MiCAL - State of Michigan

Editor’s note: This is the third installment of an interview with Jason Bombard, DO, psychiatrist and Specialty Medical Director – Behavioral Health for Aspirus on the topic of how to support someone with suicidal thoughts or behaviors.

There are many studies that make the claim that in most instances, suicide and suicidal thinking is related to mental illness or mental disorders. There are studies, too, that have found that stigma toward suicide has some foundation on that line of thought. However, the topic of suicide is not that simple. In some instances, the decision to end one’s own life, said Jason Bombard, DO, psychiatrist and Specialty Medical Director – Behavioral Health for Aspirus, can result from any number of causes, whether mental health issues, situational circumstances, or other reasons. But how do people determine if suicide is the result of panic and fear of a sudden and unexpected situation and not knowing how to deal with that situation, or if it is the result of a mental illness?

“Part of it is how you define mental illness,” said Bombard. “One of the problems is that we automatically assume that it is not a logical or a well thought out thing to do to harm yourself. Like I mentioned before: they did think this thing through and it’s just all they can come up with, it’s just the only solution they think that they have.”

University of California Santa Cruz’ Counseling and Psychological Services (CAPS), on its website (https://caps.ucsc.edu/about/index.html) provides a similar statement to that of Bombard’s: People feeling suicidal are overwhelmed by painful emotions and see death as the only way out, losing sight of the fact that suicide is a permanent “solution” to a temporary state–most people who attempted to kill themselves but survive later say they are glad they did not die.

This is further supported in a Sept. 23, 2020 Medical News Today article by Yvette Brazier, titled “What are Suicidal Thoughts?” In her article, Brazier stated that suicidal thoughts (also referred to as ideations) can occur when a person feels that they are no longer able to cope with an overwhelming situation. This could stem from financial problems, the death of a loved one, the end of a relationship, or a debilitating illness or health condition, adding that some other common situations or life events that might cause suicidal thoughts include grief, sexual abuse, financial problems, remorse, rejection and unemployment. Bombard concurs with Brazier’s suggestion that the topic is more complex than just attributing suicide to mental illness.

While studies have found a definite link between mental illness and suicide, Bombard said it is not always necessarily the case.

“But most of the time, it’s more likely that it’s situational things,” he said, “things that are going on in their life that is causing people to have these issues.”

Recently on a popular social media site, under the site’s subsite, Real Depression Project, someone posted:

“I just saw a friend post about their struggle with suicide, and a quote in their story was ‘I came to realize that I didn’t want to die. I just wanted my life as I knew it to end.'”

Bombard said that a frequent assertion he has heard from many people is that suicide is an act of selfishness on the part of the person who has chosen to die. Bombard disagrees.

“For a lot of people, that is not the thought process they’re having at all. They really do believe that ‘the world would be better off without me.'”

Having dealt with survivors of people who have died by suicide for years, Bombard said he absolutely guarantees that nobody is ever better off for losing a family member to suicide.

Bombard pointed to statistics regarding children of suicide victims, saying “Their rates of substance abuse, their rates of suicide, their rates of mental health issues are way higher than the general population.

“Because losing somebody hurts,” he said, “even if that person was making some mistakes. And again, you have a lifetime to fix those mistakes and apologize for the things you’ve done wrong, if you take that time. But if you take that time away from people, then you don’t have any chance to make those things right again.”

Bombard again mentioned people believing that they would be doing the world a favor by not being around anymore.

“One of the things that you can say to people if they are feeling that way,” he suggested, “explain to them how important they are, and how much losing them would mean to them.”

Bombard said that is a very powerful statement for someone to hear, because “if you feel like you aren’t any good to anyone, then to hear from somebody, ‘Hey, if I didn’t know you were still around, I wouldn’t be alright, either; so, I need you here.'”

No one has to suffer through suicidal thoughts and there is help for friends and family members who are trying to assist someone in a suicidal state. There is hope.

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988 has been designated as the new three-digit dialing code that will route callers to the National Suicide Prevention Lifeline (now known as the 988 Suicide & Crisis Lifeline), and is now active across the United States, states https://mical.michigan.gov/s/988-lifeline.

When people call, text, or chat 988, they will be connected to trained counselors that are part of the existing Lifeline network. These trained counselors will listen, understand how their problems are affecting them, provide support, and connect them to resources if necessary.

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988 is for anyone in emotional distress or having a behavioral health or suicidal crisis. It is also for an individual who is worried about a loved one and not sure how to support that person or where to get them help. Trained counselors, who are not clinicians, are available to provide free, confidential emotional support to all callers.

Michigan Crisis and Access Line (MiCAL) is Michigan’s 24/7 statewide crisis, support, information, and referral line. It is for ALL Michigan residents) and is meant for people in crisis or distress who do not know where to turn. It is also a Warmline for people who need someone to listen to them. “Everyone deserves support and hope when struggling with behavioral health issues,” the website states.