solitary flight

§79 Suicide is preventable

Suicide is preventable. Suicide calls for intervention.

Augustine reasons with Donatus and against the calling of martyrdom: I hope to “drag you away from your disastrous errors,” writes Augustine, “which make you your own enemy, and lead you to recognize and choose the truth.” [1]

He warns Donatus that Donatus will die a double death: the death of a life and the eternal damnation of the dead as “everlasting punishment.” Augustine promises Donatus a better life in renouncing martyrdom. He bargains with him. He describes a different path in life: “come now: curb your spirit of injustice and rebellion; and then you will find the banquet of salvation within the true church of Christ.”

Augustine grounds his concern on the “calling of love,” which “refuses to allow you to perish.” He justifies intervention accordingly: “… if we have the power, we should both keep them from what is bad, and push them towards the good” so that they might be “healed by deterrence.”

The suicide prevention movement in the United States began in 1958, with the establishment of the Los Angeles Suicide Prevention Center. Founded by Norman Faberow, Robert Litman, and Edwin Shneidman, LASPC combined research, treatment, and a crisis center in order to engage the many dimensions of suicide. Their work established suicide as a public health issue, rather than an unspeakable taboo.[2]

And it inaugurated the building of a nationwide system, adding advocacy and education to the movement.

Shneidman left LASPC to co-direct the newly established Center for Suicide Prevention at the National Institute of Mental Health. Through the support of the National Institute of Mental Health, he gather scholars from around the world to meet in Chicago on the topic of prevention. This first meeting led, in 1968, to the founding of the American Association of Suicidology, to continue research and crisis intervention.

In 1976, AAS launched a certification program for crisis centers to establish and promulgate best practices around the country. Currently, eighty centers around the country operate with ASS certification. In 1989, AAS began certifying individual crisis workers as well.

In 1971, Shneidman founded Suicide and Life Threatening Behavior, a peer-reviewed journal. Suicide and Life-Threatening Behavior keeps professionals abreast of the latest research, theories, and intervention approaches for suicide and life-threatening behaviors. The journal publishes scientific research on suicidal and other life-threatening behaviors, including research from biological, psychological, and sociological approaches.

Issues examine such topics as risk factors for suicide in particular populations, assessment and risk-management approaches, advances in evidence-based prevention, methodological and ethical issues in intervention research, cross-cultural and international findings, and mental health needs of those bereaved by suicide.

The Suicide Prevention Resource Center lists the following national organizations and federal agencies, in addition to the AAS and NIMH, concerned with prevention: American Foundation for Suicide Prevention, National Suicide Prevention Lifeline, U.S. Substance Abuse and Mental Health Services Administration, National Center for Injury Prevention and Control, Indian Health Services, Suicide Awareness Voices of Education, Children’s Safety Network, and Injury Control Research Center for Suicide Prevention.

For the Suicide Prevention Resource Center, suicide is a problem — “the suicide problem” — that must be solved. Suicide correlates to “serious mental illness” and opioids, as well as sex and gender, race and ethnicity, age and geography. The solution advanced by the center comes by way of strategic planning. Prevention is a logic model of problem and goal-setting, resource inventory and obstacle analysis, intervention design, implementation, and evaluation.

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[1] Augustine, Letter 174.
[2] Shneidman and Faberow, “The Los Angeles Suicide Prevention Center: A Demonstration of Public Health Feasibilities,” American Journal of Public Health and the Nation’s Health 55, no. 1 (1965): 21-6.