 Lakeland Currents, your public affairs program for North Central Minnesota, produced by Lakeland PBS, with host Ray Gildow. Production funding for Lakeland Currents is made possible by Bemidji Regional Airport, serving the region with daily flights to Minneapolis-Saint Paul International Airport. For information available at BemidjiAirport.org. Closed captioning for Lakeland Currents is sponsored by Niswa Tax Service, tax preparation for businesses and individuals online at NiswaTax.com. Good evening everyone and welcome to Lakeland Currents. Tonight we're going to talk about an issue that's pretty touchy for people to talk about. It's a program we have never done before on Currents and I think it's one that is so much needed and that is suicide and suicide prevention. And I hope that by the end of this show we have done some things during this program that can help you if you are a recovering family or if you have people who are in need of help. My guest this evening is Cassandra Lincolnmeyer and she is the area regional, is an area director for the American Foundation for Suicide Prevention. Thank you for coming on board. It's a very, very timely topic as we were talking before we went on air. One of the fastest growing areas in the world but also in Minnesota and the United States is depression. It's a very, very fast growing issue and we need to have people like you and your organization that can help us start to deal with this. Maybe you could just tell us a little bit about your background and a little bit about what your foundation does. Yeah so I came to AFSP a little over a year ago so I started in 2017 prior to that they were a volunteer led organization so there's two boards that operate here in Minnesota. So one is Greater Minnesota which is basically everything above Interstate 90 all the way north and then our Southeast Minnesota chapter covers the lower quarter of the state. And so I came in to help these boards and to expand our work across the state which is exciting. We get to do more things in areas like Brainerd in the lakes region and even further north. So that's a little bit about what I do right. I'm going to take the work that I'm going to explain here shortly and help to get to expand it. So that's my role in Minnesota. I get to work with amazing people and volunteers all across our state. But our organization started in the late 1980s. We came together as a group of researchers and a group of family members who had lost someone to suicide and wanted to know why. Why this is happening. What we can do to help stop suicide and to create ways and programs for suicide prevention. So these two groups came together and founded the American Foundation for Suicide Prevention and we've been growing organization ever since. We now have chapters in all 50 states. There's people like me in most states or in chapters so we're kind of regional or area directors all across the country. And we kind of focus on four main areas as an organization. We look at awareness and fundraising. That's what every non-profit you're going to have. You're getting your name out, your event, and events to help raise money for your organization. But then we also are major areas that are education, training, advocacy, and loss support too. So I kind of look at it into three main categories when we're looking at our work. We have our prevention training, which is everything we do on the front side. That's our trainings in prevention, our advocacy work. We have our intervention training, which is kind of the middle of the road and that's for in the moment real at risk and crisis moments. And then our postvention work is our loss support and our suicide survivor outreach program. So we have kind of different areas that we work with people on all different levels from prevention to intervention to postvention. Is there any particular area that you want me to expand on? What do you want me to start with? Well, just to give you some of my own personal experience, I've had a number of friends who have lost family members through suicide in the past three months. And in the last couple years, probably I've known four or five families that have lost people. And the thing that I've always found is that first of all, they don't want to talk about what happened. And the second thing that seems like I always hear is there were no clues that this was going to be coming. Is that a common couple themes that you deal with? Yeah, I think so. I'll kind of break that into two parts. So we have this first part where we're still dealing with a lot of stigma around suicide. And it's something that can be very hard for people to bring up and to talk about. I lost someone very close to me about 12 years ago. And as a Catholic family, we didn't know if we could talk about it. We didn't know if we could have a service in our church. Thankfully, things have changed. Even since that moment, and since I started this job, working with AFSP, I've been able to see that change, which is good for us as a society. We're talking a little bit more about it. It's still very hard. People tend to be afraid if they say the word suicide, they might cause that person to think about suicide. And what we are trying to put out there is that someone who is thinking about suicide has already thought about it. If you ask them directly, say that word to them, it's not going to be the first time that they've thought about it. If you say, are you thinking about suicide? Have you thought about suicide? It's not going to be a novel idea to them if it's the very first time that they heard that word. So not being afraid to use that word, that's going to help us reduce the sigma. We'll also change the language on how we say that word and how we approach it. For the longest time, the phrase committed suicide or committing suicide was something that people said. And they still do. It's very common to hear that. You hear it on television shows, you hear it in everyday language and conversations. But what we are trying to get people to change the language part of it so that we say that someone died by suicide or took his or her own life. And the reason behind that is when we think of using the word committed, we think of committed murder or committed something else that someone might consider a crime or in religious communities a sin. So the research around suicide, which I'll jump into a little bit later on too, it's not a crime and it's not something that we want to associate with that. You're not going to be put into jail or prison. So changing even just that little bit of it, that phrasing on how we even approach suicide will help to decrease that stigma as well. I was reading the brochures that came from your organization and in Minnesota we have a suicide every 12 hours. That is hard to believe, isn't it? I mean it really is. And it seems like more and more are young people, young high school kids, junior high school kids, and there's even have been elementary kids have talked about this. When you work in the area of prevention, how do you approach that? Yeah, I'm glad you brought that up. So in Minnesota, it's about two people per day. We lose almost 800 Minnesotans every year. And that makes it the eighth leading cause of death overall in our state. But for young people, age 15 to 34, it's the second leading cause of death. So that's a big problem, right? And it's something that we as a state and community should take and look at pretty seriously. The second leading cause of death for young people, it's pretty scary when you think about it. And there's a number of programs and research that's being done in that particular program that we're developing to help prevent suicide among young people. We have specific programs that we bring into schools. We partner with a lot of other organizations too to bring programming into schools or into religious community. It's just anywhere where we can get people talking and get some education out there around it. But it's particularly tricky and heartbreaking to see young people die by suicide. It affects communities. Any suicide is going to affect a community. It's particularly heartbreaking though to see a young person. So the more we can get out there and get people talking about it on the prevention side of things, on being proactive in preventing it, the better off and the more lives that we can save, the better off our communities will be. I know I had one friend whose husband died by suicide. I'm trying to use your language. And he had this all planned out. He was teaching her how to mow the lawn with a writing lawnmower, doing all kinds of things. He was planning his exit. Is that typical or do you see a lot of it just random? Yeah, I'm glad you brought that up. So I'll talk a little bit about the perception that we see when it comes to someone who has died by suicide. So often we look at a triggering event, what we call an environmental factor. We'll see job loss or bullying or a divorce or a financial crisis. So we look at this big life event in that person. But what we don't see are these underlying factors. They might have what we call historical factors. There might have been other people in their lives who have died by suicide, who are related to them. And there's research being done into the genetic tendencies. And there's also the environmental factors, which we see, the historical ones. And then biological factors as far as they might be living with a diagnosed or undiagnosed mental health condition. And we know that nine out of 10 people who do die by suicide are living with a mental health condition. Again, whether or not it's been diagnosed or adequately treated is a big factor as well. Nine out of 10. And we've actually studied, yeah, we've studied people's brain. So after they've died by suicide, if you look at a person's brain, it's chemically different than a healthy brain. And so we know that there are biological and possibly genetic factors in that person's brain and that person's structure that is influencing that decision and that choice. And so sometimes when the feelings of hopelessness and despair can come on really intensely, and it can be a very quick decision, or in that example that you provided, it can be something that's been building for a while. And all these factors are playing apart and causing pain in that person. And when that pain gets to a certain level, that person is just focused on getting out of that pain. It's like a tunnel vision almost, right? They're only thinking about a way to get out of that pain. And like I said, so sometimes it can be very intense and will come on and last for just a few seconds or a couple of minutes. Sometimes these feelings will last for hours. So there's still kind of a lot of research into that, that question of why and how it can take someone, what we look at is maybe a snap decision, or it's something that they're planning for, which is a warning sign. And we can talk about that too, some warning signs to look for. Do you have any research to show how many people who die by suicide might have just terminal illnesses? Yeah. I don't know any of those facts and figures like off the top of my head, but I know that there's research done into that as well. And that I think falls into your biological factor. So I do know that certain illnesses can increase risk of suicide beyond mental health conditions. So having health problems such as diabetes or other things can influence that as well. So not just mental health conditions, but also chronic health conditions that physically affect the body can play a role in it as well. Recently, one of the national networks did a really good piece on a young girl who died by suicide. And there were a lot of family videos of her of how happy she was. She was a dancer and an actor and everything they saw was just as happy person. But she had a diary and this diary was so dark and so depressing. And when she finally died by suicide, they were totally shocked until they found that diary and they found that it was almost like two different people in the same house. Do you see that from time to time with others too? Yeah. And I think when we look at, you know, after suicide, it's, it's, it's can be very tough and very hard for people to look back and try to identify. And it's, but it's also very common. We look back and try to see where what we have missed, right? Or what we didn't see. And I think for that particular individual, well, in many cases, I think the, the important part is the prevention side of it is letting people know that it's okay to seek help in those situations. And it's hard, you know, after a loss to look back and think, well, where could we have done this? But I think we as a society, right? Culturally, our communities can be better about this and promoting taking care of yourself as far as your mental health goes and your physical health goes because that plays an important part as well. But in those cases, I think we need to, to really focus on that prevention sort of things and let people know that it's okay to not be okay. And if you are thinking about suicide, that's your indication, your clue, to ask someone for help. You know, if you're feeling desperate and isolated, those are your indications to seek help. And there's a number of ways to do that. It can be reaching out to someone, you know, that you're close to, but it can be as simple as sending a text message to our crisis line or making a phone call to the crisis line. And we, as a country, are making that a lot easier. In fact, we just pass legislation and there's more money and funding federally that's going to continue to support both the crisis text line and our national suicide prevention hotline. So we can see on that high scale, we are making this more of a priority. There's obviously a lot more work that we can do. But this is a really good first step. And I think with that additional funding is going to be some more awareness. And so people will feel, hopefully, they'll have that resource, they'll feel more comfortable making that phone call. And maybe not on behalf of themselves, but you, if you see someone in your life that you're worried about, that's your indication, your clue to make that call, do some research online, find out a way to offer them some help, or for yourself to look for help as well. But it's very hard to look back after a loss and try to figure out what we could have done. So many people feel the guilt. We've done something wrong. We didn't do this with our son or our daughter or our brother. Whoa. And then it's just something they don't want to talk about. There's that stigma about suicide that is this deep, dark place. Like you said, it's like somebody committed murder. And so it's hard for people to talk about that. It really is. It's very hard. And then when you work with people on their loss, what are some of the techniques you use? How do you help people through that period? Well, our organization has really great resources for loss. I'll give you a couple examples of what we do. So we have support groups for both adults and then teens and youth and adult support groups. So we have those located across the state. People can look online and find them. That's usually a good place for people to start when they're seeking resources for loss. The important thing is to find what works best for you to help you through your grieving process. So we have support groups. We also at AFSP have our survivor outreach program where someone who's newly bereaved can reach out to us and we will match them with a volunteer for a one-time meeting, but a volunteer who's gone through a similar loss. And maybe it's a phone call. Maybe it's their meeting for coffee in this day and age and with distance. Maybe it's Skype. Maybe it's an online video chat or something. But we partner someone who has a similar loss simply to have that interaction with someone who can relate to you on a very personal level, who's experienced that sort of loss. But grief is different for individuals. And so when we want people to find what they're comfortable with, sometimes it takes people years to reach out and to maybe attend their first support group meeting. Maybe do attend their first event with AFSP or with a different organization with loss and dealing with suicide. And sometimes it's right away. It depends on kind of where they're at and how they want to grieve. But it's very personal. But I want to stress there's lots of great resources and it's important to find something that works for you. As a person who has lost someone, you then are at a higher risk yourself for suicide. So it's really important as a grieving person to take care of yourself too during that process. So finding that help reaching out to your family doctor or practitioner, reaching out to the support groups or survivor outreach program, they're going to help you heal and stay safe as well. You talked about the brain scans that are being done by people and that's really fascinating to me because they're doing that with football players or people who have CTE. Is there much information you have yet to see if there's a genetic link in families? Yeah, that's another part. So traumatic brain injuries have been linked to an increased risk of suicide. So those athletes who are injured that way, people who are injured in car accident or other traumatic ways, there's a risk, an increased risk for suicide. And it's again, your brain has changed a little bit chemically. You might also be suffering from again a mental health condition too. You might have depression or anxiety as a result of this and that can again be a factor for suicide. I've had a friend in the health field who told me that his experience is when someone decides they're going to commit suicide, you can't stop them. You can delay it, but later on they're going to do it. Is that a fair statement? It's not accurate. If someone who has tried and we call them a lived experience, someone who is lived experience, the most people who are thinking about suicide or have attempted do not go on to die by suicide. And it's good that you bring that up because one of the ways that we keep people safe in that moment is removing them from that potential situation if someone is actively considering or in a high risk situation, removing them from that and creating space between them and what we call their lethal means or their preferred means. And so creating that space or removing that means is going to help keep that person safe. And that can be, we see that in different ways, but if you want, I can give you a couple examples of that as well. So we know that firearms are used in 52%, a little over 50% of deaths, suicide deaths. And so removing that or creating good education and if you're a gun owner, knowing how to keep your friend or someone safe or how to keep your gun safe, if there's a crisis is important. Again, creating some space or just having a gunlock on your weapons too can keep someone safe. If it takes maybe three seconds to take off a gunlock, it might be three seconds that stops that person. So again, a little bit of space right there, blister packaging and potentially lethal medications can help keep someone safe. If they have to punch out the individual pills, again, that's creating some time between that decision and that means, right, that action. Community-wise, installing barriers on bridges can help to stir suicides. And that actually can deter that individual, but also can help bring down the whole rate for that region on those particular bridge barriers. And another common one are installing CO carbon monoxide, is that right? Yes, carbon dioxide sensors in your car. So if it reaches an unsafe level, your car will shut off. So there are ways to give people time, right, to give them time between that reaction, that choice, and that means and that time is what can save their life. So you talk about the biological side of things. If they're able to someday start seeing that there are brain issues or people are tendencies to do this, do you see that maybe medications coming that will help people deal with that? Yeah. And I think that's good. Again, part of being, treating your mental health condition in what way works best for you. For some people, it's combinations of psychotherapy or medications. It can be either or. The important thing is to find what works best for you. But yeah, absolutely medications can help just get people healthy. Sometimes it might be in a lifetime being on that medication or it might be a few months. It's whatever the program is for you. But yeah, I think the important part is to find what works best for you, whether it's a combination of therapies or medications. You've talked a little bit, obviously, of the loss and the impact that it has on families, but this has a huge economic impact in Minnesota and nationally. Could you talk a little bit about that? Yeah. So the latest report that we ran showed that in the United States, it's $69 billion lost in productivity and wages per year. So that's the fiscal impact that it has on us as a country. And just we know that for every person who dies by suicide, there's at least 100 people who are affected by it on average. And so that could be entire communities are affected by it. So again, that fiscal part plays a big part of it too. But there's other social levels that are coming into it to fear your entire community. That's a lot of money. And you talked a little bit about loss, but about the science of loss. What's happening there? What are they studying there? Yeah. So there's all, there's really great programs or excuse me, research programs that we're funding. We're the largest private funder of research for suicide and suicide prevention. And you can read about them online. But there's some really exciting stuff coming out as far as new methods for prevention, again, studying how our brains are working chemically. And I'll be excited, I'm excited to see down the road some of the results of these, these projects that are happening right now. But it again, these, we're actually seeing now these, these research projects result in things that we can use as far as new treatments and programming and education to help people stay safe and stay alive. How about the families that just have gone through this loss? Do you have programs? You said you have support groups. You have networks of people, but a lot of people don't feel comfortable calling support groups. Is there places online they could go or is there other places that could help them if they're a private family and they just, they need some help, but they're maybe not comfortable asking for it? Yeah. I would say start with our website. Go, that's a great place to start. You can see the resources listed there, as far as if you're thinking about suicide or if a family member is thinking about suicide or if you know someone who has died. So different ways to kind of channel how the, the support that you need and the resources that you need. But I also think too is an individual finding the people close to you. For some, it might be reaching out to maybe a member of their like religious community or just a close personal friend, someone that they can open up to. But that's where I would start is finding the way that that's comfortable. Maybe it is just doing online and looking at AFSP's website or other websites for programming. Also counties offer services. Our state offers services and programs as well. So there is support out there. It's a matter of finding it. And I know that, you know, Minnesota is a big state. There's lots of rural areas. And I'm very thankful that we do have, you know, the suicide prevention line. And we have in most places internet access where you can reach it because it might be a two-hour drive to your family doctor or your, you know, your practitioner. And so having some of that stuff either that you can call in or look online is really important, I think, in that grieving and healing process. And that's the Minnesota, are the American Foundation for Suicide Prevention dot org. Yep. It is just our acronym AFSP dot org. AFSP dot org. Yeah. And our website has not only the law support, but also our training programs on there too for more education if you want to work on the prevention side of things as well. So organization that we got about a minute left here, but organizationally, what's your biggest challenge? I personally, I think our biggest challenge is still the stigma associated with suicide and the challenge of getting people to seek help when they need it. Maybe not in a crisis situation, but just if they're feeling depressed, anxious, getting people smart about their mental health, getting our culture smart about mental health is going to save lives. So I think for me, changing that perception around, you know, it's not easy to pull yourself up by your bootstraps if something is wrong in your brain. If you are hurting, you know, mental health is just as important as physical health. And so for me, that's the big, that's the big perception shift that I want to see. Well, thank you for jumping out with us. It's really powerful information. And I hope that people will use your website. It's great work that you're doing. Thank you very much. Thank you for having me. You've been watching Lakeland Currents. We're talking about what you're talking about. I'm Ray Gildow. So long until next time.