Cyber-bullying: Cruel and not cool/MIdday November 29, 2013 MUMBAI Fatema Pittalwala

http://www.mid-day.com/news/2013/nov/291113-cyber-bullying-cruel-and-not-cool.htm

Cyber-bullying: Cruel and not cool/MIdday  November 29, 2013 MUMBAI Fatema Pittalwala

Cyber-bullying: Cruel and not cool

Bullies have always existed, and in the age of technology, their methods have only become more devious. As cases of online bullying grow, we get to grips with its causes and effects

November 29, 2013

MUMBAI

Fatema Pittalwala

Countless children and even adults have known the terror of being singled out and heckled, manhandled, even injured, by the schoolyard or neighbourhood bullies. While home was generally the safe refuge from this menace, it is no longer so. The digital age means that today’s bully can follow a child home, or anywhere there is an internet connection. It is the age of the cyber-bully, and it is a frightening one.

Illustration/Amit Bandre

No boundaries
According to psychiatrist Dr Parul Tank, people don’t realize that cyber-bullying is different from real-life bullying; the abuser is a faceless stalker, which makes it harder for some to handle. She says, “The emotional outcome of cyber-bullying is similar to that of real-life bullying. The difference is that there is no escape from cyber-bullying; it can happen 24 hours a day, 7 days a week.

Media professor Arpita Ghosh feels that validation from external sources is extremely important for individuals. Pic/Sameer Markande

And cyber-bullying messages can be posted anonymously and distributed to a very wide audience, in a matter of minutes. When you are bullied by someone during a face-to-face interaction, you can immediately understand the seriousness of the issue and react accordingly. Online bullying borders on cruelty. The victims in their most vulnerable stage are left to be judged by the world. Many times, deleting inappropriate messages and pictures after posting, and tracing the source, is very difficult.”

Consulting psychiatrist Dr Hozefa Bhinderwala comes across 4-5 bullying cases, every month

Need attention
Uday Vaidya, founder of Munee Consultants, an organization dealing with behaviour counselling, says, “Online bullying is a typical adolescent problem. With changing lifestyle trends among families and individuals, communication between individuals has also changed. Children are attracted to social networking sites because online, they receive the attention that they miss in real life.

NGO Aasra’s director Thomas Johnson says suicide is a result of multiple causes. Pic/Sameer Markande

Most of the time the attention is from the opposite sex and from a stranger. Today, a child constantly needs to be reminded that he/she is loved and cared for. Children are increasingly insecure. With their parents’ busy lifestyle, children may not always receive validation from their folks. Hence they look for affection from the second best thing available to them, ie, the internet.”

Dr Parul Tank urges parents to watch out for signs such as withdrawal among children. Pic/Sameer Markande

Visible changes
Dr Tank adds, “If a child is using the internet excessively, and quickly shuts the laptop or hides the screen when someone someone enters the room, he or she might be doing something you may not approve of. Emotional withdrawal, irregular sleep patterns and other behavioural changes are some signs that tell you there is something going on in a child’s life. Parents have to be sensitive towards such problems and they should make it a habit to listen to their children without immediately judging or interrupting them.”

Counselling consultant Uday Vaidya feels that cyber-bullying is a teenage issue

Agreeing with this, consulting psychiatrist Dr Hozefa Bhinderwala says, “When a child is bullied online, they usually feel alone and helpless. There are no bystanders to witness the bullying and when it is online, it is extremely personal and confidential, and sometimes people take drastic steps to deal with it. Many times, parents are ignorant about their child’s online life. We need to take serious steps to curb cyber-bullying and start being proactive.

Curriculum developer Reema Parekh wants schools to have online etiquette workshops. Pic/Nimesh Dave

Online etiquette should be a part of the school curriculum, as the digital age is here to stay. I have come across cases where bullying is not only done over internet websites, but also over mobile social networking apps, and I come across about five such cases every month. The platform for bullying is vast and not concentrated in any particular website. As there is a legal age for driving and drinking, there has to be a legal age for having accounts on the internet. Until the child is of age, they should share the account with their parents and there should be transparency between them.”

Numbers game
Media professor Arpita Ghosh says, “When it comes to online media, especially social networking sites, we don’t use them constructively. Today for individuals, validation from external sources is extremely important. Posting photos, counting the number of likes, checking and responding to comments are some of the things that give a high or low to any child. We feel that the online world is a safe medium to share our thoughts.

But we have to remember that we are hiding behind a computer screen and the same goes for the other person. I agree that schools have counsellors, but how interested are they, really, in a child’s problem? It is a must for schools and parents to be more attentive towards children’s online activities. I remember my nephew had a spat with his friend. He was so angry; he logged onto a popular social networking website, and included his fight in his status update.

Now, that status was there for a while, for all of his 300 or so friends to view, including the one he fought with. I don’t understand the need people feel to pour out their entire anger and frustration over the internet. Individuals need to be confident and they should not be insecure. The fear of rejection and being ridiculed is something kids, and at times even adults, can’t handle.”

Ghosh continues, “Being adventurous is one thing, but I don’t know why kids today, in spite of being well aware, are foolish enough to trust strangers online. A while ago, a girl befriended a boy and went to a Santacruz hotel, where she was found dead. It is sad to hear such news, but then again, why should you go with a stranger and believe that you could be safe? Kids are smart, but they need to be smarter.”

Multiple causes
Thomas Johnson, director of the NGO Aasra, a crisis intervention centre for the distressed and suicidal people, feels that one should understand today’s social situation before coming to any conclusion regarding the cause and effect of suicide cases. He says, “Today, children are dependent more on technology than on person-to-person interaction. If they have a problem, kids prefer talking about it through posts and tweets, rather than to their parents and friends in real life.

Hence, if anything negative is said about them on a social networking site or on a chat, they take it to heart, as this interaction holds a lot of value for them. When a child commits suicide, it cannot be ascribed to a particular incident or person. It could be a result of multiple things bothering a child. A child needs a strong support system, which should include the child’s parents, friends, family and anyone whom he/she could talk to. If a child is weak and unable to cope, they will take the plunge. Bullying is nothing but a form of aggression. Not only kids, but even adults today express their frustration online.”

Police awareness
Madhuri More, assistant police inspector at the cyber crime cell of the Mumbai Police, says, “When we are online, we rarely realize that we have logged onto the World Wide Web”, she says, with the emphasis on ‘world’. She continues, “Not only children and teenagers, but sometimes even adults act irresponsibly. Everything depends on a single click. We have had cases where people accept friend requests from strangers and then they complain about stalking and harassment.

I agree that all sections of the police don’t understand the gravity of cyber bullying or any cyber crimes. But the cyber investigation unit is trying their best to make sure that all police officers understand the complaint and register it accordingly. Sometimes, because of lack of awareness, they dismiss the complainant and say, ‘account delete kar do’ (delete your account). This should not happen and that is why we conduct week-long cyber crime awareness workshops for Mumbai police. Regardless of rank, department or anything else, all police personnel attend this workshop.”

Simple solutions
Reema Parekh, a school curriculum developer, says, “Bullying is something that you cannot completely put a stop to. But during teenage years, parents and children should try hard to have better communication and relationship. Children should be able to talk to their parents about things going on in their life, and parents should be able to detect the signs that tell them something is up with their child. Children are very much influenced by the media; hence their exposure to these things should be monitored.

Also there have to be stricter laws for bullying, and proper action needs to be taken against bullies. Social networking sites should have stricter rules regarding age requirements for having an account online. Schools should also educate their children about bullying and its effects. To understand the depths of cyber-bullying, awareness should be created among teachers, parents and children. It all begins at home and in school.”

Online safety tips
>> Never reveal personally-identifiable information online
>> Never share your password with other people (except for your parents)
>> Never arrange meetings with strangers
>> Don’t believe everything you read or see online
>> Don’t download files or software without your parents’ permission
>> Don’t respond to inappropriate messages or emails
>> Don’t post inappropriate content
>> Be wary of personal questions from strangers
>> Don’t be bullied into fights
>> Don’t use adult sites
>> Understand that what you put online will be there forever
>> Source: http://cybercellmumbai.gov.in

Recent case
On November 19, a 14-year-old girl committed suicide by hanging because she was harassed online by a 16-year-old boy. The minor took the drastic step after she was tormented and stalked by a boy who posted offensive material on her social networking account. A resident of Iraniwadi in Kandivli (W), the Std IX student and her father had approached the local police station with his daughter to lodge a complaint, fearing that the boy would harm her. The father alleged that the police had shown no interest in the matter, and they returned without a complaint being filed. 

Teen Barred From Facebook Kills Herself By Vibhuti Agarwal/ India real time/ Wall Street Journal

http://blogs.wsj.com/indiarealtime/2013/10/25/indian-teen-barred-from-facebook-kills-herself/


Thursday, December 5, 2013 10:28:37 GMT

INDIA

• October 25, 2013, 2:10 PM

Teen Barred From Facebook Kills Herself

• By Vibhuti Agarwal

Paul Sakuma/Associated Press

The suicide of a teenage girl in Mumbai after she was barred from FacebookFB +1.04% puts the spotlight on India’s teenage suicide trend.

The parents of a 17-year-old Indian girl who killed herself late Wednesday after they barred her from Facebook, have said that they are in deep shock at her death and simply wanted her to concentrate more on her studies.

Aishwarya S. Dahiwal, a second-year college student from Parbhani in the western Indian state of Maharashtra, had asked her parents’ consent to log on to Facebook Wednesday night, police investigating the case said.

An argument ensued during which Ms. Dahiwal was reproached by her parents for “paying less attention to her studies,” using social networking sites and making long phone calls to friends, G.H. Lemgude, the investigating police officer in Parbhani told India Real Time Friday.

Her body was found on Thursday morning. She had killed herself by hanging, the police said.

Ms. Dahiwal’s death has once again put the spotlight on the teenage suicide trend in Maharashtra, one of India’s most developed states.

A total of 16,112 people killed themselves in the state last year, placing it second in the list of Indian states with the highest suicide rate, according to the National Crime Records Bureau. Tamil Nadu was the state with the most, there were 16,927 suicides there in 2012, followed by West Bengal with 14,957 and Karnataka where 12,753 took their own lives.

According to information available on the NCRB website, family problems were thought to be the single largest factor driving people to end their lives.

In a note recovered from Ms. Dahiwal’s room after her death, according to police, the teenager wrote that her parents’ decision not to allow her to access Facebook had driven her to decide to take her own life.

Her father Sunil Dahiwal told India Real Time Friday: “We still can’t believe it. We are in deep shock.”

“We just wanted her to focus on her studies. We never thought she would ever take such a harsh step,” Mr. Dahiwal added.

A case of accidental death has been registered and investigation is underway, the police said.

Johnson Thomas, director of Aasra, a Mumbai-based helpline that works towards prevention of suicides, said the problems presently faced by young people range from peer and academic pressure to lack of communication with parents and broken relationships.

In June, a 25-year-old Bollywood actor Jiah Khan committed suicide after an alleged failed relationship.

In a separate incident, a teenager ended her life last month in Mumbai, she was experiencing depression after her mother’s death, local reports said.

“The fact that majority of suicides are by those between 15 and 35 years imposes a huge social, emotional and economic burden on society,” Mr. Johnson said.

He also blamed the breakdown of India’s traditional family system for people taking their own lives.

In big cities like Mumbai – where it is common for both parents to work – children tend to become isolated and spend too much time chatting with friends on cellphone and using social networking sites like Facebook, Twitter and others, according to Mr. Johnson.

A survey by Tata Consultancy Services in June showed nearly 92% India’s high school students prefer to go on Facebook than make phone calls to communicate.

Mr. Johnson argues there’s a simple solution. “Parents should take out more time to understand the needs of their children, communicate better a build a strong relationship with them. This will greatly alleviate the problem.”

Follow India Real Time on Twitter @WSJIndia

International Survivors of Suicide Day , November 23rd. , 2013

International Survivors of Suicide Day , November 23rd.

Every year, survivors of suicide loss gather together in locations around the world to feel a sense of community, to promote healing, and to grieve for their loved ones with those who have had similar experiences. Tomorrow is a day specifically for survivors to gather in a safe and healing space where everyone can comfortably participate in a way that is meaningful to them.

This year's International Survivors of Suicide Day helped to gather and comfort thousands of survivors of suicide loss around the world. Both the newly bereaved and those who are years out from their loss came together to remember and honor their loved ones and further build a community of survivors. We hope you were able to attend in person or experience the online broadcast and we thank those who worked so hard to make this year's events welcoming and healing.

"I turned to International Survivors of Suicide Day. I did so to find a way to give, to teach and to help others and myself heal, grow and venture forward. Getting involved and meeting those who have lived with the challenges and encountered some of the same experiences can forge new paths or help reopen some that had long since been abandoned."

Bill Zito, a Board Member at our Westchester chapter, lost his wife, Carol, a decorated police officer and investigator, in 2006. He writes about the twisted road of coping and grief he and his daughter have taken since their wife and mother died.

Inside the National Suicide Hotline:Preventing the Next Tragedy(Time Magazine/Josh Sanburn)

Mental Illness

Inside the National Suicide Hotline: Preventing the Next Tragedy

As U.S. suicide rates rise, experts are divided over which strategies save more lives

By Josh Sanburn @joshsanburnSept. 13, 201315 Comments

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Kevin Hines paced along the Golden Gate Bridge, trying to figure out whether to obey the voices in his head urging him to jump. Anyone paying the slightest attention to Hines should’ve seen that something was horribly wrong. Sure enough, after about a half-hour, a woman approached him. Hines thought she was there to save his life.

Instead, she was a tourist wanting Hines to take her picture. The look of desperation on his face apparently didn’t register. Elation crumpled into despair. “Nobody cares,” he thought. “Absolutely nobody cares.”

Hines soon hurdled a railing, stepped out onto a ledge 25 stories above San Francisco Bay and jumped. He immediately regretted it. Falling 75 miles an hour headfirst toward the water, Hines realized that if he was going to save himself, he had to hit feet first. So he threw his head back right before he plunged 80 feet into the cold waters, shattering two of his lower vertebrae. He eventually surfaced and was rescued by the Coast Guard. Only one out of 50 who jump survive.

Thirteen years removed from his attempt, Hines is now an author and lecturer, and doing quite well considering his experience. Hines frequently travels around the country talking about what happened on September 25, 2000. Diagnosed with bipolar disorder, he still has auditory and visual hallucinations as well as paranoid delusions. But today, he has a support network of family and friends that check up on him and identify early warning signs that could lead to Hines harming himself again. He logs his symptoms into an online document he shares with others so they can keep an eye on him. Hines says that’s what separates him from so many others who have suicidal thoughts.

“When you learn to be self-aware with mental illness, you can save your own life,” Hines says.

In May, the Centers for Disease Control released data showing that in 2010, 38,364 people weren’t able to save themselves. For the first time, the number of suicides surpassed deaths from motor vehicle accidents and most researchers believe that number is low, if anything, because many suicides go unreported. The suicide rate for Americans aged 35 to 64 rose 28.4 percent from 1999 to 2010. According to the CDC, $35 billion is lost due to medical bills and work loss costs related to suicide each year. And while suicide rates are not as high as they were in the early 1990s, they’ve climbed steadily upward since 2005.

As more Americans commit suicide, some in the field question the effectiveness of current prevention programs. Over the last 15 years, public policy and federal funding have shifted toward a broader mental wellness movement aimed at helping people deal with anxiety and depression that could eventually lead to suicidality. But that shift may have left those most at-risk of suicide, like Hines, without the support they need.

One program sits at the intersection of those two approaches. The National Suicide Prevention Lifeline, which expects 1.1 million to 1.2 million calls this year and receives about 15 percent more callers each year, is broadly marketed to the general public through billboards and ads that reach those suffering from anxiety, depression and loneliness but are often not actively suicidal. At the same time, it’s an emergency resource for those who are at immediate risk of killing themselves and who struggle with chronic mental illness. But some in the field question its effectiveness, along with the effectiveness of many other services and programs funded and promoted on a national scale. Those in the field often use the metaphor of a river to illustrate the divide: Is it worth getting to more people upstream or narrowly targeting those like Hines downstream?

At the Waterfall

The bridge phone inside New York City’s suicide prevention call center only rings about once a month. But when it does, often in the middle of the night, it emits distinct, deep chirps – as if the phone itself is in distress. The operators manning the 24/7 LifeNet hotline recognize the ring immediately. It means someone’s calling from one of the area’s 11 bridges, and they’re likely thinking about jumping.

LifeNet, a mental health and suicide prevention hotline servicing New York’s metropolitan area, is located in the H2H Connect Crisis Contact Center, which serves as one of 161 call centers that make up the National Suicide Prevention Lifeline network, headquartered in the same building. During its busiest hours from 9 a.m. to 7 p.m., the hotline has roughly 20 operators working the phones inside their unassuming L-shaped office space in lower Manhattan. The operators could easily be mistaken for a collection of telemarketers. The large computer screen at the head of the call center showing the number of lines being processed could easily reside inside QVC’s customer service center.

(MORE: Childhood Vaccination Rates Good, But Measles Cases Hit Record High)

You don’t get a sense of what truly happens in this room until you run across the bridge phone, which is a direct line to the call center. It’s LifeNet’s equivalent of the Oval Office’s mythical red phone. On the wall above it, black Ikea picture frames display detailed information for each bridge and the locations of its call boxes: “Northbound 3rd Avenue Exit,” “Westbound Light Pole 60.” If someone calls, they can use the caller ID, check the information above the phone and immediately locate the caller and send help.

If it were up to those who work at LifeNet, however, they would get rid of the bridge phone altogether. “What we want is to get people upstream,” says John Draper, director of the National Suicide Prevention Lifeline. “We don’t necessarily want to get people who are on the edge of the waterfall. If they are, we can help them. But it’s a huge cost savings for the entire mental health system if you can get people further upstream.”

Draper is the National Suicide Prevention Lifeline’s soft-spoken, goateed, pony-tailed director and a whole-hearted advocate for early treatment. Talk to him and you realize why he’s in this field, something, he says, chose him. Draper speaks calmly but with purpose. He looks you in the eye. He routinely uses your name in conversation.

In the 1980s, Draper was part of a mobile crisis team, a group of clinicians that goes into the homes of people who are psychiatrically ill but unable or unwilling to get help. He says he soon came to the realization that the country’s mental health system operated behind bricks and mortar, “where it waits for people.”

“It says, ‘Ok, you’re mentally ill?’ I’ll see you Tuesday at 9 a.m. Hope you can make it.’ The system is not set up for the convenience of the user,” he says. “And as a result, two-thirds of the people with mental health problems in this country never seek care. So here was this program that goes into people’s homes. I was like, man, this is the way it should be.”

A decade later, the Mental Health Association of New York City established a 24/7 crisis information and referral network and hired Draper. Several years later, the Substance Abuse and Mental Health Services Administration (SAMHSA), which is part of the U.S. Department of Health and Human Services and now funds the national lifeline with $3.7 million annually, assessed callers who had contacted crisis centers like New York’s and found that most of them felt less distressed emotionally and were less suicidal after the call. Draper calls it a groundbreaking finding.

LifeNet came into its own in 2001 when it became a central resource for those affected by the Sept. 11 terrorist attacks, which in New York City was just about everybody. People were reporting depression, anxiety and other traumatic responses in massive numbers. LifeNet’s call volume and staff doubled, and it’s never gone down. That time in the spotlight positioned the hotline to administer the national suicide prevention lifeline starting in 2004.

Today, Draper and his staff oversee a network of more than 160 independently operating call centers around the country. Call 1-800-273-TALK, and you’ll be routed to the call center closest to the phone number from which you’re calling. The staff helps develop risk assessment standards for operators around the country so they can consistently and quickly determine the seriousness of a situation over the phone.

Draper expects call volume to increase again this year. About 8 million adults in the U.S. are thinking seriously about suicide, but only 1.1 million actually attempt it. So when Draper sees the volume actually reaching that 1.1 million number, which he expects it to this year, he views it as a good thing.

“If your calls are increasing, does that mean more people are in distress?” he says. “That’s not necessarily true. It means more people may have been in distress all along but didn’t know this resource was there. So the more we promote awareness of this resource, once it gets out, then it stays out there.”

The problem for people like Draper is definitively determining whether suicide prevention efforts are working. The only way you ever know if you’re saving someone’s life is if they come out and say so, and that makes it difficult to truly gauge the effectiveness of the lifeline or any other prevention program or service.

“The lifeline is a valuable addition to our efforts,” says Dr. Lanny Berman, executive director of the American Association of Suicidology (AAS). “It’s indeed a resource for people in suicidal crisis to reach out immediately and get help. Whether it is effective in saving lives remains to be seen.”

But some of the available data seems to indicate that the lifeline is having a positive effect. Studies done by Columbia University’s Dr. Madelyn Gould have found that about 12 percent of suicidal callers reported in a follow-up interview that talking to someone at the lifeline prevented them from harming or killing themselves. Almost half followed through with a counselor’s referral to seek emergency services or contacted mental health services, and about 80 percent of suicidal callers say in follow-up interviews that the lifeline has had something to do with keeping them alive.

“I don’t know if we’ll ever have solid evidence for what saves lives other than people saying they saved my life,” says Draper. “It may be that the suicide rate could be higher if crisis lines weren’t in effect. I don’t know. All I can say is that what we’re hearing from callers is that this is having a real life-saving impact.”

LifeNet, downtown Manhattan, 10:15 a.m., Wednesday, June 5

Dely Santiago puts on her black Sennheiser headset and takes a look at the queue. Five callers waiting to speak with an operator. A dozen others on the line.

Like its hometown, New York City’s suicide prevention call center never sleeps, and Santiago is one of 50 employees that keeps it running day and night. Santiago, 29, has been working in the mental health field since she was 18, as a behavior modification specialist and a psychotherapist. She began working for LifeNet in 2009 as a crisis counselor and is now an operations manager, primarily tasked to supervise operators – but she still takes calls.

Santiago uses just one phone, but 14 separate hotlines feed into it. There’s the National Suicide Prevention Lifeline, of course, and LifeNet, New York City’s local mental health and substance abuse line. But there’s also Spanish LifeNet; Asian LifeNet; Project Hope (for victims of Hurricane Sandy); BRAVE (an anti-bullying line); a Disaster Distress Helpline; an NFL Lifeline (for those with football-related mental health issues). Many of the operators are trained to answer all of them.

This morning, Santiago’s first call is from OASAS Hopeline, the New York state hotline for substance abuse. While she never knows exactly who’s calling, she always knows which line is coming through. If a LifeNet call pops up on her caller ID, it’s often someone reaching out for basic information about clinics or resources in the area. That’s low stress. But if it’s the National Suicide Prevention Lifeline, she takes deep breaths before answering so she can stay calm. This one, the state’s addiction line, is somewhere in the middle.

On the line, Santiago runs through a series of questions to get a sense of the seriousness of the call. Her voice is soothing, lilting even, but firm.

“You obtained a DWI in which county?”

“Has alcohol been an ongoing issue for you?”

“Any thoughts of suicide or hurting anybody else?”

The operators routinely ask callers whether they have suicidal thoughts, even on non-suicide prevention calls, because there’s no way to tell whether a substance abuse call could quickly turn into a suicide call. You just have to ask. That way, you increase your chances of helping them upstream.

The queue doesn’t let up. Several people are on hold. More are talking to operators. Once a crisis counselor has finished a call, each one is logged in to a database with a report number and a brief description. They get three minutes to log it in and take a breath before the phone rings again.

“Hello, LifeNet,” Santiago says. “How may I help you?”

Casting a Wide Net

Many programs that receive federal funding, like the National Suicide Prevention Lifeline, are widely advertised nationwide, something DJ Jaffe thinks should be targeted instead to those most at risk.

Jaffe is the founder of Mental Illness Policy Org and got involved after his sister was diagnosed with schizophrenia in the mid-1980s. “A lot of suicide prevention campaigns are based on reaching out for help if you’re feeling depressed rather than calling if you’re truly suicidal,” he says. “That’s being funded with suicide dollars. Telling someone who’s feeling bad to reach out. Is that going to reduce suicide? Spending massive amounts of money marketing to the public via television shows, PSAs, billboards? It’s a giant waste of money because we know where we can focus it.”

AAS’s Berman is similarly critical of public awareness campaigns promoting services like the lifeline. “The general zeitgeist in the field is public education is good, and it’s better that people know about the problem and really know that prevention is possible,” he says. “But I don’t know that public awareness campaigns work for the people you most want to reach, the people who are already suicidal.”

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A 2009 study in the journal Psychiatric Services looked at 200 publications between 1987 and 2007 describing depression and suicide awareness programs targeted to the public and found that the programs “contributed to modest improvement in public knowledge of and attitudes toward depression or suicide,” but could not find that the campaigns actually helped increase care seeking or decrease suicidal behavior. A similar study in 2010 in the journal Crisis actually found that billboard ads had negative effects on adolescents, making them “less likely to endorse help-seeking strategies.”

According to the National Institutes of Mental Health, 90 percent of people who die by suicide in the U.S. suffer debilitating mental illness. Other risk factors include prior suicide attempts, a family history of mental disorders and violence in the home. If we know who’s most at risk, people like Jaffe and Berman argue, shouldn’t we target them in a smarter way? If a factory closes, for example, shouldn’t efforts be made to market suicide prevention services in that community?

SAMHSA is the government’s arm in the field of suicide prevention, and while mental health coverage has been expanded for tens of millions of Americans as part of the Affordable Care Act, SAMHSA’s funding requests for suicide prevention efforts have been decreasing. For fiscal year 2014, SAMHSA requested $50 million for its suicide prevention measures, $8 million less than in 2012. Funding for National Suicide Prevention Lifeline crisis centers to provide follow-up to suicidal callers and evaluate the lifeline’s effectiveness, also decreased by almost $1 million when compared to 2012. SAMSHA did however request a $2 million increase for the National Strategy for Suicide Prevention, which, among other things, would be used to develop and test nationwide awareness campaigns.

AAS’s Berman characterizes the national strategy as including both public and targeted approaches to prevention but is concerned that SAMHSA is too focused on “upstream” measures like increasing overall awareness.

“The bottom line is that the people most at risk are people who don’t get into treatment, and a public health approach shifts attention from high-risk patients to large populations of folks who might develop mental health problems,” he says.

However, Richard McKeon, SAMHSA’s acting chief of the Suicide Prevention Branch, says federal efforts have always had a significant focus on people most at-risk. “Much of our suicide portfolio focuses on those who are actively suicidal,” he says. McKeon cites efforts like the collaboration with the National Association of State Mental Health Programs directors, which produced a white paper for state mental health officials so they could better focus on people with serious mental disorders.

McKeon says that focus is evident in the National Strategy, which was revised last year and lays out a comprehensive approach to preventing suicide at the local level. He also cites the National Suicide Prevention Lifeline and says it deals not just with people who are depressed, but also with people every day who are at high risk of suicide, 25 percent of which are actively suicidal. But still, the behavioral health of the entire population is a priority for SAMSHA, McKeon says.

“Our suicide prevention efforts do take place within a broad public health context,” he says. “Ideally, we’d like to be able to prevent people from becoming suicidal in the first place.”

A program called the Good Behavior Game, which was awarded $11 million over five years by SAMHSA and is designed to identify early behavioral health problems is one initiative McKeon points to as having an impact on catching people upstream. It’s used in 22 economically disadvantaged school systems across the country and has been cited as effective by the Institute of Medicine. The Garrett Lee Smith Memorial Act is used to fund youth suicide prevention programs as well and has been described as successful at raising awareness by peer-reviewed journals like Suicide and Life-Threatening Behavior.

“A lot of the work we do is aimed at identifying youth who are at most serious risk right now,” he says. “We are dealing with a lot of high-risk situations among very vulnerable people, but there’s also solid scientific basis for early interventions.”

LifeNet, 11:14 a.m.

It took a little less than an hour for Santiago to get her first call on the National Suicide Prevention Lifeline, and it’s in Spanish.

The male caller has contacted the center six times since 7 a.m. He tells Santiago he’s depressed, anxious. He’s hearing things that aren’t there and can’t connect with his psychiatrist. He says he feels like he’s going to die. Actually, he says he already feels dead. This isn’t unusual. This is the kind of thing Santiago and the rest of the operators deal with every day.

Call center operators go through about 100 hours of training before they take their first solo call and are trained to use minimally invasive approaches. EMS is rarely called because it can be very traumatic. Sometimes callers will harm themselves while on the phone, but the operators are trained to know the signs of a real suicide attempt.

“There are people who will cut themselves to try and cope with pain,” says Gloria Jetter, a 29-year-old clinical supervisor. Some will truly attempt to take their own lives while on the phone, but this often shows the deep ambivalence of those who are suicidal. They want their pain to end, but part of them wants to live. That’s the part of them calling people like Jetter.

(MORE: How Cutting Physical Education in Schools Could Hurt Grades)

The caller that stands out for Jetter came about a year ago. A middle-aged male dialed the suicide prevention lifeline incredibly distraught. He felt like he was a burden on his family and thought everyone would be better off if he were dead. “He was drinking heavily,” she says. “And it turned out he was actually driving a truck, and he had called because he was just so horrified at his own thoughts, which was that he had a gun with him in the car and he was going to go shoot himself where someone wouldn’t find out.”

Jetter was able to talk the man into pulling his vehicle to the side of the road. He left the gun in the truck and walked toward a hospital as Jetter stayed on the phone with him for the mile-and-a-half walk. The man was just one of many older men she and her colleagues started hearing from as the recession hit.

A Midlife Crisis

The most stunning statistics to come from the CDC report released in May concern the shockingly high suicide rates for older males. The rates for men aged 50 to 59 increased by almost 50 percent from 1999 to 2010, and LifeNet’s crisis counselors began observing a change in their callers when Wall Street crashed and the Great Recession began to take hold.

While rates went up in cities across the country, it hit rural areas even harder. Wyoming has the highest rates of any state. Park County, home to Yellowstone National Park, had 12 suicides per 30,000 people in 2012. Compare that with the national average, which is closer to 12 suicides per 100,000 people. The woman in charge of coordinating the state’s efforts to prevent suicide is Terresa Humphries-Wadsworth, who has been trying to bring the rate down by targeting those most at-risk.

“In Wyoming, we have a tough-it-out kind of mentality,” she says. “Locally, they call it ‘Cowboy Up’ – being very independent, solving problems for yourself.”

Rural areas have historically had higher suicide rates than urban areas, and most experts believe it’s a combination of several things: higher gun ownership per capita, more isolation from friends, family and suicide prevention resources, and a by-the-boot-straps culture. In the suicide prevention field, Wyoming is a perfect storm.

To start, the state is fourth in gun ownership rates. Keeping guns out of the hands of those with mental illness became a topic in gun control debates across the country after the shooting at Sandy Hook Elementary School in Newtown, Conn., largely focused around the problem of homicide. But gun suicide is actually a bigger problem than gun homicide. According to a report by the Institute of Medicine and the National Research Council, gun suicide accounted for 61 percent of the 335,600 people who died from firearm-related violence between 2000 and 2010.

Besides Alaska, Wyoming also has the lowest population density in the U.S. and only one call center networked to the national lifeline. To counteract the state’s macho culture of self-sufficiency, which often prevents men from seeking help, Wyoming’s mental health officials decided to go looking for them. Last year, the Wyoming Department of Health began reaching out to men who had attempted suicide to better understand why they did what they did and found 10 middle-aged men willing to speak candidly one-on-one.

Wyoming Department of Health

One of several posters created by the Wyoming Department of Health aimed at middle-aged men at risk of suicide. Wyoming has more suicides per capita than any U.S. state.

“When we sat with them, we said, ‘Tell us your story, and go way back,’” says Rich Lindsey, a technical consultant hired to work on Wyoming’s suicide prevention campaign. “We discovered that if you’re going to effectively get to them, you need to go upstream in their life, at a point where things are going wrong but they’re not yet thinking about suicide.”

Lindsey discovered that trying to target a campaign to someone who was already thinking about suicide was more likely to fail because that person was already shutting themselves off from the world around them. The chances of reaching them at that point were slim.

So the state took that information and developed an awareness campaign consisting of local TV ads, billboards and posters featuring an older, rugged man with bushy eyebrows, lonely eyes and phrases like “We feel ya, brother,” “It’s tough out here,” and “Get out of hell,” as well as a unique phone number so they could track the response rate.

The one-county, $50,000 pilot program elicited 10 calls from February to June. Lindsey says it’s too early to says the campaign is a “win,” but it’s been effective enough that the program will be expanded to two more counties. For those who advocate upstream approaches, the Wyoming experiment may be viewed as a model. But for others, $50,000 on a public awareness campaign and a mere handful of calls may not seem worth it.

LifeNet, 11:25 a.m.

Santiago is logging in her previous caller, the man who had called six times that morning. She says he wasn’t actively suicidal and told her that talking to the call center’s crisis counselors helped him make it through the day. But she thought if he called back a seventh time, she would explore getting him to an emergency room.

“What are the chances he’s calling back?” I ask.

“Oh, he’s calling back,” Santiago says. By the end of the day, Santiago will have answered 20 to 25 calls from any one of the 14 different hotlines.

You may think that a suicide prevention office would be a dreadful place to work, but it’s really just like any other around the country: idle chatter near the water cooler, lunch breaks with co-workers, cinnamon rolls in the break room. It’s just that from this room, lives are being profoundly affected every day. And even though the exact number of people who have truly been helped will never be known, the lifeline has very strong advocates, including Kevin Hines.

Hines’ story is not merely dramatic; it’s a test case in how the mental health system broke down. There are essentially three main ways to prevent suicide: treatment; means prevention; and access to prevention resources. At the time, Hines wasn’t properly being treated for bipolar disorder; the Golden Gate Bridge has no physical barriers to prevent suicide attempts; and as for the bridge’s suicide prevention call box, Hines didn’t know it was there.

“Had I known, I’m sure I would’ve called,” he says, “because I desperately wanted to talk to somebody.”

Back in New York City’s suicide prevention call center, I ask Draper if it’s difficult to come in to work each day, to motivate his employees to take another call and assure them that what they’re all doing is actually working.

“When I tell people what I do, they say, ‘Oh, Draper, that must be really depressing,’” he says. “And I say, man, I’m in the suicide prevention business, not the suicide business. What I see every day and what our crisis center staff hears every day is hope. And they know that they’re a part of that.”

He says it’s important to remember that 1.1 million adults are attempting suicide every year, but 38,000 are actually dying by suicide.

“What that is telling us is that by and large, the overwhelming majority of suicides are being prevented,” he says. “And those stories are not being told.”

Correction: A previous version of this story stated that in fiscal year 2014 SAMHSA requested $8 million less for suicide prevention measures than in 2013. The department requested $8 million less compared to fiscal year 2012.

Josh Sanburn @joshsanburn

Josh Sanburn is a Time.com writer.
Read more: Suicide: Do Public Mental Health Campaigns Work? | TIME.com http://healthland.time.com/2013/09/13/inside-the-national-suicide-hotline-counselors-work-to-prevent-the-next-casualty/#ixzz2maUVecj4

International Volunteers Day( 5th December 2013): Theme for 2013: YOUNG.GLOBAL.ACTIVE

International Volunteers Day( 5th December 2013): Theme for 2013: YOUNG.GLOBAL.ACTIVE
Aasra takes this opportunity to appreciate and thank all it's volunteers (past and present) for the wonderful work they have been doing in the service of the depressed and the suicidal
                                              
International Volunteer Day (IVD) offers an opportunity for volunteer organizations and individual volunteers to make visible their contributions - at local, national and international levels - to the achievement of the Millennium Development Goals (MDGs).

For IVD 2013 we celebrate globally that young people act as the agents of change in their communities. On 5 December, 2013 join us in recognizing all volunteers' commitment and applaud hundreds of millions of people who volunteer to make the world a better place.

IVD 2013 is a global celebration of young people acting as the agents of change in their communities.

Volunteer your time and efforts for a social cause, Contact Aasra - helps in suicide prevention www.aasra.info

December 1st- World Aids Day

December 1 is World AIDS Day. The theme is Getting to Zero: Zero Discrimination, Zero New Infections and Zero AIDS-related deaths.

2.4 million people are HIV positive in India
India has reduced new HIV infections by 57% since 2001
Not enough ART – anti-retroviral therapy: Less than 10% people getting drugs
Drug addicts, men who have sex with men (MSM) and female sex workers are the high risk groups
Still need to fight the stigma

The biggest challenge in India after the lack of drugs is the stigma attached to the ailment.

FIGHT THE STIGMA , UNDERSTAND THE PROBLEM , TAKE THE NECESSARY PRECAUTIONS, CARE FOR THE AFFLICTED WITHOUT PREJUDICE