Five Questions With: Dr. Heather Morse Hall

"Looking at the most recent available data, it looks like the suicide rate has been increasing, both nationally and in Rhode Island."

Dr. Heather Morse Hall is chair of the Department of Psychiatry at Newport Hospital, part of the Lifespan hospital network. Newport Hospital recently announced that it was supporting National Suicide Prevention Month with prevention tips, treatment options and how to help suicide loss survivors. Hall received her medical degree from the State University of New York Downstate.

PBN: Are there any discernible trends in the numbers of suicides nationally, as well as in Rhode Island?
HALL:
Looking at the most recent available data, it looks like the suicide rate has been increasing, both nationally and in Rhode Island. According to the Centers for Disease Control and Prevention, suicide rates overall declined from 1991 to 2000, but then increased from 2000 to 2009. The Rhode Island Department of Health reports that in the period from 2005 to 2009, the suicide rate in the state was lower than the national average, but getting closer to it every year.

PBN: Do events such as the Great Recession have a palpable effect on mental health numbers, including suicide numbers?
HALL:
Unemployment and resulting financial stress are big risk factors for suicide. This is especially true when people lose their housing and their families fall apart; they can become hopeless and end up in despair. Because health insurance has historically been linked to employment in this country, job loss has often meant a sudden lack of access to mental health care, at a time when people need it most. There was a study published in the British Journal of Psychiatry that suggested that more than 10,000 additional suicides (above the baseline rate) in Europe and North America could be attributed to the economic downturn.

PBN: Is modern technology creating new forms of isolation that lead to depression and suicide?
HALL:
As people get more connected electronically, they often are less connected in the “real world.” Rates of participation in social clubs (bowling clubs, the Elks, etc.) have been falling for decades. People are less likely today to visit each other, or talk on the phone, than they were 10 years ago. Kids are less likely to play outdoors or walk home from school, than they were 10 or 20 years ago – both because they are tied up in texting and video games, and because of parental fears. We’ve all heard the stories of online bullying leading to teen suicide – this is part of the over-dependence on social media, to the exclusion of real-world relationships and self-esteem.
All of this isolation and dependence on social media contributes to depression. When people feel alone, that other people don’t care about them or aren’t there for them in a real way, they start to feel they don’t matter, no one would miss them. It’s a short step from “no one would miss me” to “what’s the point?” The more people feel truly integrated in their families and their communities, the more they feel meaningfully connected, the less vulnerable they are to depression and thoughts of suicide.

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PBN: Have you treated patients for suicidal depression who later bounced back in impressive ways?
HALL:
The answer is a resounding yes! As a psychiatrist, I meet a lot of people at that lowest point in their life, when everything looks bleak and hopeless. It is one of the most rewarding things to see someone move on from that point, and to be able to look back with them years later and see how far they’ve come – moving on to new jobs, new relationships, new lives. And there are others who haven’t made substantial life changes, but for whom life feels better – they are able to enjoy life again, be around their family and actually enjoy it. When I see someone who is depressed, and he or she feels like things are not going to get better, I can speak with the experience of knowing so many people who felt that way, but for whom things did get better. It sometimes seems cliché to say “that hopelessness, that’s the depression talking,” but it’s true.

PBN: What is the most important thing for survivors of suicide loss to remember?
HALL:
Not to blame themselves. Everyone can miss those warning signs, even people who are trained experts in treating depression and working with suicidal people. Increasing suicide awareness, and decreasing stigma, can help us all to be more aware and to reach out more to those at risk, but it doesn’t mean we can reach everyone who needs it. If you didn’t know at the time that the person was struggling, or you did, and did everything you knew how to do – it’s important to stop blaming yourself.

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