Suicide as a Policy Issue

The concept of public health has sharply expanded since the days when it just meant stopping the spread of communicable diseases like TB. It has come to encompass the harm of tobacco, guns and domestic violence. Last week, Surgeon General David Satcher added suicide, describing it as a “serious public health problem” in the United States.

Satcher’s “Call to Action to Prevent Suicide” essentially urges greater national attention to the warning signs of suicide. It is the latest indication of how far social thinking has advanced since the days of St. Augustine, when the estates of those who sinned by killing themselves were confiscated and stakes were driven through their bodies.

Though suicide rates for the general population have remained fairly stable over time, Satcher pointed to a rise over the last three decades among some groups, particularly the elderly and children in their early teens.

Satcher’s report identifies numerous, concrete means of spotting the early warning signs of suicide and focuses on ways of helping high-risk groups. For instance, because it’s been found that 70% of elderly suicide victims visited their primary care physician in the month before killing themselves, he suggests that such physicians be well trained to recognize mental distress. And in light of the problem among teenagers, he suggests improving ratios of high school guidance counselors to students. That will be a tall challenge in Los Angeles County, for while experts recommend a maximum of 300 students per guidance counselor, L.A. County schools average 986 to 1. A pending bill by Assemblyman Carl Washington (D-Paramount) would greatly help by providing grants to school districts willing to hire more guidance counselors.

One noteworthy prevention group, the Suicide Prevention Advocacy Network, is a national grass-roots effort that Elsie and Jerry Weyrauch started after their adult daughter Terri hanged herself in a closet.

Terri’s despair is far easier to sympathize with than the twisted thinking of Mark Orrin Barton, the Atlanta stock trader who killed a dozen other people before taking his own life last week. Typical of the 85 people who commit suicide on an average day in America, Terri was by no means abusive toward others. She was a physician whose patients described her as loving and industrious.

Satcher has no magic answers. He acknowledges that psychologists and other scientists are still a long way from unraveling the mystery of why some troubled people lash out at others and some deliberately harm themselves.

Nevertheless, his campaign usefully aims to remind Americans that one of the culture’s greatest strengths--the value it places on independence--can sometimes be taken too far. The ultimate message: We are our brothers’ keepers. Old wisdom, but ever valuable.

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Suicide Watch

Though the numbers are still small, the biggest percentage increase nationwide has been among the 1- to 14-year-olds.

Source: U.S. surgeon General”s Office.