Thursday, March 31, 2016

Get Through the Crisis and LIve

I suppose if you live long enough, you gather some of those moments that are both vivid and vague – some mixture of surreal and so real.  As I think about one such moment in my life, I could describe exactly where I was, I could sketch the room down to the furniture placement and direction I was facing.  I know the date and the day of week.  What I cannot describe is the time of day, the weather or who called me with certainty.  Even the conversation is vague, but the reason for the call is vivid.  Too vivid.  My co-worker’s son, who was a 13-year-old 4-H member, had killed himself.  He was a delightful young man.  I was new to the job, so I had only worked with him for six months, but in that time, I was with him often through summer 4-H activities and after school programs.  He was an upbeat, energetic kid with an engaging and infectious smile.  I believe he acted impulsively that day, not truly realizing the permanence of his action.  


The day for him was a bit unusual.  He had gotten into some small trouble at school.  His mother had been called in and both were visiting with the school administrator when the alarm sounded for a fire drill, which meant he walked outside with his mom and the principal in front of the whole student body. He was given the choice between in-school or out-of-school suspension.  He opted for out-of-school.  His mom took him home, lined him out with some chores and went back to work.  When his dad came home, not much later… his son was gone.


I recently attended a training for 4-H Extension where one portion addressed youth in crisis.  As a former, and still certified, school counselor and teacher, I have had experience working with youth at crisis points.  One of my Extension colleagues was also formerly a school counselor and she made a salient point during discussion – all of us are counselors.  If a youth chooses to connect with you, you have been chosen by them for a reason.  My colleague encouraged us to be aware and to recognize the fact that we can all have enormous influence.  I think what she was trying to say is keep your eyes, ears and your heart open.  


Graphic used under license agreement from PresenterMedia.com
Montana has a high rate of suicide and has been among the top five states for nearly 40 years.  We tend to focus on youth suicides, perhaps because it seems like such a tremendous waste of potential life.  Maybe youth suicide bothers us because we realize that some of the things we once thought were huge challenges in our youth, only seemed so huge because we lacked experience in dealing with them.  The more challenges we face and conquer, the more we feel empowered to keep doing so.  I think, in the case of my young friend, he had never had anything that even slightly tarnished his otherwise stellar reputation before that day and he didn’t know how to handle it.  While to the adults in his life, his trouble may have seemed trivial and insignificant (or at least out of proportion with the cost of his life), to him, in that moment, it was monumental.  Certainly, no matter what age, some of what people are dealing with seems insurmountable, torturously difficult and painful.


Graphic used under license agreement from PresenterMedia.com
During the training, the instructor talked about how misunderstood suicide can be.  He spoke of the people who have attempted suicide at the Golden Gate Bridge in San Francisco.  Of the “jumpers” who have attempted suicide at the bridge, very few have survived.  However, and this is particularly important, of those who attempted and lived, when asked what their first thought was they went over the edge, the overwhelming majority said, “I wish I hadn’t done that.”  In fact, one jumper said, “I instantly realized that everything in my life that I’d thought was unfixable was totally fixable—except for having just jumped.”


A mid-century study followed up with 515 people who were prevented from attempting suicide at the bridge during a 30+ year time span revealed that indeed more than three decades later, 94 percent were still alive or had died of natural causes.   This study reveals that suicidal behavior is often acute and crisis-oriented.  It is quite likely temporary, if the person can make it through the high-risk period, which may be just a few months.  I have often heard it said that suicide is a permanent solution for a temporary problem.  


Which brings me back to my colleague’s comment that we are all counselors.  I’m not suggesting that we absorb responsibility for anyone else’s decisions.  For instance, the day that 4-H member completed suicide, I don’t know that I could have done anything to change the outcome, as I was entirely unaware of the events of that day, until it was too late.  Nor could any of the adults surrounding him have predicted the suicide based on previous interactions with him.  I do think, however, that if anything at all might have interrupted him, the impulse would have passed and he would have made it through what he perceived as a critical crisis.  You never know when you might be able to be that needed interruption.  

If you are in crisis and want help, call the Montana Suicide Prevention Lifeline, 24/7, at 1-800-273-TALK
(1-800-273-8255).  Reach out to someone.  There are people in your life and in your community who have their hearts open and want you to live.  

Graphic used under license agreement from PresenterMedia.com
The following resources were curated by Montana Department of Health and Human Development and can also be found on their website.

2014 US Suicide Data
After an Attempt
After a Suicide Toolkit for Schools
Let's Talk Montana
Primary Care Guidelines in Assessing Suicide Risk in Veterans
Suicide Mortality Review Team


Suicide Prevention Resources for LGBT Youth
Tools for Primary Care

Wednesday, March 2, 2016

Hands and Head to Save a Heart

I was at a funeral once and somebody died. Unfortunately, it wasn’t only the person for whom the funeral was being held.  At the reception, somebody sitting behind me collapsed.  Her husband was attending to her, but it seemed like those of us sitting a table away were in slow motion.  I suppose we didn’t react quickly because people close to her were with her. Sometimes you want to give people privacy and not cause a scene.  As it looked like things were not improving, I asked the people I was with, “Should I go find a nurse?”  I suppose it just a few minutes, but when I asked the question, someone from my table jumped up and said, “Oh, I’m an EMT.”

It still seems strange to me that it took so long for us to react, even someone trained.  Had it been a cardiac arrest, even seconds count.  Starting chest compressions immediately can make all the difference.  Earlier this month, I was with 4-H members who received “hands only” CPR training.  The training video showed a man collapsing in a shopping mall and no one reacting.  I watched the video thinking that it was so unrealistic.  Surely someone would come to the rescue in such a situation, and then I remembered about the funeral. 

Kevin Lauer, who was teaching the class from Gallatin HeartRescue, gave some pretty amazing statistics.  According to their Facebook page, “The Gallatin Heart Rescue is a collaborative project focused on improving bystander CPR response to out-of-hospital sudden cardiac arrests.”  They have looked at locations where bystander or hands only CPR has been taught to a high percentage of residents and the cardiac survival rates are very impressive. In the Seattle area, 70% of residents have been taught bystander CPR and the survival rates for a cardiac arrest are above 50%; whereas, the rate is closer to 8% survival where the population has been less saturated with learning hands-only CPR.  Nationally, 92% of those who suffer sudden cardiac arrest die before they reach the hospital.
Since 2012, Gallatin Heart Rescue has been on a mission to improve the concentration of people who know bystander CPR and who will react quickly and confidently when someone needs help.  This week they reached a milestone of 25,000 people trained.  The survival rates in the Gallatin area have risen as the number trained to perform hands-only/bystander CPR has risen.  The program has been so successful that there is now a Montana Heart Rescue program.

They have some pretty dramatic video footage of survivors and their families.  One young girl, Annie age 9, whose father was a fit man in his forties, said, “My father had sudden cardiac arrest right after a very hard work out.  Luckily someone at his gym knew CPR.  That man save my dad’s life. My dad lives, but without CPR he would not be at the dinner table tonight.”  She makes a plea for people to take 30-45 minutes to learn hands-only CPR, because it may give someone years of their life. 

Locally, our Emergency Medical Services department also knows the benefit of training.  
In Teton County, staff at three major employers are trained yearly, as well as all of the local guest ranches.  All school bus drivers are trained yearly, as well as several school staff members.  Heart Saver classes are offered to the public every few months.  In Teton County, to receive training in CPR and First Aid, contact Deb Coverdell, Teton County Emergency Medical Services at 466-5552.

Success begins with bystanders knowing what to do and acting quickly. It is important to know how to call 911, how to start chest compressions and how to find and use an AED, automated external defibrillator. Take a few minutes to watch these two videos.  If we all do our part, people who collapse from sudden cardiac arrest can head back to the rest of their lives, instead of to their funeral.