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Suicide prevention is a complex and difficult problem for health care systems. If a patient is admitted to a hospital or behavioral health clinic, they may be well cared for at the time, but studies show that the first days and weeks after discharge are the most dangerous time for people with suicidal thoughts.
Sanford Health has launched a pilot program, Caring Contacts, designed to help patients after they leave the building. The idea is incredibly simple: send a handwritten letter to each patient to let them know they’re important.
The idea behind caring contacts
“We know that suicidality is strongly associated with feelings of loneliness and isolation,” said Jeff Lichter, Ph.D., director of behavioral health integration at Sanford Health. “Sometimes it’s called ‘Death of Despair’ because people feel like no one cares about them in their worst moments.”
“When we communicate in a person-to-person way, not a form letter, an email, that’s something people perceive as being created by a caring person. It’s important.”
Dr. Leichter said Caring Contacts goes back nearly 50 years, with the first thoughtful letters sent to Vietnam veterans who were being treated for suicide or attempted suicide. The letters do not ask for anything, they do not ask for a phone call or any follow-up. Simply send a message carefully and carefully.
“The messages are encouraging and supportive, and when you think about receiving mail, that’s something we don’t get anymore,” he said. Larissa MarshIntegrative Health Therapist and Licensed Clinical Social Worker at Sanford Health in Fargo, North Dakota. The goal and theory is that by receiving the cards, people will feel more socially connected and in turn less suicidal.
Marsh handwrites the letters for the program at Fargo. She followed up with 19 patients in the pilot, sending letters to high-risk patients who agreed to participate. The first card will be mailed two to three days after you leave Sanford. Additional letters will be sent at regular intervals throughout the year. So far, the results have been incredibly encouraging.
“We’re using a social networking scale, and people’s scores are going up, up, up,” Marsh said. “And many comments are positive.”
She then goes into a few of the patients’ responses:
- “This is wonderful. I love them.”
- “The cards brighten my day.”
- “When I go to the mailbox and look at the cards, things get better.”
- “I saved them all, and read them back.
- “I feel better than I did six months ago.”
The story of Arlene
Arlene Wilken works with Marsh and Dr. Lichter to develop messages for patients in Fargo. But unlike her colleagues in the pilot program, she has a non-clinical background. She has a personal connection to suicide.
Her husband, Mark Wilken, suffered from severe depression. Twenty years ago, the employer closed its doors and then went out of business. He was 44, and Arlene told Mark, “The clock just ticked.”
“He has lost his self-esteem and self-esteem. He lost his way. He lost interest in his hobbies. “It just kept going down and down,” she said.
She encouraged her husband to seek counseling, but it was “not something he was ready, willing or comfortable with,” she said.
In the year In 2014, at the age of 56, Mark took his own life.
“There’s not a day that goes by that I don’t think about him,” says Arlene. “He was in a deep hole that he didn’t know how to get out of. He didn’t know how to help himself.
Arlene is now helping people she doesn’t know and often doesn’t even meet, and she’s almost suicidal. For the Care Contacts program, she insists that each letter has a specific message.
“He can’t flirt. His heart cannot be light. It should come from the heart without seeming insincere and eager. It’s a bold statement, ‘You deserve it. We care. We are here for you,” she said.
And it was feedback that made her realize the program was making a difference.
“Introverted people often don’t come forward and say positive things,” says Arlene. “But when you hear people say, ‘That makes a difference, I appreciate your card,’ I believe it really does. It makes me proud.”
Positive results
For those who work on this project in the first stages, there is a universal consensus: their time is well spent, the cost and effort are minimal, the benefits for patients are clear.
“It’s not a treatment in itself, but it’s a very simple way to supplement the care you’re receiving,” Dr. Leichter said. “We’re looking at the comments we’ve received from the patients involved, and some of them are very emotional.”
“It makes care personal. It feels like an extension of me. You have an appointment and you can feel very infertile,” Marsh said. “I don’t want to make light of it; But this shows that you are more than patient. Even when you walk out the door, your life matters. We think of you when you’re here and we think of you when you’re gone.”
For Arlene Wilken, the last word comes as easily as writing a letter. It’s what you say to someone struggling with suicidal thoughts. And what she still wants to tell her husband Mark after all these years:
“You are valuable to everyone. You are needed and valued whether you see it or not. There are so many people who love you and want you around and you have so much to offer.” “Wait one more day,” said Arlene. And if that day isn’t better then the day after that will be. Life is worth living.
Whether you’re struggling with suicidal thoughts or a loved one, get help by contacting one of the following.
Visit sanfordhealth.org Find resources, risk factors, warning signs, and steps you can take to help your loved one.
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Behavioral health, Fargo
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