Suicide prevention is a complex and difficult problem for health systems to address. If a patient is admitted to a hospital or behavioral health clinic, they can receive appropriate treatment at that time, but studies show that the most dangerous time for patients with suicidal thoughts is the days and weeks after discharge. is.

Sanford Health has launched a pilot program called Caring Contacts. This program is designed to help patients after they leave the building. The idea is surprisingly simple. Send each patient a handwritten letter to let them know they are important.

Concept of Caring Contact

“We know that suicide is highly correlated with feelings of loneliness and isolation,” said Dr. Jeff Reichter, chief administrator of behavioral health integration at Sanford Health. “It’s sometimes called the ‘death of despair’ because people often feel like nobody cares in their worst moments. “

“When people reach out in a human-to-human way, rather than a form letter or email, people realize it was produced by a caring person.

Dr. Reichter explained that the idea for Caring Contacts dates back nearly 50 years, when the first compassionate letters were sent to Vietnam veterans who had been treated for suicidal thoughts or had attempted suicide. The letter does not ask for anything, such as a call or a request for follow-up. They are simply sent with messages of care and compassion.

Larissa Marsh, Integrative Health Therapist and Licensed Clinical Social Worker at Sanford Health in Fargo, North Dakota, said: “The goal and theory is that simply by receiving the card, people feel more socially connected and, in turn, less suicidal.”

Marsh handwrites the program letter in Fargo. She followed up with 19 of her patients as part of the pilot and sent letters to high-risk patients who agreed to participate. The first card will be sent 2-3 days after she leaves Sanford. Additional letters will be sent periodically for one year. So far, the results are incredibly promising.

“We use the social connection scale, and people are scoring higher and higher,” says Marsh. “And a lot of the feedback has been positive.”

She then examined some of the patient’s reactions.

• “This is great. I love them.”
• “The cards really brighten my day.”
• “If you go to the mailbox and look at the card, things will get better.”
• “I saved them all. Go back and read them.”
• “I feel much better than I did six months ago.”

Arlene’s story

Arlene Wilken works with Marsh and Dr. Leichter to create messages to be sent to Fargo patients. But unlike her pilot colleagues in her program, her background is non-clinical. She has a personal connection with suicide.

Her husband, Mark Wilken, suffered from severe depression. Twenty years ago he quit his job after his employer closed. At his 44 years old, Arlene said of Mark that “time dragged on.”

“He lost a lot of self-respect and pride. He lost his way. He lost interest in his hobbies. He just kept going round and round,” she said.

She encouraged her husband to seek counseling, but said, “He wasn’t ready, willing or comfortable to do it.”

In 2014, Mark took his own life at the age of 56.

“I don’t think of him every day,” Arlene said. “He was in such a deep hole that he didn’t know how to get out. He didn’t know how to help himself.”

Arlene now devotes herself to suicide prevention, helping people she doesn’t know or have never met. For the Caring Contacts program, she asserts that each letter carries the right message.

“Don’t be silly. You can’t do it lightly. It has to come from the heart without looking dishonest or showy. Saying ‘You deserve it’ is a bold statement.” we care We are here for you,” she said.

And it’s the feedback she receives that lets her know the program is working.

“People who are trapped in themselves usually don’t come forward and say something positive,” Arlene said. “But when I hear people say, ‘This makes a difference, thank you for your card,’ I believe it certainly does. It gives me pride.”

positive result

There is universal agreement among those working on this project in its early stages. Their time is well spent, the associated costs and efforts are minimal, and the benefits to patients are clear.

“It’s not a cure-all by itself, but it’s a very simple way to supplement the care they’re receiving,” says Dr. Leichter. “We’ve seen the comments we’ve gotten from the patients involved, and some of them are very moving.”

“It personalizes care. To me, it feels like an extension of that. With commitments, it can feel very sterile,” Marsh said. “We don’t want to oversimplify, but this shows that you’re not just a patient. Your life matters, even when you walk out the door. I care about you even when you’re not here.”

For Arlene Wilken, last words are as easy as writing a letter. That’s what she would say to anyone struggling with her suicidal thoughts, and here’s what she still wants to say to her husband Mark all these years later.

“You are worth a little bit of who you are. You are needed and valued whether you see it or not. I love you and want you by my side.” There are a lot of people and you have a lot of things,” said Arlene. “Hold on for one more day. And if one day is bad, the next day will be better. Life is worth living.”

Whether you yourself struggle with suicidal ideation or love someone who struggles with suicidal ideation, get help now by contacting one of the following:

Visit sanfordhealth.org to find resources, risk factors, warning signs and steps you can take to help your loved one.

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Posted in Behavioral Health, Fargo