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By Jerome Friedman
news@barnstablepatnot.com
The recent suicide death of an
18-year old son of a National Foot-
ball League head coach has once
again put suicide in the headlines
and on the news. The tragic death
of this young man, combined with
the fact that many media stories
focus on increased suicide at-
tempts during the holiday season,
makes this an appropriate time to
look at the facts about suicide and
the help that is available.
Suicide isa serious public health
problem that devastates individu-
als, families, and communities.
However, completed suicides are
only part of the problem. Many
more people are hospitalized or
treated and released as a result of
suicide attempts than are fatally
injured. Suicide is a very com-
plicated issue that results from
complex interactions between
biological , psychological, social,
and environmental factors.
Even today,however, victims are
blamed and surviving friends and
family members are stigmatized.
Consequently, suicide is shrouded
in secrecy. This limits the amount
of available information that
is crucial to suicide prevention
activities. The purpose of this
article is to provide some useful
information including a quick
overview on facts about suicide
and some resources on suicide
prevention and education.
The facts on suicide
Suicide takes the lives of ap-
proximately 30,000 U.S. citizens
each year, according to data from
the Centers for Disease Control.
More people die each year from
suicide than from homicide. In
addition, asrecently as 2002, more
than 132,000 individuals were
hospitalized following suicide
attempts.
Broken down by gender, suicide
isthe eighth leading cause of death
for all U.S. men and males are four
times more likely than females to
die from suicide. However,women,
according to CDC statistics, re-
port attempting suicide during
their lifetime about three times
as often as men.
Groups at high risk
Broken down even further, it
is clear that two of the groups
at highest risk are youth and the
elderly.
Many adolescents and young
adults experience stress, confu-
sion and depression from situa-
tions that occur in their families,
schools and communities. Often,
these feelings and emotions can
overwhelm young people and lead
them to the point where they see
suicide as their only option.
Consider these facts on youth
suicide:
Overall, suicide is the eleventh
leading cause of death for all
Americans, but isthe third leading
cause of death for young people
ages 15 to 24.
Almost 4,000 people in this
age group committed suicide as
recently as 2001.
In 2001, firearms were used in
54 percent of youth suicides.
More teenagers and young
adults die from suicide than from
cancer, heart disease,AIDS, birth
defects, stroke and chronic lung
disease combined.
Although suicide among young
children is a rare event , from
1980 to 1997, the rate of suicide
among persons aged 10to 14years
increased by 109 percent.
In terms of the elderly popula-
tion, many elderly suicide victims
have been diagnosed with mild
to moderate depression. Older
adults who are suicidal are more
likely to be suffering from physi-
cal illnesses and be divorced or
widowed.
Consider these facts on elderly
suicide:
Suicide rates increase with age
and are highest amongAmericans
ages 65 years and older.
In 2001, 5,393 Americans over
age 65 committed suicide, accord-
ing to the CDC.
From 1980 to 1998, the largest
relative increases in suicide rates
occurred among those 80 to 84
years of age.
Suicide rates among the elderly
are highest for those who are
divorced or widowed.
Firearmsare the most common
method of suicide by both males
and females, 65 years and older.
Suicide prevention
Research has also shown that
many suicides are preventable;
however, effective suicide preven-
tion programs require commit-
ment and resources. Some key
elements of suicide prevention
include:
Effective, easily accessible clini-
cal care for mental, physical and
substance abuse disorders
Improving education for nurses,
physician assistants, physicians,
social workers, psychologists and
other counselors
Providing training for clergy,
teachers and other educational
staff , correctional workers and
attorneys on how to identify
and respond to persons at risk
for suicide
Providing educationalprograms
for family members of persons at
elevated risk
Providing family and commu-
nity support for people with risk
factors
Focusing on cultural and re-
ligious beliefs that discourage
suicide and support self-preserva-
tion instincts
Jerome Friedman,LICSW, is a Program
Manager at Behavioral Health Services of
Cape Cod Healthcare. He oversees the Psy-
chiatric Assessment Team and the Psychiatric
Urgent Care service at Cape Cod Hospital.
He received his MSW degree from Smith
College School of Social Work,and a BA
degree in Psychology from Boston University.
Mr. Friedman has 25 years of experience in
the treatment of psychiatric illnesses and
addictive disorders, and in the management
of systems that care for patients. In addition,
Mr. Friedman supervises the Outpatient Sub-
stance Abuse Service for Cape Cod Human
Services,an affiliate of Cape Cod Healthcare.
His office is at 27 Park Street, Hyannis,
and he can be reached a 508-862-5690 or
jfriedman@capecodhealth.org.
Awareness, education key in preventing suicide
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Choices for successful tattoo removal
By Kathy Manwaring
news@barnstablepatriot.com
Sean Connery has one. Ben Af-
fleck has two. It's a safe bet that
you or at least a friend may have
one, if not more. Some may be
cherished, bearing a meaningful
image or symbol. Some may be
unpleasant reminders of people
or events from times past , as
Angelina Jolie discovered upon
divorcing the man whose name
she had etched into her arm.
Tattoos have become one of
the most popular forms of body
adornment in the world today.
Inspired by ancient tribal rituals,
many of today 'stattoos have risen
to the level of fine art.
Some , however , are simply
unattractive , causing the bearer
embarrassment. Such tattoos are
often the result of spur-of-the-
moment impulses or not done by
trained professionals. What is left
is a less-than-lovely illustration
permanently printed beneath
the skin.
As getting tattooed has in-
creased inpopularity,sohastattoo
removal. In the past , methods
involving microdermabrasion
and plastic surgery were used
to remove an unwanted tattoo.
Not only were these ineffective at
removing all of a tattoo but they
often left unsightly scars.
Advances in technology have
led to safer, more effective tattoo
removal through the use of lasers.
Dr.Nicholas Vandemoerofthe Cos-
metic Surgery Center in Hyannis
advocates laser tattoo removal as
he feels it is a safer, more effective
means of tattoo removal.
"Tattoos in general tend to fade
over time because the body tends
to react to the ink," explained
Vandemoer. "We use the body's
ability to take over that foreign
matter."
In laser tattoo removal, any one
of three different lasers may be
used to remove ink. Dr.Vandemo-
er'soffice utilizes the Alexandrite
laser, which works well on yellow,
red and green inks, and the YAG
laser on darker colors, such as
black and blue.
"We use alaser that kind of scat-
ters the coloration into the tissue
and makes it easy for the body to
take away," said Vandemoer.
While the lasers are useful in
the removal of most tattoos, Van-
demoer cautions that the actual
removal procedure is timely.
"We see patients one time a
month and it usually takes 18to 20
months for complete removal,"he
said. "Youhave to keep scattering
the pigment slowly to minimize
scarring."
Scarring is an aspect of tattoo
removal that even technology
cannot fully erase. In many cases
there will still be residual tattoo
ink as well as a faint scar, depend-
ing on the number of procedures
received and the type of scar
treatments used.
"You can put silicone sheet-
ing on a scar," said Vandemoer.
"Unfortunately except for facial
skin every other area of skin is
unforgiving. Scarring is a risk of
any procedure used to remove a
tattoo. "
There isalsoamoderate amount
of pain involved in tattoo removal.
Some saythe removal can be more
irritating that the actual applica-
tion of the tattoo.
Vandemoer notes that topical
pain relief and Novocain are avail-
able for pain management.
Because it is the most effective
means of tattoo removal, laser
treatment does not come cheaply.
Cost per session averages about
$350 whichmeans that 20 sessions
willset aperson back about $7,000.
That is quite a contrast to the
cost of the average tattoo, which
is approximately $300.
In the end , while Vandemoer
would advise against any per-
manent ink work, it is certainly
best to do the research. Check
the credentials of the tattoo art-
ist and the materials that will be
used. Take time to consider the
decision to get a tattoo rather
than act on impulse.
Most importantly, be sure the
image is one that will withstand
the test of time. After all, that
skull and crossbones might look
cool now but what about when
you're 80?
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A GUIDE TO TRADITIONAL & ALTERNATIVE APPROACHES TO HEALTH
If you or someone you know is in crisis and needs immediate
assistance, call 1-800-SUICIDE (1-800-784-2433). Locally,there are
three resources to call in the event of a psychiatric emergency:
ThePsychiatricAssessmentTeam(PAT)at l-800-513-4PAT;thelocal
Department of Mental HealthEmergency Services at (508) 778-4627
or Samaritansof Cape Cod (A Crisis Hotline) at 1-800-893-9900.
In addition, the following organizations also offer valuable
information:
American Association of Suicidology (AAS)
www.suicidology.org
1-202-237-2280 (not a crisis hotline)
American Foundation for Suicide Prevention (AFSP)
www.afsp.org
1-888-333-AFSP (not a crisis hotline)
1-212-363-3500 (not a crisis hotline)
Suicide Awareness Voices of Education (SAVE)
www.save.org
1-888-511-SAVE (not a crisis hotline)
National Alliance for the Mentally 111 (NAMI)
www.nami.org
NAMI Helpline: 1-800-950-NAMI (1-800-950-6264) (not a crisis
hotline)
Steps toward preventing suicide
Thefirst stepinpreventing suicide isidentifying andunderstand-
ing the risk factors, or the things that increase the likelihood of
a person attempting to harm him or herself.
Years of research have pinpointed the following as risk factors:
• Previous suicide attempt(s)
• History of mental disorders, particularly depression
• History of alcohol and substance abuse
• Family history of suicide
• Feelings of hopelessness
• Barriers to accessing mental health treatment
• Loss (relational, social, work or financial)
• Physical illness
• Easy access to lethal methods
• Unwillingnessto seek help because of the stigma attached
to mental health and substance abuse disorders or suicidal
thoughts
• Isolation, a feeling of being cut off from other people
Resources