Suicide prevention in South Dakota
Top 3 Takeaways from a Focus on Suicide Prevention
As suicide numbers have continued to rise over the past few years in South Dakota, I wanted to dive into a few of the ongoing prevention efforts around the state. There are many more elements of this story that we'll cover in future episodes, but these are three key ideas I took away from this first report.
“Access to care” is more than a convenient location.
Dr. Matthew Stanley is one of my go-to sources on mental health stories. He's the Vice President of the Behavioral Health Service Line with Avera. When we talked about telehealth as a possible solution to mental health care access, he explained it as more than overcoming a physical distance between patient and provider. He talked about healthcare disparities—the fact that where you live, your socio-economic status, and other factors can determine the level of health care you receive—and explains that these same disparities can impact mental health care.
For example, patients used to drive to a participating clinic to connect to a counselor by telehealth. Dr. Stanley says no-shows were common. But after COVID prompted systems to bring telehealth direct to consumers, Stanley says patients were much more likely to make their appointments. “Which told me, it wasn’t that these people didn’t want to follow up and didn’t appreciate and want the care,” he explains. “It’s that the social determinants of their situation were barring them from getting to the appointment. So they couldn’t afford child care, or the gas, or couldn’t get a ride, or couldn’t get off work. And now, suddenly, it’s much easier for them.”
In fact, access to mental health care is a very complex issue. The cost of treatment can be prohibitive for many people regardless of telehealth options for counseling. Patients with specific backgrounds or needs may not trust their care providers. Stigma and shame still stops many people from following through with treatment, especially in small communities. A person may be hesitant to pick up medication in their local pharmacy in case they run into someone they know. And in many cases, people don’t know how to reach out for care in the first place.
A complex problem requires a complex approach.
Dr. Stanley and I went on to talk about different facilities and ways of receiving mental health care. “From an access standpoint,” he explained, “what we’re trying to do is build, I think, layers of access.” In other words, no single new facility or technology is likely to solve this problem. This reminds me of the “swiss cheese” approach to COVID-19 mitigations—each method has its own weaknesses, but a combination of methods offers a better chance for success. Some of the layers of mental health care we learn about here are new facilities, a LOSS Team that supports families who’ve recently lost someone to suicide, and a program that connects law enforcement responding to a crisis with mental health providers. None of these initiatives on their own will solve rising suicide rates, and there are certainly many more layers yet to build. But even if no single approach is perfect, every one of them counts.
Bridget Swier is the Director of Outreach and Communication for the Front Porch Coalition, a suicide prevention organization based in Rapid City. She also survived her own suicide attempt eight years ago. In my conversations with Bridget for this program, I was struck by her candor and conviction. “I think the best thing is to have those open conversations at the dinner table about mental health and checking in with each other,” she said. “I think it’s important that if we are able to and feel comfortable enough to share our stories, to let other people know that, ‘Look, this happened to me. This is what I went through. You can make it to the other side. It’s not easy. I won’t tell anyone it’s easy…but it is possible.’”
Suicide prevention efforts can be difficult to quantify. We often know about those who die; it’s never truly known how many survive. But stories are important. Every person of every age, profession and background who shares their story of survival offers hope to someone like them. There are endless ways to share these stories in public and private ways, but the sharing is important. I’m grateful to Bridget Swier for sharing her story with me and with the many people she helps through the Front Porch Coalition. I share her conviction: stories matter, and you never know who your story could help.