More than once as a LifeCycle Lawyer, I have had a client come in to my office to sign a Last Will and Testament one day and try to kill themselves the next day. While some clients try and fail to at committing suicide, one was completely successful eating his shotgun while sitting at one end of his dining room table, having placed his new will at the other end.
When his daughter called me to ask for help dealing with the cleanup and other sequelae of her father’s death, my first thoughts after hanging up the phone comprised questions of what I could have done differently to prevent my new client’s death by his own hand.
I went over his first and only phone call setting up the appointment for later that day. I reviewed his estate planning questionnaire, on which he detailed his ancestry and descendants; his assets and liabilities; who he wanted to do and get what when where how and why he wanted them to do and get such; and the check boxes describing his instructions to any future healthcare providers treating him to “do not resuscitate” him and, if he should have an incurable disease, to neither feed him nor water him, but rather simply keep him pain-free and let him die with dignity. I played over in my mind as best I could the conversation we had as we discussed his estate plan and I drafted it up and brought in two associates to witness it and then as we continued to chat while I scanned it into the client’s cloud file.
Suicide is a Leading Cause of Death in the United States
- According
to the Centers
for Disease Control and Prevention (CDC) WISQARS Leading Causes of Death Reports,
in 2016:
- Suicide was the tenth leading cause of death overall in the United States, claiming the lives of nearly 45,000 people.
- Suicide was the second leading cause of death among individuals between the ages of 10 and 34, and the fourth leading cause of death among individuals between the ages of 35 and 54.
- There were more than twice as many suicides (44,965) in the United States as there were homicides (19,362).
Suicide Rates Have Steadily Increased Over the Past 20 Years
- According
to the National
Institute of Mental Health statistics for each year from 1999 through
2016,
- The total suicide rate increased 28% from 10.5 to 13.4 per 100,000.
- The suicide rate among males remained nearly four times higher (21.3 per 100,000 in 2016) than among females (6.0 per 100,000 in 2016).
Almost Everyone Is at Risk for Suicide?
Suicide does not discriminate as apparently all genders, ages, and ethnicities can be at risk.
Things that increase the main risk factors for suicide include:
- Having made a prior suicide attempt
- Suffering from depression and other mental health disorders
- Suffering from substance abuse disorder and excessive behavior addictions such as gambling, pornography, inappropriate sexual behaviour
- Family history of a mental health or substance abuse disorder
- Family history of suicide
- Family violence, including physical or sexual abuse
- Having guns or other firearms in the home
- Being in prison or jail
- Being exposed to others’ suicidal behavior, such as a family member, peer, or media figure
- Medical illness
- Being between the ages of 15 and 24 years or over age 60
What Are the Warning Signs of Suicide?
The NIMH lists many behaviors that may indicate someone is thinking about suicide. Such behaviors may include:
- Talking about wanting to die or wanting to kill themselves
- Talking about feeling empty, hopeless, or having no reason to live
- Planning or looking for a way to kill themselves, such as searching online, stockpiling pills, or newly acquiring potentially lethal items (e.g., firearms, ropes)
- Talking about great guilt or shame
- Talking about feeling trapped or feeling that there are no solutions
- Feeling unbearable pain, both physical or emotional
- Talking about being a burden to others
- Using alcohol or drugs more often
- Acting anxious or agitated
- Withdrawing from family and friends
- Changing eating and/or sleeping habits
- Showing rage or talking about seeking revenge
- Taking risks that could lead to death, such as reckless driving
- Talking or thinking about death often
- Displaying extreme mood swings, suddenly changing from very sad to very calm or happy
- Giving away important possessions
- Saying goodbye to friends and family
- Putting affairs in order, making a will
Pay Attention to Your Friends’ and Family Members’ Warning Signs
Because most people keep their frank suicidal ideations to themselves, it remains difficult to predict who will act on their suicidal thoughts. While, even among people who have risk factors for suicide, most do not attempt suicide, you still have to help as many of your friends that you can catch avoid slipping down that slope. Therefore, if you really want to help those around you avoid from falling victim to their own suicidal thoughts, you need to build and maintain good relationships with them (as best you and they can and will allow), be on the lookout for the warning signs, recognize them as they occur, and as with almost everything else these days, “If you see (or even hear) something, then say something!”
But, what should you look for? The best thing to look for is changes in people’s patterns, even insignificant changes. If you notice someone developing feelings of hopelessness and/or helplessness, stop and talk with them about it; not as a therapist (most of us aren’t), but as a friend (which is a lot easier job).
Other changes can include a loss of a sense of humor, becoming more sensitive to the comments of others, increasing concerns of impending death in the absence of apparent disability or disease.
All the Above Notwithstanding, You Cannot Save Them All, But You Can Do All That’s Reasonable to Try
Note that last warning sign of a possibly impending suicide above, the one about putting affairs in order and making a will. I’m a LifeCycle Lawyer, which means I do a lot of wills, trusts, and powers of attorney. The vast majority of my clients come to me saying, “I want to get my affairs in order, just in case something happens to me.”
Often times in the past, drafting such documents was the only interaction I had with most of my clients. They came, we got their affairs in order, they left. Some—most actually, I seldom saw again.
Someone increasingly telling people “I just wanted to do this in case something happens to me soon,” should give anyone cause to stop, look at, and listen closely to what that person might be really quietly not saying.
But, when you don’t have a prior relationship with such a person who comes out of nowhere and only wants to have a one-shot, limited attorney-client relationship to get there affairs in order and never wants to see that lawyer again, it is all but impossible to notice any changes in their behavior that would make you stop, look at, and listen to them further.
“I just wanted to do this in case something happens to me soon,” were the magic words my shotgun suicide client said to me and I deeply regret not picking up on them. I hadn’t known the man before the morning he arrived on the day before he died. And, obviously, even if it would have been my modus operandi at the time, I wouldn’t have had much of a chance to continue a relationship with him.
Now, I try to do things much differently as a LifeCycle Lawyer. First, I almost never agree to be someone’s one-shot lawyer. If a prospective client does not buy in to the concept of starting and continuing an ongoing professional relationship that requires at least one monthly contact between us whether the client needs legal services or not, I almost never accept that prospect’s request for singular, limited-scope services.
Second, I limit my retainer-client panel to a combination of 200 personal clients and 100 small-business-owner clients at a time.
Third, I contact almost all of my retainer clients at least once a month for a meaningful, focused, five-minute personal phone call, for which call both the client and I make an appointment. We do not talk about legal issues; we talk about life issues, about how each of us is feeling as real people, with real personal lives.
Fourth, I send almost all of my retainer clients an email a week discussing issues like the one we are discussing in this blog post.