Knowing what to do when dealing with a family member or someone else considering suicide can be overwhelming for anyone involved. Unfortunately, this issue doesn’t seem to be going away anytime soon. Recent data from the Centers for Disease Control and Prevention (CDC) shows a continued increase in suicide rates over the last 18 years.

That’s why organizations like the Suicide Prevention Resource Center are constantly searching for solutions aimed at preventing people from dying by suicide. One of the latest approaches includes talking about “lethal means counseling,” or safety in a health care setting.

What is lethal means counseling?

Elly Stout, director of the Education Development Center for the Suicide Prevention Center, recently wrote about the importance of reducing the lethal means in health care settings as an effective suicide prevention method.

Lethal means are anything commonly used by someone to end their life, such as medications or guns. Stout wrote that there’s “significant evidence of effectiveness” when it comes to “lethal means counseling in health and behavioral health care settings.”

“It’s up to all of us to promote these conversations as a critical part of safer suicide care around the country,” Stout wrote.

In addition, lethal means counseling should be a “key part of safety planning, which is a collaborative process between patients or clients and clinicians to create a written list of coping strategies and supports to use when suicidal thoughts arise,” Stout wrote.

What is an effective safety plan?

Along with removing lethal means from someone seeking help for suicide prevention, many health care workers and clinicians who deal with such issues believe that creating a safety plan can be an effective tool for someone at risk of suicide.

The Suicide Prevention Resource Center created a video outlining the importance of creating a collaborative safety plan. Such a plan should “identify specific behaviors, actions, and situations that help them stay safe,” according to the center’s website.

“It needs to be clear to the patient that this is something that’s being done collaboratively with them,” Vince Watts, MD, MPH, director, VA Interprofessional Fellowship in Patient Safety, VA National Center for Patient Safety, said in the video. “It’s really them identifying things that help them and then the staff trying to write those down, maybe give hints from their prior experience with other patients. But the patient safety plan is not something the staff would come up with. It’s something that the patient comes up with.”

Health care facilities need to take suicide prevention seriously

Attorney Skip Simpson has seen over and over again what happens when medical facilities do not take proactive steps to prevent deaths by suicide. When patients come to a hospital, the first priority should be to make sure they are in a safe environment. Removing lethal means is a critical step in that direction.

Seeking help for suicide prevention is difficult enough. The least hospitals can do for patients who do so is to remove risks from their environment.

You may have seen him on Saturday Night Live, cracking jokes and sporting a jokers’ grin. You may have heard of him in the tabloids after a highly public split with pop sensation Ariana Grande. And, if you are familiar with the trademarks of borderline personality disorder, you aren’t surprised by the whirlwind romance that came to an abrupt end.

Pete Davidson has taken the internet’s attention once again after the end of the relationship, but this time with a series of words on Instagram that brought out just how deadly the disorder can be.

“I really don’t want to be on this earth anymore.
I’m doing my best to stay here for you but I actually don’t know how much longer I can last.
All I’ve ever tried to do was help people.
Just remember I told you so.”

Ending the message with a heart emoji and deleting his Instagram, the celebrity drew concern from all corners of the globe. Some blamed Ariana, his recent ex (who herself just lost a former boyfriend to drugs) as if women are rehabilitation centers for troubled men, and as if her decision to leave a relationship was worth blaming another death on. Pete Davidson was accounted for, unharmed. And he was speaking up. Approximately 5.9% of adults in the US has BPD, according to NAMI. It’s time we learned about it.

What is Borderline Personality Disorder?

Profoundly misunderstood by the healthcare community, BPD is not an abbreviation for bipolar disorder, which is a severe disorder mostly affecting moods, but is a personality disorder that can change someone’s very worldview. Often described as unpredictable (and also often co-morbid in those with bipolar disorder) this disorder takes life away from sufferers. They view things in extremes, their hobbies and interests can flip at a moment’s notice, and their lives are a rollercoaster of unstable relationships.

How they view themselves and others is a constantly changing, never settling process.

Thought to stem from childhood abandonment, abuse, unstable relationships or other adversity such as poverty or an unstable home, BPD is deadly and acts quickly. Symptoms may include:

• Chronic feelings of emptiness
• Inappropriate, intense anger
• Difficulty forming bonds and trusting
• Self-harming behavior such as cutting, picking, or substance abuse
• Recurrent suicidal thoughts or threats
• Dissociative feelings, feeling cut off from reality
• Sudden, severe mood swings
• Sudden, fast moving relationships that end just as quickly
• Pushing people away intentionally, only to cling to them

People with BPD are often vilified. Seen as abusive, uncontrollable and people to stay away from, Pete Davidson has done the community a sincere service by addressing his illness. He’s spoken about his time in rehab, in which he thought that drugs induced moments of blind rage and breakdowns which impaired his memory. After first receiving a diagnosis for bipolar disorder, and another mental breakdown, he was properly diagnosed with borderline personality disorder.

How different are bipolar disorder and BPD?

Pete had been tweeting his support for Kanye West in speaking about his mental health, which had been a hot topic as the celebrity stumbled through the political sphere and often seemed like a puppet to some. His internet presence made very little sense. His grandiose behavior and recent history with extreme debt seemed like red flags to some, but humor for others. Kanye spoke up finally about his history with a bipolar diagnosis, making a dent in the stigma against mental illness (especially for men, and men of color) and it had given Pete the courage to talk about his own struggles.

Bipolar Disorder and BPD can be housed in the same brain, creating what must only be a truly painful daily experience for a sufferer, but their key differences are:

• Shorter, more frequent mood swings for BPD-a bipolar person can be hypomanic or manic or exhibit depression symptoms for weeks to months, BPD exists on a constant swing
• BPD produces more feelings that have the sufferer question who they are, and a fear of abandonment. This severely affects familial bonds, close friendships and relationships
• Borderline is a personality disorder, affecting some parts of the brain separate from a mood disorder like bipolar. Recovery and maintenance can be different.
• Fear of abandonment and unstable personal relationships are more unique to BPD as a symptom, whereas bipolar patients can have them as a product of their disorder.

Suicidal Ideation and Passive Suicidal Thoughts

Many people with various mental health conditions exist in a permanent state of wanting death. This can take the form of an ideation, almost like a yearning daydream, or a reoccurring thought that the sufferer simply wants life to end. This may not be accompanied by a plan or action, or even self-harm, but as a welcome intrusive thought that has made itself home among day to day activities.

Imagine every waking moment gagged by wanting life to end. Every anniversary dinner, every birth of a child, every morning coffee is dull and flat because you are alive and hate every moment of it. This is merely another symptom of BPD that is incredibly hard to control, as it can occur in any mood. Living in the public light has given Pete Davidson the opportunity to do several things that put a dent into the stigma around mental illness: ask for help, voice his feelings, and freely share his diagnosis while lifting up another performer.

Finding Hope

Though Ariana Grande begged fans to “be gentle” with her ex after he cited online bullying as a trigger for his disorder, Davidson has been publicly struggling. Ironically, that publicity has reached thousands diagnosed with the disorder, thousands more wondering if they’ll soon join statistics. Men especially are not encouraged to show mental “weakness” and too often live in a culture that would rather see them dead than in therapy.

Pete Davidson, Kanye West and many others are challenging that. Davidson himself wrote:

“I’ve spoken about BPD and being suicidal publicly only in hopes that it will help bring awareness and help kids like myself who don’t want to be on this earth…to all those holding me down and seeing this for what it is – I see you and I love you.”

Currently, the go-to therapy method for addressing BPD is DBT-dialectical behavioral therapy. Unlike CBT or cognitive behavioral therapy, which helps people identify  and change core beliefs and behaviors, DBT is skills-based.  Learning how to cope, and learning how to live, are two things that some patients may need to learn.

Offering a message of hope from such a large platform to anyone struggling with their mental health or suicidal thoughts is something that an entire massive online audience needed to hear. Thank you, Pete Davidson for your humor, entertainment, and helping your brothers and sisters of the world in a way only you could do. Don’t go anywhere; we desperately need you.  You are giving folks hope where there was none, and left us laughing too. What a gift to us.