Plus: tips on labor conditions for mental health workers in El Cajon and La Mesa below~
By Jonathan Goetz
September 11, 2024 (El Cajon) -- September is suicide prevention awareness month. According to CNN, the United States has made great strides in reducing suicides and suicide attempts among teens and youth over the last decade, but rates have increased in those over 35.
San Diego County crisis and referral numbers include:
Public hotline (County of SD): 888.724.7240
Private agency (API): 800.766.4274
Warmline (typically non-emergencies): 619.295.1055, 3:30 p.m. - 11 p.m. except major holidays
Nationwide call/text: 988
In person: If it escalates from an "ideation" v. into "acute" danger then wait at y/our local Emergency room in case they think s/he should be admitted to a medical institution but beware they may put a person on a 72-hour-hold but typically won't keep her or him locked up for longer than a week unless s/he's like really adamant about not leaving.
I would attribute a drop in bad stats from teens and youth (TAY) to understanding and acceptance of the LGBT community and huge efforts by the mental health community, financed in no small part from the millionaire's tax payed mainly in Hollywood/L.A. and San Francisco/San Jose on income above a million dollars per year, for ensuring as many Californians as possible survive into adulthood.
For those above 35 and above, perhaps ageism in y/our culture contributes, much unlike say Japanese culture, which delights in the wisdom inherent with increased life experience found more often than not in older persons. Another contributing factor may be unmet life expectations.

Sometimes the most effective thing you can let y/our loved one know is that you want him or her to live. Maybe s/he's not sure:
I would suggest if someone is contemplating suicide the most effective way to convince someone in the moment to not give up on y/our future has been, "I don't want you to die," is usually how they say it but I would make it a little more positive and upbeat perhaps with, "I want you to live," or "I want you alive."
Those seem to be effective for me in moments of despair which last hours to weeks to months but in most common especially when someone first goes on an antidepressant so don't assume anything except that your loved one may want to be reassured but not lectured scornfully although the instinct does involve a fight v. flight sometimes prompting radical change so be ready for but do not initiate brainstorming.
Thanks, but really~ no thanks...
In fact, it is recommended by County of San Diego Broadway clinic's Mindfulness exercises to, poorly paraphrased, most certainly do NOT problem-solve while emotions have too firm a grip on you.
Let cooler heads prevail~ let's weave!
Wait until you're calm to problem-solve because one's thinking is not morally but instead fundamentally flawed when s/he is extremely emotional, such as is taught in the Wisdom of Dr. Low, angry (temper turned outward), or in despair (temper turned inward), so most definitely do NOT make any major decisions except from a calm grounded state, although your emotions may prompt interesting motivation to make major changes to yourself. In Dialectic Behavioral Therapy (D.B.T.) Dr. Marsha Linehan says a motivation to change oneself is vital for mental health treatment to be of most benefit.
Unsolicited advice is often considered criticism, which may trigger a sharp acute reaction when excited. Refer them instead to a mental health crisis line like 9-8-8 or they're a sibling or someone very close, ask them to call you instead of doing something like that, or a local Emergency Room where they can be transferred short-term to an institution. I still remember Melanie, Gary, and now, Chris, saying "call me instead," when recent/repetitive/current (respectively) suicidal ideation came up in conversation.
With some people, unsolicited advice can make the ideation worse, whereas with others it could be helpful instinctively to re-direct the patient's energy. If you want to give it advice, first (and often only) validate "I am so sorry that sounds tough that ... ," and perhaps solicit, if you're trying to refocus the person on a pleasurable activity, crisis hotline or if you really want to critique their faults, make sure s/he is calm first, "would you want to know what I might do instead?" And then perhaps more validation: "because it sounds like you're not happy and so I've just gotta think there's something less devastating," and in closing, whether you've opened with it or not, make sure s/he knows about the Biden administration's inaugural 9-8-8 or even better a local number such as the San Diego Access & Crisis Line (ACL) 888.724.7240 or the 24 Hour API Crisis and Referral Line at 800.766.4274 also for San Diego residents countywide. For non-emergencies there is also a warmline here locally from 3:30 p.m. - 11 p.m. seven days a week except holidays: 619.295.1055. Anyone can dial or even text 988 nationwide and now that I'm covering El Cajon but from affordable housing in a semi-rural County in Kansas (this month we're wearing purple ribbons for recovery) without (w/o) a 24 hour warmline (but we do have a 24 hour crisis line) I hit up Bing Copilot and s/he was really helpful in that late-night hour.
The four levels of care in El Cajon
Please note: level of care not to be confused with standard of care, all three are excellent although Heartland best holds onto staff for longest periods of time among all three (3) of El Cajon's primary mental health providers.
Heartland:
If you're struggling with emotion regulation, in El Cajon, Virginia teaches Dialectic Behavioral Therapy (D.B.T.) a pioneering behavioral health treatment from Dr. Marsha Linehan developed around a mental health condition she invented meant to be treated without medication, for clients of Heartland Wellness Recovery Center (see link below) and elsewhere.
The clinic also has one or two psychiatrists for medication management, and pretty much everyone who works there stays.
Lisa leads a peer-run "spot" program to change your responses to common trivialities based on The Wisdom of Dr. Low, also for Heartland patients and nationwide.
According to A.I. in consultation with the Recovery International website, "Dr. Low used his wisdom to develop a way to help people master their fears and anger by cultivating self-esteem and resiliency using a cognitive-behavior, peer led program that has helped hundreds of thousands of people manage symptoms triggered by daily events."
Broadway:
If you're lower maintenance with the County on Broadway, Abel leads a weekly mindfulness exercise class. They also have one or two psychiatrists. There are several weekly classes including one that doesn't require enrollment for friends and family of those with mental illness downstairs.
Medical doctors on Broadway rotate as often as every two years however the remainder of the staff is pretty much fixed.
API:
For the highest need clients, Alvarado Parkway Institute (A.P.I.) provides up to four days a week of comprehensive behavioral health services throughout San Diego including El Cajon, La Mesa and City Heights, for therapy, medication management, a meal or two, and local transportation, subject to approval from a medical doctor in their stable from the community.
Doctors connected from the A.P.I. network are stable for decade(s) whereas their interns change as frequently as every 12 or 16 weeks, depending on their academic institution, but frequently serving as many as four stints depending on their degree/certification program, and staff, shift leads, etc., working a length of time anywhere in between. The A.P.I. inpatient hospital in La Mesa also contracts as needed for one-day slots from at least one app matching registered nurses (R.N.'s) with gig opportunities.
Housing:
If one needs housing, the East County Transitional Living Center (ECTLC) is a faith-based discipleship program that will expect you to work, quit smoking and in general frowns upon psychiatric medication, but does its best to make qualifying accommodations. If you don't wash out, their one-year certificates of graduation are gold in convincing landlords rent to an otherwise perhaps questionable person (but they're very strict) in east county and re-entering stable housing.
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Credits
Photo 1: Author
Photo 2: Recovery International - like N.A. except no drug addiction necessary and excludes higher power references, just Dr. Low's "spots" you learn, practice and report back on y/our "spotting" and when you told yourself the saying that week in a weekly peer facilitated support group. Please note: You can't bring up catastrofic events in these free peer-facilitated groups, so save those for your one-on-one's, as only trivialities are supposed to be discussed at y/our weekly San Diego R.I. meeting.
Photo 3: Instagram
Photo 4: JRG Publishing/ECM file photo
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Disclaimers:
The author's perspective in this article was developed from various sources. His feedback is not a complete list of every preventative or loss control measure. The information is not intended to replace additional safety manuals or the advice of another qualified professional(s). (S)/(h)/(w)/e make(s) no guarantee of results from use of this information. (S)/(h)/(w)/e assume(s) no liability in connection with the information nor the suggestions made.
The opinions in this editorial reflect the views of the author and do not necessarily reflect the views of East County Magazine. To submit an editorial for consideration, contact editor@eastcountymagazine.org.
Comments
YES!
hear a song about Rachel Platten's October 2023 she made it #PTL
Rachel Platten - I Don't Really Care (Set Me Free) (Official Lyric Video) (youtube.com)
today
I will be thankful for my stable housing~