Category: Suicide

Introduction

The public approach to problem-solving and prevention of disease or other adverse phenomena is comprehensive and powerful because it allows the simultaneous examination of an issue from multiple perspectives including health, physical, social, legal, and psychological areas. The population-based approach, as well as public policy development and implementation, can bring substantial changes to the social environment and improve the quality of life.

Therefore, the evaluation of regulations and strategies and the factors that contribute to the positive outcomes in the administrative process is essential to the achievement of better policy effectiveness. Based on this, the given health policy research (HPR) aims to investigate current policies on the prevention of teenage suicide. Nowadays, intentional self-harm is one of the most common causes of death worldwide, and some studies reveal that suicide is especially common among people of 15-30 years old (Kutcher & Szumilas, 2008). It means that suicide is a significant public problem that can be solved only through a comprehensive approach.

Key Elements of the Research Process

Conceptualization

Problem statement

According to the Centers for Disease Control and Prevention (CDC) (2015), one-fifth of the U.S. teenagers think of suicide each year. Nearly 8 percent of adolescents (about 1 million people) attempt suicide, and approximately 1,700 die by suicide annually (CDC, 2015). The present-day suicide prevention programs, as well as national and state policies, primarily aim to provide mental health specialists, educators, and community leaders with appropriate resources to identify teenagers who are at risk and refer them to competent care (Pennsylvania Department of Education [PDE], 2015).

But even though suicide intervention and postvention are essential to dealing with this issue, most researchers claim that youth suicide is preventable (Kutcher & Szumilas, 2008; CDC, 2016; White, 2016). Therefore, teenage suicide prevention efforts should be core to the effective public health policies that focus on decreasing teenage suicide rates at the local and national levels. Therefore, it is important to analyze what aspects of public policies and national strategies better affect the reduction of youth suicide rates.

Research questions

1. What is the major focus of the current preventive strategies and policies?
2. What are the prerequisites for the success of the national teenage suicide prevention strategies?
3. Are they responsive to the needs of the target population?
4. How and under what conditions can public policy improve mental health outcomes contribute to the decline in teenage suicide rates?

Knowledge paradigm

The given HPR project is constructed according to the principles of critical realism. From this theoretical perspective, social reality is independent of various social actors but, at the same time, it influences and is influenced by them (Gilson, 2012). It means that individual behavior is affected by micro and macro-social processes and structures. Based on this, the study put in the critical realist framework aims to determine the causes of the social phenomenon, i.e. health policies and teenage suicide. Moreover, the relationships between causes and effects are regarded as non-linear, dynamic, and complex as they are linked to both social actors and contexts (Gilson, 2012).

Thus, the application of the critical realism paradigm allows the multilateral explanation of health policies and helps to identify the processes which explain the results of strategic interventions.

Groundwork: HPR Data

The study evaluates the sample of twelve randomly collected resources including five health policy research papers, four qualitative peer-reviewed articles, and three quantitative research located through MEDLINE and NCBI databases. The selected data derives from the highly credible academic and professional resources, including the Ministry of Children and Family Development and the CDC, and, therefore, it serves as high-quality evidence.

Methods: Literature Review

The review of literature related to teenage suicide and relevant public health policies is conducted at the early stage of the HPR. The literature review includes the systematic search, location, and evaluation of materials on preventive health policies and the published HPR information. This research method allows the analysis of underlying assumptions behind the formulated research questions and facilitates the interpretation of the HPR findings.

Research Design

Qualitative research

Qualitative methodology is selected because it allows researchers to fulfill the gaps in knowledge through the description of data. The main strength of the qualitative research methodology is its focus on comprehension, explanation, and interpretation of evidence rather than statistical estimations.

Validity threats

Interpretative research is always characterized by a high level of subjectivity, and the validity of qualitative cannot be proved according to the traditional scientific criteria. However, it is considered that knowledge in itself is always interpretative, and it always depends on the individual perspective (Lessor, 2000). Moreover, it is possible to increase the objectivity of data interpretation by adequate research structuring and integration of supportive evidence.

Sampling

The non-probability sampling technique is applied during the selection of academic studies and published HPR. The non-random selection of sample studies was primarily influenced by the character of the investigation and the overall orientation to the topic and formulated research questions. The convenience sampling is employed because it is characterized by simplicity and a high level of access to the objects of evaluation and, at the same time, by using convenience sampling, it is possible to include all available and suitable materials as part of the sample.

Measurement: Validity and Reliability

Validation of qualitative research determines whether other professionals in the field of study will be able to accept the authors view, understand the initial data provided in the paper, and comprehend the offered suggestions and conclusions (Whittemore, Chase, & Mandle, 2001). To achieve a high level of HPR validity, the strategy of analytical induction is applied. This method implies the reassessment of the working hypotheses by the introduction of new data on different stages of the research process. The additional information sharpened data interpretation and conclusions and facilitated the achievement of the maximal level of generalization.

Data Collection

Secondary data collection is performed in the study. The secondary data is characterized by accessibility and availability. Moreover, it allows the comprehensive evaluation of the problem and refinement of research objectives. However, the main disadvantage of this method is the reduced control over the research process in terms of setting study aims and limitations, as well as a high level of dependability on the boundaries and frameworks identified in the published materials.

Data Processing

Data editing, classification, and tabulation were carried out in this project. The first step helped to clean the information from potential biases and eliminate inconsistency in different research findings. The following classification and tabulation of both qualitative and quantitative evidence by themes and attributes largely facilitated the comparison of data and increased their readability.

Data Analysis

Grounded theory is used as a method of evidence analysis and synthesis. This approach implies the development of theory on the basis of systematic collection and analysis of data related to the subject. In this case, the phases of data collection, data analysis, and generation of the theory are interrelated (Lessor, 2000).

By following this principle, the inductive method of analysis is selected. It means that the analytical models, themes, and categories are developed as the outcomes in the process of evidence evaluation  they are introduced merely after data collection and analysis. In the given theoretical framework, the emphasis is made on the natural variations in data derived from the previous literature findings which were categorized and systemized to support and generate new theoretic ideas.

Application

Communication of the HPR evidence is important as it may contribute to the improvement of the rulemaking and policy operation processes. The publication of a manuscript in a professional or scholarly resource significantly increases its value because publishing verifies the credibility of evidence and data validity. However, in order to achieve this objective, it is important to comply with high standards of writing: ethics, proficient language use, styling, etc. A published work serves to inform decisions about practices, planning, and policymaking.

Ethical Considerations

The main requirements of the Health Insurance Portability and Accountability Act (HIPAA) and Institutional Review Board (IRB) regarding research conduction is the protection of participants well-being and rights. The protection of privacy is the central point of the HIPAA and IRB regulations. It is important to use personal information of study participants confidentially and avoid its disclosure without their permission.

The given HPR paper is written according to the principles of ethical research conduct by selecting only those research resources which showed the compliance with the mentioned standards, i.e. did not disclose personal information of study participants outlining only the necessary information about their demographic backgrounds, used only harmless methods of data collection, implemented the principle of informed consent, and minimized the risk of data misinterpretation.

Literature Review

Factors Defining Policy Inefficiency

According to Knox, Conwell, and Caine (2004), the current endeavors towards youth suicide prevention are still focused on identifying and intervening individual cases just before or during suicidal events (p. 40). Prevention of suicide in teenagers is primarily based on clinically-focused or community-focused approaches rather than the population-based ones. The primary cause of it is rooted in the fact that, in the recent past, the U.S. mental health specialists suggested to consider each suicide attempt as an individual or interpersonal act.

Although, since then, the transition from the individual-oriented approach to school, family, and community-based approaches was made, the preventive efforts are still localized. The researchers suggest that it is the lack of evidence on the effects and significance of suicide prevention that creates the barriers to the implementation of teenage suicide prevention strategies at the nation-wide level (Knox et al., 2004).

Policy Focus

As stated by Kutcher and Szumilas (2008), national suicide prevention efforts often focus on risk factors including the onset of major psychiatric disorders, social disadvantages, childhood abuse, distress, dysfunctional family relationships, etc. It is considered that the best effect can be achieved if the policies address causal and, at the same time, modifiable risk factors. The evidence for the impacts of preventive policies and interventions is still insufficient, but the research findings obtained by Gould, Greenberg, Velting, and Shaffer (2013) reveal that school-based skill training, development of suicide awareness in teenagers, education of health care specialists, media education, and restrictions on the acquisition of lethal means may be considered promising prevention strategies.

Core Components of the National Youth Suicide Prevention Policy

According to White (2016), a comprehensive strategy for teenage suicide prevention will target both welfare promotion and risk reduction. The specific objectives of national public policies thus should include community strengthening, reduction of social disparities, and promotion of social justice, improvement of social support, as well as youth and family education. However, it is important to consider the fact that when preventive measures implemented independently of each other, their positive effect may be reduced. Therefore, it is important to develop an integrated approach to improving the situation by targeting many areas of concern simultaneously.

Resilience promotion

First of all, researchers suggest increasing the accessibility of support resources to all social strata, provide them with information about available helping resources, and improve community members skills of navigating them (White, 2016). According to the CDC (2016), better connectedness of youth and families to social and community organizations benefits them. However, nowadays, there are many barriers to enhance family-organization connectedness including the limited capacity of locally rendered service, excess costs, insufficient quality, and many others. Since the promotion of resilience is a potentially effective measure in suicide prevention, the policy should make efforts towards removing the existing material or social barriers to support seeking.

Youth education

Teenage skill-building is regarded as an essential part of suicide prevention efforts by most health policy researchers. The core skills that should be developed are coping skills, problem-solving, goal setting, stress management, interpersonal communication, cultural sensitivity, self-awareness, and many others (White, 2016). The given approach is mostly school-based and implies personnel training and the creation of a response team and staff development (PDE, 2015).

Family support and parent interventions

Interpersonal connectedness is associated with a reduced risk of suicidal behavior. Social integration and the lack of social isolation protect individuals from thinking of suicide. For example, one of the cross-sectional studies on the U.S. youth behavior revealed that improved relationships between teenagers and their family members, as well as a higher level of perceived family care, decreases the risks of suicide (CDC, 2016).

It is considered that empowerment-based parent education and skill development may have a positive effect on youth suicide reduction rates (White, 2005). By learning how to deal with family conflicts and identify early signs of suicidal behavior in children, parents may become more engaged in the improvement of the situation and bring a positive change into the community.

Addressing the Needs of Vulnerable Subpopulations

There are a few significant differences associated with suicidal behavior among various demographic subgroups. For instance, the data shows that suicide in males is more frequent than in females while, at the same time, women tend to have suicidal thoughts more often than men (CDC, 2016). Moreover, suicides are especially common among minor racial and demographic subgroups, e.g. American Indians (CDC, 2016) or same-sex orientation youths (Russell & Joyner, 2001).

It is also observed that bullying and exposure to aggressive peer behavior trigger the development of psychological problems and social isolation in teenagers and increase the probability of suicidal ideation in them (Borowsky, Taliaferro, & McMorris, 2013).

The findings indicate the importance of the development of the school-based and community-based interpersonal connectedness as they are core to the prevention of suicide in youth. The policy thus should focus on the promotion of positive attitudes to diversity and the creation of a favorable environment by reducing social and structural oppression of minority youth, providing equal opportunities, and eradicating violence among peers (White, 2016).

Impacts of Substance Use Policies on Youth Suicide Rates

Substance intake and particularly alcohol drinking is one of the risk factors that provoke suicidal behavior. According to Markowitz, Chatterji, and Kaestner (2003), nearly one-third of teenage suicide victims suffer from various substance abuse disorders. Based on this, the researchers suggest that state and national alcohol policies on the establishment of legal drinking age, alcohol taxation, and availability may play a big role in the prevention of suicide among youth (Markowitz et al., 2003). Therefore, by including the alcohol policy tools into the teenage suicide prevention strategy, it will be possible to make it more efficient.

Impact of Suicide Research Evidence on Suicide Rates Decrease

Widespread adoption of evidence-based practices is a prerequisite for successful policy enforcement (U.S. Department of Health and Human Services, 2008). Research advancement is thus one of the ways to improve policy formulation and implementation. The development of adequate data and case report systems, improvement of analytical tools, conduction of participatory action research, and enhancement of collaboration between researchers and stakeholders foster the positive practical results in suicide prevention (Little et al., 2016).

Policy Implementation

Rulemaking

The accuracy of policy formulation and the selection of the right language is essential to its successful implementation. At this stage, it is important to take into account evidence and use it for the formulation of clear objectives, and the creation of well-balanced rules and regulations which will not be too specific or too vague (WHO, 2012). Additionally, the interaction of executive branch representatives with multiple stakeholders, legislators, etc. may allow the amendment of policy statements and significantly facilitate their implementation.

Operation

At this phase, the design and conduction of administration procedures are performed. And since the quality of the policy itself is as important as the skilfulness of the administrative personnel, it is important to integrate operation activities with the rulemaking process. Any inconsistency and contradictions between policy objectives will be especially evident in the operational phase and will result in policy implementation failure. Thus, when planning policy operation activities, it is important to make sure that all policy characteristics are well combined and will not lead to conflicting outcomes.

Conclusion

The HPR has outlined some key elements of the population-based approach to preventing suicide in teenagers. The findings reveal that a comprehensive strategy should target multiple suicide-related issues at the individual, community, and national levels simultaneously. The major youth suicide prevention operations include the promotion of competencies, awareness development, risk reduction, improvement of protective factors, and enhancement of early detection practices. It is important to strategically combine these actions and efforts in various settings: hospitals, schools, social organizations, etc.

The most promising policy regulations should target both individuals and their social environments by supporting connectedness, compliance with human rights, and minimizing the exposure to negative influences. Additionally, it is important to improve research design and methods to generate new evidence on youth suicide and use it for the improvement of policy implementation and policy administration outcomes.

References

Borowsky, I. W., Taliaferro, L. A., & Mcmorris, B. J. (2013). Suicidal thinking and behavior among youth involved in verbal and social bullying: Risk and protective factors. Journal of Adolescent Health, 53(1). Web.

Centers for Disease Control and Prevention. (2015). Suicide Prevention. Web.

Centers for Disease Control and Prevention. (2016). Strategic direction for the prevention of suicidal behavior. Web.

Gilson, L. (2012). Health policy and systems research: The abridged version. Web.

Gould, M. S., Greenberg, T., Velting, D. M., & Shaffer, D. (2003). Youth suicide risk and preventive interventions: A review of the past 10 years. Journal of the American Academy of Child & Adolescent Psychiatry, 42(4), 386.

Knox, K. L., Conwell, Y., & Caine, E. D. (2004). If suicide is a public health problem, what are we doing to prevent it? American Journal of Public Health,94(1), 37-45. Web.

Kutcher, S. P., & Szumilas, M. (2008). Youth suicide prevention. CMAJ : Canadian Medical Association Journal, 178(3), 282285. Web.

Lessor, R. (2000). Anselm Strausss Grounded Theory and the study of work. Sociological Perspectives, 43, 1.

Little, T. D., Roche, K. M., Chow, S., Schenck, A. P., & Byam, L. (2016). National institutes of health pathways to prevention workshop: Advancing research to prevent youth suicide. Annals of Internal Medicine. Web.

Markowitz, S., Chatterji, P., & Kaestner, R. (2003). Estimating the impact of alcohol policies on youth suicides. The Journal of Mental Health Policy and Economics, 6(1), 37-46.

Pennsylvania Department of Education. (2015). Model youth suicide awareness and prevention policy. Web.

Russell, S. T., & Joyner, K. (2001). Adolescent sexual orientation and suicide risk: Evidence from a national study. American Journal of Public Health, 91(8), 12761281.

U.S. Department of Health and Human Services. (2008). Substance abuse and suicide prevention: Evidence & implications. Web.

White, J. (2005). Preventing suicide in youth: Taking action with imperfect knowledge. Web.

White, J. (2016). Preventing youth suicide: A guide for practitioners. Web.

Whittemore, R., Chase, S. K., & Mandle, C. L. (2001). Validity in qualitative research. Qualitative Health Research, 11(4), 522-537.

World Health Organization. (2012). Public health action for the prevention of suicide: A framework. Web.

From time immemorial there have been cases of people deciding to take their own lives by committing suicide. Arguably, the rates of suicide vary from one region to another, and from one age group to another. As a result, people and especially psychologists have been trying to understand why people would choose to commit suicide. There have been discussions on various platforms whether suicide is a personal affair or does it, to a certain extent, involve the society. Reasons as to why somebody would come to a point of taking his or her own life are still a point of debate. Understanding suicide will, therefore, require one to understand the reasons both on a personal level and on a societal level that can push people to kill themselves.

In understanding suicide, it is vital, to begin with outlining the various categories of suicide. To begin with, we have fatalistic suicide where somebody feels that life is in the extreme end and there is no way a human being can live under that given conditions. Secondly, we have anomic suicide where one finds life as being meaningless especially due to loneliness or isolation. Thirdly, there is altruistic suicide in which case one sacrifices his or her own life for the sake of society. Lastly, there is egoistic suicide where one decides to end his or her own life after failing to meet personal or societal expectations (Werth, 2013). Notably, the conditions under which people used to commit suicide anciently are somewhat different from modern conditions (Rogers & Lester, 2010). In modern society, Anomic and egoistic are the most prevalent. On the other hand, fatalistic and altruistic characterizes traditional scenarios.

What makes one commit suicide can sometimes be very private and difficult to comprehend. However, there are the most common causes that have been documented. Various writers have associated suicide with decreasing societal ties which then lead to isolation. This has made many people keep to themselves whenever they have problems leading to depression (Werth, 2013). As a matter of, depression has been identified as a single highest contributor to suicide. Depression destabilizes the emotional state of a person leading to extreme sadness and despair.

Given the loose societal ties, people are often on their own. Consequently, nobody is aware when they make such desperate decisions. Another cause of suicide is the view that one has become a burden to the family and society at large. The burdensomeness thought mostly comes about when one is unable to provide for his or her own needs and has to depend on society members (McLaughlin, 2007). In scenarios like this, people tend to think that their death will be a reprieve to society. They, therefore, prefer committing suicide rather than staying a life. People can also be pushed to commit suicide when members of society discriminate against them. This leads to low self-esteem and loneliness (Rogers & Lester, 2010).

The discussion about the causes and effects of suicide is not about to end soon. This is because we still do not know exactly what leads to cases of suicide. The data that we collect and the views analyzed are all subjective. Apparently, the exact reasons why somebody would commit suicide are well known by the deceased who cannot talk (Rogers & Lester, 2010). However, it is crucial to note the role of society and culture in not only maintaining social norms but also ensuring the well-being of everybody. In this regard, it means that the ideal way of reducing suicide cases is to ensure inclusivity of people in society. Nonetheless, it should be noted that there are people who would never want to reveal their problems.

References

McLaughlin, C. (2007). Suicide-Related Behavior: Understanding Caring and Therapeutic Responses. Hoboken: John Wiley & Sons.

Rogers, J. R. & Lester, D. (2010). Understanding Suicide: Why We dont and How We Might. Amsterdam: Hogrefe Publishing.

Werth, J. L. (2013). Contemporary Perspectives on Rational Suicide. London: Routledge.

Introduction

Physical assisted suicide refers to deliberate annihilation of life done by another person through an open request of the individual wishing to die. It may entail killing a sick person out of apprehension and sympathy for his suffering. For years, medical doctors have been proscribed from assisting long- suffering patients in committing suicide (Dahl, 2008, p. 127).

This issue is touching and controversial and ranges from abortion. It has not been established whether the physical assisted suicide is expedient for a community. This paper will discuss the pros and cons of physical assisted suicide. In my opinion, I believe that physical assisted suicide is beneficial and should therefore be legalized.

Discussion

Major argument  Pros of Physical Assisted Suicide

Premise 1: Physical assisted suicide saves patients from terrific pain and misery.

Many disorders such as cancer lead to a slow death and doctors have adequate knowledge and skills to know when the days of a patient are limited. Patients suffering from such ailments know that they will die, and their pains only continue increasing day by day. It is, therefore, questionable about why the doctors should let these patients suffer continuously till their bodies collapse. It is humanitarian to give the patient the choice to articulate when he has had enough pains. Imagine what it would be like to spend six months vomiting, coughing, enduring pain spasms, losing control of excretory functions and suffering psychologically (Hendin & Foley, 2002, p. 315).

Premise 2: The entitlement to death should be primarily determined by an individual.

The government constitution does not at any point state that the authority has the power to keep an individual from carrying out suicide. After all, if the patient and the family agree it is what they want to do, whose business is it anyway? Who else is it going to hurt? (Dahl, 2008, p. 127). In a nation that is allegedly free, physical assisted suicide should be a basic right.

Premise 3: Physical assisted suicide allows individuals to die with self respect rather than having the ailment diminish them to a shell of their previous selves.

Patients who are about to die are at times unable to look after themselves and discomfitures such as vomits, salivations, urine and fecal waste must in this case be attended to by treatment subordinates. Practically, all persons want other peoples final reminiscence of them to be how they were at some point in life but not what they were during their last moments. Other patients and families have the same wishes for themselves. We should let people die with their dignity, pride, and self-worth intact (Kopelman & Allen, 2001).

Premise 4: Costs associated with medical care can be decreased.

Physical assisted suicide minimizes the enormous costs associated with long- suffering patients as it is extremely expensive to maintain a dying patient. For instance, one must shell out money for x-rays, laboratory examinations, hospital operating costs and medical staff remunerations. Is this the best way to spend our money when the patient himself would like to die? Would not the money be better spent on the patients that can be saved? (Weir, 1997). It is, therefore, completely unrealistic to use the money for patients who either way will die.

Premise 5: Through physical assisted suicide, crucial body parts can be saved.

This permits medical doctors to save other persons life and this places the wants of those living at the fore front. There is high demand for organs such as hearts and kidneys. These are essential to enhance the lives of individuals whose lives can be saved. Physical assisted suicide allows physicians to preserve vital organs that can be donated to others (assuming the patients are organ donors) (Kopelman & Allen, 2001).

Minor argument  Cons of Physical Assisted Suicide

Premise 1: Many religious convictions forbid physical assisted suicide

Almost all religions have a regulation in opposition to murder and the most fundamental directive in the Bible is Thou shall not kill (Svenson, 2003, p.199). We need to defend the morals of both the patient and the doctor.

Premise 2: Physical assisted suicide breaks the doctors Hippocratic vow.

Each medical doctor is supposed to take a vow upon receiving a health degree. This states that the doctor should do no mischief on the part of the patient. Assisting in suicides would be a violation of that oath, and it would lead to a weakening of doctor-patient trust (Svenson, 2003, p.199).

Premise 3: It impels Physicians and patients to surrender patient recuperation too early.

If a patient is informed that he has for instance six months left to survive with increasing serious pains, then he may choose to end his life before it gets worse. This wipes out valuable time that can be spent with family and friends and denies the slim chance of a recovery or the possibility of discovering a doctor error (Kim, 2001, p. 226).

References

Dahl, E. (2008). Giving death a helping hand: physician-assisted suicide and public policy: an international perspective. Dordrecht: Springer.

Hendin, H., & Foley, M. (2002). The case against assisted suicide: for the right to end-of-life care. Baltimore: Johns Hopkins University Press.

Kim, C. (2001). Pros and cons: social policy debates of our times. Boston: Allyn and Bacon.

Kopelman, M., & Allen, K. (2001). Physician-assisted suicide: what are the issues? Boston: Kluwer Academic Publishers.

Svenson, G. (2003). Physician-assisted suicide: the anatomy of a constitutional law issue. Lanham Rowman & Littlefield Publishers.

Weir, F. (1997). Physician-assisted suicide. Bloomington: Indiana University Press.

What are at least two facts presented by each side of the critical issue?

According to the pro side of the argument, putting into consideration behavioral research and clinical experience, psychiatrists are inevitable for any sick person to die quickly. Also, public opinion polls indicate that most people prefer terminally ill patients to be assisted by physicians in suicide.

The con side, on the other hand, believes that the safeguard takes advantage of a scientific clinical course of action. This, they use to conceal the conflict of ideas about suicide in society. It in turn leads to the shifting of responsibility of a dilemma from a patient or his close associates to an external specialist (Halgin, 2008).

What are at least two opinions presented by each side of the critical issue?

The pro side thinks a psychiatrist is useful in determining whether the patient can make a reasonable and sensible choice about losing a life. Also, skilled mental health professionals and psychologists have enough experience. Very few people appreciate this fact. This is rife in cases where patients and their close associates are obligated to deal with issues that involve the termination of life (Halgin, 2008).

The con side postulates that proficiency is not a scientific but a complicated social paradigm hence finding out sufficient capacity to make a decision is difficult. Psychologists should not be empowered to bring themselves into play as determinants of the correct moment for the death of an individual (Halgin, 2008).

What are some of the strengths associated with the Pro side of the issue? What are some of the weaknesses?

Strengths

A lot of apprehensions occurs when a terminally ill patient requests for a quickened death (Halgin, 2008). Downheartedness and thoughts of suicide overwhelm most of these people. From research carried out in the year 1994, most physicians with little knowledge in psychiatry were unable to diagnose these. From this, the researchers concluded that mental disorders could not damage the insinuation of these people thus; their reasoning to rationalize suicide is different from clinically depressed people (Halgin, 2008). Mental health professionals can treat this depression by disconnecting the patients fears.

There is no straightforward modus operandi describing what drives one to have suicidal thoughts. In line with this research has found out that the key thing needed by these patients is mollifying and sufficient psychosocial care at their deathbed.

Weaknesses

The pro side does not explain the effects of improved social-psychological supports and improved palliative care on the hastened death ideation of terminally ill patients. They have also not explained how certain issues, such as religious beliefs affect an individual for end-of-life decisions.

What are some of the strengths associated with the Con side of the issue? What are some of the weaknesses?

Strengths

There is full backing for a required psychiatric assessment to authenticate the competence of any individual that requests for physician-assisted suicide at any given time (Halgin, 2008). Those psychiatrists that have taken care of these patients with suicidal thoughts can attest to how to a very large margin these patients can have mixed feelings about suicide (Halgin, 2008). Suicide is a perfect specimen for Parsonian analysis because society has adopted a varied number of models for apprehending and dealing with suicide (Halgin, 2008). These models may either be clashing or matching.

Initially suicide many considered suicide as a choice and hence the need to consider the legal framework in handling it. Many views depicted it as a punishable crime that not only attacked an individual but also the general community at large (Halgin, 2008). When viewed in terms of religion, suicide is still a choice, but the disqualifying factor is the fact that the key values that signify that it violates a human being. A good example is the Catholic Church that is opposed to any given form of suicide (Halgin, 2008).

The modern medical model takes suicide as a sign of mental illness rather than a practice of free will by an individual. What cements this is the fact that studies link it to treatable psychiatric disorders. From similar studies, treatment of these disorders decreases the rate of suicide cases by a wide margin. The chief opinion is that the main psychiatrists should be there to treat the patients and not just to watch them.

Weakness

Though the psychiatric may be willing to treat the patients, the patient decides whether to have it.

How credible were the authors of each argument?

Both authors for the pro and con side have registered a high level of credibility in their arguments. This is by the concise way in which they lay their arguments, supporting them with relevant facts and research findings (Halgin, 2008). It is also worth noting that their experience overtime in their profession is also very instrumental in the opinions that they give concerning the idea of whether psychiatrists should serve as gatekeepers for these suicide cases or not. It is also clear from their arguments that they are not just being hypothetical but, rather, they appreciate that the other sides opinions only the difference arises due to several strengths.

Based on the statements presented in this critical issue, which author do you agree with? Why?

I agree with the cons side. It is because I believe human life is of great importance and hence very valuable. I, therefore, fall for the idea that these psychiatrists should not just act as gatekeepers to see people lose their lives, but their main aim should be to try their best to ensure life is preserved (Halgin, 2008).

Which side of this critical issue does contemporary research support?

Contemporary research supports the cons side of the argument. It is clear when we from that, according to research, mental disorders cause suicidal thoughts, and the same research reveals that these disorders are treatable. There is, therefore, no doubt that suicidal thoughts are treatable rather than letting patients succumb to them.

Reference

Halgin, R. (2008). Taking Sides: Clashing Views in Abnormal Psychology. New York: McGraw-hill.

The patients desire to die by asking their physicians to prescribe lethal doses of substances that hasten death has been a controversial issue in different spheres of the American society. The medical practice of helping patients to commit suicide is commonly called physician-assisted suicide (PAS).

As opposed to another end-of-life practice called euthanasia in which the physician actively participates in killing the patient, PAS takes a more voluntary approach in which a competent patient must make a formal request to the physician by providing a written consent before the process can be carried out (Hudson et al., 2006; Munson, 2012).

The proponents of PAS have argued in favor of this practice by referring to the two major principles of medical ethics, which include the patients right to self-determination and patient autonomy.

The right to self-determination dictates that competent patients possess the right to make informed decisions as far as the amount, circumstances, and timing of their medical care is concerned. Moreover, this right extends to the patients choices on the timing of their death. The right to self-determination implies that competent patients have the right-to-die, which must be respected and upheld by members of the medical community.

On the other hand, patient autonomy implies that the patients reserve the right to choose medical practices and interventions that best represent their cultural, religious, and personal philosophies. Therefore, if the right to choose death reflects the patients cultural, religious, and personal principles, no one should prevent them from exercising this basic right, at least according to the principles of medical ethics (McCormick, 2011).

A perusal of recent literature demonstrates that the need to respect the patients right-to-die provided by the principles of medical ethics has won the hearts of many Americans. A survey conducted in 2006 with the aim of examining the level of support for the right-to-die movement shows that more than 84 percent of the 1,500 adult participants support the move to enact laws that protect the patients right-to-die if they are suffering from an advanced illness (McCormick, 2011).

On the other hand, a considerable number of Americans, notably Christians and some members of the medical community have strongly argued against a public policy that allows the killing of terminally-ill patients.

Their argument is based on the social slippery-slope, which holds that a public policy that legalizes PAS is vulnerable to undesirable consequences in that some unscrupulous physicians may take advantage of the lenient rules to kill their patients the moment they run out of ideas on how to treat their advanced medical conditions (Pereira, 2012).

Keeping the arguments from both sides in mind, this paper reviews the current legal status and the effects of legalizing assisted suicide in the states of Oregon, Washington, and Montana with the aim of supporting the move to legalize PAS in other parts of the United States.

The Current Legal Status of Assisted Suicide

In the United States, physician-assisted assisted suicide and euthanasia are illegal in all U.S. states except Oregon, Washington, and Montana.

The three states have taken bold steps in terms of allowing physicians to help their patients to kill themselves by prescribing a lethal dose of substances that hasten death. This move has been seen as a step in the right direction by the proponents of PAS and euthanasia who have argued that there is no need to limit the basic rights of the American people, which are enshrined in the U.S. Constitution.

For instance, the right to privacy, individual liberty, and dignity has been increasingly cited in support of the need to legalize assisted suicide in the United States. Here, the proponents of PAS and euthanasia have argued that since the Constitution expressly guarantees the right to privacy, liberty, and dignity to the American people, there is no need to create rules and statutes that contradict these basic rights.

Therefore, in 1994, the citizens of Oregon saw the need to uphold their basic right to dignity by endorsing the Death with Dignity Act with more than 51% of the votes cast in the citizens ballot initiative.

The act gave all practicing physicians in the state of Oregon the opportunity to help persons with advanced illnesses in killing themselves by prescribing lethal doses of substances that hasten death while preserving their dignity. However, this act clearly states that a person seeking assisted suicide must be ailing from an illness that limits his or her life expectancy to a period of less than six months (Munson, 2012).

Despite the citizens majority endorsement of the act, its implementation was delayed due to legal challenges and court cases until 1997 when more than 60% of the voters turned down the move to repeal the act. As a result, the Death with Dignity Act was enacted later in 1997, and Oregon became the only U.S. state to legalize assisted suicide (Munson, 2012).

Despite failed attempts to legalize assisted suicide in different U.S. states, the state of Washington became the second state after Oregon to enact laws that legalize assisted suicide.

In the 2008 citizens Ballot Initiative 1000, voters in the state of Washington enacted laws legalizing assisted suicide by 58% of the votes cast. The laws passed in Washington were similar to those found in Oregons Death with Dignity Act except that the citizens of Washington preferred the terms, hastened death and aid-in-dying in the place of physician-assisted suicide.

Therefore, in the state of Washington, practicing physicians are permitted by law to prescribe lethal doses of medications that hasten death to their patients. However, for a patient to qualify for hastened death he or she must be an adult of 18 years and above suffering from a terminal illness that limits the life expectancy to less than six months (Munson, 2012).

Apart from Oregon and Washington, reports show that the Supreme Court in the state of Montana ruled that physician-assisted suicide is legal in a court decision issued in 2009. This makes Montana the third U.S. state to legalize PAS. In delivering the court decision for Baxter v. Montana, the justices argued that the patients decision to seek assisted suicide does not threaten public peace since it involves a private and compassionate agreement between the patient and the physician.

Moreover, the courts majority noted that the physician and the patient must be actively involved in creating the necessary means through which the patient must make a private decision on his or her own mortality. This implies that the patients private decision is not in any way a threat to public peace and other innocent people.

However, the courts decision did not decide on whether the people of Montana have a constitutional right to seek assisted suicide by claiming the constitutional provisions that guarantee the right to privacy and dignity. Nonetheless, it is not yet clear whether PAS is legal in Montana since recent reports show that the bill enacted by the state legislature in 2010 was rejected by Montanas Senate Judiciary Committee (Pereira, 2012).

Safeguarding Assisted Suicide

In the process of upholding the patients right to die as described in the laws enacted in the states of Oregon, Washington, and Montana, the framers did not overlook the possibility that some unscrupulous physicians can take advantage of the lenient laws to advance their undesirable practices. As a result, there are many effective safeguards protecting innocent people from various undesirable consequences of legalized assisted suicide.

First, the laws legalizing assisted suicide dictate that all requests for PAS must be voluntary in that the patient must provide a well-considered and informed consent to the physician before the process can be carried out. Precisely, the laws direct that the patients must provide at least three types of requests (two oral and one written) to the physician in the presence of at least two witnesses before the physician prescribes a lethal dose of a substance that hastens death.

Second, it is a legal requirement that the prescribing physicians can only carry out assisted suicide after seeking second opinion and lengthy consultations with another practicing physician. This enables the prescribing physician to confirm the patients claim on his or her terminal diagnosis and prognosis, the patients level of mental competence, and the patients ability to make informed decisions (Munson, 2012; Pereira, 2012).

Another important safeguard entails the requirement that the prescribing physician must inform all the patients requesting assisted suicide about the availability of alternative ways of managing their advanced illnesses including hospice and palliative care services. This information is very useful to the patients since it allows them to make informed decisions before undertaking assisted suicide.

Furthermore, the laws legalizing assisted suicide require that the persons permitted to prescribe the lethal doses of medications that hasten death must be practicing physicians. This eliminates the possibility that unauthorized people will be involved in carrying out such a delicate procedure. Finally, the laws dictate that all cases of assisted suicide must be reported to the relevant authorities for record-keeping and regulation.

The Effects of Assisted Suicide

A perusal of data on assisted suicide since Oregon enacted its laws in 1998 to date shows that there is no significant increase in the rate of mortality in the states where PAS is legal. Studies indicate that 129 people died in 1997 to 2002 after ingesting a lethal dose of a substance that hastens death prescribed by physicians in the state of Oregon. Overall, the number of deaths as a result of assisted suicide has remained slightly below 0.1% of all the deaths that have occurred in the state of Oregon since 1997 to date.

On the other hand, statistics show that 36 people have died as a result of physician-assisted suicide in the state of Washington since the law was passed in 2008. Further, due to the on-going confusion about the legal status of assisted suicide in Montana, there are no reliable statistics showing the number of people who have died as a result of PAS (Munson, 2012).

Generally, the number of people dying as a result of assisted suicide does not reflect the general assumption that legalization of PAS leads to a slippery slope whereby physicians will begin to kill their patients indiscriminately.

But instead, the legalization of PAS in the states of Oregon and Washington has seen significant improvements in the way physicians offer end-of-life care to their patients. For example, in the state of Oregon, studies show that after the laws legalizing assisted suicide were passed, most physicians increased the use of morphine for pain management by 50% in 1997-2000.

Further, the number of hospital referrals increased by 30% while the use of pain medications in the end-of-life care increased by 76% at around the same period. Therefore, it is safe to conclude that the other U.S. states are wrong in believing that the legalization of PAS will cause many undesirable consequences such as the indiscriminate killing of terminally-ill patients.

References

Hudson, P. L., et al. (2006). Desire for hastened death in patients with advanced disease and the evidence base of clinical guidelines: A systematic review. Palliative Medicine, 20, 693-701.

McCormick, A. J. (2011). Self-determination, right to die, and culture: A literature review. Social Work, 56(2), 119-128.

Munson, R. (2012). Intervention and reflection: Basic issues in medical ethics (9^th ed.). Belmont, CA: Wadsworth Publishing Company.

Pereira, J. (2012). Legalizing euthanasia or assisted suicide: The illusion of safeguards and controls. Curr Oncol., 18(2), 38-45.

introduction

Suicide among adolescents and young adults is a subject that receives extensive media coverage and academic attention (and it is, in fact, a disturbing issue), while late-life suicide is much less covered and studied. At the same time, research shows that older adults constitute a vulnerable population in this regard because their suicide rates are often higher than those of young people (Conwell, Van Orden, & Caine, 2011). Individual suicide cases may reveal psychological or physical health problems, but the phenomenon in general (measured by suicide rates in a country or among specific groups) may reveal larger-scale problems with the social or health care systems. Suicide rates are different for men and women and different races. To explore the issue, it is necessary to examine epidemiological data, address the causes and factors of late-life suicide, and discuss prevention measures and efforts.

Epidemiology

According to Conwell et al. (2011), suicide rates for both men and women peak in old age in many countries. Some countries (including the United States and Canada) nonetheless demonstrate different dynamics, as there are slight decreases in rates after middle age, but there are still several points on the graph at which suicide rates grow after the age of 65. The authors provide rather disturbing statistics that show that men commit suicide in their later life significantly more often than women; in this context, white men display the highest rates, as 45 out of 100,000 white men of older age commit suicide in the United States annually, while the average is 11.5; i.e., almost four times less. Historically, people aged 65 and older constituted the age group with the highest suicide rates in the country, and it changed only in the early 2000s, when their rate decreased (and it has further decreased since then, too), while the rate among people who are 34 to 64 increased and exceeds 15 per 100,000 annually.

Despite the decrease in suicide rates, suicide remains one of the leading causes of death for men in the United States, according to Oliffe, Han, Ogrodniczuk, Phillips, and Roy (2011). The authors also show that the rate is directly connected to age; i.e., men who are older than 75 commit suicide more often than men who are 65 to 74. This is a particularly disturbing statistic if it is assumed that the decision to commit suicide is linked to the conditions (including social or health-related conditions) associated with old age, as according to the estimate referred to by Conwell et al. (2011), 20 percent of the United States population will be comprised of people older than 65 by the year 2030; i.e., more and more people will be entering this vulnerable group with high suicide risks.

Causes and Factors

Considering the factors of age and gender, it can be argued that the influences contributing to the high suicide rate among older men include psychological pressures, health problems, and social issues. First of all, Oliffe et al. (2011) stress that severe forms of depression are the primary cause of suicide in this group. From this perspective, many ways can be identified in which late-life presents more risks and more potential triggers and reasons for the development of depressive symptoms. First, older men are more likely to have had a long history of personal relationships with a high probability of having been in years-long emotional relationships with a single partner. If there was an unsuccessful marriage, depressive symptoms are likely to occur; moreover, failed marriages may prevent men from developing healthy relationships in the future, which contributes to their isolation, perceived loneliness, and lower level of maintaining an active social life. All of these are contributors to the risk of suicide.

Further, there is the issue of masculinity, which has recently attracted extensive attention from theorists and researchers in the context of older mens vulnerabilities and health risks. Evans, Frank, Oliffe, and Gregory (2011) argue that the perceptions of masculinity and the socially acceptable image of it can often affect the deterioration of older mens health. Specifically, since masculinity is traditionally linked to physical strength and endurance, health problems that naturally occur more frequently in older men may cause inadequate reactions, such as bitterness due to lowered perceived masculinity. Instead of making a reasonable decision to seek medical attention and assistance, older men may deny their difficulties and become reluctant to address their health-related problems. As Cleary (2012) puts it, Hegemonic, conventional, masculinity constructs encourage men to deny their emotions and feel shame when they cannot live up to these ideals (p. 504). Therefore, efforts aimed at achieving the image of a sufficiently masculine man are barriers to successful health care and contributors to the development of suicidal thoughts and moods.

Conwell et al. (2011) identified four major categories of causes and factors in suicide among older people: psychiatric illness, social connectedness, physical illness, and functional capacity. The first category was found to be responsible for more suicide cases than any other category, and it has been partially discussed above in the example of depression; like depression, many other psychiatric conditions are more likely to be developed late in life than earlier. Concerning social connectedness, it has been confirmed that older adults are more likely to become isolated and develop an inability to maintain social connections or make new ones (Steptoe, Shankar, Demakakos, & Wardle, 2013). When deprived of social support, or unable or unwilling to receive it, or in denial concerning their issues, the vulnerability of older men increases and with it their suicide risks.

The role of physical illness and functional capacity should not be overlooked. Difficulties associated with less energy and activity and decreased ability to cope with everyday tasksboth due to health problemsare important contributors to the psychological problems that may lead to suicide. Also, in case an older man requires a difficult medical treatment, he maybe not only discouraged to continue living with a disease but also reluctant to receive necessary psychological support (Oliffe et al., 2011). Concerning functional issues, late life is associated with changesoften dramatic changesin occupation. If a man is retired, he may find it hard to find a type of activity that can keep him busy with something meaningful during the day. Since it is a significant part of perceived masculinity to engage in meaningful activities such as providing for ones family (Cleary, 2012; Evans et al., 2011), men who are deprived of this opportunity may perceive their late-life as meaningless, which can make them think about killing themselves.

For the characteristics of late-life suicide specific to men, there are also evolutionary and neurobiological causes and factors (Conwell et al., 2011; Evans et al., 2011). For men, there is the gender hierarchy (Evans et al., 2011, p. 13), and the position of a man in this hierarchy is altered as the man grows older and his body is changing. This phenomenon of change in the perceived gender position is primarily associated with attractiveness; in late life, men are less likely to see themselves as attractive to potential romantic partners than they used to see themselves during their youth and middle age. From an evolutionary perspectivethat is, the perspective of the early stages of the development of humans as a speciesmens old age was associated with the loss of power, as younger and stronger males were able to physically defeat the previous leader, who was becoming weaker due to his age. It can be argued that this perceived loss of power is still the feeling that many men experience when they grow older although their domination (e.g., in their families) may not explicitly be undermined by younger, healthier men.

Prevention

Now that major causes and factors in suicide among older men have been identified, the available prevention measures should be discussed. The main element of the prevention strategy proposed in the relevant literature consists of ensuring a higher level of individuals engagement in health care, seeking and receiving support, and self-care. Conwell et al. (2011) stress that engagement is a major predictor of successful suicide prevention; i.e., older persons should be willing to cooperate with health care providers, social workers, and other professionals who are there to support them and help them overcome possible difficulties associated with their illness, frailty, and depressive symptoms. Moreover, cooperation should be established not only with providers but also with close ones; e.g., family members. Steptoe et al. (2013) confirm that enhancing family ties is an important instrument for preventing mortality in older people, but the use of this tool requires those peoples readiness to be open to the support their families can provide them instead of withdrawing from family and social interactions and isolating themselves.

The process of planning preventive measures should take into consideration the specific concept of perceived masculinity. As has been demonstrated, men may be more likely than women to develop depressive and suicidal thoughts due to their decreased physical strength and healthiness. Lapierre et al. (2011) emphasize the role of communication in addressing this issue; specifically, the authors suggest the notion of positive aging (p. 88). Reaching more people with the idea of aging as a process that opens new life prospects, providing images of aging with dignity, and resisting the common understanding of late-life as a time of feebleness and helplessness can help decrease the suicide rate among older men. The mechanism behind this potential decrease includes improving the perceptions of what late life is like among people who are 65 and older or will be 65 soon and promoting a positive image that suggests that leading a healthy and active lifestyle is not only possible in old age but also desirable. This approach can help older men avoid viewing their age as something shameful and humiliating.

Finally, there is a need to identify more immediate preventive measures that may be needed in acute suicide risk cases than are typically found in general and population-based suicide prevention programs. Specifically, Conwell et al. (2011) state that [e]ffective diagnosis and treatment of depression is most often cited as an example of indicated preventive intervention because of the close association between affective illness and suicide in older people (p. 458). A major consideration in the provision of such interventions is the recognition of older adults as a vulnerable group in terms of suicide risks. Concerning men specifically, patient communication and patient education should be carried out with special care to avoid the reinforcement of patients perceived masculinity-related barriers to receiving proper care and practicing proper self-care. From this perspective, it is the responsibility of health care providers, social workers, and family members to enable older men to receive help in the context of their suicidal thoughts by eliminating barriers based on an erroneous understanding of aging and the processes associated with it.

Conclusion

Among older men, suicide is a daunting problem. They commit suicide more often than young men and women and more often than older women. Major causes include physical and psychiatric illness and perceived noncompliance with masculinity standards; both factors create higher risks of depressive symptoms and, subsequently, suicidal thoughts. To prevent suicide in the addressed group, it is necessary to initiate communication campaigns in which an image of positive aging will be promoted. Also, older men should be encouraged to receive support from their families and care professionals despite the possible perception of masculinity-based barriers. In more acute cases, proper diagnosis and treatment are needed. It is important to recognize older men as a vulnerable group in terms of suicide risks and ensure that this population receives more attention from professionals and researchers.

References

Cleary, A. (2012). Suicidal action, emotional expression, and the performance of masculinities. Social Science & Medicine, 74(4), 498-505.

Conwell, Y., Van Orden, K., & Caine, E. D. (2011). Suicide in older adults. Psychiatric Clinics of North America, 34(2), 451-468.

Evans, J., Frank, B., Oliffe, J. L., & Gregory, D. (2011). Health, illness, men and masculinities (HIMM): A theoretical framework for understanding men and their health. Journal of Mens Health, 8(1), 7-15.

Lapierre, S., Erlangsen, A., Waern, M., De Leo, D., Oyama, H., Scocco, P., & Quinnett, P. (2011). A systematic review of elderly suicide prevention programs. Crisis, 32(2), 88-98.

Oliffe, J. L., Han, C. S., Ogrodniczuk, J. S., Phillips, J. C., & Roy, P. (2011). Suicide from the perspectives of older men who experience depression: A gender analysis. American Journal of Mens Health, 5(5), 444-454.

Steptoe, A., Shankar, A., Demakakos, P., & Wardle, J. (2013). Social isolation, loneliness, and all-cause mortality in older men and women. Proceedings of the National Academy of Sciences, 110(15), 5797-5801.

The doctors job is to follow ethical standards, including loyalty to patients and respect for their choice. However, the profession concentrates on philosophical, religious, and cultural traditions and beliefs. Physician-assisted suicide can be seen as voluntary death by a medical professional. At the same time, the doctor provides all the necessary means and information regarding the patients desires for the end of life. However, such cooperation on the part of a doctor cannot be ethically conditioned.

Allowing euthanasia can cause irreparable harm to the patient if done incorrectly. Thus, a person can be left without the possibility of a habitual existence. Even though many patients who decide to die to suffer from incurable diseases voluntarily, the doctor cannot assist them. In this case, the moral commandment that a person cannot take someone elses life is violated (Clarke et al., 2021). Moreover, doctor-assisted suicide is wholly opposed to the definition of a profession aimed at helping people. The doctor is seen as a healer, while physician-assisted suicide does not seem to control and calculate the risks, which can be a threat to many patients.

The dilemma lies in the Hippocratic oath given by all doctors, one of the points of which is not to harm. Thus, helping a patient with a death wish can be seen as a deliberate wish to injure the person. Moreover, it may reduce the level of trust between patients and medical staff since taking a life cannot be ethically justified. In addition, the religious view forbids doctors to help patients at the end of life, referring to the commandment not to kill a person. Furthermore, killing may be considered offensive due to societys moral attitude. The patients pain can be alleviated with the help of available medicines, while the loss of life is an irreversible action.

Reference

Clarke, C., Cannon, M., Skokauskas, N., & Twomey, P. (2021). The debate about physician assisted suicide and euthanasia in IrelandImplications for psychiatry.International Journal of Law and Psychiatry, 79, 12-14. Web.

The United States is a developed country with vast investment in various sectors of the economy. The countrys economic power was revealed recently when the Covid-19 crisis set in, causing many businesses to be closed and jobs lost. The countrys leadership strategically provided economic stimulus funds to ensure that Americans continued to live well through the pandemic and beyond (Charles 2020). However, the problem of increasing rates of suicide across the country is alarming and it raises the question of whether adequate efforts are made to curtail this crisis. The suicide crisis has been in existence and recent trends indicate that more Americans are losing their lives through self-harming. This paper examines the suicide problem deeply, intending to identify possible contributing factors and how a viable and lasting solution can be achieved.

Thesis Statement

Suicide cases in America are increasing at an alarming rate and a lasting solution is needed to alleviate the economic and psychological stress that results from the deaths of people. An integrated approach can be more useful in the achievement of the desired results rather than focusing on the matter as a public health issue.

Suicide is a societal problem associated with a state of the mind that leads the victims to make sub-optimal decisions about their lives. They act as if something deeply rooted in their souls is pushing them to choose to take their lives. Many reasons can lead people to make the wrong decisions of committing suicide. It is alarming that in 2017 only, over 47,000 American citizens took their lives (Lyons, 2019).

More than 47,000 Americans died by suicide in 2017, twice as many as by homicide, according to the latest federal count, and another 1.4 million attempted to take their lives (Lyons, 2019).

Analysis of the methods used to commit suicides reveals intriguing facts that should guide the process of healing the country and finding a feasible way forward. More than half of the cases in 2017 were expedited through the use of guns whereby the gun owners would shoot themselves. In other cases, family members would access a gun owned by one of their own and use it in the act of suicide.

More than half of all suicides involve the use of a firearm, leading some psychologists, gun control advocates, and suicide prevention groups to urge limiting access to firearms (Lyons, 2019).

Suicidal trends are not discriminative on the victims age since the problem spans from minorities to old people. School-going children are vulnerable due to their interaction with mobile gadgets with access to social media platforms and the internet. The impact of cyberbullying can be detrimental and can mislead children to commit suicide knowingly or unknowingly. Bullying and discrimination of children at school can also cause the diminishing of self-esteem levels leading to suicidal thoughts. The onset of Covid-19 affected to a great extent how learners receive instructions from various institutions with many learners obliging to online lessons. While this tendency has a positive impact by the virtue of appreciating the role of technology in our lives, it can also be a source of tragedy.

An increasing share of K-12 schools in the United States are reporting incidents of online bullying, sometimes with tragic consequences. Victims as young as 8 have taken their lives after being persecuted by mean-spirited rumors and personal attacks posted on social media sites. Bullying victims also are more likely than other students to bring a gun to school, sparking renewed debate over whether states and schools are doing enough to prevent harassing behavior (Susan, 2020).

Suicide rates are also connected with overall mental health with matters such as depression having a high likelihood of triggering the action. Depression can be caused by elongated episodes of uncontrolled stress stemming from various factors. Stress can emanate from financial challenges, health problems, and other difficult situations a person is exposed to. Failure to seek appropriate medical and psychological guidance can lead to adversities whereby a victim can no longer withhold the pain. Difficult financial and health decisions force some Americans to leave the country to seek cheaper medical care in other countries (Kerry, 2020). These decisions are not easy to make since the risk attached to the more affordable options in other countries is not publicized. In other situations, educated young Americans might find difficulties in securing reasonably paying jobs after investing heavily in education (Lorna, 2019). The result of all these problematic aspects of life can be the source of stress whose ripple effect can be manifested through suicide behavior.

While some causes of suicide are directly connected with the act, it is not easy to conclude that the rest have significance in the process. For instance, seeking medical health abroad can be stressful but it is a better option for those who choose to undertake the process. The government, however, has a collective responsibility to ensure that health care costs are reasonable and Americans can have ease of access to medical facilities and care (Kerry, 2020). However, financial challenges are characteristics in every other country and people can learn how to manage their finances and how to survive difficult times.

Conclusion

The solution to the suicide crisis can be found if a multi-directional approach is used in addition to the available health care services. The government should pass a law to control the accessibility of guns since there is a direct connection between the number of deaths by suicide and the use of guns as tools to facilitate the act. Bullying and cyberbullying should be controlled by legal means to protect Americans from these attacks that can lead to suicide. Efforts should be made to facilitate self-awareness about safety while browsing the internet and social media platforms. People should be equipped with skills to prevent cyber-attacks and to protect themselves from being bullied. In all organizations starting at the family level, members with suicidal thoughts should be identified in advance and advised to seek psychological assistance as a preventive means. Lastly, the government should keep all records for analysis to find out if the strategies to minimize the prevalence of the act are effective.

References

Charles, P. W, (2020). The pandemic economy. Web.

Kerry, D. Y, (2020). Medical tourism.Will rising health costs trigger a post-coronavirus revival? Web.

Ladika, S, (2020). Bullying and cyberbullying. Web.

Ladika, S. (2020). Gun control. Web.

Lorna C, (2019). College costs.Does a four-year degree still deliver value? Web.

Lyons, C. L. (2019). Suicide crisis.Suicide, 29(25). Web.

Presenting Plan

Joanne is a 45-year-old divorced woman with a history of mental illness who has tried suicide three times, which is an immediate crisis, including overdosing twice and attempting to sever her arms. She visits a psychiatrist once a month and is given treatment, but she does not take it as recommended. The client decided to stop by spontaneously to express appreciation and gratitude to her counselor. Joanne confesses to carrying a weapon in her car and merely wants to go for a drive after being questioned more. Furthermore, she does not exhibit a desire to agree to talk to her mental health professional, according to the facts of the situation.

Precipitating Event

Since Joanne has a history of mental health issues, multiple triggering factors expedite her current difficulty. She tried to commit suicide three times before, twice overdosing and attempting to slit her wrists. Joanne does not utilize her medicine constantly and has a high-stress job that requires her to work 60 to 70 hours per week. Her interests and social activities provide her with limited joy outside of her job. Moreover, she is divorced from her spouse after he admitted to being gay, and she has not tried to date ever since the breakup. Joanne confesses to committing adultery with her sisters partner for a year. Due to her remorse, she quit the relationship, but her spouse tends to seek her.

Risk Factors

Joanna is at an extremely increased risk of suicide due to a number of variables:

• Initially, she has a history of previous suicidal behaviors, which puts her at a significantly higher risk;
• Moreover, having the means and capacity to harm herself, in the form of a pistol in her car, places her in danger (Jackson-Cherry & Erford, 2018);
• Furthermore, she has a lengthy history of mental health problems and is now not taking her medicine as advised.
• Additionally, she is plagued with guilt due to her sisters infidelity with her spouse, particularly since she perceives her sister to be her greatest ally and a support factor.

Resources and Protective Factors

There are different material, personal, social, and community resources available to Joanne, used as aspects of protection. One mitigating factor that may reduce the likelihood of suicide is considered to be a positive therapeutic interaction. The notion that Joanne decided to express gratitude to her counselor might be interpreted as a sign of a healthy therapeutic process. Concerning material resources, she has a physician willing to listen to her concerns and provide the right antidepressant medicine. Her therapist is also someone she can confide in and discuss many of her ideas and difficulties with.

Another protective element is that he might be perceived as a support network for her  a personal resource. Joanne has an underage child from her previous relationship to whom she is responsible as a parent, it is a related challenge. Although it is demanding, Joannes employment appears to provide her with some life happiness. Another mitigating element that might aid Joanne is the significance she derives from her profession. As social and community resources, Joanne has access to a vital resource in the form of her community treatment center or suicide helpline.

Spirituality

While Joanne did not express any particular interest in religion or spirituality, it is important to question whether she is interested in or has the option of integrating it into her therapeutic process. Assessing the effect of religion and spirituality on crisis preparation and referral is critical (Jackson-Cherry & Erford, 2018). Religiousness is considered a key protective measure against suicide attempts in many forms (American Association of Christian Counselors, 2014). Through a holy place and a community, spirituality may provide a feeling of connection and togetherness, which should be incorporated into Joannes therapeutic plan to help her recovery (American Counseling Association, 2014). Joanne may find that linking to her inner basis helps her manage loneliness and anxiety.

Intervention

A suicide intervention known as a safety planning treatment can be observed to decrease suicidal symptoms and improve treatment involvement. In terms of immediate interventions for this patient, it is obligatory to emphasize the need to compromise privacy and restrict autonomy since Joanne possesses a weapon (Substance Abuse and Mental Health Services Administration, 2009). Her therapist should attempt to be with her until she is admitted to the hospital. Her practitioner will subsequently speak with his superintendent to determine the best course of action. Joanne requires multiple interventions over the following three months to constantly persuade her to take her medicine. Risk analysis and suitable follow-up measures should be implemented to ensure her safety throughout this period.

Treatment Plan

Problem 1: The initial presence of a background of chronic or recurrent anxiety and depression.

Goal 1: Joanne would practice with her therapist to create healthy habits and behaviors regarding herself and the environment via cognitive therapy to detect and avoid the return of her depressive symptoms (Kolski et al., 2014).

Objective 1: Joanne will take her prescription treatments constantly and continuously and maintain a daily medication log.

Intervention 1: Her counselor will analyze her medication record with her at each appointment.

Objective 2: Joanne will maintain her mental process and practice self-care regularly.

Intervention 1: Joanne will collaborate on cognitive-behavioral methodology techniques and tactics with her practitioner.

Problem 2: The presence of feelings of hopelessness and worthlessness and reduced interest in life activities.

Goal 1: Joanne will recognize suicidal or self-harming thoughts if they arise.

Objective 1: Joanne will build a support network and participate in one of her favorite hobbies or activities.

Intervention 1: Joanne will regularly find and communicate with helpful persons in her network.

Objective 2: As a self-care and despair minimization method, adhering to a regular exercise routine is obligatory.

Intervention 2: Joanne will investigate her passions and abilities to participate in various tasks and exercises.

References

American Association of Christian Counselors. (2014). AACC Code of Ethics. Web.

American Counseling Association. (2014). Code of ethics. Web.

Jackson-Cherry, L. R., & Erford, B. T. (2018). Crisis assessment, intervention, and prevention. Upper Saddle River, NJ: Pearson.

Kolski, T. D., Jongsma, A. E., & Myer, R. A. (2014). The crisis counseling and traumatic events treatment planner, with Dsm-5 updates. Hoboken: Wiley.

Substance Abuse and Mental Health Services Administration. (2009). Addressing suicidal thoughts and behaviors in substance abuse treatment. Quick Guide for Clinicians. Web.

The impact of the medias information about suicide on population behavior has repeatedly been the subject of various studies and discussions. One of the first evidence of an established connection between information in the media and the followed suicides was the publication in 1774 of Johann Wolfgang von Goethes novel The Sorrows of Young Werther (Yom-Tov & Fischer, 2017). The character of this writing committed suicide due to unhappy love, and soon after the story was released, many reports of suicides committed by young men in the same way appeared. Later, the name Werther effect began to be applied to imitative suicides, which spread widely due to media. Although there is the opinion that mass information negatively affects the depressive state and provokes suicide, a positive effect can be noticed.

Due to the advent of Internet technologies in our lives, the issue of increasing the number of suicides with the dissemination of information about them requires a new understanding. In the Internet space, everyone can be a producer of any content without being limited to editing filters or other restrictions. Such specific features suggest bullying, increased stress levels, and the possibility of depression for users. Moreover, the Internet is a convenient tool for influencing a persons psyche, and, like sects and cults, movements that provoke suicide can be created here.

However, media have not only the ability to provoke suicidal behavior but can also carry a powerful preventive effect. This effect can be fully realized, but it is necessary to create a clear science-based strategy to counteract the propaganda of suicide. For example, it is vital to inform media users about psychological assistance resources  a helpline, online consultation, and more. Moreover, it is crucial to support the activities of organizations that detect suicidal movements and are engaged in the prevention of suicide. However, according to Till et al. (2017), a method such as helping potential suicides via the Internet may be more effective than repressive methods of blocking dangerous sites.

Moreover, communication on social networks for many, on the contrary, becomes a kind of cure that eliminates feelings of melancholy and loneliness, which reduces the risks of depression and, therefore, suicidal outcome. Most people who commit suicide tentatively try to draw the attention of others to their problems and let them know about suicidal intent. Thus, many residents of the forums support those users who agree not to harm themselves and decide to seek psychological help. This phenomenon is called Papageno Effects  a decision on suicide can be influenced by how the media talk about this problem and its causes.

Thus, the media plays a dual role in the emotional state of people prone to depression and suicidal behavior. On the one hand, it can encourage a person to take his or her own life; on the other hand, it can provide psychological support. The period from the emergence of suicidal thoughts to the attempt to implement them is called presuicide: the individual is in an oppressed state, his or her gloomy thoughts increase, dissatisfaction with living conditions grows. This mood is a favorable ground for introducing and developing the oppressive state characteristic of the pre-suicidal period. During this period, the media can play an important role. According to Yom-Tov and Fischer (2017), there is very little time after people see a suicide message in the media and decide to take similar actions. For this reason, journalists need to soften such news, considering their specifics. Modern media can positively affect both society and the individual, reducing suicidal moods.

References

Till, B., Tran, U. S., Voracek, M., & Niederkrotenthaler, T. (2017). Beneficial and harmful effects of educative suicide prevention websites: randomised controlled trial exploring Papageno v. Werther effects. The British Journal of Psychiatry, 211(2), pp. 109-115.

Yom-Tov, E., & Fischer, S. H. (2017). The Werther Effect revisited: Measuring the effect of news items on user behavior. In Proceedings of the 26th International Conference on World Wide Web Companion, pp. 1561-1566.