Robin Williams’ Suicide—Will It Lead to Needed Changes in Mental Health Treatment?
By Joel E. Miller
AMHCA Executive Director & CEO
The death of actor and comedian Robin Williams has served as a stark reminder that we have a long way to go in helping people at serious risk for suicidal self-harm. Part of the challenge, as you know, is that despite the stigma, suicidal thoughts are quite common, particularly among people who are depressed.
It is an incredible tragedy when anyone takes their own life. But when someone with the stature of comedian Robin Williams dies by suicide, it seems to magnify the loss.
Not because his death matters more than that of anyone else—it doesn’t—but because of how it may affect people who are also suffering from mental illness and at risk for suicide, as well as the impact it has on those close to the victim.
Suicide prevention experts note that in the weeks following the death of famous people, suicides will spike between 2 percent and 12 percent. It’s a contagion of sorts in that the news of one high-profile suicide will infect others struggling with the same demons. The National Suicide Prevention Lifeline reported that calls to its helpline after media reports of Williams’ death spiked to 7,500 requests for help. I am not sure where we are in early September regarding cries for help a month after the Williams tragedy.
But I do know one thing: Despite the terrible mass killings like the one at Sandy Hook Elementary in Connecticut and here in Washington, D.C., at the Navy Yard, the Williams suicide is likely to generate more rhetoric than action. And for millions who are suffering with mental illness—many with no access or poor access to care—there is still little hope that things will change.
Though wealthy and beloved by the public, Williams grappled with depression and substance abuse much of his life. It’s easy to see how someone suffering from depression and feeling hopeless could think: If Robin Williams, who had the best help that money can buy, commits suicide, what chance do I have?
How is it possible that a man so gifted and successful would do this at the age of 63? Depression is a disease of the brain, and it can strike no matter your station in life.
In 2008, a study by the U.S. Centers for Disease Control and Prevention (CDC) found that more than 1 million people in the United States attempted suicide, and many were left with temporary or permanently disabling conditions and elevated risk for future suicide attempts.
Some legislatures are considering policy measures that would require that mental healthcare providers have a certain amount of suicide prevention in their training, and some states already require this provision. The debate in those legislatures is around whether current training is sufficient.
So where do we start to address the needs of individuals with a mental illness who may be prone to suicide?
Here at the American Mental Health Counselors Association (AMHCA), we are going to do everything we can to make sure we are implementing and facilitating programs to inform clinical mental health counselors—and other mental health professionals and stakeholders —about evidence-based practices and best practices to address the needs of individuals at-risk for suicide.
On the macro side, AMHCA will inform all key stakeholder groups that CMHCs’ training and experience involves the prevention, intervention, and treatment of mental health and emotional disorders.
We will use our communication platforms to emphasize that suicide is a serious public health problem that takes an enormous toll on families, friends, classmates, and co-workers, as well as on our military personnel and veterans.
Nearly 40,000 Americans took their lives in 2011, the most recent year for which we have data. Suicide accounted for 12 deaths for every 100,000 people nationwide, making it the country’s 10th leading cause of death (see Figure 1). Unlike many other leading causes of death, suicide continues to claim more lives each year. In 2011, someone in the country died by suicide every 13 minutes.
No complete count is kept of suicide attempts; however, the CDC gathers data each year from hospitals on non-fatal injuries resulting from self-harm behavior.
In 2012, the most recent year for which data is available, nearly half a million (493,596) people visited a hospital for injuries due to self-harming behavior. This statistic suggests that approximately 12 people harm themselves (not necessarily intending to take their lives) for every reported death by suicide. Together, those harming themselves made an estimated total of more than 650,000 hospital visits related to injuries sustained in one or more separate incidents of self-harming behavior.
A Teachable Moment Rather Than Another Educational Campaign
Since the death of Robin Williams, there have been calls by policymakers, providers, families, and consumers for another major national educational campaign (or an ALS-like ice-bucket challenge) to inform the public of the magnitude of the mental illness and suicide problem, and about the terrible toll that suicide exacts on our society on so many levels, including an economic level.
I am not sure another campaign is what we need.
I believe AMHCA and the clinical mental health counseling profession can make a major contribution—not in a macro policy way, but through actions on the frontlines by assessing and treating clients’ mental illness, one person at a time.
We should use the Robin Williams tragedy as a teachable moment. Mental illness is treatable; suicide is preventable; and most importantly, help is available for people who aren’t rich.
As with suicide deaths, rates of attempted suicide vary considerably among demographic groups, and the rate of suicide of returning military and veterans is twice the national rate … but when it is your client, your colleague, your son or daughter, your mate, your friend … you are a one-person sample. AMHCA wants to reach CMHCs and people connected to those who are in distress to help prevent suicide.
Making a Difference by Building “Bridges to Safety”
From Sept. 10 through Oct. 9 is “Suicide Prevention Month.” Each year, during this period, many clinical and non-clinical U.S. organizations work towards the goal of preventing suicide by implementing joint educational projects.
AMHCA’s goal is to make a unique contribution by sponsoring and implementing a series a webinars, and facilitating network and peer engagement, on suicide prevention and intervention discussion groups. The emphasis of the series is on training practitioners on emerging and new strategies to prevent suicide.
AMHCA’s suicide prevention program, called the “AMHCA Bridges to Safety Webinar Training Initiative,” includes three webinars (see page 28 for a detailed description of each webinar, and information on how to register).
- Sept. 16: “Best Practices in Assessment and Treatment for Persons At-Risk for Suicide or Suicide Attempts”
- Oct. 7: “Best Practices in Post-Vention and Case Management Following Suicide Attempts”
- Oct. 15: “Best Practices in Suicide Prevention: Assessment and Care of At-Risk Veterans”
Experts in Suicide Prevention Are the Webinar Series Presenters
Judith Harrington, PhD, LPC, LMFT, will lead the discussion on the Sept. 16 and Oct. 7 webinars. A psychotherapist who has been in private practice since 1988, Harrington specializes in training and development of mental health professionals in suicide intervention.
Understanding Suicide Prevention
AMHCA’s white paper on“Understanding Suicide Prevention”contains an expanded list of “The Top 10 Things to Know about Suicide Prevention and Intervention.”
The four-page brief is a preliminary look at the needs of persons at-risk for suicide or suicide attempts. Readers are encouraged to pursue the plentiful evidence-based practices and best practices that are reviewed in widely available publications and sites.
She also provides adult counseling and psychotherapy services, as well as couples and family therapy.
Lynne Santiago, PhD, LMHC, will lead the discussion on the Oct. 15 webinar. A drug and alcohol counselor at the Department of Veterans Affairs, and COO and director of professional development at Veterans Counseling Veterans, Santiago is the founder and team member of the Veterans Administration Suicide Prevention Program. Veterans Counseling Veterans is a nonprofit organization that organizes trainings and provides mentorship and supervision to military veterans who are becoming mental health professionals with an interest in providing mental health services to their fellow veterans.
Webinar Follow-up Dialogue and Implementation
After the special educational and interactive webinar series on suicide prevention programs is completed, AMHCA will create and sponsor a special virtual, interactive process that will take suicide prevention strategies to a new level of engagement among AMHCA members and other mental health stakeholder groups.
Your participation in the Bridges to Safety Webinar Training Initiative will show the mental health field, consumers, and families how the profession can make a real difference in the lives of Americans who are living with mental illness and prone to suicide.
I welcome your comments about this program and related webinars we are sponsoring. Email me at firstname.lastname@example.org.