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Simple things you can do to help someone who may be thinking about suicide

This problem is bigger than numbers. It's people. It's moms, dads, kids, siblings, grandparents, friends, and partners.

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Sometimes it's hard to recognize if someone is depressed.

Suicide affects people across race, age, gender, and socioeconomic status. Quite frankly, suicide doesn't care.

More than 45,000 people died by suicide in 2020 alone, according to the Centers for Disease Control and Prevention. For people between ages 10 and 34, it's the second leading cause of death. While thousands complete suicide each year, an estimated 9.4 million adults in the U.S. had serious thoughts of committing suicide.

This problem is bigger than numbers. It's people. It's moms, dads, kids, siblings, grandparents, friends, and partners.

These are complex but treatable issues, and yet too often it's still considered taboo to discuss or speak frankly about suicide or mental health.

When a friend, loved one, or colleague appears to be suicidal, it can be hard to know what to do or say. But the numbers don't lie. Our silence won't slow this public health crisis; when it comes to helping someone in need, inaction is not an option.

Health professionals and people who specialize in suicide prevention say there are small actions you can take to help.

Here are some simple things you can do to help someone who may be thinking about taking their life:

1. Know what to look for.

Familiarize yourself with the warning signs. People thinking about suicide or self-harm may talk about feeling hopeless, trapped, or in incredible pain; withdraw from friends or family; experience drastic changes in mood; and/or increase their use of alcohol or drugs. Someone considering suicide may also talk or write about wanting to die. But the warning signs aren't always cut and dry.

"We tell people to look for changes," says Andy Cartmill, a trainer of suicide and intervention models and senior program educator with Addiction Services for Washington County, Oregon. "Trust your intuition. If you think something is up, there's no harm in being honest and saying, 'I just noticed a change. Are you doing OK?'"

2. Show support without judgment or anger.

Even if your friend hasn't reached out to you, check in. Let them know you care about them and you're concerned. This isn't the time to panic, argue with them, or even to try and talk them out of it.

"We tend to fix things and point out people's strengths and say, 'What about your wife?' 'What about your kids?'" Cartmill says. "It's possible they might not perceive those as strengths. So they very well might think, 'I'm doing my wife or kids a favor by relieving them of a burden.'"

Simply listen. And allow them to speak without judgment.

3. Ask specific questions.

If you're not sure if your friend is in immediate danger, the best thing to do is ask.

Individuals at the highest risk for suicide in the near future will often have a plan, the means to put the plan into action, a time frame, and intention. Asking questions will help you determine immediate risks, and the answers may inform what you do next:

"Do you have a plan to harm or kill yourself?"
"Do you have access to weapons or things you can use to harm yourself?"
"Have you thought about how or when you would do it?"
"Are you thinking about suicide?"

If you don't know what a statement or response means, ask for clarity. This may feel awkward or intimidating, but it's important to be direct and honest. And don't worry, talking about suicide won't plant the seed in someone's head.

"Research over and over again says that is not going to happen," Cartmill says. "That's one of the things people are afraid of ... 'If I ask that question, am I going to get them thinking about suicide?' and the answer is no."

4. It's OK to not know what to say.

If you're not a trained health professional or crisis counselor, this territory can be tough to navigate. It's OK to not have the perfect speech or talking points. It's first and foremost your job to listen and recognize they're hurting. That means not changing the subject or minimizing their pain.

"You don't have to be an expert; you really don't. Listening respectfully and being honest is OK," Cartmill says. "It's OK to tell people, 'What you're saying is scaring me. I want you to be OK,' and go from there."

5. Suggest professional help, or offer to help them find it.

This is not an effort to pass them off to someone else and instead aims to get them to a doctor or therapist better equipped to help with their pain. If they're seeing a professional, encourage them to get in touch with them immediately. You can even offer to accompany them to the appointment.

If they're not under a doctor or counselor's care, help them find a mental health professional or call the U.S. National Suicide Prevention Lifeline at 800-273-TALK (8255). It's a free, 24/7 service that can provide people thinking about suicide and those who care about them with support and connections to local resources.

6. Remember, if it's an immediate or crisis situation, it is OK to use the emergency room.

If you wouldn't hesitate to call for a broken bone or allergic reaction, don't hesitate with suicide. In a true crisis, it can't wait.

Suicide doesn't care. But lots of people do.

Keep the number for the National Suicide Prevention Lifeline in your phone, 800-273-TALK (8255). In an emergency, having that number handy for yourself or someone you care about may make all the difference.

Even talking about suicide or suicidal ideation may seem overwhelming or scary, but experts agree: Hope and recovery are possible. There are many treatment options available, with several at low or no cost. It starts with paying attention to warning signs, reaching out, and getting help if you need it.

This article originally appeared on 04.12.17

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8 things to consider before you write a 'please reach out' post about depression.

After the deaths of Kate Spade and Anthony Bourdain in early 2018, there was an influx of social media posts about what can be done to help prevent suicides.

Many, if not most, were posts with suicide hotline numbers and messages telling people to reach out if they are struggling with suicidal thoughts.

The CDC reported in June that U.S. suicide rates have increased more than 25% since 1999. Out of the top 10 causes of death, suicide is one of the three of those causes that are actually increasing. It's undoubtedly a serious public health problem and one that hits close to home.

I feel torn between gratitude that people are recognizing the severity of the problem and frustration with these types of responses.

Unfortunately, posting a hotline number and asking people to reach out isn't very effective when it comes to actually preventing suicide.

It's a much more complicated issue than it may seem on the surface. Reaching out is harder than you think, and often those who do seek treatment are unable to get it. Friendship and phone numbers might look helpful, but they can't solve the larger problems that feed into the suicide epidemic.

If people really want to help, it's important that they (1) think through and thoroughly understand the issue and (2) take actions that can actually have a real effect on supporting people who struggle with mental illness.

Here are a few key ideas and actions that can help everyone better understand suicide:

1. Don't think or assume that all people who are suicidal are not getting help. Many, if not most, are.

Depression is a freakin' monster of a beast. If you haven't experienced suicidal thoughts before, then you can't speak to the heaviness, the solidness, the loneliness, and the shame that exists parallel to depression. It's exhausting.

The terrible reality and truth of depression is that sometimes all the help isn't enough.

2. Try to understand why a depressed or suicidal person might not find a hotline number helpful.

When I've been stuck in depressive states, I lack the feeling of connection with myself and with others. Posting a phone number is impersonal, and it feels like a one and done type of effort.

3. Remember that mental health, suicide, and depression are full-time struggles.

The last time I saw this many postings of the suicide hotline number was when Chester Bennington died. Why does it have to take a public tragedy to garner support? It in some ways, it invalidates the experience of the person struggling with depression.

4. Keep in mind that in order for a hotline to be helpful, the depressed person has to feel worthy of being saved — and they often don't.

One of the pernicious parts of depression is that it tells you that you aren't worthy of receiving help, of succeeding, of living; in other words, you think you aren't worthy of doing the very thing you need to do to hopefully save your life.

So then what?

5. Instead of telling people to reach out if they need to, reach out yourself if you see signs that someone you love is depressed.

When someone is in the throes of depression, reaching out for even simple things can be an impossible task. It's up to friends and family to be proactive in checking on loved ones.

If you're concerned about someone, pick up the phone and tell them. Don't know what to say? Tell them that, too. Often it's not what you say but the fact that you said something at all that can make someone feel like they are connected to something larger than themselves.

6. Don't wait until there are signs to tell someone they matter to you.

Often after someone dies by suicide, their loved ones will say they had no idea or didn't see any signs the person was depressed. Mental illness is tricky in that it knows how to cover itself up when others are around.

So don't wait! There's nothing wrong with telling someone you love that they matter to you and its important to you that they're in your life. If they aren't depressed, they'll be touched by the gesture. But if they are, you may have just had an effect on their life.

7. Vote in November.

The Trump administration has asked the courts to strike down several pillars of the Affordable Care Act, including its protections for Americans with pre-existing conditions. Mental illnesses are considered preexisting conditions. If this goes through, treatment, medications, therapy, hospitalization, and more will be even more inaccessible to people who need them than they already are.

8. Work to end mental health stigma by paying attention to the language you use.

Focus on using person-centered language so that people can be seen first as a person and not defined by their mental health issue. Combat stigma by talking about mental health issues on a regular basis.

I wholeheartedly believe that everyone who is posting the phone number to the National Suicide Prevention Hotline is well-intentioned and wants to help people they know if they are feeling depressed. And that's great! But with more information and understanding, we can do better to help the people who need it most.

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A few weeks ago, one of the volunteers who staffs the check-in desk tapped on the doorjamb of my office.

"A guy on the phone — Luis — asked if we can send him his mail," he said. "The guy says it's really important."

I was working at a nonprofit that offers services that help people living on the streets acquire permanent supportive housing. Forwarding mail is not one of those services.

"Sorry," I replied. "Bethesda Cares' policy is that we don't forward mail. We'll hold it for people, but we can't forward it. Luis has to come get it himself or send someone with written authorization to pick it up." The volunteer nodded and went back to the phone.

I turned back to my work, but the volunteer was back within a moment. "He says he just got a job. The guy's finally working, but it's during all the hours that we're open. He can't get here and doesn't know who he could send. He says the mail has important ID stuff in it. He's afraid he'll lose the job if he doesn't have it."

Well, crud.

I understand why we don't forward mail for the 375 clients who use Bethesda Cares as their mailing address (liability, workload, cost), but Luis had recently got into housing and had a job. I didn't want to go against policy, but I didn't want to bust this guy's chops either. The volunteer and I brainstormed for a moment, and we decided that Luis could send me a self-addressed, stamped envelope and that I would get it back out to him, which is exactly what happened a few days later.

Having no mailing address pretty much stinks, more than you might think.

Practically speaking, people who are trying to enter or re-enter society have to create and re-create connections, paper trails, and systems of interactions with large commercial and governmental entities. If you don't have a mailing address, this task is nearly impossible. While a lot of correspondence is now done online, plenty of agencies that process crucial paperwork like IDs and benefits information still rely on the good old U.S. Postal Service.

Emotionally speaking, having "no fixed address" — which is how law enforcement and administrators refer to someone who is homeless — leaves you untethered. Maybe you have a bus stop you call your own, but you know that's not the reality. Having an address, a place where people can find you (even if only by snail mail), reaffirms your existence. It confirms your identity, especially when you're desperate for any permanent elements in your life.

Knowing that friends, families, and agencies can find you, even when you yourself don't know where you're going to sleep, is an anchor.

So in addition to helping people find housing, Bethesda Cares allows clients to use its mailing address as their own.

And when I say "as their own," that's exactly what I mean: We want clients to use just our street address, without our organization's name. Adding "c/o Bethesda Cares" reveals their status as homeless, and we want them to have the dignity of keeping their current situation private if that's their preference.

Some clients check their mail only sporadically; they aren't really expecting much. For others, though, coming in to ask for their mail is an important weekly touchstone. It's a layer of routine in their otherwise chaotic lives. It's a reason to come in to our safe space, where they know someone will greet them by name, address them respectfully, offer some coffee and maybe ask how they are. It's a place where they can seek respite from the elements without being told to move along.

Most importantly, it's a reason to come into the place where they will eventually seek other services — like talking to a case worker about housing.

I'm well aware that our office mailing address is a sorry substitute for a home address.

But it's not intended to be a permanent fix. Every service we offer is designed not only to ease our clients' lives, but also to serve as a tool of engagement. It's a chance to say "yes" to someone who's become deeply disenfranchised in society, who is unwilling or unable to believe that anyone will consistently have their backs.

In order to use our address, clients must have an intake interview with a caseworker. We learn their stories and a bit about their immediate needs. And we get to say "yes" — "Yes, you can get your mail here," "Yes, come have a hot meal every day of the year," "Yes, we have clean socks for you."

And, eventually, "Yes, we can help you seek housing."

Homelessness represents the total collapse of support systems, both public and personal.

Rebuilding that shattered trust takes years.

Every touchstone we provide and every indignity we soothe brings that client one step closer to taking the leap of faith they'll need to apply for housing — the leap of faith needed to hope for something better after so many years of accepting the worst.

While our office guides clients on the long path out of chronic homelessness, our greater community has a vital role, too, in making sure that our clients know they aren't forgotten and that they are worthy of our time and our resources.

Anyone can help restore a person's dignity. Just find a local organization working to end homelessness and drop off a package of cookies. Drop off clean socks or unopened toiletries. Maybe include a note filled with kind thoughts.

That way, when clients come in to check on their mail, you'll be helping to reinforce, in any way you can, that they matter.

This story originally appeared on amylfreeman.com and is reprinted here with permission.

Proof that a traumatic past does not have to dictate your future.

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As a child, Lakesha Burton had dreams of becoming an Olympic runner — but life took her on another course.

It had nothing to do with her athletic abilities: She was faster than all the boys in elementary school, and her coach told her she had definite promise.

Her dream was derailed because she was sexually abused by her stepfather when she was only 11 years old.

The negative emotions she experienced as a result took her down a dark path that led to drugs and various delinquencies. Eventually she got pregnant at the age of 14.

"I purposefully got pregnant because I thought that might end my abuse," Burton admits.

[rebelmouse-image 19530630 dam="1" original_size="640x427" caption="Image via Christian Haugen/Flickr." expand=1]Image via Christian Haugen/Flickr.

But the abuse didn't end. When her stepfather attempted it in front of her baby, she decided she had to take her and leave home.

She stayed at a friend's house that first night and woke up to the police who had been called by her friend's mother.

According to Burton, one of the officers named Victor Jefferson kneeled down, hugged her, and said, "I believe you. And I’m going to make sure this man never touches you again."

Her stepfather was arrested, but the charges against him were dropped. This fueled Burton's downward spiral, and soon enough, she was on the verge of suicide.

Thankfully, after a revelatory experience at church, Burton was inspired to turn her life around.

[rebelmouse-image 19530631 dam="1" original_size="640x427" caption="Image via Alejandra Rdguez/Flickr." expand=1]Image via Alejandra Rdguez/Flickr.

Praying at a local church revival helped her feel relief from her emotional pain for the first time. She decided then and there that she'd dedicate her life to helping others.

She went back to school, and joined the Jacksonville, Florida, Police Athletic League (PAL). There, she started playing basketball there regularly.

PALs exist all over the country and aim to foster positive relationships between police officers and kids in the community through various programs.

Burton with kids at PAL. All photos below via the Jacksonville, Florida, PAL.

Her basketball training at PAL led to her landing a full scholarship to the University of Central Florida, where she got herdegree in criminal justice.

She chose this major because she wanted to bring all child molesters to justice. "I wanted to be that police officer that responds and treats victims with dignity," Burton says. And that's exactly who she became.

In her time working for the Jacksonville Sheriff's Office, she's already put several child molesters in jail.

She also managed to track down and thank the officer who initially offered her comfort after her own traumatic experience years before.

"You are my angel; you changed my life," she told him.

Two years ago, she returned to PAL as an officer intent on giving something back to kids who might be struggling.

Burton on the job at the Jacksonville PAL.

Because she had a difficult childhood, she thought the kids would be able to relate and open up to her. If kids are opening up about their issues, she says, there's a chance more traumatic incidents will be prevented.

She once spoke with two girls at PAL about low self-esteem, and when she told them she struggles with it too sometimes, they started crying. She asked them, "What can I do to help you see your value?" They replied, "Can we have a slumber party?"

So, Burton began organizing a massive slumber party for 200 girls at her PAL, and it was so successful, they do it every year now.

Some of the teen girls at the Jacksonville PAL with Burton.

This past year, they even organized a surprise flash mob for them. After one sleepover, a girl came up to Burton and said, "Oh my gosh, we didn’t know police officers were cool!"

"I thought, 'Oh my gosh, this matters,'" Burton exclaimed.

Today, as PAL's executive director, Burton is spearheading many community-building initiatives.

Burton's Lunch with a PAL initiative in full swing.

She established a program called Mobile PAL, which takes all the relationship-building activities PAL practices indoors onto the streets of Jacksonville.

"There’s a lot of enforcement in the low-income areas," Burton explained. "Younger people don’t know how to process that. So Mobile PAL goes out and engages them with fun activities. It allows kids to humanize police officers."

She even contacted local restaurants to help her launch the program Lunch with a PAL where kids can have a free meal with officers and talk about anything.

Burton organizing a game through Mobile PAL.

According to PAL's most recent impact report, 100% of students in the program were free from physical harm and arrest.

Ninety-seven percent matriculated into the next grade at school.

The organization is helping kids better themselves and feel more connected to police officers. The officers are doing all they can to show kids there are many who want to be there for them. So far, it seems to be working.

PAL has programs in cities all over the country. You can learn more about the organization as a whole here, including learning how to start your own, and finding your local PAL. If you're a child going through something, you don't have to do it alone. Officers at PALs around the country are here to help.

Update 7/21/2017: Minor points of this story were changed for clarity.

Family

The royal family: Mental health is just as important as physical health.

"[Mental health] matters just as much as our physical health," Prince William said at a recent event in London.

"There are times when, whoever we are, it is hard to cope with challenges — and when that happens, being open and honest and asking for help is life-changing."

Photo by Stefan Wermuth-WPA Pool/Getty Images.

Prince William, along with Princess Catherine and Prince Harry, gave important speeches on destigmatizing mental illness on Jan. 17, 2017.

The royals addressed a room full of reporters at the Institute of Contemporary Arts about the necessity for all of us to reach out if we're struggling in silence.

Photo by Stefan Wermuth-WPA Pool/Getty Images.

The three threw the event to support Heads Together, an initiative aimed at prioritizing mental health in Britain and the official charity partner of the 2017 London Marathon.

The royals dropped some serious truths about why this issue matters so much.

Kate explained how talking really can feel like a dose of medicine.

Harry noted why he's looking ahead with lots of hope when it comes to our perceptions of mental health.

And William noted that 2017 could be a big year in changing the conversation around mental illness.

Coincidentally, the message of the royals' Heads Together event is particularly meaningful in the U.S. right now, where the Affordable Care Act is on the chopping block.

The same day William, Kate, and Harry gave their speeches in London, mental health advocates in the United States got some potentially sobering news.

The nonpartisan Congressional Budget Office released a study that found stripping away key provisions of the Affordable Care Act may cost 18 million people their health insurance in the first year alone, according to The New York Times. That number could tick upward to 32 million throughout the next decade, marking a major reversal in the health care coverage expansion we've seen since Obamacare passed.

This, of course, wouldn't just affect physical health ailments. Many plans provided by Obamacare offered services like depression screenings and included access to physicians who could diagnose and treat conditions like bipolar disorder. Millions of Americans could lose access to these life-changing mental health benefits.

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While continued destigmatization of mental illness shows great progress, it's also vital that progress is reflected in the laws we live by.

Prince William is right — 2017 can be a major tipping point for helping those in need of mental health services. But we should make sure the right kind of care is available to those brave enough to speak up, too.

Here's how to tell your representative in Washington you think mental health coverage is vital and believe the Affordable Care Act should stay.