Help in a time of crisis

Third in a series of articles dealing with suicide awareness and prevention

It is perhaps a commentary on the society in which we live. Suicide rates in the U.S. are on the rise. Statistics gathered from 1999 to 2009 indicate a suicide occurred on average every 16 minutes. In that same time period, 40 of the 4082 deaths in Stoddard County were attributed to suicide.

"Missouri ranks 22nd out of the 50 states in suicide rates," says Bootheel Counseling Center's Crisis Counselor Sylvia Webster from Dexter, who covers a four-county area including Stoddard, Mississippi, Scott, and New Madrid.

Bootheel Counseling is the area's community mental health agency and contracts with the state of Missouri to provide specific mental health services across the four-county area.

The number of suicides that are "officially" counted in the 1999 to 2009 period reflect only those deaths that could be positively confirmed as such.

"The number is somewhat deceptive," Webster explains, "since firearm and auto crash deaths that might have been suicides are not included in the count."

Calls to Bootheel Counseling's 24-hour crisis hotline often result in intervention from an expert at the center. Webster has been involved in countless efforts that have prevented individuals from taking their lives, in spite of them having clearly thought out intentions to do so at the time of the call.

The reasons that are presented for taking one's life are at times as complex as the solutions, Webster says.

"Oftentimes it's a financial crisis that leads to a relationship crisis, which leads to only more problems and some people think that there's just no way out."

When a call comes into the Bootheel Counseling hotline at 1-800-356-5395, a therapist initially takes the call and assesses the situation. If further intervention is deemed necessary, a crisis counselor is contacted.

"That's where I come in, or another crisis counselor," Webster explains. "Police or ambulance personnel may also be contacted depending on the situation."

Webster has responded to calls in the middle of the night, on weekdays and weekends. Distress seems to know no boundaries. She has spent sleepless nights in the living rooms of teenagers who see no light at the end of the tunnel and adults who feel they've exhausted every resource. She has held the hands and listened to the broken hearts of strangers in jail cells and hospital emergency rooms.

"Often we'll assess people who have been taken into protective custody by the local police until a determination can be made as to where that person should go for help," she notes.

Holidays are a particularly trying time, Webster says, for those in an emotional crisis.

"We typically see a rise in crisis calls during the holidays, but we also see a rise when school gets out and then again when school first goes back into session in the fall."

Counselors often link those calls to a feeling of isolation once children are spending several hours each day away from the parent.

Student risk assessments are also a part of a crisis counselor's workload.

"We take part in what is called a 'risk assessment,' whereby schools contact us to assess the needs of children or adolescents who are threatening to harm themselves or someone else, or who might make a statement about bringing a weapon to school."

Webster has assessed students as young as kindergarten and as old as seniors in high school. Assessments are made at the request of school authorities, and also from juvenile personnel.

Bootheel Counseling seeks no fees from individuals helped through the crisis hotline. "Many of the people we see in crisis have no job, no income, no insurance, and often no hope. The last thing they need is to have to worry about the expense of getting help," Webster says.

Services are often billed through Medicare or Medicaid, she notes.

Webster, a veteran crisis counselor having worked in the field since 1993, has seen a pattern unfold over the past couple of years with regard to those whose desperate calls come in the middle of the night.

"With the economic situation being what it is today," she explains, "we see people who have lost their jobs, whose homes are going through foreclosure -- these are really high stress situations for folks.

"Clearly relationship issues, which go hand-in-hand with the money issues, are another contributing factor when you're talking about suicide."

Also coming into play are sexual abuse issues and physical abuse by a spouse or loved one, Webster says.

In Missouri, suicide is said to be the 11th leading cause of death. In college students, it stands as the number one cause of death. Interestingly, males complete suicide threats more often than females, says Webster.

"Males often use a firearm. They're not so concerned about how they're going to look as females, who tend more to use pills or other less violent methods. Females attempt more, but males complete more suicides."

One of the myths about suicide, says Webster, exists in the theory that if someone is talking about suicide, they're not likely to do it.

"That's absolutely not true," she says. "If someone is talking about suicide, it should be taken as a cry for help."

There is a tool of sorts used by professionals like Webster that is referred to as a 'lethal triad,' or a deadly triangle. Webster explains its theory, stating, "At one point, you have an upset person. At another point you have access to a weapon, and at another, you have substances -- drugs and/or alcohol. When these three things are in play, you've got to get help right away."

With that statistic in mind, Webster is involved in an on-campus effort to educate college students as to how to deal with a crisis and with those elements of college life that too often lead to desperate measures.

Mental Health First Aid, a course comparable to CPR, teaches individuals to assist a situation until help arrives.

It's available through a faith-based grant, so it's accessible for no charge. The course is held on weekdays and weekends, during the day and in the evening hours. The total class consists of 12 classroom hours and will be offered at no charge through April. The class is designed to teach warning signs, at-risk behaviors and to become familiar with the top three mental disorders that often lead to suicide -- depression, mental anxiety, and substance abuse. The class gives students the tools to know what to do when those signs are recognized.

Anyone interested in these training sessions may contact Bootheel Counseling Services for further information at 573-471-0800 and ask for Sylvia Webster or Jennifer Hartlein.