“Sometimes things just don’t add up,” said Stewart Uzzell, operations manager for the ambulance service at Saline Memorial Hospital. “Most people who have attempted to hurt themselves will openly admit it and announce that they were trying to commit suicide. Others will say they did not intend to injure themselves or will hold back some information. You don’t want to leave them with a chance to try it again.”
According to information supplied by Saline Memorial Hospital in Benton, in the first five months of 2014, the hospital’s ambulance service answered 147 mental-health emergency calls reporting suicidal thoughts, intentions or attempts.
“That was 147 calls in 151 days,” said Rebecca Jones, communications director of the hospital, who gathered the information.
Jim Gregory, CEO of the Counseling Clinic of Benton, where personnel provides services for Saline Memorial’s behavioral-health department, said more than 700 people are screened for mental-health concerns by the counselors who work with the hospital.
“That’s almost two a day. Out of those, about 55 to 60 percent are hospitalized,” Gregory said. “We admit about one a day that we think are serious enough not to be allowed to go home. After screening, the others are considered safe enough for release.”
These numbers are not unique to Saline County. According to the National Alliance on Mental Illness, suicide is the third leading cause of death for people ages 15-24, and more than 90 percent of those had one or more mental disorders.
The Centers for Disease Control and Prevention collects data about mortality in the U.S., including deaths by suicide. In 2011 (the most recent year for which data are available), 39,518 suicides were reported, making suicide the 10th leading cause of death for Americans. In that year, someone in the country died by suicide every 13.3 minutes.
The Counseling Clinic maintains a help line with counselors during the clinic’s business hours. They take calls from individuals, along with calls from the hospital’s emergency department, the Saline County Jail and police departments in the community. Counselors and social workers talk the callers through a screening process.
After-hours calls to the clinic are routed to an answering service that takes the name and number of the caller, and Gregory said a counselor will call back within 15 minutes.
He said most of the callers to the help line will call before they make any attempt to harm themselves.
“We don’t track all the numbers, but most do not attempt suicide,” Gregory said. “They have had thoughts of it, and it scared them. They call us or they tell a friend, and the friend will get us in touch with the person.”
Gregory said the screening is complex, but there is a line when it comes to evaluating thoughts of suicide.
“Someone can say, ‘I’m tired, and I wish I were dead,’” said Gregory, who is a licensed independent social worker with a master’s degree in counseling. “Then again, if they say, ‘I’m thinking of killing myself, and there is a gun in the closet,’ that’s different, and you take action. That is someone who has a plan.”
Suicide attempts can be measured as serious attempts to die, a cry for help or an act being staged for attention.
Dr. Duong Nguyen, a psychiatrist who sees patients at Saline Memorial, said any attempt is dangerous.
“Almost anyone determined to die by suicide gets a gun,” he said. “Some take an overdose of pills, and it might be a desperate cry for help, but they end up dying accidentally. Both are tragic.”
That is why friends, first responders, emergency-department doctors and nurses, and the counselors screening people over the phone don’t take chances.
“Most any thought about suicide is serious,” Gregory said. “We have to take it that way until the person is seen and evaluated, and we know something different. You have to judge the risk factor. You don’t want someone going home and doing something two days later.”
In February, Saline Memorial Hospital expanded its behavioral-health department by 10 beds and underwent a major reconstruction. With the addition of the new beds and space, the department was divided into two separate units — one dedicated to treating adults (ages 18-55) and one dedicated to treating geriatric patients.
“SMH Behavioral Health serves patients throughout Arkansas, and expanding our beds will allow both units to see more patients locally,” said Bob Trautman, CEO of Saline Memorial. “We were at a point where we were turning patients away, which isn’t something we like to do.”
Gregory said the new adult unit is big enough for now.
“The unit pretty much stays full, and we still have to send some to other hospitals,” he said. “We are doing it far less, and it is important for these patients to be treated near their homes.”
The average patient will spend six or seven days in the inpatient psychiatric department, located on the sixth floor of the hospital, Gregory said.
“Aftercare is important,” he said. “We make an appointment for the patients to get them into a treatment center or see a doctor within a few days. Unfortunately, some don’t show up.”
Nguyen said some people who have attempted or contemplated suicide don’t want to talk about it with counselors. Others might have financial problems or a lack of insurance that keeps them away from aftercare services.
Gregory said mental-health professions will be seeing those patients again.
“Attempting suicide is an acute response,” Gregory said. “After they have been in the hospital, they feel they don’t need any more help. They won’t be doing that again. Until the next crisis.
“It is like a revolving door. They will be showing up at the ER, but they won’t take the outpatient help they need.”
The Counseling Clinic’s personnel and the doctors and nurses of Saline Memorial work together in hopes that the patients do not return as an emergency.
“Our goal is to address the mental-health condition of our patients, treat it, and provide support and education in hopes of helping them get back to living a normal life,” said Neeley Phillips, Saline Memorial’s behavioral-health program manager.
Common reasons for admission to the Adult Psychiatric Unit, along with suicidal thoughts or attempts, include excessive aggression, depression, substance abuse, anxiety or panic disorders, self-neglect, self-harm, obsessive-compulsive symptoms, or delusions or hallucinations, Phillips said.
Along with the adult unit, the hospital behavioral-health program includes a geriatric unit that provides inpatient services to adults age 55 and older with acute psychiatric and behavioral-health issues.
“There are many psychiatric illnesses that may impact a senior’s life, such as depression, bipolar disorder and complications from Alzheimer’s or dementia,” Phillips said. “Treatment and programming are specific to the geriatric population.”
For more information about the Saline Memorial Behavioral Health Department, call (501) 776-6600.
To contact the Counseling Clinic of Benton’s 24-hour help line, call (501) 315-4224.
Staff writer Wayne Bryan can be reached at (501) 244-4460 or wbryan@arkansasonline.com.