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Let’s Lead the Conversation About Suicide

June 09, 2018

By Andrew Penn, RN, MS, NP, CNS, APRN-BC
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The opinions expressed by Psychiatry & Behavioral Health Learning Network bloggers and those providing comments are theirs alone and are not meant to reflect the opinions of the publication.

I woke up this morning to learn that celebrity chef Anthony Bourdain had committed suicide, just days after the high-profile suicide of designer Kate Spade. Sadly, for every high-profile suicide, there are hundreds of distraught and bewildered families privately grieving the loss of a mother, father, sibling, child, colleague, or friend taken by the relentless cancer of mental illness and suicide. This sorrow knows no limits and our own profession has not been immune from the disorienting grief following the suicide of one of our own.

The Centers for Disease Control and Prevention (CDC) announced this week that there has been a significant increase in suicides in the United States in the last 20 years, with over half the states seeing at least a 30% increase. Almost 50% of the suicides were by firearm. Sadly, the way that firearms can amplify rage, as I wrote about in a previous blog, can be turned towards oneself.

The thing that troubles me most about high-profile suicides is that they lend an air of normalcy to the act, and the coverage risks conveying a subtle endorsement of self-destruction. There is nothing normal about suicide. Thoughts of suicide are incredibly common, and need to be drawn out into conversation, explored, and defused. But suicide, the act that overrides our most basic instinct—that of self-preservation—is like cancer, our own mind turned on itself and seducing the host into self-destruction.  

There are those who will conceal their suicidal intentions until it is too late. "We never saw this coming," people will say. But for every one like that, dozens more will live in the bardo between life and suicide, hoping someone will notice, hoping someone will give permission to give voice to the dark demons swirling around in their heads.

So many struggle silently. We can, we must, see one another better. A person doesn’t need to be a mental health professional to make a difference. Put your presence into the world. Talk about mental illness on social media and with your friends and family. Look strangers in the eye. As Ben Lee’s song goes, "We’re all in this together."

My friend and past Psych Congress keynote speaker, Kevin Hines, paced the deck of the Golden Gate Bridge hoping someone would notice the tears streaming down his face. No one said anything. He jumped (and miraculously lived. He has since dedicated his life to keeping others from this fate).

As mental health professionals, we have the opportunities to be leaders within our communities to help address this problem. We are experts in asking difficult questions and making it OK to talk about sensitive subjects. I teach my students that we must make it “OK to say yes,” when asking about something that is shameful or stigmatized.

We’ve all assessed for suicide so many times that we forget that there was a time, long ago, when we first awkwardly asked a patient if they were feeling suicidal. Remember that day when we clumsily tripped over our words, hoping that we would not offend our patient, fearful that maybe we might plant a notion in their minds? Now, we likely ask it many times as a matter of course in our daily work lives. Let’s lead by example to make talking about mental health and suicide as normal as talking about the game last night or what you’re doing this weekend.

We can help our friends and families who may be concerned that someone they know is struggling to summon the courage to ask the hard question, "Are you thinking about suicide?" Teach others that they won't plant the idea if it's not there. And if the person says yes, all they have to say is, "I'm concerned, talk to me. Let’s get you some help." They won't get it wrong. The only way to get it wrong is to say nothing.

1-800-SUICIDE is the national suicide prevention hotline.

Andrew Penn was trained as an adult nurse practitioner and psychiatric clinical nurse specialist at the University of California, San Francisco. He is board certified as an adult nurse practitioner and psychiatric nurse practitioner by the American Nurses Credentialing Center. Currently, he serves as an Associate Clinical Professor at the University of California-San Francisco School of Nursing. Mr. Penn is a psychiatric nurse practitioner with Kaiser Permanente in Redwood City, California, where he provides psychopharmacological treatment for adult patients and specializes in the treatment of affective disorders and PTSD. He is a former board member of the American Psychiatric Nurses Association, California Chapter, and has presented nationally on improving medication adherence, emerging drugs of abuse, treatment-resistant depression, diagnosis and treatment of bipolar disorder, and the art and science of psychopharmacologic practice. 

The views expressed on this blog are solely those of the blog post author and do not necessarily reflect the views of Psych Congress Network or other Psych Congress Network authors. Blog entries are not medical advice.

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