and I hope we know some things about how to talk about it.
Seriously, the prevalence of this topic in culture, media, social media, and just my own life this week has been astounding. The passing of celebrities Kate Spade and Anthony Bourdain this week have been attributed to suicide. In the midst of that, a CDC study was released Thursday, identifying “suicide rates rising across the U.S.”
At a personal level, on Monday a great church I used to attend launched their annual pub theology series, this year with a focus on mental health issues. (A video clip of my friend Fr. Ryan Waller speaking on mental health and the church is available here, and the article that he went on to publish for the Dallas Morning News is available here.) On Tuesday I started seeing patients at a psychiatric hospital, as part of my summer internship in hospital chaplaincy. On Wednesday I finished watching Season 2 of the recent Netflix series “13 Reasons Why,” a series which details the “reasons why” fictional high school girl Hannah Baker took her own life — and the ripple effects of her death on her community.
Add this all up, and it can feel overwhelming. Hence why I basically had ice cream for dinner last night and plan to take a walk to a pond later today. #selfcare
I imagine if this is an overwhelming topic for me (someone training in mental health care), how much more complex it might be for people not accustomed to talking about suicide openly, fearful of it, traumatized by it in the past or present, or currently experiencing suicidal thoughts in their own lives or the lives of their family or friends.
We have to talk about suicide. We have to do so kindly, clearly, and quickly (i.e. as soon as we notice concerning statements or behaviors). And those of us not currently experiencing symptoms of mental illness must be involved.
One of the most important exhortations I’ve seen floating around social media this week is the reminder that it isn’t enough to tell people who are struggling, “Speak up. Get help.” Rather, it can be important for friends, family, and others to speak up and be the help. That’s because a hallmark of depression, as well as some other mental illnesses, is social withdrawal. By this, I mean not just a preference for being alone but a profound psychosocial incapacity for reaching out. That all requires much more physical energy, cognitive decision making, and social connectivity than depression typically allows.
One way that we can speak up and be the help that people may need is by enacting the “QPR” method. Taught widely by the QPR Institute, this method is like CPR, which rescues people having trouble breathing, but in this case aims to rescue people having trouble finding the will to keep living.
- Question: Ask the person you’re concerned about as clearly as possible something like, “Are you having thoughts of killing yourself?”
- Persuade: Encourage the person you’re concerned about not to act on their suicidal thoughts — at least not today or not this week. For example, in crisis counseling, I sometimes tell people, “Let’s make an agreement that you you won’t act on those suicidal thoughts today. We can check back in tomorrow and go from there. How does that sound?” In addition, if they have access to a gun, rope, pills, sharp objects, or other instruments that they’ve identified as a way they might kill themself, persuade them to get rid of that object(s) at least until their crisis has passed.
- Refer: Refer the person you’re concerned about to a local mental health professional, a hotline like 1-800-273-TALK or Crisis Text Line (just text “home” to 741-741 to chat with a trained crisis counselor!), or a local emergency room if they are in imminent risk. Stick with them while they contact one of these referral sources.
Take care of yourselves, friends. And take care of your loved ones. This week and always.
“Welcome to the world. Beautiful and terrible things will happen. Do not be afraid.” – Frederick Buechner