Recently I attended a suicide awareness event held by our local school district in response to several youth who have taken their own lives in the last month.  I was honored to have been invited to participate in the event, “Let’s Talk About It” as part of a panel of community experts.  The event seemed helpful to the community members that attended and provided valuable information about the behavioral warning signs of someone who is at risk for suicide and the type and nature of the mental illnesses that can lead to suicidal behavior.  I appreciated that suicide was discussed as being part of a continuum from mental health to mental illness with suicide on the far end of the continuum.  Understanding mental health in this way highlights how we all have mental health and sometimes we need care or intervention.  A dynamic mirroring our physical health; when we get the flu, realize we are at risk for heart disease or get diagnosed with cancer.

The true experts at this event, I must say, were the panel of youth sitting across from me.  They were six high school students from around the district that had been impacted by suicide.  Some had friends who had attempted suicide or thought about it.  Others spoke candidly about their own mental health struggles and thinking themselves at times that they wanted to die. All agreed they were now trying to help their peers feel less alone and less ashamed navigating their own mental health struggles.  Their courageousness and resulting candor was inspiring.  Moving beyond Eirk Erikson’s predictable stage of development marked by a fight for independence with the intent of leading to a better sense of themselves,  these youth through brief brave moments in their conversations recognized their deepest of needs.  I’ve seen this dynamic on occasion in my clinical work, where perceptive youth, seemingly listening to an inner voice, engage in behaviors that I describe as “anti-teenager.”    In an act of what might be viewed as survival they swim upstream against adolescent expectations and find ways to communicate verbally what they need with great insight and wisdom; thereby inviting their parents, teachers, mentors, community faith leaders and counselors to meet their needs.

In this case, the youth shared pearls of wisdom; glimpses into the deepest parts of who they are with a comprehensive understanding of what they need.  They shared that they do not talk to friends about their mental health struggles due to fear of judgment. They do not want their privacy violated and at the same time want parents to check their social media sites.  They believed that parents would be better positioned to help their children if they listened more and talked less; that parents shouldn’t take no for an answer if something doesn’t seem right; that they should approach the conversation again and again and they NEED to feel their parents love them unconditionally.  Meeting these needs though, in many instances requires difficult, honest, awkward conversations.  Much like the youth on the panel modeled for the audience.  By the end of the event, everyone agreed that the conversation needs to continue.  Having the conversation about mental health and preventing suicide in reaction to the community’s loss is important, but it is one that must be revisited over and over.  I offer the following suggestions with the goal of opening space for you to consider your role in keeping the conversation going and what contributions you are willing to make.

 Tips for Keeping the Conversation Going

Know the signs

It is important that as community members we know the signs and symptoms of a mental health crisis; just as we have been educated over the years about the signs and symptoms of a heart attack so that as a community we can take swift and decisive action in order to save someone’s life.  Similarly, to know and be able to identify someone who is in severe emotional pain encourages us to initiate a conversation about mental health, offer hope and identify ways to directly link them to local services. Educating yourself is an important part of keeping the conversation going.  Here are a couple options:

Each Mind Matters, Know the Sign

http://catalogue.eachmindmatters.org/program/know-signs/

QPR (Question, Persuade, Refer)

https://www.qprinstitute.com/about-qpr

USA Mental Health First Aid

http://www.mentalhealthfirstaid.org/cs/

Reach out to someone

Once you know the signs and learn the steps to take, you will be ready to reach out to someone you know or presume to be struggling with their mental health.  People struggling with their mental health often suffer in silence for a number of reasons including fear of being judged, misunderstood or discriminated against.  It may feel uncomfortable initially but likely your efforts will be met with reassurance that they are managing fine or utter relief that someone could see their previously invisible unacknowledged pain.  It’s okay, take the risk.  Let your arm pits sweat and your heart race and then ask someone, “how is your anxiety lately”?  or “where are you with the depression these days”?  It may be uncomfortable for both of you initially but that is the point.  Moving past the stigma; core belief that we can feel physiologically that tells us we are talking about something shameful and shouldn’t be.  Once we break down those barriers and your friend recognizes that you are an ally in their fight against depression or anxiety the conversation will no longer be forbidden but welcomed.  But first, you must chose to be vulnerable.

Share your story

As the stigma and discrimination reduction (SDR) movement gains momentum celebrities, intellectuals, humanitarians, scientists, creatives, community faith leaders, civil servants and community members increasingly recognize the need to start talking openly about mental health.  Courageous trailblazers among all the above listed categories are contributing to the movement and raising awareness by sharing their own experiences with managing a range of mental health challenges.  Moving forward in this way requires that you first identify an approach that feels most authentic for you.  Some of you may use the importance of keeping the conversation going outlined here as an impetus to start that blog you’ve been contemplating or you may choose to broach a conversation with a coworker or friend privately.  Regardless of the outlet for your story, the impact is the same.  You are no longer sitting in silence and others will begin to realize that they are not alone and do not need to sit in shame and suffer in silence either.

Attend a community event

Increasingly, there is any number of community based events designed to increase mental health awareness to choose from.  Thanks to organizations like Each Mind Matters, a grassroots movement in California, identifying and locating events across the state is easier than ever.  Another approach would be to hold your own event.  Pull leaders together in your community to identify local resources and gaps in care.  Organize a meeting with your church community who interested in talking about mental health and learning more.  Host an event in your home to discuss the mental health needs of your friends and family and experiences with trying to seek care.  Engaging in these and similar activities helps create a sense of community.  It raises awareness for those who don’t understand or fear the struggle and builds an accessible support network to be utilized if needed in the future.

Here is link to find events near you state http://www.eachmindmatters.org/events/

Be respectful

How we talk about mental health is important.  The words we choose and the language we use even in our everyday lives and seemingly unrelated conversations is important.  As you engage with your friends and coworkers it is statistically likely that any number of them are struggling or will with their own mental health.  In fact, 1 in 5 adults struggle with their mental health in any given year.  Words like crazy, nuts, psycho and cray cray are deeply embedded in how we speak to each other.  I’m guilty of this myself.  Fundamentally though, this language is demeaning and serves, if even unintentionally to marginalize those that likely already feel shame and guilt for their mental dis-ease. Challenge your own assumptions about who we are (those of us that find ourselves leaning on occasion toward the illness side of the mental health continuum) and what that then means about us as mothers, teachers, fire fighters, accountants, brothers, grandparents, community members and human beings.

Take care of yourself

Similar to parenting, do as I say not as I do is nowhere near as effective as modeling in your family and community behaviors that support your own mental health.  In our fast paced, digitally driven society it is increasingly difficult to disconnect, find quiet, rest and reset.  But these breaks are good for our brains and foster our most creative innovative selves.  Seek balance by making time to do the things that create meaning in your life, allow you to know yourself better and bring you joy (i.e. reading, cycling, socializing with friends, cooking).  Get plenty of rest, exercise, eat right…and when you don’t, treat yourself as kindly as you treat others.  Give yourself permission to be who you are and to feel what you feel.  If you find that things are becoming increasingly challenging in your life and you’ve not been yourself for two or more weeks, reach out to a professional for care.  Sometimes making the phone call is the hardest part.  Invite a friend over for a cup of coffee to support you during the process or ask a family member to call for you.

If you or a friend recognizes their need for immediate help please contact

http://www.suicidepreventionlifeline.org/