“The warning signs and clues look different for different people. It may look more like something in their behavior, or it may be something they say. Generally, you want to look out for behavior changes. This could be having no interest in activities they once loved, hopelessness, desperation, recklessness, anger, isolating from loved ones, etc. It may be that a person says something directly about suicide such as ‘I’m going to kill myself.’ Or it could be they say something a bit more vague like, ‘I’m just so tired or ‘I can’t go on.’
“When we talk about warning signs, it’s not just about knowing the signs, it’s about being open to what we are seeing in the people we interact with and connecting what we are noticing in a person to the realization a person may need help.”
— Rachel Gearinger, Southeast regional director for the Tennessee Suicide Prevention Network
The man walks into the emergency room at the hospital. The first person he sees is the woman at the registration desk. He doesn’t have any obvious injuries, but she notices there’s something odd about his behavior.
“I need to see a doctor. I’m just so tired,” he says. Then he says nothing else. Just stares.
“He’s acting so weird. Is he suicidal? What can I do?” the registration employee thinks, nervousness and apprehension rising.
“We do know from statistics that emergency departments are an important setting for suicide prevention efforts,” said Rachel Gearinger, Southeast regional director for the Tennessee Suicide Prevention Network.
That’s where Badge Buddies comes in.
A collaboration between the University of Tennessee at Chattanooga Offices of Academic Affairs and Student Affairs, nursing students and the Center for Student Wellbeing, it is designed to prevent suicidal people from killing themselves. CHI Memorial and the Tennessee Suicide Prevention Network also are onboard the project.
The brand-new program, as its name implies, literally attaches a list of suicide prevention information to a badge worn around the necks of many of those who work in a health care setting.
“The Badge Buddy Project came out of a need where we know that people are going and seeking help from physical health providers prior to dying by suicide,” said Tricia Henderson, director of the Center for Student Wellbeing at UTC.
“Early intervention is the best intervention, so people can get to the help that they need and hopefully save lives,” she added.
The badge’s information is based on the Columbia Suicide Severity Rating Scale, a national tool that rates the level of suicide risk in a person. The scale has six questions whose answers can determine which resources the person needs for help and may be able to prevent the suicide.
“People can have a lot of fear and just an adrenaline rush of: ‘Oh gosh, this is a life-or-death situation,’” said Gearinger. “So as much as we can take some of that stress and take some of that unknown out of it, I think it’s really helpful for people.”
Doctors, nurses, physician assistants and medical professionals who deal directly with patients on a regular basis are generally familiar with the Columbia Scale and how to use it. But many others in health care settings aren’t, said Christy Sentell, a volunteer with TSPN. “There’s other clinical staff like our imaging department or radiology. They’re also coming in constant contact with patients,” she said. “And then you also have your non-clinical staff, which is registration. They’re the first people that see patients when they come in the door. We have volunteers that are seeing them right when they come in the door, escorting them different places.
“I think it’s important to equip everyone with this knowledge, clinical, non-clinical, whoever you are, because that person that first comes in contact with them could be the person that recognizes something’s not right, but then they don’t have the knowledge to know how to handle it,” said Sentell, who’s also project manager for Clinical Informatics at CHI Memorial.
The badge can be used by anybody, though, not just those in health care and suicide prevention, said Henderson.
Currently, the plan is to give 5,000 badges to health care employees at CHI Memorial, 250 to health professionals in the Hamilton County School System. The UTC Nursing, Occupational Therapy and Physical Therapy programs will receive about 800, however, since few people at UTC wear badges on a lanyard around their necks, they’ll be getting bi-fold cards to carry with them, Henederson said.
The Tennessee Suicide Prevention Network has approved the use of Badge Buddies throughout the state, she added.
“What we’re hoping is, if we have this screening accessible, and it’s something that people can look at and use with patients, with clients, with their friends, with their family, they’ll be more likely to ask the question related to someone’s thinking of suicide and get them to the appropriate resource,” she said.
Preventing suicide doesn’t just happen in a hospital or a doctor’s office, Gearinger said.
“We say that suicide prevention is everybody’s business because people tend to think suicide prevention, well, that’s the job of a psychiatrist or a counselor or a mental health professional. But it’s really not,” she said.
“Counselors aren’t walking down the street and saying, ‘You’re suicidal. You’re suicidal. You’re suicidal’,” she continued. “That’s up to the community to be the gatekeepers. And so it definitely is something that I think that we need to think of more as a community-wide issue versus just a mental health field issue.”
Ultimately, though, suicide prevention begins with one simple step, Henderson said.
“The most important piece is asking and telling that person, ‘I care. I’m noticing this. Are you thinking of suicide? I want you to get to the appropriate help.’”