Cavalier County addresses suicide during Mental Health Awareness Month

May is recognized as the National Mental Health Awareness Month and as such one of the hardest to talk about topics, death by suicide, has recently shaken the Langdon area.

Posted 05/12/2017

By Melissa Anderson


North Dakota ranks among the top 15 states for death by suicide based on population. Information gathered by the North Dakota Suicide Prevention Program shows that in 2015 alone, 124 people died by suicide in North Dakota. Overall, suicide is the ninth leading cause of death  and the second leading cause of death for those between the ages of 15 and 24 in the state.

Over the past several years, the state has seen a dramatic increase in the number of deaths by suicide. The causes for the high suicide rates have been stated as access to firearms, mental illnesses, substance abuse, and poor access to medical care for mental illnesses.

The State of North Dakota requires that schools complete a minimum of eight hours of professional development training in regards to youth mental health with school staff including teachers, administrators, and ancillary staff.

Munich Public School completed six hours of training at the elementary level and fulfilled the eight hours required at the high school level this past school year. This was done through various means such as having a counselor from another district hold a school lyceum on suicide prevention to the students and faculty with a special seminar for the teachers following the presentation. Ludvigson also had the school district’s teachers renew their certification for identifying warning signs or stress that could lead to suicide.

“I personally think it’s an important issue, and one thing I wish people understood is that people with mental illness get stigmatized and that prevents them from seeking help. People cannot just muscle through these mental health issues like depression,” Ludvigson stated.

Munich School also took part in four hours of trauma training in August. The program is currently being offered by the North Dakota Department of Public Instruction to assist schools in fulfilling the mental health training requirements by state law and is called Trauma Sensitive Schools: A New Perspective on Student Behavior and Learning curriculum. This program is a composition of five modules related to trauma:

• How trauma manifests in the classroom.

• The neurobiology of trauma and resilience.

• Effective strategies to assist students experiencing the effects of trauma.

• Understanding secondary effects of trauma

• Creating a trauma-informed school culture.

The program was created in partnership with PATH, the Mid-Dakota Education Cooperative, and the Department of Public Instruction.

“I’ve been impressed with the program and would like it to get more attention,” Ludvigson said.

Ludvigson explained that the basis of the curriculum is that a lot of kids who commit death by suicide have indicators of trauma. The program utilizes a list of trauma exposures, and the higher the number of exposures that a student has on the list, the more likely to commit suicide. The overlap in data provides a fairly consistent way of identifying students who are getting through a trauma and allows people such as teachers to recognize the signs and get the student the help they need.

“It has pretty good correlation to trying to catch problems before it gets too far,” Ludvigson shared.

At St. Alphonsus Catholic School, counselor and teacher Barb Boesl utilizes teaching materials created by the Jason Foundation to teach her 7th and 8th grade students how to identify the signs of suicidal thoughts and what they can do to help.

“The kids need to be aware of these signs because kids talk to kids,” Boesl explained.

Boesl shows the students a video created by the Jason Foundation that she feels speaks to the kids and helps them to get into the teachings and how to use the tools provided. One such tool that the video gives the students is the ability to recognize the warning signs that lead to suicide attempts and know what to do to help their peer.

“Educating our youth is the biggest thing we can do,” Boesl stated.

The Langdon Area School District had a in-service for professional development for their teachers and staff at the beginning of the 2016-2017 school year as required by the State of North Dakota.

“We had a fairly extensive training that used the QPR techniques,” LASD Superintendent Daren Christianson stated.

QPR, or “Question, Persuade, Refer” training, provides the educators and staff of LASD with the ability to recognize the warning signs of a suicide crisis and how to question, persuade, and refer someone to get the help they need.

“It’s good training and gives us the tools to use in order to effectively help our students,” Christianson said.

While the reason or cause of suicide is invariably complicated,  it most often is the end result of a long struggle rather than reaction to recent events such as a relationship break-up, stress at work or loss of a job. People who die by suicide generally have significant underlying mental health problems, although they may be well hidden.

“90 percent of people who die by suicide have a diagnosable mental illness at the time of their death,” the North Dakota Department of Health states.

There are effective treatments available for most conditions but they are under utilized in regards to mental health conditions. Of those that seek help for depression, for example, 80 percent receive effective treatment, but unfortunately, many do not seek the help that could potentially save their life.

At Cavalier County Memorial Hospital in Langdon, staff are actively taking steps to be able to offer more mental health care to the community here at home.

“We have joined a coalition of local participants hoping to bring more mental health awareness to the community,” CCMH Director of Nursing Lindsey Mehlhoff stated, ”Our goal is to provide education, training, and assistance in the areas of substance abuse, suicide prevention, and other mental health related issues.”

Currently, CCMH offers telemedicine services at the Langdon Clinic that connects patients with providers at the Center for Psychiatric Care in Grand Forks. The hospital is also working on bringing in an on-site mental health provider and hopes to be to able to have a provider available in the clinic to see patients on a regular basis.

“We are aware that there is a need in the community for more services, and we are actively working to fill this need,” Mehlhoff said.

Mehlhoff shared that people who struggle with mental illness often feel isolated and alone, and the most important step for someone who is struggling is for them to get professional help.  Studies have shown that treatment for underlying mental health conditions greatly reduces the number of deaths by suicide.

Mental health is a problem for a large portion of the population as nearly one in five adults in America struggle with some sort of mental illness. Yet, many people do not seek treatment because of the stigma related to mental health conditions.

“We’ve all heard the slang terms, ‘crazy, psycho, mental case’. All of these are derogatory and completely inappropriate,” Mehlhoff said, ”People that struggle with mental illness, both young and old, do not choose to do so just like those who do not choose to get cancer or heart disease.”

Mehlhoff explained that mental illness is like most disease processes whereby a mixture of personal genetics and environment can increase chances and lead to suffering from specific diseases.

“We don’t get to choose our diseases, they choose us,” Mehlhoff said.

The American Foundation for Suicide Prevention offers advice on things to look out for when concerned that a person may be suicidal. One is a change in behavior or the presence of entirely new behaviors. This is of sharpest concern if the new or changed behavior is related to a painful event, loss, or change. Most people who take their lives exhibit one or more warning signs either through what they say or what they do.

If a person talks about:

• Being a burden to others

• Feeling trapped

• Experiencing unbearable pain

• Having no reason to live

• Killing themselves

Specific behaviors to look out for include:

• Increased use of alcohol or drugs

• Looking for a way to kill themselves, such as searching online for materials or means

• Acting recklessly

• Withdrawing from activities

• Isolating themselves from family and friends

• Sleeping too much or too little

• Visiting or calling people to say goodbye

• Giving away prized possessions

• Aggression

People who are considering suicide often display one or more of the following moods:

• Depression

• Loss of interest

• Rage

• Irritability

• Humiliation

• Anxiety

“It is vital to dial 911 if you or someone you know is having a mental health crisis or is threatening to take their own life,” Mehlhoff said.

For those who are having a mental health crisis or are actively suicidal, CCMH Emergency department is always open and collaborates with the Sheriff’s department to provide a safe environment.  All of our ER staff is trained to provide care for a patient needing mental health intervention.

CCMH can utilize Avera eEmergency which will provide on-call medical professionals to assist in mental health assessments and placement in an appropriate care environment, if necessary.

It is important for people struggling with any mental health disorder to recognize that there is help, and there is treatment that can help people overcome the agonizing and sometimes scary thought processes that mental illness brings.

If you are in crisis, please call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255) or contact the Crisis Text Line by texting TALK to 741-741.

There is hope, and there is help.

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