reaching out

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.