Friday, February 26, 2010

Stuart Matis-Means Reduction Techniques

One of the difficult and traumatic questions that arises as you read the story of Stuart Matis as told in the book In Quiet Desperation, is why his parents accepted Stuart's purchase of a gun. Stuart's parents address this issue and note that they were afraid of alienating Stuart and they hoped by keeping communication open that might possibly make a difference. Yet, they were also astoundingly fatalistic (which studies show is a common response by family members, friends and even the medical profession) about the potential for Stuart to take his own life and many people have difficulty with their perspective and the context they chose place the events in.

Friends and family can dramatically reduce the incidence of Suicide by removing the guns and pills. How do you do it? I will borrow liberally from the Harvard School of Public Health Means Reduction Website and list the techniques below.

Can you really make a difference by reducing means? Yes.

First, most of the time you can make a difference because the overwhelming majority of suicide attempts are impulsive in nature and 90% of attempters do not go on to die by suicide later. Second, guns in the home are the major source of means for teenagers who commit suicide. Better control, storage or elimination of guns (and, we are actually talking handguns here since hunting weapons are rarely utilized in suicide) from the household is a huge step towards safety in the home for teens, Elders and family members dealing with mental illness including depression which many, many people will experience some time during their life.

How do we do it?

Reduce easy access to dangerous substances at home. That includes:

Firearms - Because firearms are the most lethal among suicide methods, it is particularly important that you remove them until things improve at home, or, second best, lock them very securely.

Medications - Don't keep lethal doses at home. Your local Poison Control Center can give you information about what constitutes a lethal dose for the medicines you need to keep. Be particularly aware of keeping prescription painkillers (such as oxycodone and methadone) under lock and key both because of their lethality and their potential for abuse.

Alcohol - Alcohol can both increase the chance that a person makes an unwise choice, like attempting suicide, and increase the lethality of a drug overdose. Keep only small quantities at home.

The How to Specifics-Firearms

(Adapted by the Harvard School of Public Health from Maine Youth Suicide Prevention Program )

A lethal weapon available to a person in the depths of despair can end a life in an instant! Firearms are used in five out of ten suicides in the U.S. Removing lethal means from a vulnerable person, especially a youth, can save a life. It's like keeping the car keys away from a person who has had too much to drink.

Who Can Help Store or Dispose of a Firearm?

Some law enforcement departments (not all) will take firearms. Some offer temporary storage, some offer permanent disposal options, and some offer both. First, call your local police department, sheriff or state police. Identify yourself and explain your concern. Ask for the Officer on Duty; write down his/her name and the department's name. Arrange with the officer a time and location for him/her to pick up the firearm, if they offer that service. Do not bring the firearm to the police department unless told to by the Officer on Duty.

Does the Firearm Need to Be Ready to Go in a Certain Way?

If you know how to safely unload the firearm, unload it. If you do not know how to unload the firearm, tell the Officer before he/she arrives to pick it up. If the Officer asks you to bring the firearm to the police station, name who will bring it, what the person looks like, and the time the person will arrive.

What Happens to the Firearm?

The gun owner and the Officer will complete some paperwork. What happens next depends on the department. If the owner no longer wants it, some departments may have it melted down while others may sell it. Departments that offer temporary storage may have different policies regarding how to retrieve it (e.g., if applicable in your state, the gun owner may need to bring in a valid firearm owner ID card).

What if Law Enforcement Storage or Disposal Isn't an Option?

-Temporarily store the firearm at the home of a trusted relative or friend. Be sure the person at risk cannot get the firearm before or after it is removed. NOTE: Not all people can hold the guns for you. Check the list of prohibited persons under federal law.
-Lock the unloaded firearm in a gun safe or tamper-proof storage box with ammunition locked in a separate location. (BETTER YET, don't keep ammunition at home.)
-Trigger locks are sold in sporting goods stores and where firearms are sold. Some police departments offer free locks.
-Be sure the keys and storage box combinations are kept away from the person at risk. Remember: This does not guarantee safety. Youths generally know their parents' hiding places.
-Do not place the firearm in a bank safe deposit box. Most states have laws that prohibit carrying a weapon into federally insured buildings such as banks.
-Sell the firearm following the appropriate legal guidelines.

The How to Specifics-Meds

Avoid Storing Lethal Quantities of Medications in the home.

-Find and Locate prescription Medications in the home.
-Dispose of any not in use at the time.
-Consider keeping very small quantities of over the counter drugs available and keep larger quantities under lock and key.
-Find out what the lethal dosage is for each active prescription and keep larger amounts under lock and key.
-Most pharmacists are willing to provide you with counseling on these matters and you can also call your local poison control center.
-Do not order by mail in super quantities.

Behavior changes in your loved ones that may indicate an intent to use Medications for suicide or other inappropriate uses:

-Watch for doctor shopping or unusually high numbers of visits in your loved one or friend.
-Watch for the accumulation of unfilled paper prescriptions.
-Hoarding of medications, such as pain medications, long after the event that prompted the prescription has passed.

Disposal of Medications

Borrowed from a Vermont Department of Health Factsheet:

Prescription medications should not be flushed down the toilet or poured down the drain. To properly dispose of prescription medications, use the following guidelines:

Take unused, unneeded or expired prescription and over-the-counter drugs out of their original containers.

Mix the prescription drugs with an undesirable substance (used kitty litter, coffee grounds, soil, etc.), place the mixture into a sealable plastic bag or container, and place it into the trash. Please choose an undesirable substance that pets won’t want to eat.

When discarding a transdermal patch, fold the patch into itself and then place it in the undesirable mixture.

1 comment:

  1. Very timely post, QS. Thank you for ALL of the great information. I hope it keeps someone from actually taking his/her life.

    Happy day! slp