SUICIDE WARNING SIGNS
* Talking about suicide, death, and/or no reason to live
* Preoccupation with death and dying
* Withdrawal from friends and/or social activities
* Experience of a recent severe loss (especially a relationship) or the threat of a significant loss
* Experience or fear of a situation of humiliation or failure
* Drastic changes in behavior
* Loss of interest in hobbies, work, school, etc.
* Preparation for death by making out a will (unexpectedly) and final arrangements
* Giving away prized possessions
* Previous history of suicide attempts, as well as violence and/or hostility
* Unnecessary risks; reckless and/or impulsive behavior
* Loss of interest in personal appearance
* Increased use of alcohol and/or drugs
* General hopelessness
* Be faced with a situation of humiliation or failure
* Unwillingness to connect with potential helpers
Source: Tennessee Suicide Prevention Network
For more information visit www.tspn.org
For crisis counseling call 1-800-273-TALK
For those already under heavy stress, foreclosures and job losses can be the straw that broke the camel's back and may lead to suicide, counselors and mental health advocates say.
"What we're also finding is that people don't usually commit suicide for one reason. It's usually a combination of reasons," said Dr. Sam Bernard, chairman of the Tennessee Suicide Prevention Advisory Council.
Dr. Bernard stressed that calls for help to national hot lines are a good sign that people are asking for help in tough times. The National Suicide Prevention Lifeline received 35 percent more calls in 2008 than in 2007, officials said.
"If folks are having financial problems, before they consider suicide, they should talk with someone they trust," Dr. Bernard said.
Dr. John Draper, spokesman for the national lifeline, cautioned that there has not been a study to link calls to financial problems. The 133 centers that receive calls for the lifeline are run by independent groups, he said, and each gathers data on calls in different ways.
Anecdotally, however, he said some callers are reporting financial distress as part of their overall situation, and he agreed that financial problems can be an important part of emotional troubles.
"I don't think there's any question that when you have a great deal of economic stresses that there's going to be accompanying emotional distress and people who have despair or a great sense of loss," he said.
Two nonemotional factors also could have contributed to the rise in calls at the lifeline, he said, the addition last summer of a Veteran's Administration network to the line and growing awareness through media campaigns to publicize the hot line.
Larry Thompson, chief operating officer with the Chattanooga-based Volunteer Behavioral Health Care System, which covers 29 counties in the region, said the system receives 1,200 to 1,400 calls each month. The Chattanooga center also receives 225 walk-in patients a month who visit for mental care, he said.
Calls and visits range from general emotional distress to suicidal thoughts or attempts, he said. Though the numbers of mental health calls and patients recently have decreased, in contrast to national numbers, Mr. Thompson said he sees a possible long-term effect from current conditions.
"As folks lose their jobs, they lose their insurance and access to care," Mr. Thompson said. "I think it will show up first in routine appointments and first-time appointments."
From an emotional standpoint, Dr. Bernard said, work can be a refuge for people, especially if they have many responsibilities at home. The loss of work can bring a loss of community and sense of identity.
And the stresses can carry over to those who don't lose their jobs by increased workload, "survivor's guilt" and anxiety, he said.
"Not only will someone have to take up the work of those who are no longer there, but the lingering worry is, 'They've done it once, will they do it again?'" Dr. Bernard said.
He advised employers to maintain a perspective during layoffs. To the employer, a layoff is not personal, it's just a fact of business, he said. But an employee may carry a great deal of self-worth with his or her job and take layoffs personally, he said. That imbalance, Dr. Bernard said, can raise levels of anger and agitation over an already difficult situation.
A number of warning signs may begin to show before an actual suicidal thought or attempt, he said. Some include feelings of hopelessness, rage, reckless or risky behavior, feeling trapped and an increase in the use of alcohol or drugs, Dr. Bernard said.