SAN DIEGO —Depression; suicide. Just breaching a conversation on these topics can bring uneasiness.
“Unfortunately, people are kind of scared to bring up the topic,” said Ruth Kenzelmann, Ph.D executive director OptumHealth San Diego, a health management provider, working in collaboration with San Diego County, and also operates a county-wide access and crisis line.
“There is still some stigma attached to any kind of mental health issue,” Kenzelmann said. “That does stop people from reaching out, because they don’t want to look crazy, they don’t want to sound crazy.”
OptumHealth, partnering with the County of San Diego Health and Human Services Agency, began offering a training program Q.P.R. (Question, Persuade, Refer) in November for non-professionals in the community to learn about suicide prevention, and in part to get people comfortable talking about suicide.
The training, which has been ongoing throughout the county, is easy in concept, but difficult to do, Kenzelmann explained.
“Easy in concept in the sense of being free to talk about suicide, so if you have a concern with a loved one to say, ‘I’m worried about you.’ ‘Are you having suicidal thoughts?’ So those opening questions can save a life,” she said.
“One in four people in the United States has a mental health issue, and most Californians do recognize that mental health is a serious issue…so some of that stigma is starting to be reduced, but we still have a long ways to go,” Kenzelmann said.
The word “stigma,” since its original Latin meaning to mark by branding, has come to refer to a mark of disgrace associated with a particular circumstance, quality, or person.
“This is something like diabetes, something like you break your leg,” said Kenzelmann. “There’s no shame in asking for help, or asking someone if they need help. That’s OK to do. And actually reaching out to get help is very courageous in the sense of knowing ‘OK, I need some help, I just need someone to help me pull through this,’” Kenzelmann said.
A lot of the calls they’ve been receiving on the crisis line within the last three years, are people despondent about the economic environment, or people who have lost their jobs, Kenzelmann explained.
“Depression is usually diagnosed with several different symptoms,” Kenzelmann said. “The most obvious is the depressed mood; there might be some lethargy…they may have enjoyed tennis and skiing, they may not be enjoying those things and actually stopping those things.
“Irritability can be a sign of depression. A lot of times for men and, actually, young children…there’s a lot of different types of depressive symptomatology,” she added.
“There’s not a test you can take, (like) a blood test and ‘Oh yeah, you’re depressed,’ or any kind of psych test, because it’s such a complicated issue and depressive symptoms can be part of a medical condition.
“If folks are hesitant to get help, that any kind of mental health issue, certainly depression as well, (it) can lead to some physical symptoms, can lead to family problems, can lead to work problems; obviously, one of the most serious side-effects is suicidal thoughts and acting upon those thoughts, so it can certainly escalate to some horrible things,” she said.
“Research has shown that treatment of depression as well as any mental health issue is there’s a high-rate of success. And with depression, that both medication and psychotherapy, there’s a very good chance that there’s going to be recovery to that.”
“Suicide is 100 percent preventable,” Kenzelmann said. “People can recover from having those thoughts; people can recover from depression and people can recover from any mental health issue. And recovery, I mean, live a normal life. They may still have some mental health issue, but they can recover and continue on living a health life.”
The San Diego access and crisis line is available 24 hours a day, seven days a week and may be reached by calling (800) 479-3339.
The help line is available in multiple languages to all residents of San Diego County. For information on Q.P.R. visit, sdchip.org/suicide-prevention-training.aspx.