Help and support are available for seniors who are struggling and present with these warning signs. Early detection, appropriate interventions and access, can make a difference in preventing older adults dying by suicide. The models listed below include local and national solutions addressing what works.
Medical professionals, mental health clinicians, and even the general public can be alert to the warning signs and trained to respond swiftly and urgently by taking the following 5 Action Steps[1]:
- ASK: Asking the question “Are you thinking about suicide?” communicates that you’re open to speaking about suicide in a non-judgmental and supportive way.
- KEEP THEM SAFE: If they are considering suicide, it is important to find out if they have a plan for ending their life: “What’s your plan?” When were you planning to do this? How?”
- BE THERE: Connection matters and is a protective factor for suicide by reducing isolation. This could mean being physically present for someone, speaking with them on the phone when you can, or any other way that shows support for the person at risk.
- HELP THEM CONNECT: Help someone establish a safety net for those moments when they are in a crisis is critical. An example may be helping them connect with the National Suicide Prevention Lifeline (1800-273-8255).
- FOLLOW UP: After your initial contact with a person experiencing thoughts of suicide, and after you’ve connected them with the immediate support systems they need, make sure to follow-up with them.
[1] Bethe1to movement. How and Why The 5 Steps Can Help. Retrieved from http://www.bethe1to.com/bethe1to-steps-evidence/
Specific treatment recommendations include[1] [2]:
- Integrated treatment for severe chronic co-occurring physical and behavioral health conditions
- Tele-psychiatry which allows medical providers to consult with mental health experts remotely and patients to receive face-to face treatment sessions via videoconference. This modality may be particularly important in remote, rural areas and for overcoming stigma and other barriers to effective treatment
- Addressing social isolation by connecting older adults with local aging services, which offer social contact and meaningful, engaging activities
- Psychotherapy and counseling using Cognitive Behavioral Therapy (CBT). CBT is an active, directive, time-limited, and structured problem-solving approach to addressing late life depression
Structured, evidence-based programs specifically designed for older adults include[3]:
- PEARLS (Program to Encourage Active Rewarding lives for seniors) is a brief, time-limited, and participant-driven program that teaches depression management techniques to older adults with Depression.
- Collaborative Care Management has been shown to increase the effectiveness of treatment of depression, substance abuse, and other psychiatric disorders.
- Mood-Promoting Access to Collaborative Treatment (IMPACT) is an evidence-based model developed specifically for older adults.
- Healthy IDEAS (Identifying Depression, Empowering Activities for Seniors) is a community depression program designed to detect and reduce the severity of depressive symptoms in older adults with chronic health conditions and functional limitations through existing community-based case management services.
- Screening, Brief Intervention, and Referral to Treatment (SBIRT) is an evidence-based model developed to treat substance abuse problems.
[1] Karlin, Ph.D. Chief, B.E. (2014, October 7) Suicide in Late Life: Unique Factors and Enduring Treatment Gaps; Mental Health and Aging, Education Development Center Senior Advisors, Evidence-Based Practices, Suicide Prevention Resource Center. Retrieved from http://www.sprc.org/news/suicide-late-life-unique-factors-enduring-treatment-gaps
[2] Tazeau, PhD., Y.N. (2018, June). Multicultural Aging Resource Guide. Retrieved from https://www.apa.org/pi/aging/resources/guides/multicultural
[3] Centers for Disease Control and Prevention and National Association of Chronic Disease Directors. (2009) The State of Mental Health and Aging in America Issue Brief 2: Addressing Depression in Older Adults: Selected Evidence-Based Programs. Atlanta, GA: National Association of Chronic Disease Directors. Retrieved from https://www.cdc.gov/aging/pdf/mental_health_brief_2.pdf
If the situation is an emergency because the individual is threatening to hurt himself/herself, you, or another person or is in severe physical or psychological distress, call 911.
Below are Alameda County resources that address suicide prevention and mental & behavioral health needs:
- Crisis Support Services of Alameda County: A 24-hour, 7 day per week telephone hotline service that provides phone-based crisis counseling and referrals.
- Mobile Crisis Teams: Delivers crisis intervention services at locations throughout the community (suicide, homicide, threats, evaluation psychiatric hospitalizations).
- John George Psychiatric Hospital: Provides emergency and inpatient adult psychiatric services. Services are provided on a voluntary and involuntary basis.
- Alta Bates Summit Medical Center | Herrick Campus: Offers psychiatric and medical services and care.
- Cherry Hill Detoxification Services Program: Provides a 24 hour, 7 days a week program to recover from acute intoxication using a social model of support.
- Alameda County Behavioral Health: The goal of this website is to easily guide & help the public of Alameda Countyto find resources for Behavioral Health Care Services.
- ACCESS: Alameda County Behavioral Health Care Services (BHCS) phone line 1-800-491-9099. A centralized telephone intake service operated by BHCS that offers users a free statewide 800 telephone number to call. ACCESS’ licensed clinicians have system-wide responsibility for providing telephone screening, information and referral for anyone contacting Alameda County BHCS. ACCESS staff can also help direct individuals to appropriate crisis and emergency response services as well as ongoing service resources.
- Culture and Language Specific ACCESS Services: ACCESS Lines listed below that provide cultural and language specific telephone services for Asian and Spanish-Speaking individuals and provide limited capacity to do brief crisis intervention for selected individuals.
- ACCESS - Asian Health Services 510-735-3939
- ACCESS - La Clinica de la Raza - Casa Del Sol (Oakland) 510-535-6200
- ACCESS – La Familia Counseling Center (Hayward)
- 510-300-3180 (for urgent care only)
- 510-881-5921 (for general information)
- Eden Information and Referral (I&R): Eden I&R provides information and referrals for resources in each of the geographic regions in Alameda County. Eden I&R operates the 2-1-1 service in Alameda County which provides non-emergency, confidential telephone-based information and referral to information about a wealth of self-help, housing and other critical health and human services. The service operates 24 hours a day, 7 days a week with multi-lingual capabilities.
- 2-1-1 (within Alameda County)
- 1-888-886-9660 (outside of Alameda County)
- Family Education and Resource Center (FERC): The FERC is a new family/caregiver-centered program that provides information, education, advocacy and support services to family/caregivers of individuals with serious mental health issues. The FERC is a program of the Mental Health Association of Alameda County that includes materials and linkages from the National Alliance on Mental Illness (NAMI). Additional satellite offices in Fremont, Hayward, Livermore, North Oakland.
