Confronting a New Challenge

What should we be careful to communicate this Suicide Prevention Awareness Month?

Last week I shared some of the challenges I was facing as a parent who had to send their kids back to school still in the midst of a pandemic, plus a heated debate about whether kids should or should not mask.

I’m happy to report that I’m feeling a bit better about that this week. In fact, thanks to my friend Andy Slavitt and his amazing podcast, my oldest daughter’s school has now mandated masks. I may be giving Andy a bit too much credit here, but it’s true that good science explained easily helps change hearts and minds on tough topics. Sure, there are still some COVID bumps ahead, but as a parent AND a policy wonk, I do feel that we are doing the right thing for our kids, at least in this case. (The episode, which I highly encourage you listen to, can be found here.) 

There’s another challenge I’ve been wrestling with recently, though. And I want to share it with you, readers, in the hopes of potentially bringing some comfort ahead of this year’s Suicide Prevention Awareness Month.

TRIGGER WARNING: This is a tough post talking about suicide and suicide prevention. If this topic hits too close to home, you may want to refrain from reading further.

Every September, the main topic of conversion in the mental health space is suicide prevention – for good reason. We need to talk about the signs of suicide, offer advice on how to have a conversation with someone we suspect is struggling, and remind people of the resources available to them. (There are a plethora of suicide and other mental health-related resources available here.) You may have even shared a social media post or graphic in the past, expressing to all your friends, family, and other connections that if they are having thoughts of suicide, you are someone they can talk to.

Every time I talk to the media, I am equipped to know how to talk about suicide and make people aware of where to send those who might be in need of help. I know the evidence, have written about the topic extensively – here is just one example – and like every other Suicide Prevention Awareness Month, hope to see those same messages and similar resources shared.

There’s one more message, though, that a recent experience has compelled me to share: If someone you know does lose their life to suicide, you cannot place blame on yourself.

I do believe that we – all of us – can help prevent suicide. There are so many steps we can take as individuals, as a society, as health systems, and even as a nation to help prevent suicide, including some of the action items I’ve shared previously. Still, sometimes even those steps are not enough.

While we should absolutely remain committed to the goal of preventing suicide considering the crisis at hand – 156,242 Americans died due to alcohol, drugs or suicide in 2019 – we should also leave room for this very real, hard-to-accept reality. Identifying signs of suicide early by looking for key risk factors, minimizing risk, and getting people help does, indeed, work for many people – just not all people. Suicide is also not inevitable. Many people will experience suicidal thoughts or even ideation - but this does not mean they will die by suicide. Some will, however.

It’s true. Sometimes, no matter how involved they are with care, how supportive their family and friends, how evidentially effective their prescribed medication or therapy, or how wonderful their life may seem to be, sometimes, deaths by suicide still happen. And for those watching their friends and family experiencing this, it can be hard.  

That’s why, in talking lately with individuals who’ve experienced suicide with a loved one, the message “suicide is preventable” recurring again and again over the course of at least 30 days can feel like such a direct punch to the gut. This is especially the case when the person they love never exhibited any of the warning signs, and/or when they did everything in their power to give that person a happy, fulfilling life – and intervene with a textbook response once they realized that internally, there was still something missing for that person. Even if you do everything you can, or maybe you don’t do enough, it’s still not your fault - there’s an important boundary that needs to be set here. Setting these boundaries can be hard - but they also can be the right thing to do for you and your mental health.

The message “suicide is preventable” is meant to encourage action and drive meaningful change – and God knows we need that. However,  the more we repeat "suicide is preventable" with empty rhetoric, the more that phrase can begin to be confused with doctrine and mistakenly interpreted as "suicide is entirely preventable." And to blame oneself for a loved one’s death by suicide, simultaneously bringing oneself down to depths of despair, is the exact opposite of what anyone wants to happen.

This Suicide Prevention Awareness Month, let’s keep those affected by suicide in mind, too. Let’s be careful to communicate that suicide can be prevented, rather than stress that suicide is preventable 100% of the time. Let’s be reminded also that suicide is not inevitable – some suicidal thoughts will come and go with no one taking action. Let’s be there for each other this month, and let’s do the work to reduce suicide deaths as much as we possibly can.

There’s certainly ample room for action.

NOTE: If you or someone you know is struggling with thoughts of suicide, consider calling the National Suicide Prevention Lifeline (1-800-273-TALK [8255]), or texting the Crisis Text Line (text HELLO to 741741). Both services are free, confidential, and available 24 hours a day, seven days a week.