Community effort needed to prevent suicide, experts said

Specialists and health professionals agree the only way for Montana to deal with the statewide suicide crisis is to work together in a joint community effort. 

In Montana suicide is still running rampant.

The latest data available, from 2017, showed Montana had the highest rate of suicide per capita in the nation, 28.9 per 100,000 residents, just ahead of Alaska, which had 27 per 100,000 residents.

A recent study done by Seniorliving.org — online at https://www.seniorliving.org — said that in 2018 Montana had a rate of 29.8 suicides per 100,000, which is a 64.4 percent increase over the past 20 years, the highest groups being Native Americans and veterans.

Local programs are available to help people including a program established at Fort Belknap Indian Reservation.

Fort Belknap Indian Community late last month declared a state of emergency due to a spree of suicides on the reservation.

Fort Belknap Public Informations Officer Allissa Snow said suicide is a big issue that reservations and communities are facing nationwide and Fort Belknap Indian Community is looking into what options for help are availible for tribal people.

Fort Belknap Indian Health Services also released a video to incourage suicide prevention, she said. The video can be found at https://youtube/b9jl6-7Ewel/.

Snow added that the tribe has also established an Empowering Inner Strength Team which includes agencies and people from Hays, Lodgepole and Fort Belknap.

Requests for comments from Sweet Medical Center in Chinook and Rocky Boy’s Indian Reservation clinic had not been responded to by print deadline this morning. 

Local groups are working to improve the help available to prevent suicide, stressing that it has to be a community effort.

“We notice each other,” said Applied Suicide Intervention Skills — ASIST — certified specialist Darlene Sellers. “… If I ask you if there is something wrong, that doesn’t make something wrong. If I ask you about if you’re thinking about killing yourself, or suicide, that doesn’t mean your going to do it.”

She added that Montana is a very isolated state as well as rural, and because of those factors, people don’t realize what is available around them in terms of mental health assistance. The state struggles for resources so it is up to local health providers to do what they can and for the communities to band together to help their friends, family and neighbors. 

“We need a community because not everyone is going to the doctors,” she said. 

ASIST specialist Curtis Smeby said people need to be wary of their surroundings, people in crisis or in need of mental health usually send out signals around them asking for help. He added that most communication is non-verbal and when someone is struggling with depression they usually display a noticeable sign or change in personality, such as becoming irritable or becoming overexcited.

People inherently don’t want to get into other people’s space or appear to be prying, but in a situation where someone is in need, it is important they reach out, he said. People should also not be scared to ask tough questions such as “Are you OK?” or “Are you suicidal?”

“You don’t implant an idea in somebody’s head,” he said. 

According to the data, he added, people in crisis find it a relief when someone asks because they are unlikely to ask for help themselves.

Sellers said that, according to survivors accounts, when someone is contemplating suicide they create a contract of some form with themselves, and a stranger reaching out and asking them if they need help could break their contact. They will not break those contacts themselves, she said, but having at least one person interact with them could save their lives.

The national Center for Disease Control and Prevention website said in the most recently released study in 2017, the country’s suicide rate has risen over 30 percent in the last two decades, with Montana the highest in the nation. Suicide is the sixth leading cause of death in the state.

Seller said Montana has a stereotype that in order to be strong a person has to be silent, “pulling themselves up by their bootstraps,” and to show any emotional weakness is a sign of being a weak person, but this is untrue. People should feel no shame in seeking help when they are in need, she said. 

Montana is a rural area and struggles to gather resources and provide mental health care in different communities, she said, especially farming and ranching communities and reservations.

Looking at particular groups, such as veterans and Native Americans, is not helpful if the person is only thinking in terms of high-risk groups, she said. Mental health is something everyone struggles with and something everyone needs to work in solving.

“It’s not just one group,” she said. “When we are aware and we are alert, then we will start talking to people, connecting to each other.” 

Smeby said people need to work to get people safe now and encourage or direct them to where they can get treatment or help. If someone kills themselves in the community it increases the chances of having more suicides in the future, every life matters and even one suicide is too many, he added.

“Preventing suicide takes everyone in the community,” he said.

What is available and what people should do in crisis

A number of resources are available throughout Havre and the surrounding areas for people to turn to if they need mental health care or are in crisis. 

Northern Montana Hospital licensed psychologist J. Gary Grow, director of the hospital’s Behavioral Health Department, said people should go to the hospital’s emergency room for immediate care for a person in crisis, even if a suicide attempt has not been made. He added that the local law enforcement or other people who are aware of individuals who are at risk should also encourage at-risk people to go to the ER.

“If someone finds themselves in crisis, feeling like they are unable to cope or that they are contemplating suicide and feel at risk, we urge them to come to the emergency room to be evaluated,” he said. 

The ER has doctors and psychologists available for people at risk and has someone from the Behavioral Health Department on call 24/7, he added.

North-central Montana does struggle with resources, but a number of alternative options are available for people to utilize, Grow said. Northern Montana Hospital has two licensed psychologists on staff in addition to a psychiatric nurse practitioner. He added that they see a variety of people with emotional and mental health problems who are dealing with a wide variety of issues.

He said, unfortunately, Hill Country and the surrounding counties do not have a psychiatrist but several psychiatric nurse practitioners with prescriptive authority are in the area, two of which are at Bullhook Community Health Center in Havre, who are able to provide medication to those who need it.

Bullhook also has a number of counselors, he said, and there are a number of counselors in private practice in the area, too.

The reason behind Montana’s high suicide rate is multifaceted, incorporating a lack of resources and a stigma of mental health care being for people who are crazy, he said. He added that substance abuse is also a factor, with alcohol and drugs playing a role in people’s mental health.

Mental health care is something for everyone and is something everyone needs, he said. He added that he sees a number of people for a number of reasons such as depression or anxiety. Depression and anxiety is something most people experience, particularly when they have had a significant loss, such as of a loved one, a friend or their job. Those things can make someone feel emotionally more vulnerable and isolated, it could also factor into an increase in substances use to cope with emotional distress. 

“What we really want to urge people to do is to get the help that they need before they get to a state where they are sitting at home with a gun in their hand, so to speak,” he said. “… I’ve told people many times that I’ve seen very, very few crazy people in my office. I see people who are struggling, who are going through a hard time, who need some help and most of us have been in that place or a place similar to that at some point in our life. It’s rare a person doesn’t struggling with some emotional turmoil and would benefit from some counseling at some point in their lives.”

Emotional problems have no boundaries, he said. He added that it can occur in successful people, unsuccessful people, rich people, poor people.

“We all have some vulnerability to emotional problems,” Grow said.

  Northern Montana Hospital has an area medical surgical unit referred to as “Five East” which is to use as crisis stabilization unit. People who are not safe to be on their own can be admitted and are usually kept for a day or two while the Behavioral Health Department determines if the individual needs a higher level of care. If they do they can be transferred to a dedicated psychiatric unit, usually in Great Falls or Billings.

But people should seek help before it gets to that point, he said. Although people may not be in crisis or immediate danger can still go seek help, either at Northern Montana Hospital or Bullhook. 

He added that people who are struggling with their mental health should also stay away from substance use or abuse because it could increase the level of depression and increase their chances of becoming suicidal.

“It’s very dangerous for somebody in that state of mind where they are contemplating suicide, so we striongly recomend them to stay away from such substances,” Grow said. “… It’s just a temporary fix that comes with a lot of other risks.”

He added that it is up to the community as well to encourage friends and neighbors they notice are in a difficult time or struggling with depression to seek out help.

“Therapy is a very important thing but we all can be therapeutic in a sense of being supportive and helpful to our friends and relatives and aware of when we see one of them struggling, and try to talk to them and help them and encourage them to seek out the resources that are available in the community,” he said.

Bullhook Community Health Center Behavioral Health Manager Deidre Reiter said the clinic has a number of services available for people.

“Our belief is that we want to treat the whole person and in treating the whole person that may be medical, dental, mental health issues or chemical dependency,” she said. “We would just like to see that every aspect of that person is being treated and are receiving the care that they need.”

Whenever someone goes in for an appointment, regardless of what kind of appointment, they are asked to fill out a mental health screening, she said. She added that they treat all ages of people from 6 years old and older. The clinic also has a number of services and care groups for people who are struggling with substance abuse.

Bullhook Licensed Clinical Social Worker Lindsey Reichelt has also been recently certified in trauma-focused cognitive behavioral therapy, Reiter said. She added that Reichelt is one of the few in the state who have this certification and is a great resource for the area. Reiter said many mental health care issues stem from trauma of some form and having this addition will better treat patients in need.

Another deterrent for people to receive health care is because they think it is expensive, Reiter said, but Bullhook has a sliding fee scale and offer a number of ways people are able to pay for their care. 

“We can get patients in fairly quickly. Help is here; we are right here,” she said.

She added that people are not alone and if someone is feeling depressed or in crisis they should seek out help.

People are urged to make a telephone call when they are in a crisis mode.

People who are in crisis and are at risk of self harm should immediately call 911.

Other resources include:

• The National Suicide Hotline — 1-800-273-8255

• The National Hope Line Network — 1-800-784-2433

• Suicide hotline for LGBTQ and questioning youths — 1-800-488-7386

Fort Belknap Empowering Inner Strength Team:

• Hannah Has the Eagle 406-399-0140

• Ed Buster Moore 406-399-0456

• Tescha Hawley 406-353-2525

• Darlena Azure 406-353-2525

• Tonya Doney 406-399-0242

• Thomas Molina 406-399-0302

• Walt Badrad-Mount 406-344-0814