Guest Commentary: We need a new suicide prevention strategy

By Patrick M. Anderson
For The Cordova Times

The Cordova Times published an article on suicide prevention on September 16th. It was a predictable article, like many I have read over the past 15 years. The strategy is always the same. Watch for signs of suicide and have a talk with the person showing the signs. Direct them to help. The signs of suicide are alcohol and depression. It is a very public approach to suicide prevention. If you are thought to be suicidal, there is still a stigma that follows you.

I have been member of the American Indian/Alaska Native Task Force on Suicide Prevention for a number of years. I have met many suicide prevention advocates through my service.

Before that, I was just someone affected by suicide on a regular basis. In 2011, I had conducted a lot of research and wrote a paper advocating for a new approach to suicide prevention. I have continually refined the approach. Despite sharing the concept widely with politicians and government executives, it has not been tried. We need to try new approaches. Alaska’s suicide rate has annually hovered around 23 suicides per 100,000 people for decades, despite an investment of tens of millions of dollars.

I believe there is another, more private way, to address why people have suicidal thoughts, identify who they are, and treat them. Years ago, I was explaining the Adverse Childhood Experience (ACE) Study to a young woman. The findings of the ACE Study were released in 1998. This study involved over 17,300 patients of Kaiser Permanente Health Center in San Diego and the results surprised us. The basic finding of the study said that the more traumatic experiences you had from birth to age 18 (there were 10 studied), the more likely you were to experience negative health and behavioral outcomes. One increased negative outcome was suicide. When the young woman I was speaking to told me she had experienced all 10 of the traumas that were studied, I asked her if she had attempted suicide. She rolled up her sleeves to show me cut marks on her wrist. I was very confident from our conversation that she had attempted suicide, which is why I asked her.

The ACE Study found individuals with 5, 6 and 7+ ACE’s committed suicide far more than someone with no ACE’s. Here are the findings: 0 Ace’s – 1.1% attempt; 5 ACE’s – 13.8% attempt; 6 ACE’s – 21.8% attempt; and 7+ ACE’s – 35.2% attempt. 6% of the population studied at Kaiser Permanente had 5 or more ACE’s.

Here’s another important fact from the ACE Study and from State of Alaska Suicide Prevention programs. A huge majority of completed suicides are by men, and in particular the age group from 15 to 34.

Here is my proposal. We need to identify a good program with strong privacy protections to ask individuals about the number of ACE’s they experienced during their childhood. They include schools, social service agencies, doctor offices, behavioral health providers, and a few others. If an individual is willing to, we can also chart the range and persistence of behaviors they adopted until the date of the interview. If they drink or use drugs to excess, have dropped out of high school, become pregnant on contracted an STD as a teenager, committed acts of violence, or any of a number of other behaviors that can be cataloged as an outcome of childhood trauma, we can confirm the presence of a higher number of ACE’s.

If the individual is male between the ages of 15 and 34, with 5 or more ACE’s, we know we should talk to that person right away, and start the process of healing. In fact, for anyone with 5 or more ACE’s, we should start the conversation. No one deserves to have thoughts about suicide or make an attempt.

This strategy doesn’t have to be implemented everywhere at once. We need to find a community willing to give it a try. My prediction is that not only will suicide attempts decline, but many other negative behaviors will as well. And if the strategy is successful, it will transform suicide prevention.

I want to add one final point. It is entirely possible that nutritional deficiencies and some allergic reactions can contribute to suicide attempts. Dr. Joseph Hibbeln with the National Institutes of Health has done pioneering research linking a deficiency in Omega 3 fatty acids with an increase in suicide attempts among soldiers. Other dietary linkages are being explored with violent behaviors, depression and alcohol abuse.

Patrick Anderson is an attorney who served for 9 years as the Executive Director of Chugachmiut. He lived in Cordova, the birthplace of his father, Clifford Anderson, for 3 years where he attended Mt. Eccles Elementary School. He serves on the American Indian/Alaska Native Task Force on Suicide Prevention, and is an expert on the effects of childhood acquired trauma. He can be reached at pmanderson@gci.net.