make a dent in suicide, we can’t afford to wait until somebody attempted suicide. We need to as parents, as school teachers, counselors, community as a whole; to provide our kids and our elderly with an option, before they get to a point of problem, like we tell our kids listen if you one day you have an issue, you feel bad, here’s whom you talk to. This is probably more important than anything else.

Melanie: Doctor, is there a way to predict suicide? What are some of the warning signs for the listeners and what should you do if someone tells you that they are thinking about it or if they post on social media some of their suicidal thoughts? What do we do?

Dr. Omar: So. other than what I mentioned with the same day suicide where there is really no prior warning signs or anything else, which we could help by ahead of times always encouraging our kids to seek help or to have support. The other, the non-same day suicides, generally there are signs and most kids or adults usually try to seek help, but generally they don’t go to the doctor and say I’m here because I’m trying to kill myself. They go with various complaints, especially the young people and expect the doctor or the emergency room or the urgent treatment center or the school or the parent to ask them questions. So, the simplest way I walk to parents about it is if you notice any significant change in your kid’s life, eating too much, eating too little, sleeping too much, sleeping too little, not paying attention to their appearance when they used to always pay attention to it. Anything like that. Any major change, not the quite mood changes that happen with teenagers but something that is drastically different, that’s a red flag and we should pay attention to. Among the adults, they generally try to mention something or to appear that they are seeking help. In general, what the first rule is what you do if you suspect even if you have the minimum amount of suspicion that somebody is at risk, is don’t leave them alone. Try to talk to them. Ask them straightforward are you thinking about taking your life and if yes, you insist on getting them help, by being with them, supporting them and then getting them somewhere where they can get help. Each state is different, each place is different but generally, getting them to some good professional help always can make some difference. But in my view, again, prevention is a lot more important, before they get to a point. Because once they attempted suicide once, they increase 22-fold by their odds of committing suicide another time and every time they attempt it will increase more. So, we need to focus more about detecting problems before they lead to attempted suicide.

Melanie: If you talk to someone, if you ask them about these feelings, does that put the idea into their head because parents sometimes are hesitant to ask their children about some of these changes because they feel like they are putting that idea into their head in the first place?

Dr. Omar: Correct and that’s on of those myths that we have been fighting for a long time. The myth is if you talk to kids about drugs, they will use drug, if you talk to them about sex, they will have sex, if you talk to them about suicide, you plant the idea in their head. That’s actually proven many times over that it is not accurate and it’s not true. The kids are starving to get somebody to talk to them or ask them how they feel, and they try. There is a difference between girls and boys. Girls tend to internalize when they are feeling bad and they are waiting for somebody to ask. Boys tend to have conduct issues, you know misbehave, waiting for somebody to ask why they are misbehaving and then bring it up. So, no, it does not plant the idea. If anything, it gives them the notion that somebody actually cares and that’s what they are craving. They want somebody to care. But also, another factor that we always have to explain to our parents, teachers, everybody in the community is that if everything being equal, but one household has a firearm and the other doesn’t, that’s a five-fold increase in the odds of your kid committing suicide. So, we advise parents at least either not to have firearms or if they do to separate them from ammunition not to make it easier for the kids to have access to them easy.

Melanie: You have mentioned prevention a few times Doctor, how can we help prevent suicide? What do you want the public at large to know about things that they can do and help that they can get that’s out there?

Dr. Omar: So, I think we start by thinking why did suicide triple since the mid-fifties? And what changed in the mid-fifties? Why did suicide increase almost thirty percent since 1999? What changed since then? And what changed from the fifties to today is the way society is set up.

In the fifties, the family tended to live longer together, the neighborhood was stronger. When the kid went to school, there were kids who knew, he knew everybody in the school, had a support system because all the research in the world basically comes down for young people to – if the kid has one adult that they trust and can talk to, if they have a safe place to interact without adult and if we give them something useful to do, they are going to be fine. They are not going to commit suicide or homicide or anything else. They will be fine. So, that’s what changed from the fifties to today, is the families have changed. I will tell you an example. I ask every kid I see, when was the last time you had the family meal? And say ten years ago, most kids or half the kids would remember some, now everybody looks at me like I’m from Mars or something, what does family meal mean?

And that tells me a lot about the kid goes home and nobody is paying attention to how he looks like or she looks like, how he feels, how she feels, what is going on with their life. So, we as families, we should start with the family being there for our kids, talking to our kids, taking the time to spend time with them and check about what is important to them. Because what’s important to them, is not necessarily that important to us or we ignore it, but we should be at least listening to them, what has happened in their life and what is going on.

Since 1999, what changed is the massive spread in the electronic media and the electronic media use which created new things like cyber bullying, which didn’t exist before. Cyber bullying is causing multiple problems. Cyber bullying or even just using the electronic media like that beauty queen that kept telling the boy to kill himself and every time he back off, she would encourage him. Those things didn’t exist before. So, we have to be aware and talking to our kids about the dangers as good as the internet and the electronic age is; it still carries a lot of dangers that we need to be aware of.

With adults, it’s the same thing. We need to care about each other. We stopped caring about each other. Everybody is looking at what’s in it for me for everything. If we pay attention to our coworker or neighbor or like people used to do, you go check on them if you don’t see them for two or three days or something like that. This is the first step towards prevention. The second one is we really need to get our government to start paying attention. As I mentioned, as an example, suicide kills more than all diseases combined among young people, not just like in Kentucky for example, on average, we lose 47 kids to suicide and about seven kids for all diseases combined. Yet, the state would appropriate maybe seven hundred dollars for all those diseases for every penny for suicide. That doesn’t help us either. I have been doing suicide prevention for twenty years and I’m still doing with that funding because it’s not top project for even foundations or government agencies.

Melanie: Wrap it up for us Dr. Omar, what would you like to see happen and what would you like the listeners to know about suicide< how they are seeing all of these famous people in the media and how it’s affecting us? What would you like them to know?

Dr. Omar: Well, first I want to tell everyone to understand that everyone is at risk. You don’t assume that my own son or my father or my sister is not suicide risk. Always consider the possibility that one of your family members can be at risk. Second, be close – care about your family and the people you deal with. Third, for teachers, school counselors and people who have access to young people, also notice things, try to notice things and ask questions. For health providers across the board; it is more important that this I keep repeating every time I talk to healthcare providers. It is a lot more important for a teenager who is basically healthy physically that the doctor asks questions like what do you do for fun, how is your life going, do you feel good or bad or how did you feel over the last week rather than spending more time looking in ears and eyes. This is a lot more important and this can take their life.

For government agencies, pay attention. This is a problem. Like I mentioned before, if we are losing a person every 12 minutes or 127 people per day, isn’t it time we start actually investing in preventing this issue? And for the media, I think it is very important to address the topic of suicide, but because they used to think well if we talk about it, there will be more copycat things. The fact is, if we address suicide as the consequences of it, what’s its effect on other people, the surviving family members or relatives, not glorifying the person who committed suicide, there won’t be a copycat issue. There will be more attention to basically preventing suicide. Basically, I tell the media to say suicide is not a way to take away your pain, it is just transferring your pain to other people.

Melanie: Wow, Dr. Omar, thank you so much for being with us today and sharing your expertise on this very difficult topic and giving us your really great advice on what we need to do to help reduce some of the numbers of people committing suicide and the National Suicide Prevention Lifeline is 1-800-273-8255. That’s 1-800-273-TALK or you can text TALK to 741741. You’re listening to UK HealthChat and for more information, please visit www.ukhealthcare.uky.edu. This is Melanie Cole. Thanks so much for listening.