There are historical references to suicide or suicidal ideation in persons with communication disorders- Beethoven, who was 28 and living with a severe hearing loss, contemplated suicide; Freud, who was suffering with repeated and extensive surgeries associated with oral cancer, begged for physician-assisted suicide. He died of a morphine overdose, which may have been an attempt to relieve pain or may have been an assisted suicide. Even in our field, Charles Van Riper thought of suicide "and tried it once."
Ten people with communication disorders have reported suicide ideation to me, one as young as 6, another 11, six in their teens or early 20s, and two adults. Fortunately, none of them followed through on suicide, but others do. Recently, a 17-year-old who stuttered took his own life (Uncle Brett Hart's "James Campbell Stuttering Memorial," www.stutteringhelp.org/content/james-campbell-stuttering-memorial) . Not long ago, another young man who stuttered- in a graduate program to become a speech-language pathologist-committed suicide ("Thanks for the Memories").
Several years ago, "in Orange County, California, a young teen killed two neighbors before committing suicide...An update on the young man who committed the crimes...stated that he suffered from Asperger's syndrome" (Bonnie Sayer's "Suicide among Asperger Teens").
My area of expertise is stuttering, and all but two of the people in my examples above were people who stuttered. But they are not the only people on our caseloads who express suicide ideation. Professionals should be aware of potential suicide ideation in people with communication disorders and to know what to do if a client talks about suicide.
A Real Problem
Some examples of suicide ideation in a variety of clients are embedded in several online resources.
Last summer, a post appeared on Facebook: "Am I the only one here who wants to kill himself because of how stuttering can f*** a person's life?" Anticipating these kinds of threats, Facebook has developed a form, "Report Suicidal Content" and states, "IMPORTANT: If you have encountered a direct threat of suicide on Facebook, please immediately contact law enforcement or a suicide hotline."
In October 2011, I hosted an online conference on stuttering. A consumer posted, "I just had it today, wanted to end my life because of my stuttering. Didn't want to be embarrassed anymore about my speech problem. I am 23 years old & I am a person who stutters. Stuttering has changed my life drastically...I feel hopeless." I was able to locate her through an IP address, connected her to a local National Stuttering Association chapter, helped connect her with two friends her age who stutter and are also SLPs. She's been referred for counseling as well as speech-language treatment.
After seeing her post, I asked the following question to a Stuttering Conference panel of professionals: Do any of your training programs have a required course where suicide ideation, threats or attempts in clients is discussed?" The silence was deafening. One of the 25 professionals on the panel responded. Another posted at the end of the conference saying she had signed up for a workshop on suicide. After the conference concluded, two more wrote privately and said they had added a section to their courses on counseling and communication disorders, one by scheduling a counselor to come and talk to her class.
Of course, counseling people who are suicidal is not within the scope of practice for an SLP or audiologist. Yet professionals should know the basics of what to do in many emergency situations. While someone is dialing 911 to summon help, everyone should know what to do if someone is choking, bleeding severely, having a seizure, having an apparent heart attack or stroke, or not breathing. Basic first-aid courses are required in many work settings.
As professionals, we should also have some basic knowledge of what to do when someone expresses suicidal ideation to us. Below are several helpful resources:
Crisis Hotlines and Online Support Resources
Befriender's International Network in Arabic, Chinese, German, Spanish, French, Japanese, Dutch, Russian, Suomi, Portuguese, Danish. This site also provides Helpline Information from countries around the world.
- Samaritans provides "confidential support for suicide, suicidal thoughts, feelings of despair or distress" in the United Kingdom and Ireland and has good information on how to initiate a conversation with someone you suspect is suicidal.
- San Francisco Suicide Prevention, America's oldest community crisis hotline
- Suicide Forum, a support forum for people in crisis. Quick links show how to contact the forum leaders.
- National Suicide Prevention Helpline, 1-800-273-TALK (1-800-273-8255), accepts calls from people looking for help for themselves or a loved one.
- Preventing Suicide: A Toolkit for High Schools, a 229-page PDF from the U.S. Department of Health and Human Services [PDF]
- Preventing Suicide from the Centers for Disease Control and Prevention
- The Yellow Ribbon Campaign, a training program "dedicated to preventing youth suicide and attempts."
- Suicide: the Forever Decision: For those thinking about suicide and for those who know, love and counsel them [PDF], by Paul Quinette, a free PDF book that describes QPR (question, persuade, refer) and gives helpful information of what to do when someone directly or indirectly. expresses suicide ideation.
- Stop a Suicide Today, information about suicide including another short acronym, ACT (Acknowledge, Care, Get Treatment)
- Suicide Prevention Resource Center, dedicated to "promoting a public health approach to suicide prevention" with good information about prevention basics, freely available online training and webinars, and a library of resources.
- American Foundation for Suicide Prevention, education resources including PowerPoint presentations and excellent information about suicide, including what to do "When You Fear Someone May Take Their Life"
- Suicide from TeensHealth, information for teens (also available in Spanish).
- Youth Suicide Prevention Curriculum from the Wisconsin Department of Public Instruction, two free downloads for grades 6–8 and 8–10 and a free webinar.