Articles Posted in suicide

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As many of you know, since 2012 when I became President of the State Bar of Georgia and after a dear friend of mine, who was a Past President of the State Bar, killed himself, I made suicide prevention for Georgia Lawyers one of my causes to which I devoted my time and resources to promote. We began with “How to Save a Life,” a suicide prevention program for the Georgia State Bar, which, almost immediately, began saving lives. We reduced the stigma associated with seeking help for mental health matters, especially for lawyers. We increased the number of free mental health visits each Georgia Lawyer receives to six and with the “Use Your Six” campaign.   The State Bar created the “Lawyers Living Well” program, thanks largely to the leadership of Lynn Garson, the Chairperson of the Lawyers Assistance Program. Lynn began her “Lawyers Living Well” podcast, through which she and many other wonderful Georgia Lawyers share their stories, including me.  I hope you will listen. The Georgia State Bar’s Suicide Prevention Program continues under the extremely capable leadership of Judge Shondeana Morris, and many of us participated in the “Out of the Darkness” walk in Piedmont Park to raise money for the American Foundation for Suicide Prevention (AFSP). I am so proud of the work the State Bar of Georgia has done, and continues to do, to reduce the suicide of Georgia Lawyers and their family members.

As part of this large effort, we have learned a lot. One thing we learned is the concept of “means restriction,” which is to eliminate the means by which someone could kill themselves when you know or suspect that person to be suicidal. This includes guns, drugs, ropes, alcohol, etc. It is important to remove any means of suicide from the surroundings of someone you believe is suicidal. Research has shown that if the means to kill oneself are eliminated and you prevent even that momentary thought of suicide, that person is not likely to resort to suicide again once the idea of it is gone and the means to do it were eliminated. As published in the medical journal Lancet, “[l]imitation of access to lethal methods used for suicide—so-called means restriction—is an important population strategy for suicide prevention. Many empirical studies have shown that such means restriction is effective. Although some individuals might seek other methods, many do not; when they do, the means chosen are less lethal and are associated with fewer deaths than when more dangerous ones are available.”

So I was thrilled to read that the long-awaited means restriction of nets under the Golden Gate Bridge have finally been installed.   The effort was sparked over 20 years ago when a young man, Kevin Hines, jumped off the bridge to kill himself, but he survived. He said the second he jumped he regretted it. He said: “Had the net been there, I would have been stopped by the police and gotten the help I needed immediately and never broken my back, never shattered three vertebrae, and never been on this path I was on,” said Hines, now a suicide prevention advocate. “I’m so grateful that a small group of like-minded people never gave up on something so important.” There are other examples of means restrictions, right here in Atlanta. You may recall that I wrote about a project my son, Chastain B. Clark, collaborated on, designed, created and installed at the Georgia Tech Library called “Crosland Chroma,” which is a series of beautiful screens that allow a scenic view of the city but prevent anyone from being able to jump off the library. This photos shows the beautiful means restriction on top of the Tech Library.

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A recent opinion by the The Georgia Court of Appeals, our Intermediate Appellate Court in Georgia, regarding Georgia’s obsolete “impact rule” certainly caused an impact, and not a good one.  In Holt v. Rickman, A23A0612, 2023 WL 3858619 (Ga. Ct. App. June 7, 2023) an apartment guest brought action against owners and manager of apartment complex, asserting claims for premises liability and negligent hiring, retention, and supervision after she awakened to discover maintenance worker in her bed.

The facts of Holt are startling, to say the least.  A guest of a resident staying in one of the apartments woke up to find an intruder lying next to her on top of the covers on the bed. The intruder was actually a maintenance employee of the apartment complex. He pulled the covers down saying he wanted to “see what she looked like under there.” As he did so, he touched the top of her head. The woman pretended to reach for a weapon and that caused the intruder to flee. As you can imagine, this bizarre incident had to have been frightening. During litigation it was discovered that the apartment complex hired the intruder/maintenance employee in 2016 despite a background check showing he had two pending child molestation charges. He had pled guilty to lesser charges of sexual battery against a child under the age of 16. He was on the Georgia Sexual Offender Registry. The Defendant, with this knowledge in hand,  continued to employ him as a maintenance worker with access to a master key, which led to his ability to break into the apartment and to attempt to sexually assault the plaintiff.

The Georgia Court of Appeals held that Georgia’s antiquated “impact rule” applied to the situation and affirmed the grant of summary judgment to the apartment complex. Case dismissed. The “impact rule” is not state-of-the-art science about how an event can affect someone emotionally or psychologically. In fact, it was created in 1892, when there was very little understanding, if any, of psychological trauma. The “impact rule” says that when a person suffers no physical injury as a result of the  incident that forms the basis of the claim, there is no recovery for emotional distress. Georgia’s “impact rule” provides that “[i]n a claim concerning negligent conduct, a recovery for emotional distress is allowed only where there is some impact on the plaintiff, and that impact must be a physical injury.” Ryckeley v. Callaway, 261 Ga. 828, 828, 412 S.E.2d 826 (1992). To satisfy the rule, a plaintiff must show that she (1) suffered a physical impact that (2) resulted in a physical injury which (3) caused her mental suffering or emotional distress. Lee v. State Farm Mut. Ins. Co., 272 Ga. 583, 586 (I), 533 S.E.2d 82 (2000). A plaintiff’s failure to meet any one of the three requirements of the impact rule bars recovery even in cases “in which the circumstances portend a claim of emotional distress.” Id.

July 16 marks one-year anniversary of 988 Suicide & Crisis ...
Many of you know that I often write about suicide prevention. I hope you have read my latest blog on the Crosland Chroma Suicide Means Prevention art installation on top of the Georgia Institute of Technology library. Also, when the 988 Suicide Prevention and Crisis Lifeline was introduced, I wrote a blog about that. I hope you will take the time to read these two special blog posts.

The National Suicide and Crisis Lifeline, 988, marked its one year Anniversary yesterday. United States Health and Human Services Secretary Xavier Becerra observed the anniversary by noting “Through 988, our message to Americans in crisis is clear: support is here. And thanks to President Biden, millions of Americans have been able to seek out help. Nearly 5 million calls, texts, and chats have been answered over the past year – saving countless lives.

Anecdotally, we know 988 is working. For example, in Nebraska, before implementation of the new 988 lifeline in July 2022, the Boys Town National Hotline in Omaha was the home of the Suicide Prevention Hotline. In a natural evolution, Boys Town became the call center for 988 as well as the Nebraska Family Helpline. In 2021, before the existence of 988, Boys Town received 8,777 calls to the Suicide Prevention Lifeline. Since 988 Nebraska’s implementation, that number has more than doubled to 18,300.

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This is my son, Chaz. He is an artist and an architect and I am very proud of him.  As an artist he goes by chastainbernard. The colorful panels behind him were created by artist/architect Tristan al-Haddad who owns the studio Formations. Chaz works with Tristan now and he also worked with Tristan last year to design and create these colorful panels that were installed on the top of the Georgia Tech Library, Crosland Tower (shown below) on the beautiful Georgia Tech campus in Downtown Atlanta. It is called “Crosland Chroma.” You can learn more about the conceptualization of the project here. Chaz had the incredible opportunity to work on this project while he was studying for his Masters in Architecture at Georgia Tech. Tristan was one of his many inspirational professors. You can enjoy a short video of how they painstakingly created and installed these gorgeous panels and you might even see Chaz here and there in the video.  They unveiled the Chroma Project shortly before Chaz graduated in May 2022. They make a beautiful prism through which to view the downtown skyline.  Many students study or enjoy a cup of coffee on top of Crosland Tower and now they enjoy the colorful prismatic effect these panels have on their surroundings.  It is truly beautiful.

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What may not be obvious is that these beautiful panels also serve as a type of “means restriction” to prevent suicide by way of jumping off the top of Crosland Tower. These panels are made of a super-duty strong, heavy acrylic and are only a few inches apart from each other.  They are anchored in concrete by large metal bolts. You can not possibly pull them or spread them apart to get to the edge of the tower to jump.

Those of us who study suicide in an effort to prevent it have found that “means restriction,” i.e.,  restricting whatever means someone might use to kill oneself, can help reduce suicide. According to the National Institute of Health, “Limitation of access to lethal methods used for suicide—so-called means restriction—is an important population strategy for suicide prevention. Many empirical studies have shown that such means restriction is effective. Although some individuals might seek other methods, many do not; when they do, the means chosen are less lethal and are associated with fewer deaths than when more dangerous ones are available.”  Means restriction must be multi-faceted, to include various ways one could kill oneself, e.g., removal of narcotic drugs and alcohol, removal of ways to hang oneself, removal of guns from the home or office, prevention of jumping from high places, etc. In a suicide crisis, the length of time someone seriously contemplates suicide, tends to be short-lived. Over 25% of teens nationally said it was only 5 minutes from the time they made the decision until they acted on it. Another 30% said it was less than 24 hours.  We know this from suicide survivors who have jumped from the Golden Gate Bridge in San Francisco, who have said the minute they jumped, they regretted it. If they had only been prevented by jumping for just a minute or two, they wouldn’t have done it. Now, The Golden Gate Bridge has installed large nets around it as a means restriction for those who want to jump to kill themselves by suicide. This particular Suicide Deterrent System is called “The Safety Net,” and it will, hopefully, prevent the 30 or so suicides every year on the Golden Gate Bridge.

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I don’t often write about appellate opinions from appellate courts of states other than Georgia, but as I was reading some recent appellate opinions, the Virginia case of Morris v. Commonwealth of Virginia, No. 1194-21-2 (VA Ct. App. May 9, 2023) and not for good reasons.  Morris involves Virginia’s overdose reporting statute,  Va. Code Ann. § 18.2-251.03(B)(2)Georgia has a similar statute but ours is arguably not as restrictive as Virginia’s and hopefully, our Georgia Appellate Courts won’t interpret it as strictly.

In Morris, Henrico, Virgina police officers observed a white Ford Edge trying to turn onto the road next to an emergency room. The vehicle nearly struck a curb in the turn lane and then stopped in the middle of the road, blocking through-traffic. The officers approached the vehicle, driven by Morris, and asked him to park the car. Morris said that “he was there to get help,” telling the officers that he had smoked crack cocaine. The officers thought he appeared to be under the influence of drugs and escorted Morris into the emergency room. As medical personnel drew a blood sample, Morris “made suicidal statements.” In response to law enforcement questioning, Morris said that he worked at Food Lion; he was high while at work and asked to sit in his boss’s car to call his mother; he had called his mother “because he was thinking about committing suicide”; and he had driven away from the Food Lion and had driven around awhile before heading to the Short Pump emergency room. When asked whether his mother had told him to “go to the ER,” Morris said he “chose to do so himself” because “he was thinking about suicide.” When an officer asked why he was considering suicide, Morris responded, “drugs.” Morris said that he used heroin, fentanyl, and cocaine, that he had smoked crack cocaine in his boss’s car, and that he “came to the ER to get help for the suicidal thoughts and his drug problem.” Morris alerted the officers to a crack pipe in the vehicle, which they found tucked in the crevice of the passenger seat.  Morris v. Commonwealth, 1194-21-2, 2023 WL 3310315, at 1–2 (Va. Ct. App. May 9, 2023).

The Virginia overdose amnesty statute provides full immunity from “arrest or prosecution” for qualifying individuals (prior versions had characterized the immunity as an “affirmative defense”). It was amended to cover not only someone who helps another experiencing an overdose, but also the person who “is experiencing an overdose”—assuming other criteria in the statute are met. Before these expansions, we observed that the “clear purpose” of the law was to “encourage … prompt emergency medical treatment [for] those who have suffered an overdose as a result of ingesting a controlled substance.”  Georgia’s drug overdose amnesty statute is similar.  But the Virgina statute has a curious requirement that the statute does not apply unless the individual “remains at the scene of the overdose or at any alternative location to which he … has been transported until a law-enforcement officer responds to the report of an overdose.” 

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Ever since I began the Georgia State Bar’s Suicide Prevention Program back in 2012 when I was President of the State Bar of Georgia, I have been advocating for the need for more mental health services provided during an emergency.  For longest time, all U.S. citizens have had available to them for an emergency is to call 911. This is, without question, an extremely valuable service to have when you need help from the police or fire department. But is hasn’t also proven helpful when what you have is really a mental health emergency. There have been numerous examples of incidents here in Atlanta in which, in my opinion, had there been a mental health emergency number available instead of just 911, a life would not have been lost.

The police shooting of Scout Schultz, a Georgia Tech student, is a prime example. Scout was a fourth-year computer engineering major with a minor in biomedical engineering at the time of his death.   Scout was fatally shot September 16, 2017, after approaching officers with a knife and saying, “Shoot me.”  A Georgia Tech officer who had not had mental health training shot Scout, even though Scout was yards away from him and couldn’t possibly hurt the officer with a knife from that distance.  The officers needed mental health training on how to deescalate and handle a mental health crisis someone is going through instead of shooting that person. Had we had a 988 available then, perhaps Scout would still be with us.  The same can be said for the police shooting of Nygil Cullins, who was having a mental health crisis at Fogo de Chao in Buckhead. Rather than handing it as mental health crisis, as it obviously was, the Atlanta Police shot and killed Mr. Cullins.  What is truly sad is that his mother had tried to get emergency transport for her son to a mental health living facility by calling 911 and waited for two hours. She had even called Riverwood Behavioral Health Center ahead of time to make sure they had a bed available, and told 911 dispatchers she would follow police there and fill out the paperwork when they arrived. She said “all you have to do is transport him.” Mr. Cullins waited with his mother for two hours without any help from 911 and, ultimately, left for Fogo de Chao, without mental health intervention. The Atlanta Police, rather than sending a mental health team, sent armed police officer who handled the situation by shooting and killing Mr. Cullins. Another life lost senselessly and one that 988 may have saved.

So I am thrilled that we now have available to us 988 for mental health crises. “If you are willing to turn to someone in your moment of crisis, 988 will be there,” said Xavier Becerra, the secretary of the federal Department of Health and Human Services, at a recent press briefing. “988 won’t be a busy signal, and 988 won’t put you on hold. You will get help.”  I pray this is true.  The primary goal of the new number is to make it easier for people to call for help. Lawmakers and mental health advocates also see this launch as an opportunity to transform the mental health care system and make care easily accessible everywhere in the United States. The Biden administration has invested more than $400 million in beefing up crisis centers and other mental health services to support the 988 system.

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I reaIMG_63761-225x300d with great interest a recent report from the U.S. National Suicide Prevention Lifeline that showed a reduction in suicides attributable largely to a song by music artist Logic. That song’s title is “1-800-273-8255,” the hotline number for the suicide prevention lifeline. As a result of this song, number of calls to the lifeline were up while numbers of suicides were down. The correlation to the song was proven by tracking these numbers during three time periods: the first 34 days after the song’s release, Logic’s performance at the 2017 MTV awards and an additional widely promoted performance at the 2018 Grammy Awards.  “1-800-273-8255” is a beautiful song, and if you are not familiar with it, I urge you to take three minutes out now and listen to it.  It starts with a young person saying he doesn’t want to live anymore, that he just wants to die. Then other voices enter the song and essentially talk to the young person and stay with him until the feeling he needs to die by suicide passes. Finally, the young person sings:

I finally wanna be alive, I finally wanna be alive

I don’t wanna die today, I don’t wanna die

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As I write this, many of the headlines in the news are about the so-called “shocking” suicide of alleged child sex trafficker, Jeffrey Epstein, who, allegedly, hanged himself while incarcerated in a Federal New York prison.  What is so shocking? The only thing shocking to me about this event is how the news media and on-lookers, including United States Attorney Bill Barr, think it is shocking for someone, who was known to be suicidal, predictably, takes their life by suicide.  I suppose it is only Mr. Epstein’s wealth and his ties to well-known, rich, influential people, including many politicians, that makes U. S. Attorney Barr suddenly express surprise and concern that incarcerated people are attempting suicide, many successfully, when many of them should have been on suicide watch in a Crisis Stabilization Unit (CSU) or an Acute Care Unit (ACU). We can do without the mock concern on the part of the U.S. Attorney.  This is happening right under his nose in  prisons every day and he only expresses concern when it is a wealthy person who does it?

Jeffrey Epstein’s suicide was foreseeable and predictable. Now it is being reported that he was not on a suicide watch, even though he had previously attempted suicide less than two weeks earlier. The prior suicide attempt placed him in the high-risk category for attempting again. Coupled with the fact that he was in prison for the first time awaiting trial with an indictment list that, if proven, would keep him in prison for the rest of his life (another risk factor for attempting suicide), Mr. Epstein was high risk for suicide attempt and should have been on suicide watch.

Unfortunately, this blatant disregard for the lives of inmates who are either mentally ill or acutely psychotic ( or both) and the risk it creates for them to take their own life, is prevalent in our nation’s jails and prisons.  It is particularly alarming in Georgia prisons.  As recently as just last week, the Macon Telegraph issued the results of its study into prison suicides and announced that Georgia’s rate has reached crisis proportions. Between 2014 and 2016, state records show that 20 state prisoners had taken their own lives. In the nearly three years since, 46 prison deaths were deemed suicides. Georgia’s prison suicide rate — at 35 suicides per 100,000 — is nearly double the national average. Between 2013 and 2014 alone, U.S. state prison suicide rates rose by nearly a third. And Southern states including Georgia, Alabama and Texas saw even larger increases in their rates. Georgia correctional officials believe one in five people incarcerated in state prisons have a documented mental health need.

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Friends:

Many of you know that during my presidency of the State Bar of Georgia in 2012-2013, I  made mental health of attorneys, and their family members, a primary concern. I have taken every opportunity presented to make us more aware of the stresses that attorneys face just in their daily practices and the toll that has on them and their family. We created the “How to Save a Life” Suicide Prevention Program and we know we have been successful in preventing some attorney suicides. But we also know we need to continue to effort. Often, an attorney reaches out to me about a partner in the firm, or a partner reaches out to me about his son, or counselors reach out to me to see how they can help. I am also thankful and proud that Jonathan Ringel, the Editor of The Daily Report, graciously gives me and others space in the newspaper to write about suicide prevention and to keep the conversation going. This is the only way we will eliminate the stigma of mental illness that prevents so many from reaching out for help. And help is easily available, through our Lawyers Assistance Program (800-327-9631) and the State Bar’s Lawyers Living Well Initiative.  The National Suicide Prevention Hotline is  1-800-273-8255.

And so I was honored to be asked to participate in a podcast on the mental health of lawyers by Miles Mediation. Both Editor/Journalist Jonathan Ringel and Stacey Dougan, a lawyer turned therapist, joined in the discussion as moderated by Miles neutral, Bianca Motley Broom, and CMO, Marcie Dickson. I urge you to listen and to share with your family members, friends and colleagues. It will be worth your time. And just by listening, you may save a life.

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