culture

Why Are Suicide Rates Climbing after Years of Decline?

nancyvalko assisted suicide, culture, law, medical ethics, mental health

After years of declines, the US suicide rate rose 24% over 15 years according to a new report from the national Centers for Disease on suicide rates in the US from 1999-2014.  The suicide rate rose for everyone between the ages of 10-74 between 1999-2014.

National media like the Wall Street Journal  and CNN   speculated that the economic downturn, drugs and lack of mental health resources could be factors in the 24% increase.

However, one huge factor was totally ignored: the legalization and promotion of physician-assisted suicide.

The Legalization of Physician-Assisted Suicide and Suicide Contagion

It must not be dismissed as mere coincidence that the new rise in suicides correlates to the implementation of the first physician-assisted suicide law in Oregon.

A 2012 report on suicide trends and risk factors for the Oregon Health Authority found the state’s overall suicide rate had risen 41 percent higher than the national rate . This is the “regular” suicide rate. Physician-assisted suicides are not included.

Since Oregon, four more states (California, Vermont, and Washington) have legalized physician-assisted suicide via legislation with a Montana supreme court ruling in favor of assisted suicide but without a regulatory framework. But it is only now that the media is noticing a suicide rate that has been increasing for 15 years.

There is a well-known and recognized suicide contagion effect after reported suicides. Both national media guidelines   and  World Health Organization guidelines   warn against media glamorization or normalization of suicide by the media that could lead to more suicides.

Yet, since the legalization in Oregon, the media has become increasingly positive in reporting on physician-assisted suicide. This reached a peak when People magazine devoted it cover story  and some subsequent issues to Brittany Maynard , her impending assisted suicide, and her Compassion and Choices led foundation to raise money to promote the legalization of physician-assisted suicide throughout the US.

That’s not just glamorizing or normalizing physician-assisted suicide. That’s advertising.

And it is having an enormous effect. Now the media is bowing to the pro-assisted suicide movement’s propaganda by changing even the terminology. Instead of physician-assisted suicide, news reports now use more soothing terms like “death with dignity”, “aid in dying” or “physician-assisted death”.

Make no mistake. This is a calculated tactic to increase support of physician-assisted suicide by denying reality.

Why Don’t  Physician-Assisted Suicide Laws Require Psychiatric or Psychological Evaluation?

As most of you may know,  I am the mother of a physically healthy 30 year old daughter who killed herself in 2009 using a technique the medical examiner called “textbook Final Exit”, the title of a book she read by assisted suicide supporter Derek Humphry. But I am also an RN with 46 years of experience who has cared for terminally or seriously ill people considering even physician-assisted suicide who changed their minds after suicide prevention and treatment interventions.

I am appalled that no physician-assisted suicide law actually requires a psychiatric or psychological evaluation before a person is given the lethal overdose prescription. For example in Oregon, the physician-assisted suicide law only states “If in the opinion of the attending physician or the consulting physician a patient may be suffering from a psychiatric or psychological disorder or depression causing impaired judgment, either physician shall refer the patient for counseling.”   (Emphasis added)  Not surprisingly, very few such evaluations are currently done, according to Oregon’s annual reports.

That stands in stark contrast to the standard evaluations given to other suicidal patients.

There must be no medical discrimination based on a predicted  prognosis when it comes to standard suicide prevention and treatment interventions. Suicide for any reason is always a tragedy to be prevented when possible.

The terrible despair that leads to suicide must not be ignored in favor of a cold piece of paper with a lethal prescription.

 

 

Mass Shootings and Mental Illness

nancyvalko culture, family, marriage, mental health, Planned Parenthood

The rash of recent mass shootings is alarming, especially the most recent mass shooting in San Bernardino following so quickly after the Colorado Planned Parenthood one. Now, people are not only talking about mental illness as in the Planned Parenthood shooting but also the existence of evil as in the apparent terrorist attack in San Bernardino.

Can mental illness and evil be totally separate issues? I confess I don’t know the answer to this.

But I do know that our mental health system needs vast improvement from my own personal experiences.

My first husband and the father of my children was a brilliant, caring psychiatrist whose articles were published in medical journals. When I left bedside nursing to start our family, we had a plan for me to eventually join his private practice to specifically support the families of his patients. We both believed that families were ideally the best support system for people with mental illness and we hoped that such a plan would lead to better outcomes and help keep families together. Communication was key.

However, while our children were still small, my husband started slowly succumbing to severe mental illness himself despite treatment. I was frantic to help but at that time in the 1980s and even without the current HIPPA privacy rules, I was unable to get much information about his condition or how to help him from his psychiatrist even when there were multiple hospitalizations.

As his condition deteriorated, I was told by his psychiatrist that there was nothing I could do or not do to help the situation and that he was handling the situation. Then he told me that I should consider divorce for the sake of our children.

Since I believe in the sanctity of the marriage vows, especially the part about “in sickness and in health”, I soldiered on and got second and even third opinions for my husband. Nothing helped very much and I was still shut out from comprehensive discussion of treatment plans.

My husband finally abandoned our family and I reluctantly had to file for divorce. However, I still wanted to help him.

My now ex-husband eventually went on total disability for mental illness but since mental institutions were closed decades before for “less restrictive” measures, he became homeless and eventually shuffled from one assisted living facility to another until his death in 2014.

When our oldest daughter started using drugs at 14, I ran into many of the same problems with the mental health community. Even though she was a minor, she had the right to  “confidential health services”. This came about because it is thought that minors will be more likely to seek help from a doctor if confidentiality-even from parents- is assured in matters like sex and drugs. Unfortunately, as in my case, that meant that I could be mostly kept in the dark when it came to helping my child. I could pay for rehab but I couldn’t get much information or direction about helping my daughter. I contacted mental health organizations and tried to research support groups on my own with mixed results. My daughter died by suicide using an assisted suicide technique in 2009 when she was 30 years old.

We now have “mental health parity” under Obamacare which was intended to make mental health care better by increasing coverage. However, a recent Washington Post op-ed titled “The problem with Obamacare’s mental-health ‘parity’ measure”  shows how difficult it can still be for family or friends to get help for someone with a mental illness.

Mass shootings get our attention about gun control and terrorism issues but the mental health care crisis goes on. We need to do a better job and I still believe that mental health care must try to include and help the whole family for better long-term outcomes.

Terror in Paris

nancyvalko culture, faith

My first inkling that Paris had been hit by terrorists in Paris was an alarm on my smartphone that signaled the breaking news. All throughout this weekend, my husband and I monitored the news on TV with growing horror.

The pictures of the carnage were devastating. Years ago, I worked in an ICU with trauma victims. That made me extremely sensitive to the bloody reality of violence and its’ effect on victims, families and society. I could never accept the idea of extreme violence as mere entertainment in movies, video games, etc.

My family’s thoughts and prayers today are especially with the people of France. We also pray that our leaders and society will totally commit to stopping terrorism everywhere.