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Suicide in the U.S. is a societal epidemic and a staggering public health crisis that demands attention from medical experts.
In 2021, someone in the U.S. died by suicide every 11 minutes, according to the Centers for Disease Control and Prevention. That rate equates to nearly 50,000 Americans every year. Another 1.7 million people in the U.S. attempted suicide in 2021, and over 12 million more had suicidal thoughts.
And the numbers appear to be getting worse: Preliminary numbers for 2022 show a 2.6% increase in suicide deaths from 2021.
Suicide particularly affects younger people – it remains one of the top three causes of death for those between ages 10-34. High school students identifying as lesbian, gay, bisexual, transgender, queer and questioning, or LGBTQ+, attempt suicide four times more often than heterosexual students.
These statistics make it clear that far more attention needs to be given to how to talk about suicide, both with loved ones and in medical and other professional settings.
As a team of experts who educate medical students on how to identify and treat suicidal patients, we are well aware that most medical schools do not yet adequately address the topic of suicide.
In turn, many of their students, once they become physicians, are not adequately equipped to identify, assess and refer suicidal patients. Yet, these health care providers are expected to play a key role in the battle to prevent suicide. But as the numbers make clear, this approach is not enough.
Destigmatizing suicide
Suicide has a long history of stigma, made worse by how it’s portrayed in the media. Often, when someone dies by suicide, the media uses euphemistic phrases such as “no foul play suspected,” rather than clear and accurate language describing the death as a suicide. This type of coded language implies the subject of suicide should not be addressed directly and leaves questions about what actually happened.
When a person takes their own life, the phrase “committed suicide” is often used, as if it were a sin or a crime. This is partly because, historically, most religions have considered suicide to be sinful and as a result it is treated as taboo. Although laws against suicide have been repealed in the United States and many other places, attempted suicide is still considered a crime in some states.
The verb “commit” in the context of suicide can suggest a criminal act. In contrast, using language such as “died from suicide” or “took her own life” is less stigmatizing and more neutral, which is why these phrases are recommended by advocates of mental health as best practices. Consistent with this approach, many media organizations have developed specific guidelines for reporting about suicide. For example, the Associated Press Stylebook recommends avoiding use of the phrase “committed suicide.”
Similarly – largely because of the societal and historical stigma surrounding suicide, which medical education is not immune to – medical schools do not equip up-and-coming doctors with the language and skills needed to recognize it and properly address it with their patients.
Shortage of mental health care
The first point of contact for patients seeking treatment for mental health conditions is usually their primary care physician. About 44% of those who died by suicide worldwide between 2000 and 2017 had visited their primary care provider within one month of their death.
This could be due to a combination of factors, including the continued stigma of mental health, limited access to mental health professionals and ease of access to and comfort with their primary care practitioner as a first step. Research shows that gaps between general medical services and specialty mental health options are preventing adults and kids from getting the mental health care they need.
In addition, the vast majority of patients with depression are treated by their primary care physicians rather than psychiatrists.
The shortage of available psychiatrists means that primary care physicians provide treatment and prescribe mental health care by default, especially for children, adolescents and geriatric patients. In fact, primary care providers – in other words, practitioners who are not psychiatrists – prescribe more than half of all psychiatric medication. And a 2023 study found that approximately one-third of patients received mental health care from their primary care provider.
Finally, many psychiatrists in private practice do not accept insurance, including Medicare and Medicaid, leading to reduced availability of psychiatric care.
Thousands of additional lives might be saved if primary care physicians and other practitioners who are not psychiatrists were better trained to ask the vitally important questions about suicide. In addition, better recognition of the warning signs of suicide, readily available psychiatric care and the elimination of stigma of mental illness would facilitate better quality of care.
Training the next generation of doctors
Why do so many Americans take their lives shortly after seeing a primary care provider?
It may be because many doctors are unprepared or uncomfortable discussing suicide or don’t pick up on the signs of suicidal ideation. It’s also possible that the doctors simply don’t have the necessary time to spend with the patients, even when intervention is needed.
At Florida International University, we train all medical students, beginning in the first year, on how to discuss suicide with patients. This helps to normalize the topic as just another part of their medical training, which, in turn, destigmatizes it.
We then emphasize the need for comfort and familiarity with the topic, as well as the many myths surrounding it. For example, there’s a false belief that asking a patient about suicide will increase the likelihood they will act upon the suicide. Research indicates otherwise.
Finally, students are told that doctors must create a safe environment for their patients to be open about discussing sensitive topics. In short, doctors must ask questions about suicide in a way that’s not pejorative or dismissive. They must not apologize to the patient or shy away from the subject.
Statements like “I’m sorry to have to bring this up” or “I’m sorry if this question seems too personal” can be an indication of discomfort or uneasiness. Instead, doctors should ask direct and specific questions like “Have you had any thoughts about ending your life” or “Are you having any thoughts of suicide?”
After a risk assessment is completed, then a patient would be hospitalized if they are at risk – there is no mandate for doctors to report on or act on depression.
The need for universal suicide screening
Although universal suicide screening has yet to be made the best practice nationally, there are multiple reasons why a standard screening process would be beneficial. Training in suicide assessment and prevention can be made mandatory for medical license renewal, which would include universal screening practices.
For example, adopting best practices could include offering suicide screening during routine health care visits to identify people at risk who might not otherwise be identified.
Another example: More than half of 15,000 children and adolescents who were seen in a pediatric hospital emergency room for nonpsychiatric reasons between March 18, 2013, and Dec. 31, 2018, were also experiencing suicidal ideation and behaviors. These examples emphasize the critical need to train doctors in suicide assessment and prevention. Currently there are fewer than 10 states that require any training on suicide assessment and prevention for doctors to renew their medical license.
In addition, doctors can use empathy, compassion and a nonjudgmental approach, rather than making the patient feel like they are being cross-examined by a lawyer. Interacting empathically leaves the patient feeling more understood and comfortable disclosing sensitive information.
There is a growing movement toward addressing mental health issues in medical schools. Our program prioritizes training a new crop of physicians who will be prepared and motivated to discuss suicide with their patients.
If you or someone you know is considering suicide, please call or text 9-8-8 for confidential, free support.
Rodolfo Bonnin, Assistant Dean for Institutional Knowledge Management and Associate Professor of Psychiatry and Behavioral Health, Florida International University; Leonard M. Gralnik, Chief of Education and Associate Professor of Psychiatry and Behavioral Health, Florida International University, and Nathaly Shoua-Desmarais, Assistant Dean for Student Success and Well-Being and Associate Professor of Psychiatry and Behavioral Health, Florida International University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
Lakeport Fire donated the vehicle to the city in June 2021. City Manager Kevin Ingram said the city had planned to refurbish it for use as a police command vehicle, but they had not been able to secure the necessary grant funding and so had not done anything on that planned conversion.
Chief Patrick Reitz is moving forward the process of upgrading the district’s existing ambulances, which Ingram said is estimated to take 18 months.
The fire district wants to take the surplus ambulance and refurbish it for use as a backup ambulance while the others are being upgraded, Ingram said.
The ambulance has 141,000 miles on it and an estimated value of under $10,000, according to the staff report.
Councilman Brandon Disney moved to approve the return of the ambulance, with Councilmember Stacey Mattina seconding and the council approving it 5-0.
In other business on Tuesday, Community Development Director Joey Hejnowicz presented a resolution authorizing the submittal of an application to the California State Department of Housing and Community Development for funding under the HOME Investment Partnership Program.
Hejnowicz said the city is seeking $750,000 for the Bevins Street Senior Apartments project at 447 Bevins St.
The project will be a three-story building on an undeveloped parcel. Hejnowicz said it’s proposed to include 40 units, 32 of which will be one-bedroom units, with eight two-bedroom units. One unit will be reserved for a manager.
The income range will be 30 to 60% of the area’s annual median income, which he said is between $22,000 to $44,000 for a family of three.
The funding would actually be loaned to the Pacific Companies, which Ingram said owns another apartment complex at Martin and Bevins streets.
The council approved the resolution unanimously.
The council also approved a design immunity ordinance authorizing Ingram to sign written contracts and conveyances and have design approval authority, and accepted the Annual Comprehensive Financial Report for Fiscal Year 2022-23 presented by Assistant City Manager/Finance Director Nick Walker.
Mayor Michael Froio called the audit an “amazing document” that he learns from every year. He added that he appreciated the work Walker put into it and that it was good to see an outside auditor give him high marks.
Ingram acknowledged a lot of work goes into the document and that he also learns a lot from it.
With that work completed, Walker said the budget cycle starts next week.
Froio recommended people read it, adding it’s a government transparency measure. The council approved it unanimously.
Toward the end of Tuesday’s hour-long meeting, during which staff gave updates, Public Works Director Ron Ladd reported on the work by his crews and utility workers to respond to the storms on Sunday night and into early Monday.
He said they called in some people on their day off. “They were here immediately.”
Ladd said every other person in Public Works and utilities also called to see if they were needed. He added that they have a great group of workers that responded to the situation.
“They were amazing. Good job,” said Mattina.
Froio said he was sad to lose the cypress tree in Library Park. That tree fell on Sunday, pushing up the sidewalk and resulting in an overnight closure of Park Street.
Overall, however, Froio said the city of Lakeport seemed to fare well in the storms.
Email Elizabeth Larson at
The open house will take place from 4 to 6:30 p.m. Wednesday, Feb. 21, in the council chambers at Clearlake City Hall, 13050 Olympic Drive.
Community members also will be able to comment remotely by emailing input to Senior Planner Mark Roberts at
Join the city to re-envision the old airport site as clearlake’s community hub, commercial and medical center.
The open house will include a chance to view early programming concepts for the site.
Community members are invited to share their valuable insights and feedback on the proposed
Development and to engage in discussions about the project's potential impact on the site and community.
City staff and representatives from the design team will be available to answer your questions and provide insights into the project's environmental review process.
Learn about the steps involved and gain a deeper understanding of how your input can shape the future of this development.
Light refreshments will be provided.
For more information, contact Mark Roberts at 707-994-8201.
Starting in late January, Gov. Newsom directed an all-of-government response to storms that have impacted nearly all residents.
The response included over 8,500 boots on the ground to support communities with roadways, flood operations, rescue teams, sheltering, and more.
State swift water rescue teams, composed of both California Governor’s Office of Emergency Services and Cal Fire assets, made a combined 47 rescues and assisted six locally-led rescue operations. These state operations complemented the work of local governments conducting their own rescues.
The storm brought more than a foot of rain to certain parts of Southern California, hurricane-force wind gusts in Northern California, broke daily rainfall records, and resulted in the second highest amount of rainfall ever recorded in a 72-hour period in downtown Los Angeles.
Since late January, these combined storms have killed at least 12 people.
“Just in the last few weeks, California has lost 12 lives to successive storms. Our thoughts are with their families and friends, as well as with communities across the state as they begin efforts to clean up damage and recover.
During these storms, we mobilized an all-of-government response, including our swift water rescue teams that have made 47 rescues. We’re grateful to our thousands of first responders who have saved countless lives and kept our state going in the face of record-breaking rainfall and snow.”
The phenomenon of bullying, harassment and sexual abuse in workplaces throughout North America is widespread and harmful to both individuals and organizations. In fact, bullying at work affects up to 30% of workers over time.
As practitioners and researchers who study workplace violence, including bullying, harassment and sexual abuse, we define workplace bullying as harmful acts of mistreatment between people that go beyond incivility and cross the line to intentionally causing harm.
Bullying behaviors range from verbally insulting or socially excluding someone to sabotaging the victim’s work, inflicting psychological terror and engaging in sexual abuse or physical aggression. Manipulation and provocation also play a role in bullying dynamics, and cyberbullying has emerged as a new form of workplace harassment. Research suggests the impacts of workplace bullying affect employee health and safety and the workplace overall.
In a grocery store line, if someone invades your space, shoves you aside or threatens physical harm, the police may intervene, potentially resulting in an arrest. However, in the workplace, incidents involving bullying, assault, sexual abuse or other forms of violence are typically addressed through internal investigations. Our research suggests that treating workplace bullying as a matter of public health rather than employment law is necessary to protect those being targeted.
Workplace bullying results in real harms
Targets of workplace bullying often experience serious repercussions, including stress and burnout, along with other diagnosed mental health issues and, in extreme cases, suicide.
Bullying can affect physical health, with symptoms including sleep disturbances, cardiovascular diseases, body aches and pain, loss of appetite and headaches. Targets often describe an inability to concentrate; since they’re spending time worrying about what is going to happen to them next, job performance suffers. The negative impacts can spill over to a target’s personal life and affect their relationships with family and friends.
It’s not unusual for targeted workers to feel uncomfortable coming forward and talking about their experiences. But suffering in silence can lead to an even more toxic climate at work that can undermine your victims’ sense of security, with long-term consequences for their well-being.
Personality traits of bullies and their targets
Workplace bullies often target those who possess qualities highly valued by employers: self-sufficiency, cautiousness and innovativeness. Those targeted typically are motivated, have a kind perspective and prefer to avoid getting involved in office politics or engaging in competitive behavior. They take charge of their work and responsibilities.
Bullying often involves an imbalance of power, where the perpetrator acts to obtain power and control over the target.
Researchers find that bullies tend to have low self-esteem, problems with anger management and even personality disorders. Bullies often target people based on their appearance, behavior, race, religion, educational background, LGBTQ+ identity or because of perceived threats to their own career.
There’s no hard-and-fast profile, but males tend to exhibit more of the traits associated with bullying. Those who possess tendencies toward what psychologists call dark triad traits – Machiavellianism, subclinical psychopathy and subclinical narcissism – often gravitate toward jobs that offer high levels of freedom and hierarchical structures.
Are you being bullied?
Have you noticed a decline in your emotional or physical health? Is your job performance being affected? Feeling constantly stressed, anxious or demoralized are signs that something isn’t right.
Think about whether you feel singled out. Do you sense that you’re being isolated because of how others treat you?
If you do conclude you’re being bullied, your first priority is keeping yourself safe. Defending yourself against workplace bullying takes courage, but there are steps you can take to diffuse, distance and document what is happening to you.
In the moment when bullying is occurring, focus on trying to keep your emotions in check and avoid being reactive. For example, try to gain some psychological distance in an emotionally charged situation – politely walk away, don’t engage, give yourself time to settle your emotions. Taking space by stepping away can disrupt the immediate intensity of the situation. It helps you stay in control rather than allowing a bully to force you to respond impulsively in the moment, which can lead you to say or do something you’ll regret.
Try your best to de-escalate the situation. Some tips for how to stop an interaction from spiraling include:
- Using polite, firm language to ask the bully to stop the conversation.
- Asking the bully to leave.
- Removing yourself from the situation if the bully won’t go.
- Informing your supervisor immediately.
If you feel threatened, calmly and politely stop the interaction by removing yourself in a nonthreatening way. As challenging as it can be, the key here is to stay composed and remain respectful.
How to respond to an ongoing situation
It may be helpful to engage in some advanced planning with a friend or colleague. Rehearse a bullying situation and practice how you would respond to help you get comfortable using emotional distancing and de-escalation. Advance practice can help you handle an emotionally charged encounter.
Seek the support and safety of your peers. They can talk things through with you and become your allies if they are asked to describe or even testify about a bullying incident they witnessed.
Strive for an attitude of strength and confidence in yourself. Workplace bullies often choose to attack people they peg as easy targets. Present a strong front, trust in yourself and have confidence in your work – these attributes may make you less likely to be targeted.
Document your experiences when you perceive there is a problem. Be objective: Note the time and date, what happened, who was present, what was said and how it made you feel. Keeping a record helps quantify what is happening. Your organization should have policies and procedures to support you if you believe you are being bullied at work.
A caveat, though: Keep in mind, human resources departments are often ill-equipped to manage these issues, and complaints may be mishandled, improperly dismissed or simply ignored. Sometimes, if you’re able, it is better to look for a new job.
In order to effectively tackle the problem of workplace bullying and harassment, it is important for both employees and organizations to acknowledge and actively address these concerns. By establishing policies against bullying and fostering open lines of communication, workplaces can create safer spaces that enhance the well-being and productivity of their employees.
Jason Walker, Program Director & Associate Professor of Industrial-Organizational and Applied Psychology, Adler University and Deborah Circo, Assistant Professor of Social Work, University of Nebraska Omaha
This article is republished from The Conversation under a Creative Commons license. Read the original article.
At Tuesday’s board meeting, Anthony Arton was formally appointed to the job.
In a Tuesday statement, the County Administrative Office said Arton is “a seasoned leader, with more than two decades of experience in development and oversight of public health, emergency management and community engagement programs.”
In the county’s statement, Arton is quoted as saying he is looking forward to working closely with the Health Services team, community partners and Public Health Officer Noemi Dr. Doohan, “to promote the best possible health outcomes in Lake County.”
He added, “Dr. Doohan has done outstanding work to establish strategic relationships locally and at the state level in recent months, and I am confident we will build on those successes. Effective health programs must serve all residents, and maintaining a connection with our richly diverse communities is essential to that work. I am truly excited to be here, and for the opportunity to serve Lake County.”
Arton most recently served as public health director for Coos County, Oregon, since October 2020.
Before serving in Oregon, Arton was public health director and emergency planner for Missouri’s Johnson County.
Earlier jobs included working with students in the Dallas/Fort Worth area in Texas, at the University of Central Missouri and at Polk State College. He also was a legislative intern at the Missouri State Capitol, according to his LinkedIn page.
The county said his diverse professional background also includes training in firefighting, management of Hazardous Materials and Health Insurance Portability and Accountability Act, or HIPAA, compliance.
Arton has effectively planned and implemented strategic programs and capital improvement projects, and written emergency preparedness plans, while successfully managing funds from a variety of state and federal sources, the county reported.
"With a professional and educational background involving emergency services and healthcare, Director Arton is best prepared to forge strong relationships needed to excel as Health Services Director in Lake County," said Board of Supervisors Chair Bruno Sabatier. “Lake County's health metrics avail us of many opportunities, and Director Arton brings Public Health experience to enable change in our health outcomes. We look forward to supporting his efforts."
Arton holds master and bachelor’s degrees from the University of Central Missouri, and graduated near the top of his class as the prestigious Walter Hicklin Government and Public Service Scholar. Furthering his education on a continual basis is a priority for Arton.
He succeeds Jonathan Portney, who the board terminated in September following a tumultuous tenure marked by no confidence letters, a staff exodus and disagreements with other department heads, including then-Sheriff Brian Martin.