WORCESTER — Sometimes a fear of even saying the word suicide — as if bringing it up could cause someone to act on it — hinders prevention efforts.

The stigma associated with suicide, now the third-leading cause of death in the state among adolescents and young adults, behind car accidents and murders, has prompted the formation of a new local coalition focusing on awareness and prevention.

The Central Mass Coalition for Suicide Prevention, co-chaired by Dr. Barry N. Feldman, director of psychiatry programs in public safety and assistant professor of psychiatry at the University of Massachusetts Medical School in Worcester; and Paul A. Richard, executive director of the Leominster-based SHINE Initiative, had an inaugural meeting in October, and has a larger one planned for 4 p.m. Nov. 27 at the Worcester Public Library.

The focus, Dr. Feldman said, will obviously be on suicide prevention, especially in youth. But, he said factors such as identifying those at risk, including middle-, high-school and college students, and military veterans, and finding them services is key. Also, he said, “post-ventioncq,” meaning reaching out to families and loved ones left behind after a suicide, and offering counseling at schools will be emphasized.

“We have to show people how to deal with the unfortunate aftermath,” Dr. Feldman said.

The coalition will consist of mental health professionals along with the public, clergy, school and college personnel, law enforcement, human service agencies, and family members and friends of people who have taken their lives within the last year or so.

“The goal is to prevent suicide in Central Massachusetts,” Mr. Richard said. “And first and foremost, more people need to be aware. We need to educate, and make people more comfortable with talking about it and the impact it has on our lives.”

Parts of Central Massachusetts, he said, have a higher suicide rate than the state, because of factors such as isolation, limited access to health care and lack of awareness.

SHINE, a nonprofit organization with a mission to recognize mental illness in children and young adults through research, education and programs, last month sponsored a heavily-attended mental health conference at which Dr. Feldman was one of three panelists. He also gave a presentation on youth suicide, and conducts workshops and training sessions on suicide for law enforcement agencies, emergency responders, health care providers and educators.

“There is a significant need for local services. We have to fill in the gaps in Central Massachusetts, and let people know about access to services,” he said.

“The real goal is to try to reduce risk factors and restrict access to means,” he said.
Dr. Feldman has researched suicide for 15 years and found that a major cause is untreated depression.

“Depression presents itself very differently in young people. There can be irritability, anger, and agitation, and sometimes binge drinking,” he said.

Most suicides, he said, are preventable, but people considering taking their own lives are usually in a crisis and do not make good decisions.

“They get tunnel vision,” he said.

Dr. Feldman recounted answers he got when he asked suicidal patients what it felt like to be in that condition.

“They say things like ‘it feels like my brain is broken.’ Like a broken bone. It’s intense psychic pain,” he said.

Along with depression, warning signs include previous suicide attempts, access to ways of killing oneself such as pills or guns, and certain demographics such as gender, age, and ethnic group.

Risk factors include mental illness, and drug and alcohol abuse. Dr. Feldman said while a “suicide gene” has not been discovered, there is some evidence of suicides in families with histories of depression, mood disorders, schizophrenia and alcoholism.

While bullying has recently been connected to suicide in media reports, Dr. Feldman said there is not an epidemic of suicide because of bullying.

“There is no causal relationship, but it is an important risk factor in groups that are marginalized by race, religion, or sexual orientation. It puts those kids at risk,” he said.

Mr. Richard said the coalition plans to establish support groups, and hold more seminars.

“SHINE was drawn into it because our mission deals with mental illness in children and young adults. There is a stigma associated with suicide, and people don’t know how to address it. It’s not like a broken arm; there’s no visible pain,” he said.