Preventing Subsequent Suicide Attempts One Phone Call at a Time

By Lauren M. Whaley, CHCF Center for Health Reporting

Every day in California, nine people die by suicide. Both in California and nationwide, suicide is the 10th leading cause of death. According to a recent study, in 2009, more than a half-million adults in California seriously thought about killing themselves. Last fall, the California Mental Health Services Authority launched a statewide campaign called Know the Signs as part of a larger suicide prevention initiative.

One of the highest risk groups for suicide is people who have previously attempted suicide. In Sacramento, an innovative program seeks to reach that group directly and easily: through the simple phone call.

One of the program’s clients is John, a 29-year-old student at Sacramento’s American River College. Today, he describes himself as happy-go-lucky. But a year ago, he had lost two jobs, was facing bankruptcy and had to move in with friends.

Already feeling “emotionally and mentally stripped,” he was then was diagnosed with HIV. “That took away pretty much the last thing that I had, which I thought was my health,” he recalls.

One day last August, he reached an end. Feeling he was “tired of doing this,” he decided to take his own life.

“In my room, I wrote out my note,” he remembered. “I got all my medication out on my bed and I just started taking it. And … All of a sudden, what I just realized is here I am laying here on my floor. … I think, ‘Oh My God, what am I doing? What am I doing?’”

He called out for help, and his roommates called 9-1-1.

He woke up in downtown Sacramento at Sutter General Hospital's emergency department with nurses pumping his stomach. He recovered. But before he was discharged, he was visited by a social worker, who told him about a unique program that would match him with a suicide prevention specialist. John signed up. That person would give him a call every few days for a month just to check in.

“Ultimately, I knew that I had a cushion for support,” John said about receiving those calls. “I knew that if I was having a hard time, I absolutely had somebody available there.”

The program is a partnership between Sutter Medical Center and WellSpace Health. Calls are made from a WellSpace Health clinic in South Sacramento. It’s Roop Dhillon’s job to call people like John who have recently been to the ER for thinking about suicide or attempting it.

“A lot of times that [ER] visit alone could be a pretty overwhelming experience,” said Dhillon. “What we’ve heard from a lot of participants is their hardest part of leaving the emergency room was feeling alone once they got home.”

What makes the ED Follow Up Program innovative is that it is proactive. Dhillon calls people who have just gotten been discharged. People who are vulnerable. People who are most likely to try to take their own lives again.

Dhillon calls her clients from the same room where the clinic runs a more traditional 24-hour crisis hotline. The outreach program has served about 300 people so far, and none have died from suicide.

Liseanne Wick, who manages suicide prevention and crisis services at the clinic, was drawn to suicide prevention over a decade ago after her brother took his own life.

“Personally, it will never bring my brother back, but it really brings meaning to that experience knowing that we’ve affected the lives of thousands, literally, over the last 10 years, probably tens of thousands,” she said.

Wick can’t know if a crisis hotline or the Follow Up Program would have helped her brother, but she’s sure the clinic is helping people now. “We know that statistically; we know that anecdotally from our experience,” she says. “I can’t speak for my brother, if he would have called or if he had knowledge of suicide hotlines. I wish he would have, though, because I know that it makes a difference, and we save lives on a daily basis.”

Indeed, John sounds like a convert when talking about how the follow-up program helped him. He said when he would see the number pop-up on his cell phone, it would remind him to pause. To assess how he was doing. And to realize he wasn’t alone in the world.

“So if you’re at a point where it just makes more sense to end it all because it’s not worth bothering anymore,” he said, speaking to those who may be considering hurting themselves. “Just pick up a phone and reach out to somebody for help. Let them tell you why it’s worth the bother.”