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Petra Kottsieper, Ph.D.
On October 5 the annual Walk Out of the Darkness, held by
the American Foundation for Suicide Prevention will take place here in
Philadelphia as well as many other cities around the country.
I will be walking in this walk as a person who came very
close to losing a family member to suicide, know people who have successfully
committed suicide, as someone who has a past history of mental health concerns,
and as a mental health professional.
"Suicide claimed
39,518 lives in 2011 in the United States alone, with someone dying by suicide
every 13.3 minutes. A suicide attempt is made every minute of every day,
resulting in nearly one million attempts made annually."
Losing someone to suicide is a profound event, sometimes not
surprising to the families and friends of the person who choose to end his or
her life, and sometimes it explodes into people’s lives completely unexpectedly.
Many people who attempt or complete suicide experience extreme psychological
pain and suffering and often see suicide as the only way out. Often, people are unable to reach out in
their darkest moments despite the relatively abundant resources that exist in
the US. Why is this?
Stigma, fear, and hopelessness are all answers to this
question. Stigma of mental illnesses remains a significant barrier to help
seeking. Public stigma is not just grounded in the well documented beliefs and
resulting stereotypes that people who are "crazy" are dangerous and
unpredictable, but also in the fact that having "mental" problems is
seen as something fundamentally different than having a "physical"
problem. And while mental and physical illnesses may very well experientially
vary, problems with mental health concerns are observed not only as different,
but are also judged as worse. This is undoubtedly rooted in our perception of
the superiority of the mind over our body; mind as the seat of our
"rationality" and emotional balance. In addition, some "mental health”
problems, obviously due to their complexity, remain poorly understood. In other cases we know a lot, have effective
treatments, but these treatments are still not considered readily acceptable to
be sought out. Acknowledging that a
family member, friend, or even oneself is having a mental health concern means
that one has to accept this in the context of likely societal distancing and
associated negative judgments.
This is where the annual walk comes in. The walk addresses what is at the heart of
the pervasive problem of stigma that continues to exist and makes it hard for
many people to seek help for the problems they are experiencing. The walk is
about "coming out," shining a light on the significant public health
issues of suicide and having survivors come together being visible and open
about having lost a family member without fear and embarrassment. Ending the
taboo.
So what can we do as
friends, family members, professionals, individuals who are struggling?
As a society we need to become so much more aware of what
mental health problems really are. In addition to understanding their
etiologies we also need to understand suicidal ideation as a phenomenological
experience. This is especially important for professionals who need to work on
gaining a better understanding of suicidal thoughts of his or her presenting
patient. We need to talk to people about
suicide, and research indicates that even as professionals we are often not
comfortable with this topic.[i] We need to carefully examine our responses as
professionals to suicidal talk of our patients and to carefully assess if
hospitalization is necessary or not. In many cases it is not, but fears of
liability and risk pervade our profession.
We need to continue to de-stigmatize mental health concerns
and embrace the recovery framework that has become mental health policy in many
parts of the US following the U.S. President's 2003 New Freedom Commission on
Mental Health that emphasized the need for a transformation of our nation's
mental health system.
We need to embrace the position that people generally can
get better, provide hope and afford quality mental health care to
everyone. Recovery also does not always
mean a return to baseline functioning. This means we all need to become more
tolerant of mental health symptoms, as long as the individual chooses to live
with these symptoms and the person is not endangering him/herself or others. It means we need to treat everyone with
respect, empathy, and compassion. We
need to make it acceptable for someone with an acute exacerbation of, for
example, debilitating anxiety to take a sick day at work for self-care or an
emergency appointment with their treatment professional, and not having to lie
and call in with a cold.
If we lose someone to suicide we need to stop "forcing”
survivors to talk about their grief behind
closed doors. Research has shown that
survivors of suicide are treated differently than survivors of other deaths by
other causes. Specifically, the "societal
perception that the act of suicide is a failure by the victim and the family to
deal with some emotional issue and ultimately society affixes blame for the
loss on the survivors" is something
that we can all work on to combat in our own lives.[ii]
While I am not saying or arguing that everyone who attempts suicide
has a mental illness or mental health concern, it is undoubtedly true that many
people that attempt or successfully completely suicide, do. It is time that we talk more openly and
urgently about this public health crisis. We need to end the stigma that prevents so many people from at least
attempting to seek help, especially in light of the many available treatments
and avenues for help that are available.
This help can be gotten from a lot of sources; families, friends,
clergy, suicide hotlines, therapists, and medical professionals. We all play a role in this. If you know someone who is not doing well, or
you suspect may not be doing well, ask them how they are really doing today.
**If you are someone you know is struggling with thoughts of suicide get help now. Contact
**If you have lost someone to suicide, there is support. Contact
**If you are someone you know is struggling with thoughts of suicide get help now. Contact
- http://www.suicide.org/hotlines/pennsylvania-suicide-hotlines.html
- https://www.afsp.org/preventing-suicide/find-help
**If you have lost someone to suicide, there is support. Contact
- http://www.suicide.org/support-groups/pennsylvania-suicide-support-groups.html
