[Editor’s Note: This Guest Blog is from Stephen Mendelsohn, one of the leaders of Second Thoughts Connecticut.]
People with Chronic Health Conditions and Disabilities
Living with chronic or terminal physical conditions can place significant stress on individuals and families. As with all challenges, individual responses will vary. Cancer, degenerative diseases of the nervous system, traumatic injuries of the central nervous system, epilepsy, HIV/AIDS, chronic kidney disease, arthritis and asthma are known to elevate the risk of mental illness, particularly depression and anxiety disorders.
In these situations, integrated medical and behavioral approaches are critical for regularly assessing for suicidality. Disability-specific risk factors include: a new disability or change in existing disability; difficulties navigating social and financial services; stress of chronic stigma and discrimination; loss or threat of loss of independent living; and institutionalization or hospitalization.
Until recently, the CTSAB was considering assisted suicide of the terminally ill as a separate issue from suicide prevention. The active disability community in Connecticut, however, has been vocal on the need for suicide prevention services for people with disabilities. There may be unintended consequences of assisted suicide legislation on people with disabilities. Peace (2012)** writes that “Many assume that disability is a fate worse than death. So we admire people with a disability who want to die, and we shake our collective heads in confusion when they want to live.”
People with disabilities have a right to responsive suicide prevention services. The CTSAB intends to continue to explore the needs of the disability community for such services.
Targeted Recommendations:
- Develop greater scrutiny of someone’s intentions to die.
- Identify and train practitioners to develop expertise in the work with disabled people who are suicidal.
- Do not “assume” suicide is a “rational” response to disability.
- Treat mental health conditions as aggressively as with a person without disability.
- CTSAB should encourage and increase participation from the disability community and encourage educational presentations.
Cathy Ludlum presented our issues to the CTSAB back in March 2014 and it appears they have taken our concerns about disability discrimination in suicide prevention seriously. Second Thoughts Connecticut is now listed on their website as a member. Other states still need our input into their state suicide prevention plans to include the disability perspective. Some states, such as Oregon and Washington (the first two states to legalize assisted suicide), have state suicide prevention plans that only focus on youth while ignoring elder suicide. Our success in Connecticut can be useful not only in encouraging a change in other states’ suicide prevention policies, but in making our case that what Compassion & Choices calls “aid in dying” is suicide that should be treated no differently merely because the person affected is old, ill, or disabled.
** This refers to the Hastings Center article by Bill Peace, an NDY Board member, entitled Comfort Care As Denial of Personhood.