According to the American Association of Suicidology, nearly 91 people commit suicide per day, ranking suicide as the 11th highest cause of death in the United States. Suicide is the 3rd leading cause of death in the 15-24 age group.

In 2006, the overall suicide rate was 10.9 suicide deaths per 100,000 people. For every suicide death, there were 12 to 25 attempted suicides occurring. The National Suicide Prevention Helpline is available twenty-four seven at 1-800-273-TALK (8255). All calls are anonymous.

In a story told to CNN, Alexis Moore recalled her attempt to commit suicide, a plan she had detailed over a five day period. She drank vodka for two hours and laid out twenty Xanax pills; ingested several pills, went to her room to cry and then returned to take more pills.

After she took several pills, Alexa heard a knock on the door which she ignored until he she heard a bang on her bedroom window. The man who was banging on the window was Andrew, who met Alexa at a business event three days prior.

Alexa let Andrew in and the two sat down to talk in her living room; Alexa has not attempted suicide since. “If it wasn’t for Andrew, I’d be dead now,” said the now 35-year-old second year law student in California. Andrew and Alexa are now a couple living together in Sacramento.

So what did Andrew do to change Alexa’s mind?

“I was living in this really unkempt place, and he had to get through a lot of brush and tree branches to get to my bedroom window. I know it sounds simple, but knowing that someone was going that extra mile was all it took for me to let him in.”

“After I let him in, he just gave me a hug. He said, ‘I was worried about you,’ When we talked, there was no judging me. There was no fear in his eyes. All I felt was comfort. He just listened and that’s all I needed,” explained Alexa.

Professional therapists highly encourage depressed people to get professional help. Even with professional help, depressed patients still benefit from a close support system. However, sometimes members in the support system are unsure of what to say.

Dr. Nancy Rappaport, assistant professor of psychiatry at Harvard Medical School, stressed that small words of kindness can go a long way.

Traci Parks, a 42-year-old photographer from Columbus, Ohio, reported feeling suicidal three times in her life. Parks attributed her husband telling her, “Please don’t kill yourself, I love you so much and I don’t want you to kill yourself,” as saving her life. When her husband died unexpectedly five years later, her friends offered a similar sentiment.

“One person told me she and her husband didn’t want me to kill myself, that they would miss me terribly and they thought I had a lot to offer the world even though she knew I didn’t feel that way,” Parks recalled.

Speaking a simple sentence such as “I don’t want you to die,” or “my life would be less fulfilled without you” can be a strong enough statement to resonate with a suicidal person. Sending a card is another way to let a person know you care.

Some depressed people indicate that they wish to be left alone but Traci Parks says it’s the last thing one should do. Traci’s husband would beseech Traci to go out at night with him and his friends. “The unspoken rule was I didn’t have to talk or interact. I did have to eat, and I did have to go.”

Apex Behavioral Health can help you or your loved one who is feeling depressed or suicidal. It is always better to act before it is too late. Trust your instincts, if you truly feel that someone needs help, they probably do.

On the opposite end of the spectrum is the Dignitas organization, or the “Right to Die” movement for assisted suicide in Switzerland. Switzerland is the only country where assisted suicide is legal for non-Swiss citizens. Dignitas has helped over a thousand people die since 1998.  One factor to note is that Switzerland allows assisted suicide but not euthanasia, the difference being that the person who wishes to die must take the lethal dosage themselves.

Zurich, Switzerland

The vast majority of people who visit Dignitas are people who have been diagnosed with a terminal illness or an incurable, progressive disease who wish to invite death on their own terms.

 ”Usually, if the person has terminal cancer, motor neuron disease or multiple sclerosis and they are telling us ‘I don’t like to live some weeks or months until the terrible end’, then it is quite clear and we have no difficulty in saying yes,”  said Ludwig Minelli, the founder of Dignitas who runs the world’s first assisted suicide center in Zurich.

Ludwig Minelli, the founder of Dignitas.

There are several steps and precautions before a person can receive Minelli’s assistance in assisted suicide.  One has to pay to become a member of Dignitas and send in their medical records complete with a letter explaining why things have become intolerable and $2797.83 (£1,860). The medical files are sent to one of the medical doctors affiliated with Dignitas who determines whether or not he would write a prescription based on the medical history. If he agrees, the staff contacts the person to schedule a date and time for the death, along with offering hotel advice. 

Once the patient is in Switzerland, the individual has to pay for two appointments with the doctor, who further checks the patients’ medical records and prescribes the lethal prescription. The patient then must pay $2797.83 ( £1,860) for two staff members to organize and witness the death. The death is also videotaped for legality reasons with the police.

In the months before their death, Minelli and his staff try to find alternatives to suicide for the patient. They repeatedly question if the patient really wants to die and states, “As long as we are able to help them in the direction of life, we help them in the direction of life.”

Minelli believes that the right to choose to die is a fundamental human right. His vision is that everyone should have the right to end their life, not just the terminally ill, but anyone who wants to. Minelli does not pass moral  judgment and said “We don’t discuss moral questions. What moral? Which moral? Catholic? Muslim? Buddhist? We are just working on the atheist base of self-determination.”

The Swiss Criminal Code says that anyone who acts on selfish motives to assist someone in killing themselves can be punished with up to five years in jail. Dignitas interprets this to say that helping someone to die is not illegal as long as there isn’t a selfish intent, such as helping someone die in order to gain an inheritance.

Swiss medical regulations prohibit doctors from prescribing doses to healthy people and restricts involvement in suicide for the mentally ill. Dignitas cannot legally help profoundly depressed people in their quest for suicide; they can only assist people with a terminal illness.

Minelli is trying to fight that rule and he is currently involved in several legal battles with the Swiss government to clarify the law that governs suicide. He is not being prosecuted by any other country for any of the suicides he helped orchestrate.

At its core, Dignitas consists of three main beliefs. Minelli’s conviction is that once you give someone the freedom to talk about suicide it reduces a person’s desire to go ahead with it. Second, Minelli believes that the offer of assisted suicide, when the patient is given the go-ahead from the doctor, gives relief to patients that are in significant pain.  He attributes the relief to knowing that their future doesn’t have to be a decision between “the hell of their own suffering or attempting a high risk suicide by themselves.” 

According to Minelli’s research, 80% of people who are approved by the doctor for an assisted suicide do not follow through with it.

Lastly, Minelli thinks that providing a service to help people kill themselves will lessen the high number of failed suicides that leaves the person in more pain. He argues that not everyone who shoots themselves dies, and sometimes the individual remains alive in a terrible physical state. Failed suicides burden the nation’s health system, leading to another motivation for Dignitas.

“If we want to reduce the number of suicides and suicide attempts, we should break the taboo of suicide. We should not say suicide should not happen, we should say suicide is a marvellous opportunity given to man to withdraw them from a situation that is unbearable for them,” said Minelli.

Referring to suicide as a “marvelous opportunity” has not sat well with top Swiss conservative officials who are irritated with the nation being viewed as  ”Suicide Tourism.”  

Since Minelli’s involvement in assisted suicide, the Swiss government announced it would consult on whether to ban or greatly regulate assisted suicide.  One of his opponents in the public prosecutor’s office has told Minelli that eventually there will be a “biological solution” to the Dignitas issue, hinting that he hopes Minelli passes.

Minelli’s decision to found Dignitas stemmed from watching his dying grandmother repeatedly asking the doctor to help her end her life when he was a child.

“Death is the end of our life. After a good life, we should have a good death. A good death is death without pain, where you can say ‘I had a good life, and I can now go to the other side. Now a days, death is exported to institutions, to hospitals. Death has become a lonely occasion,” explained Minelli.

Minelli showed a reporter the death apartment where people can experience a  ’good death.’ He told the journalist, David Levene, that he had numerous difficulties finding an apartment willing to house Dignitas. Neighbors at previous apartments complained at the constant presence of undertakers while a different apartment was shut down by the local council.

An apartment in an industrial area was very simplistic which horrified several clients’ family members. Daniel Gall wrote a book called “I Accompanied My Sister” which denounced the whole experience. Gall told the reporter, “It was ugly. Very, very ugly. It was the most horrible factory, next to the biggest brothel in Zurich. The conditions were monstrous.”

Minelli now hosts Dignitas at a two-story house located in an industrial industry, partially financed by donations from members. Dignitas is a non-profit organization.

The Dignitas location.

 To enter the house, guests walk across a wooden bridge over a goldfish pond until they arrive in a light room with a reclining hospital bed in one corner and a large sofa in another corner. By the bed there is a CD player along with open boxes of tissues ready on the table. There is another bed to die in down the hallway. The reporter states that the place is not funeral like, but clean, sunny and neutral, similar to a holiday rental apartment.

People who come to Switzerland to die with Dignitas are encouraged to bring family or friends. One patient brought 12 friends along. The staff gives restaurant advice for a last meal, but notes that the people are usually eager to get on with the death process.

One of the rooms at Dignitas.

Minelli said he is never present at the deaths. Beatrice Bucher, a paid member of the staff who works in head office, has been present at more than 20 deaths. The people are asked to come after eleven A.M., so the police formalities that occur after the death can occur during office hours.

“They need to know that they can go home at any time. I’m constantly asking if this is what they want. I have to be clear that this is the really the moment,” Beatrice said. On more than one occasion she has helped people return home who have changed their mind. “One woman still calls me to say thank you.”

The first stage occurs with two Dignitas members sitting at a round table with the individual who has chosen to die and his or her family members. The individual has to sign many documents, setting out the desire to die. It is up to the individual when they decide to take the anti-vomit medication that prepares the stomach and the lethal drug is given half an hour later.  The individual decides when he will take the cocktail.

“If someone wants to talk about their life for six hours, we will never hurry them,” Minelli said. “The music, all the details, are their choice. We are servants of their desire for self-determination.”

Bucher stays at the table and goes through the documents with the family. 

Nurse Beatrice Bucher.

  ”Sometimes they will sit at the table and talk about their family and their life and we have a nice time. Sometimes the person who is going to die will appear to be angry and quite bossy, and tell me to hurry up, but I know it is not how they are feeling inside.

Once I had a mother – not so old, in her 50s – who was really ill. She came with her daughter who was perhaps 25. The mother was very firm that she would go quickly and that it was not a problem. She told the daughter that she was not to cry and made her go and stand in the kitchen. I had to explain that this is not the way, you should not tell your daughter she cannot cry,” said Bucher.

“Some people say thank you and tell their family they love them, that they have had a really good life and that they are grateful that they can die,” she continued.

Regardless of one’s personal views on suicide, suicide should always be considered as a last option. There is always professional help available at Apex. If you are mentally ill and feeling suicidal please call a hotline or seek professional help before doing something irreversible.

Again, the National Suicide Hotline is 1-800-273-TALK. The therapists and psychiatrists at Apex (734-729-3133 for the Westland office)  are available and more than willing to help you.