Strong Committed Relationships Can Buffer Military Suicides

Can being in a strong committed relationship reduce the risk of suicide? Researchers at Michigan State University believe so, especially among members of the National Guard.

Suicide rates for members of the military are disproportionally higher than for civilians, and around the holidays the number of reported suicides often increases, for service members and civilians alike. What’s more alarming is the risk of suicide among National Guard and reserve members is even greater than the risk among active duty members.

When returning from a deployment, National Guard members in particular are expected to immediately jump back into their civilian lives, which many find difficult to do, especially after combat missions. Some suffer from post-traumatic stress disorder, depression or high anxiety in the months following their return. These mental health conditions are considered at-risk symptoms for higher rates of suicide.

The researchers wanted to know what factors can buffer suicide risk, specifically the role that a strong intimate relationship plays. They discovered that when the severity of mental health symptoms increase, better relationship satisfaction reduces the risk of suicide.

“A strong relationship provides a critical sense of belonging and motivation for living – the stronger a relationship, the more of a buffer it affords to prevent suicides,” said Adrian Blow, family studies professor, and lead author. “If the relationship is satisfying and going well, the lower the risk. National Guard members don’t typically have the same type of support system full-time soldiers receive upon returning home, so it’s important that the family and relationships they return to are as satisfying and strong as possible.”

The researchers surveyed 712 National Guard members who lived in Michigan, had been deployed to Iraq or Afghanistan between 2010-2013 and reported being in a committed relationship. The study measured three main variables – mental health symptoms, suicide risk and relationship satisfaction – each on a separate ranking scale. The soldiers were asked questions such as how enjoyable the relationship is, if they ever thought about or attempted suicide, how often they have been bothered by symptoms of depressive disorder, etc.

Results showed significant associations between each of the mental health variables (PTSD, depression and anxiety) and suicide risk, indicating that higher symptoms were predictive of greater risk.

However, once couple satisfaction and its interaction with mental health was factored in, the association between mental health symptoms and suicide risk was changed. Specifically, for those with higher couple satisfaction, the increased symptoms of PTSD, depression and anxiety were no longer a risk for suicide.

“Our findings show that more needs to be done to enhance the quality of relationships to improve the satisfaction level and through this decrease the suicide risk,” Blow said. “Having a partner who understands your symptoms may help the service member feel understood and valued. There are family support programs available, but we need to do more to enhance relationships post deployment. Relationships do not get enough consideration in the role they play in preventing military suicides, and I would love to see more attention devoted to this issue.”

Other co-authors included Adam Farero from MSU; Heather Walters and Marcia Valenstein from University of Michigan; and Dara Ganoczy from the Veterans Health Administration. The study was funded by the Veterans Administration. The study was published in the official journal of the American Association of Suicidology.

What Schools Can Do To Reduce Risky Behaviors and Suicides Among Lesbian, Gay, and Bisexual Youth

A high school English teacher in New Mexico told me about one of his students who had difficulty focusing in class. When the teacher showed concern, the student confided in him that her parents had kicked her sister out of the house after they found out she was dating a girl. The teacher tried his best to console the student and referred her to the school counselors for help.

The next year, the same girl sought his support when her parents took similar punitive measures against her because she, too, came out as a lesbian. This time he spoke openly with her, explaining that she had to keep her spirits up; that no matter what happened, she had to be true to herself. In concluding the story for me, the teacher explained that he knows the school needs to be a safe place in a community that may not accept his student. But even though he strives to create a safe environment, he does not think all staff people or students at the school are equally accepting.

At another high school, I heard something quite different. When asked about the experience of lesbian, gay, and bisexual students, an administrator responded – simply and implausibly – “We don’t have any of those kids at this school.”

Such accounts from teachers, administrators, nurses, and counselors illustrate the importance of schools and school staff for students struggling with their sexual orientation in a world that does not always support or even acknowledge their existence. Paradoxically, schools are often the only places lesbian, gay, and bisexual youth may find marginally more accepting than the surrounding community – and of course schools may not be more accepting. The everyday traumas experienced by these youth, especially when they find themselves in schools that ignore their needs, can put lesbian, gay, and bisexual students at increased risk for depression, substance misuse, and suicide.

Research Links Suicide to Sexuality

According to the Youth Risk and Resiliency Survey conducted by the U.S. Centers for Disease Control and Prevention, more than two-fifths of lesbian, gay, and bisexual youth have seriously contemplated suicide. These young people are three times more likely to think about taking their own lives than their straight peers and four times more likely to actually plan and attempt suicide.

In addition to risk of suicide, lesbian, gay, and bisexual youth are twice as likely to be bullied or threatened with a weapon on campus and three times more likely to miss school because they feel unsafe. Risk behaviors that could result in negative health outcomes are also prevalent at a higher rate among lesbian, gay, and bisexual youth. For example, such young people have higher rates of smoking cigarettes, drinking alcohol, misusing prescription medicines, and using dangerous drugs including cocaine and heroin.

These statistics underline serious threats to many American young people. What can be done? The Center for Disease Control has identified several evidence-based ways to reduce the risk of suicide and risk behaviors among lesbian, gay, and bisexual youth – by creating safer and more supportive school environments. So far, however, these strategies have not been fully or consistently implemented, and they are only rarely combined to create an optimum response.

How Schools Can Help

Schools are a critical point of intervention because they are the places where students spend most of their waking hours. When it comes to reducing risky or suicidal behaviors, schools are second in importance only to families. School nurses and counselors also often provide the first line of response to student medical or behavioral health issues. In rural settings where resources can be scarce, the school or school-based health center may be the main place students can find support or help. Based on available evidence, the Center for Disease Control has defined several strategies that can be adopted and combined to ensure that all American young people are supported and protected, regardless of their sexual orientation. According to these recommendations, schools can take the following steps – and, to date, only eight percent of schools do all.

  • Create “safe spaces” like a designated classroom, office, or student organization where students can receive support from school staff or other students. Only about 60% of schools currently have such spaces available.
  • Prohibit bullying and harassment based on sexual orientation or gender expression. Most schools report having such policies in place, but a fraction of them do not.
  • Facilitate access to medical health and behavioral health providers with experience serving lesbian, gay, and bisexual youth. Fewer than half of US. high schools facilitate such access.
  • Promote professional lessons on how staff can create safe and supportive school environments. Less than 60% of high schools provide this type of support to their faculty.
  • Deliver health education that includes information relevant to lesbian, gay, and bisexual youth. Only one-fourth of U.S. schools do this.

These strategies are an important way to address the needs of not only lesbian, gay, and bisexual youth, but may also help transgender and gender non-conforming students as well. Unfortunately, research on these subgroups and programs to help them remains to be done. An important recent development is the inclusion a gender identity question in the 2017 Youth Risk and Resiliency Survey.

Recognizing the existence of sexual and gender minorities in America’s schools and gathering large-scale data about their experiences can provide a clearer picture of the challenges various groups of students face – and, in turn, allow improved responses to their needs. By creating safer and more supportive school environments, we can reduce dangerous behaviors, eliminate many suicides, and improve academic and health outcomes, not only for sexual and gender minority youth, but also for all other students in our schools. Problems and tragedies that affect some students reverberate among many – and undermine America’s future.

Age-Related Racial Disparities in Suicide Rates Among Youth Ages 5 to 17 Years

Suicide rates in the United States have traditionally been higher among whites than blacks across all age groups. However, a new study from researchers at Nationwide Children’s Hospital and collaborators published today in JAMA Pediatrics shows that racial disparities in suicide rates are age-related. Specifically, suicide rates for black children aged 5-12 were roughly two times higher than those of similarly-aged white children.

“Our findings provide further evidence of a significant age-related racial disparity in childhood suicide rates and rebut the long-held perception that suicide rates are uniformly higher in whites than blacks in the United States,” says Jeff Bridge, PhD, director of the Center for Suicide Prevention and Research at Nationwide Children’s and lead author of the publication. “The large age-related racial difference in suicide rates did not change during the study period, suggesting that this disparity is not explained by recent events such as the economic recession.”

For older children, the trend reverses back to the national average. For youth aged 13-17 years, suicide was roughly 50 percent lower in black children than in white children.

Researchers obtained data for cases in which suicide was listed as the underlying cause of death among persons aged 5-17 years from 2001-2015 from the Web-based Injury Statistics Query and Reporting System (WISQARSTM) of the Centers for Disease Control and Prevention.

From 2001-2015, for American youth aged 5-17 years, 1,661 suicide deaths in black youths and 13,341 suicide deaths in white youths occurred. During this period, the overall suicide rate was about 42 percent lower in black youth (1.26 per 100,000) than in white youth (2.16 per 100,000). However, age strongly influenced this racial difference, as seen when suicide rates among 5- to 12-year-olds and 13- to 17-year-olds were analyzed.

“The existing literature does not adequately describe the extent of age-related racial disparities in youth suicide, and understanding these differences is essential to creating targeted prevention efforts,” says Dr. Bridge, also a professor of Pediatrics, Psychiatry and Behavioral Health at The Ohio State University College of Medicine.

While the findings highlight an important opportunity for more targeted intervention, these data are limited and cannot point to the potential reasons for the observed differences.

“We lacked information on key factors that may underlie racial differences in suicide, including access to culturally acceptable behavioral health care or the potential role of death due to homicide among older black youth as a competing risk for suicide in this subgroup,” Dr. Bridge elaborates. “Future studies should try to find out whether risk and protective factors identified in studies of primarily white adolescent suicides are associated with suicide in black youth and how these factors change throughout childhood and adolescence.”

“Parents and health providers should be aware of the importance of asking children directly about suicide if there is a concern about a child,” added Dr. Bridge. “Asking children directly about thoughts of suicide will not put the idea in a child’s head or trigger subsequent suicidal behavior.”

Responsible reporting on suicide and the inclusion of stories of hope and resilience can prevent more suicides. You can find more information on safe messaging about suicide here.  If you’re feeling suicidal, please talk to somebody. You can reach the National Suicide Prevention Lifeline at 1-800-273-8255 or text “START” to Crisis Text Line at 741-741.

Will Veteran Suicide and Mental Illness Rate Improve?

Even in Afghanistan, I will seek pet therapy! – Rick Rogers (pictured above)

It was about 9 years ago.  I decided to put down the rifle and pick up the DSM. You see, I was an infantryman since I was age 17.  That means, since I was a child, I was literally trained to kill people.  Looking back at it, that sounds like a profound concept.

I am proud of my time in the military.  I am proud of my brothers and sisters who have ever answered the call.  But…  I am also worried.

As I said, 9 years ago, I decided to change my path.  I didn’t realize where that path would lead.  I seen multiple traumas and death happen to my fellow comrades.  I went through some trauma myself, but I still worried about others more than myself.  So, I decided to become a Mental Health Specialist in the military.

It’s been a long road going from Infantryman to Social Worker. There are a lot of learned attitudes and behaviors I had to change. Can you believe it? I literally had to learn empathy.  And that took a long time.

Just about anyone in the military knows that drinking alcohol is a part of the lifestyle. Everyone I looked up to drank and considered me a p**sy if I didn’t.  So… when I was sent to Germany back in the early 2000’s as a 19 year old kid, you better believe I drank. It was legal!

Looking back at my adventures between then and now, I don’t regret a thing. Yes, there were many embarrassing moments, and I have lost many friends along the way.  I also met some great people.  My alcohol use made my path rockier than anything else.

Many others have had this experience as well.  Between 1998 and 2008, binge drinking went from 35% to 47% of veterans, and 27% of that 47% experienced combat. 

Between 2002 and 2008, misuse of opiate prescriptions went from 2 percent to 11 percent in the military.  These prescriptions were mostly due to injuries sustained in combat, as well as the strain of carrying heavy equipment.

This concerns me. When I was young, I had a good time. Looking back, maybe it wasn’t.This might not be every veteran’s experience, but the culture encouraged substance use and discouraged getting help. There are others that would agree with me.

This could explain why 20 veterans a day on average commit suicide. This is actually down from 22 a day before the 2014 study from the VA.  However, it is a 32% increase since 2001. In 2014, veteran suicides accounted for 8.5% of U.S.’s adult suicides, and the rates were especially high among 19-29 year old compared to the older generation.

Let’s not forget about the infamy of PTSD. Up to twenty percent of veterans have suffered from this. Of course, those who suffer are more likely to admit their distress to a computer program than a battle buddy or their superior.  This, again, goes with the constant culture that causes our military to fear judgment.

These wars have been a constant the last two decades, and have cost all U.S. citizens a pretty penny. According to one report, the VA spends $59 billion a year on health care.  This number is 3 times as much as it was since before 2002.

And let’s not forget the cost this country has incurred for being in war for this long.  Well, we don’t really know an exact number.  The cost is estimated by many to be in the billions or even trillions.  This isn’t including the interest from borrowed money.

So, after looking at all these figures, I am overwhelmed.  How can I even make a dent in helping our nation’s veterans? The current administration is planning on increasing our presence in war zones.  I am expecting the rate of PTSD and suicide to increase once again.  Also, our country will continue to spend.  It seems to me that we are all participating in a death and mental illness factory.   The thing is, I didn’t even get to the physical injuries many of our combatants have suffered from.

I love our nation’s military.  I want every one of them to know that I am here to support them.  But most of all, we all need to be here to support each other.

UA Study to Take ‘Deep Dive’ into Risk Factors for Veterans, Suicides

University of Alabama researchers, America’s Warrior Partnership and The Bristol-Myers Squibb Foundation have partnered on a four-year, $2.9 million study to explore risk factors that contribute to suicides, early mortality and self-harm among military veterans.

“Operation Deep Dive,” funded by the Bristol-Myers Squibb Foundation, aims to create better understanding of the risk-factors, particularly at the organizational and community level.

Drs. Karl Hamner, director of the Office of Evaluation for the College of Education, and David L. Albright, Hill Crest Foundation Endowed Chair in Mental Health and associate professor in the School of Social Work, are the principal investigators for UA on the study.

Recent research has shown that neither PTSD nor combat exposure are good predictors of veterans and suicide, so researchers must cast a wider net, Hamner said.

“Previous research has focused primarily on individual-level risk factors, like prior suicide attempts, mood disorders, substance abuse and access to lethal means, but suicide is a complex phenomenon, and those factors don’t paint the whole picture,” Albright said.

The study is innovative in that it focuses on veterans across the spectrum of service, gender and lifespan, utilizing data from America’s Warrior Partnership and the U.S. Department of Veterans Affairs, new data collected during the study, and data from the Department of Defense.

For instance, female veterans, who are 2.5 times more likely to commit suicide than civilian women, will be spotlighted in the study.

Both the DOD and the VA will be vital in identifying veterans with varying medical histories, combat experiences and discharges from military services. America’s Warrior Partnership will also help fill the gaps in identifying veterans who don’t fit criteria for VA benefits, like National Guard or Reserve personnel who aren’t activated, or anyone who has a dishonorable discharge, which could be for a variety of reasons.

“The scope of this study is timely and so needed that we really believe we can move the needle,” Hamner said.

The first phase of the study is a five-year retrospective investigation of the DOD service use and pattern of VA care utilization to examine the impact of less-than-honorable discharges on suicides and suspected suicides, and the differences in suicides between those who receive and do not receive VA services.

“Helping to identify the trends or predictors of veterans’ suicide could help immensely in reducing suicide rates and provide much needed interventions for this community,” says John Damonti, president of the Bristol-Myers Squibb Foundation. “This project will take a deep dive to better understand what was happening at the community level to design better, more targeted intervention programs.”

The second phase will incorporate these findings into a three-year study that will include input from medical examiners, mental health experts, veterans and family members, and the community to conduct a “sociocultural autopsy” of all new or suspected suicides in America’s Warrior Partnership’s seven partnership communities, as well as in comparison communities.

The results will explore how community context and engagement affect prevention of suicides in veterans and “why some former service members commit suicide, while others do not.

“The overarching goal of the study is to understand triggers of suicide in order to prevent potential suicides before they occur,” said Jim Lorraine, president and CEO of America’s Warrior Partnership. “With each organization bringing its own areas of expertise and data, we can make a difference in the lives of our nation’s warriors, particularly the most vulnerable veterans.”

Both Hamner and Albright are committee chairs for the Alabama Veterans Network, or AlaVetNet, which connects Alabama veterans to resources and services. Alabama Gov. Kay Ivey recently signed Executive Order 712, which tasks the group in helping reduce and eliminate the opioid crisis as well as reducing the high veteran suicide rate.

The VMAs Spotlights Suicide Prevention Anthem 1-800-273-8255


National Suicide Prevention Month begins on September 1st, and MTV officially kicked off suicide awareness with a performance of “1-800-273-8255” by Logic along with Khalid and Alessia Cara at the VMAs. The song’s title just happens to be the number to the National Suicide Prevention Hotline, and the performance also included a group of suicide attempt survivors who came on stage wearing shirts with the number to the suicide helpline.

The song begins from the perspective of someone who wants to die and feels there is no one there to care about what happens to them. The opening hook for the song states, “I don’t want to be alive, I just want to die today, I just want to die.” Some may take an issue with the beginning of the song, but it can not be understated the importance of identifying those feelings in order to seek help.

A recent study which included 32 children’s hospital across the United States revealed an alarming increase in self-harm and suicidality in children and teens ranges from ages 5 to 17 over the past decade. Also, the School of Social Work and Social Care at the University of Birmingham released a recent study stating, “Children and young people under-25 who become victims of cyberbullying are more than twice as likely to enact self-harm and attempt suicide than non-victims.”

The second hook starts with “I want you to be alive, You don’t gotta die today, You don’t gotta die.” The song moves from a place of darkness to a place of support. When someone expresses suicidal thoughts, it is critical to not dismiss their feelings or minimize the weight of the issues preventing them from wanting to live. The Center for Disease control list death by suicide as the number 1 cause of death in the 15-19 age group. According to the National Data on Campus Suicides, “1 in 12 college students have written down a suicide plan as a result of stresses related to school, work, relationships, social life, and still developing as a young adult.”

John Draper, Director of the National Suicide Prevention Lifeline, in an interview talked about the impact the song is already having. During his CNN interview, Draper stated, “The impact has been pretty extraordinary. On the day the song was released, we had the second-highest call volume in the history of our service. Overall, calls to the hotline are up roughly 33% from this time last year.”

“I finally want to be alive, I don’t want to die today, I don’t want to die” are the lyrics and the tone in which the songs end. Then, it leads into an incredibly woke statement by Logic, and here is a sample:

“I am here to fight for your equality because I believe that we are all born equal, but we are not treated equally and that is why we must fight!” – Logic VMAs

The trend for suicide deaths is on an upward climb. A 2015 study by the Center for Disease Control state there were twice as many suicides than homicides in the United States. It’s time we end the stigma and myths surrounding suicide attempt survivors “doing it for the attention.” Suicidal thoughts may be an ongoing struggle instead of a one-off event to prevent. In this case, we need to arm loved ones and at-risk individuals with information as well as tools and resource to manage their mental health status.

Suicide Warning Signs

Another useful resource is the Crisis Text Line in which users can send a text to a trained counselor and typically receive a response within 5 minutes. Texters can begin by texting “START to 741741” to get connected.

Mental Health providers and practitioners are always looking for ways to connect and reach those most at risk for suicidal and self-harming behaviors, and pop culture often has a direct connection to those who are the most vulnerable. Unfortunately, a recent study identified a link between 13 Reasons Why and suicidal thoughts in which it found “queries about suicide and how to commit suicide spiked in the show’s wake.”

Unlike Netflix’s “13 Reasons Why”, this song is already showing the opposite effect by increasing queries and online searches about the National Suicide Prevention Hotline versus queries on how to commit suicide. If you have not seen this powerful VMA performance, I urge you to check it out.

Netflix Drama “13 Reasons Why” Linked to Suicidal Thoughts

Internet searches about suicide were higher than expected after the release of the immensely popular Netflix series “13 Reasons Why”. This is according to a new study published in JAMA Internal Medicine and led by San Diego State University Graduate School of Public Health Associate Research Professor John W. Ayers.

The researchers delved into Americans’ internet search history in the days after the series was released, and found that queries about suicide and how to commit suicide spiked in the show’s wake.

The series depicts the anguish and eventual suicide of a teenage girl as experienced by a friend listening to a series of audio-cassette journal entries she left behind.

Identifying trends

For the study, Ayers and colleagues turned to data from Google Trends, a public archive of aggregated internet searches. The team focused on searches originating from the United States between March 31, 2017, the series’ release date, and April 18.

They collected all search phrases containing the word “suicide,” except for those accompanied by the word “squad,” as those were most likely for the unrelated movie “Suicide Squad,” released around the same time.

The team then compared those phrases’ search frequency over that time frame with a hypothetical scenario in which the “13 Reasons Why” series had never been released, based on forecasts using historical search trends.

“This strategy allows us to isolate any effect ‘13 Reasons Why’ had on how the public engaged with and thought of suicide,” said study coauthor Benjamin Althouse, a research scientist at the Institute for Disease Modeling in Bellevue, Wash.

All suicide-related queries were 19 percent higher than expected following the show. Some of that bump came from higher-than-expected numbers of searches for phrases like “suicide hotline” (up 12 percent) or “suicide prevention” (up 23 percent). But an alarming percentage of the spike also came from phrases like “how to commit suicide” (up 26 percent), “commit suicide” (up 18 percent) and “how to kill yourself” (up 9 percent).

“In relative terms, it’s hard to appreciate the magnitude of ’13 Reasons Why’s release,” added study coauthor Mark Dredze, professor of computer science at Johns Hopkins University in Baltimore, Md. “In fact, there were between 900,000 and 1,500,000 more suicide-related searches than expected during the 19 days following the series’ release.”

A public health challenge

It’s not clear whether any of those searches led directly to suicides, Ayers said, but previous research has found that increases in internet searches for suicide methods are correlated with actual suicides.

“While it’s heartening that the series’ release concurred with increased awareness of suicide and suicide prevention, our results back up the worst fears of the show’s critics: The show may have inspired many to act on their suicidal thoughts by seeking out information on how to commit suicide,” Ayers said.

The team notes that some of the harm potentially related to the series’ release could have been avoided by following existing media standards.

“The World Health Organization has developed guidelines for media makers to prevent this very problem and it is critical that they are followed,” said coauthor and SDSU alumnus Jon-Patrick Allem, now a research scientist at the University of Southern California in Los Angeles. “These guidelines discourage content that dwells on suicide. ‘13 Reasons Why’ dedicated 13 hours to a suicide victim, even showing the suicide in gruesome detail.”

Mental Health Issues Suffered By Gay Men

The mental health issues gay men have to deal with aren’t limited to stigma and discrimination. According to a recent study, gay men are four times more likely to commit suicide than straight men. Moreover, more than half of the men who identify themselves as gay suffer from anxiety or depression. In short, the mental health issues suffered by gay men are a serious problem so finding ways to counter them is crucial.

As mentioned above, the mental health issues suffered by gay men are a serious problem and the best way to counter them is spreading awareness about gay mental health. Spreading awareness about the mental health issues suffered by gay men will help to improve their health and allow them to live a stress free life. So, without further ado, let’s take a look at the common mental health issues suffered by gay men.

Internalized Homophobia

Years of exposure to myths, stereotypes and homophobic rhetoric has forced gay men to internalize this negativity and believe, consciously or subconsciously, that these myths, stereotypes and homophobic rhetoric are true. This mental health problem suffered by gay men is known as internalized homophobia. Internalized homophobia is known to worsen general stress which in turn leads to poorer physical health.

Body image and Femininity issues

If you browse gay dating/hookup sites, you will find many profiles with the statements ‘No Fats, No Fems.’ This statement basically means that the individual isn’t interested in dating men with feminine qualities. This is an indication of larger issues in the gay male community such as overvaluing stereotypical heterosexual qualities and unreasonable body image expectations.

According to a recent study, the pressure of being masculine forces gay men to be less emotional and affectionate. Moreover, body image issues increase their risk of developing an eating disorder. As it contradicts the acceptance, quality, and openness the gay community should provide, the pressure to be masculine causes many gay men to feel frustrated and stressed.

Overworking to prove themselves to the world

Also according to the aforementioned study, on average, gay men have a higher income and are more successful than straight men. This may sound as great news, but it isn’t. Some gay men see their sexuality as a deficiency. So, to compensate for their ‘deficiency’, gay men try to be high-achieving or perfect in other aspects of life. The pressure to be perfect in different aspects of life causes great stress and anxiety in gay men. This is a mental health issue that troubles many gay men today in Australia and abroad.

The fear of bullying, being judged or rejection causes many gay men to isolate themselves or suffer from social anxiety. Also, legislations that limit their right reinforces to gay men that they’re not equal to heterosexuals. All of these things lead to the aforementioned mental health issues suffered by gay men.

13 Thoughts on 13 Reasons Why (Spoilers)

Clay in Netflix’s 13 Reasons Why

Recently, I watched the new Netflix series 13 Reasons Why (based on a book with the same title). The framework for the series is that an adolescent, Hannah Baker, has died by suicide and left behind audio tapes detailing every component that she believes led up to her death. In addition, she has a methodical plan for the specific people who should listen to the tapes, how they should be listened to, and the order in which people hear them. Some people say this is art and entertainment, and therefore, exempt from social responsibility.

Nonetheless, many people will watch this series, which makes it important to view the series critically and to consider its implications. My thoughts aren’t fully formed yet, but I wanted to write something as the series came out without waiting until I had it all sorted out. My feelings and opinions may develop more as I process the material for a longer period of time. However, I’m open and curious about other perspectives.

1. The series is set up as a mystery that quickly pulled me into the story, and I finished the whole series within a few days. While this is a compelling way to reveal a mystery, I believe that it contributes to stigma by painting the picture of a woman who ended her life for the purposes of getting attention from the individuals she believed ruined her life. The tone of her delivery is blaming and feels vengeful. I worry this perpetuates the myth that suicide is typically driven by desire for attention, selfishness, or revenge…which it most certainly is not.

2. There is a scene that is explicitly blaming of one of the few kind (though not perfect) people in the series (Hannah’s friend and love interest, Clay). Hannah’s friend, Tony, tells Clay that Hannah would have been alive if he had acted differently. He later softens his tone, saying it is not Clay’s fault and Hannah is responsible for the choice that she made. Still, the blame message is there in a scene where Hannah tells Clay repeatedly to leave her alone. He reluctantly leaves the room. The show then depicts a parallel universe where the “right” things happened: Clay insists on staying despite Hannah clearly asking him to leave her alone, he turns the conversation around through persistence, Hannah feels loved, and suicide is prevented. In light of the violations of consent elsewhere in the series (including two rape scenes), I was bothered by Clay being painted as having done the wrong thing when he honored Hannah’s wishes to leave her alone.

3. Hannah decides, as her last attempt at help-seeking, to reach out to her school counselor about her suicidal thoughts and being the victim of rape. The counselor, insensitively and against best practice guidelines, implies she may be partially to blame (e.g., asking if she verbally said no to the perpetrator, asking if she had been drinking) and jumps right into telling her that her only choices are to: 1) report the assault or 2) to move on. She leaves the office, and he doesn’t follow-up with her in any way. He doesn’t ask for more details or conduct a suicide risk assessment, and he does not try to reach out to her parents to prevent her from harming herself. Of course, there are some counselors out there who might act in this irresponsible way. However, the vast majority would not. In a show that is viewed by a lot of young people, the depiction of the counselor matters a lot. People are already reluctant to reach out to mental health professionals. I worry people would feel even more discouraged from seeking help after seeing this terrible, judgmental, unethical interaction.

4. The series accurately portrays some of the risk factors for suicide: social isolation, loneliness, and disconnection from others (including in the painful forms of bullying), perceiving herself as a burden (e.g., she describes herself as a “problem” for her parents and especially feels burdensome after accidentally losing some of their money), family conflict (her parents argue about issues including finances), witnessing and then being a victim of sexual assault, and hopelessness about her future (e.g., with regard to college and other plans).

5. I appreciated the series emphasizing how crucial social connections are for health and talking about different types of loneliness – including individuals truly isolated and those who feel “lonely in a crowd.” It seemed to make the point that even apparently popular people (like Zack) can feel lonely. I believe this sends the message that anyone is vulnerable to loneliness, and we shouldn’t assume people are doing well just because they appear that way on the outside.

6. One of the themes of the series is that – at any point – one person listening, reaching out, or doing something differently could have prevented Hannah’s suicide. Ultimately, this is a positive message. Unfortunately, I think it’s lost and distorted because it is used to blame people for their failures to save Hannah rather than demonstrating that one person could have made a difference and changed the story to a hopeful one. If the counselor or one of her parents had connected with Hannah and supported her in seeking help for her struggles, this point would have been much more persuasive. Instead, the story feels more demoralizing than inspiring to me.

7. Hannah’s death scene is a graphic depiction of her cutting her wrists with razor blades in a bathtub. In a documentary-type episode made about the series, they said that it was to show the painful and hard-to-look-at nature of suicide. To me, it feels like a choice to make a dramatic, visually startling conclusion to the story rather than to deliver a lesson. It makes sense – this is a series meant to be watched and to get people glued to their screens not a PSA. It’s possible that an individual who feels suicidal might see that and be afraid; however, it’s also quite plausible that an individual feeling suicidal might mistakenly view it as an end to all of Hannah’s emotional pain and problems. Anecdotally, there are cases of suicidal individuals watching scenes of suicide building up to taking their own life.

8. There are warnings in the beginnings of episodes where there are graphic scenes (e.g., sexual assault, suicidal behavior). It would have been helpful if the episodes had information about resources, such as the National Suicide Prevention Lifeline and the American Foundation for Suicide Prevention, embedded in them too. It would be a simple way to reach a lot of people. Again, the series created a separate short documentary-like episode with mental health professionals and resources in it. However, it appears completely separately from the series (rather than as the 14th episode, for example). It would reach more people if it was connected to the full series.

9. The pain Hannah’s parents experience after her death is excruciating. I feel this is one of the most realistic aspects of the series. It shows their horror, their confusion, their regret, and their desire to prevent other suicides from occurring. In the documentary afterwards, they suggest that this might show individuals who feel suicidal about the pain that others would experience if they died. I think this may be the case for some, but for certain individuals, tragically, they might imagine that people wouldn’t feel the same way about their death. That’s the cruelty of perceiving oneself as a burden – people struggling with mental health problems may not see how the world is better with them in it.

10. Related to the second point, several characters clearly violate Hannah. Marcus and Bruce grab her, Tyler and Justin take and share revealing pictures without permission, and Bryce rapes her. When Hannah and Clay are starting to kiss, Clay asks, “Is this okay?” I really liked this scene because it shows how directly asking about consent is natural and enhances, rather than ruins, the moment. It also shows a welcome contrast in that Clay genuinely respects and cares about her feelings and perspective. Sadly, this positive point gets diminished when the scene turns into Hannah yelling for him to “get the hell out” and the suggestion that if he had only ignored her wishes, he would have saved her life (as described above).

11. From one perspective, it seems like a point of the series is to teach bullies that their actions can lead to someone dying by suicide. However, most people who are bullied do not die by suicide – people are often remarkably resilient in the face of great adversity. It’s important that people who are on the receiving end of bullying know that. Secondly, most of the people on Hannah’s tapes are more concerned about protecting their own secrets (e.g., that Courtney is attracted to women, that Justin allowed Bryce to rape Jessica, that Ryan published Hannah’s poem without her permission) than how they hurt Hannah. If the message is supposed to be an anti-bullying one, I don’t think it really connects with bullying people in the audience. I guess that it would resonate more with people on the receiving end of bullying who feel a sense of hopelessness about the bullies having any potential for empathy and a sense that there is no help available to them.

12. On two occasions, two adults (the counselor and the communications teacher) state that the warning signs for suicide include withdrawing from friends and family, changes in appearance, and trouble in group projects. This was a great opportunity to share the real warning signs for suicide, but unfortunately, only the first one really maps onto the list.

13. A lighthearted, sweet aspect of the series is that Clay is different from his peers in that he cares relatively less about what other people think of him. He still cares what people, including Hannah, think of him to some extent, but he doesn’t try as hard as his peers to be something he’s not. He feels nervous around Hannah, but doesn’t ever really pretend to be someone else. He doesn’t let other people’s opinions make him feel bad about himself. Again, Clay’s not perfect (he says some mean things to Hannah and looks at a revealing picture that Tyler took without consent).

But, overall, he’s smart, sensitive, caring, a good student, interested in the world beyond the walls of his school, helps others, takes reasonable caution in his decision-making, and likes geek stuff like Lord of the Rings and Star Wars. During one exchange, Hannah says to Clay, “Wow. You’re an actual nerd. There’s courage in that.” Most of the other characters in the series view themselves and their worth in terms of what their peers think of them. This generally rings true with regard to this developmental period in adolescence. It’s refreshing to see someone who has some self-acceptance and a sense of what’s right in the midst of all of the tragedy.

You can also listen to the Jedi Counsel first podcast episode on this series and our second episode. If you or someone you know needs help, please reach out. There is hope and help is available at the suicide prevention lifeline.

Four Tips for Dealing With Mental Health Needs in College

CAMBRIDGE, MA, USA - NOVEMBER 2, 2013: Harvard Yard, old heart of Harvard University campus, on a beautiful Fall day in Cambridge, MA, USA on November 2, 2013.
Photo Credit: Harvard University

Utilization of mental health services on college campuses have been increasing quickly each year, and college campuses are increasing mental health services in an effort to meeting the needs of students. A recent study found that 1 out of every 12 college students has written out a suicide plan.

Due to the increase in federal funding, programs that focus on eliminating suicide, reducing stigma, and bringing awareness of mental health issues have been placed in middle school, high school, and colleges throughout the country.

On many college campuses, counseling services have been improved in order to cater to students’ schedules and expand the utilization of therapy by hiring more counselors and extending the hours. Being a college student is already difficult and adding a mental health issue can make it seem impossible. Here are some tips to help you get through another semester.

1. Learn about the resources offered on campus

Many students with mental health needs don’t know that their campus has resources that can help them. Before you start classes it would be helpful to set up services at the Counseling Center and Disability Center. College offers accommodations that could help you get through a tough semester and really set you up to succeed despite any challenges you may face. Some accommodations that may be offered are extended deadlines, a quiet/private place to take exams, and more.

2. Don’t be afraid to ask for help.

Due to stigma, many people feel afraid or even ashamed to reach out for help. Just like going to the doctor for a physical illness, mental health needs should be dealt with in the same manner. There are people out there to help and the first step is to ask. Identify and locate your University’s Student Health and Wellness Center who can assist you or help provide you with information to assist someone you care about.

3. Stay connected on campus.

It’s very important to make connections on campus. Not only will you make friends, but it will also provide you with a support system on campus. Take a look at the clubs and events held on campus and join a few. Students who are a part of social life at their school tend to do better and cultivate solidarity in their lives.

4. Create a self care plan.

The most important of these tips to maintaining mental health during school is to create your own self care plan. These are your own steps, resources, and supports that can help you get through tough times. This may include remembering to take your medication every day, picking up yoga, going to a Zumba class each week, and/or eating healthy foods. Self care is such a vital part of mental well being. Even taking 10 mins at the end of each day to relax can help you feel so much better.

New Study Finds 1 in 12 College Students Make a Suicide Plan

Cornell University students cross the college's Thurston Avenue Bridge in Ithaca, N.Y. on Tuesday, March 16, 2010. In the past month, three students have fallen from campus bridges. (AP Photo/Heather Ainsworth)
Cornell University students cross the college’s Thurston Avenue Bridge in Ithaca, N.Y. on Tuesday, March 16, 2010. In the past month, three students have fallen from campus bridges. (AP Photo/Heather Ainsworth)

Des Moines, Iowa – This week, ending on Friday February 12, 2016, former foster kid turned national speaker and author Travis Lloyd is seeking support in the form of online votes for a new Suicide Prevention campaign aimed at impacting college campuses nationally titled #STOP1in12. #STOP1in12 represents the epidemic of high suicide rates amongst college students aged 18-24 and references the statistic that 1 in 12 college students has written down a suicide plan as a result of stresses related to school, work, relationships, social life, and still developing as a young adult.

Center For Disease Control (CDC) lists suicide as the #1 cause of death amongst this age-range.
The #STOP1in12 campaign is competing for initial launch funding through the Dream Big Grow Here Competition, hosted by the Center for Business Growth and Innovation at University of Northern Iowa. This funding will allow the campaign to launch with marketing and awareness in the first 5 states of the developing national campaign. Sponsors of the event include Iowa Bankers Association, iHeart Media, VentureNet Iowa, Technology Association of Iowa, IA Source Link, America’s Small Business Development Center of Iowa, U of I Credit Union, and UI Partners.

Anyone with a Facebook account can log in from their mobile device or computer to vote.

To vote, visit & click the link to the Dream Big Grow Here competition at the top of the page.

Campaign Developer Travis Lloyd has personal experience with stressful situations as a former foster kid himself who later served multiple communities as a mental health nurse and Mobile Crisis Worker, even talking someone off a bridge at one point. Travis states, “There were times that I would get called to talk a college student out of swallowing a bunch of pills because they were home-sick or got broken up with. So many people laugh at that, but it is a harsh reality and one that matters. We as a public need a better understanding so we can support each other instead of brushing those feelings under the rug.”

The staff at Changing Lives Entertainment is encouraging everyone in the community to be an active ambassador simply by voting. Every vote can make a big difference in launching this campaign on a national level by funding marketing efforts and initial media production.

The first campaign stop, where they plan to do the initial video shoot, is scheduled for September 9, 2016 during Suicide Awareness Week at Hawkeye Community College in Waterloo, IA.

To sign up for #STOP1in12 Campaign Updates, visit

Why You Haven’t Heard about the #DoubtfireFace Challenge


The ALS “Ice Bucket Challenge” is undoubtedly one of the most successful and engaging fundraising efforts in recent history. The challenge, which involved posting a video of yourself getting doused by a bucket of ice water, quickly gained popularity and became a social phenomenon. Teens, adults, celebrities, politicians, and even former President George W. Bush all took part in the challenge, with their videos gaining tens of millions of views. The result? The ALS Foundation saw donations skyrocket to over $110 million, a gigantic increase over the $2.7 million raised during the same time period last year. These incredible results show how the power of social media can be harnessed to raise awareness and support important causes.

But at the same time, the Ice Bucket Challenge (a term which the ALS Foundation has moved to trademark) swept across the internet, another challenge was desperately trying to gain traction. The #DoubtfireFace Challenge benefiting the American Foundation of Suicide Prevention (AFSP) aims to raise awareness about suicide. Instead of a dumping cold water on your head, the challenge encourages participants to take cake (or whipped cream) to the face, recreating the classic scene in Mrs. Doubtfire where late actor Robin Williams dunked his face in a cake. According to the website, the goal of the challenge is to celebrate Robin Williams while raising money for suicide prevention efforts. The challenge has all the same ingredients that made the Ice Bucket Challenge so successful: a laugh-inducing activity, ability to challenge your friends and family, and raising awareness for an important cause. So why haven’t you heard of the #DoubtfireFace Challenge?

The answer itself is simple, but the problem it highlights is not. Depression and suicide are highly stigmatized, and for this reason people are uncomfortable talking about suicide and chose to avoid the topic all together. The public discourse about suicide that does occur is often fraught with misunderstanding and judgment. This was alarmingly evident after the death of Robin Williams, which many people termed a “selfish act” by the actor. Such comments perpetuate stigma of mental illness and further exacerbate the problem with how suicide is viewed in the media and by the public at large.

The truth is, depression is a chronic disease of the brain just as is ALS. They both affect the brain and can rob the individual of quality of life, make daily functions more difficult, and impact an individual’s ability to care for their self. And, at their worst, they both claim lives. The biggest difference between suicide and ALS is that no one blames the individual for having ALS. You’re not considered “selfish” or at-fault when you suffer from ALS. Certainly no one in the media labels ALS as the product of some personal deficit or weakness.

What makes this problem all the more heartbreaking is that suicide claims 535% more lives than ALS every single year. Even more staggering is that suicide is the second leading cause of death globally for 15-29 year olds. These statistics aren’t doctored, they’re reality. Yet, despite the shocking reality of the situation, we as a society continue to remain silent when it comes to suicide prevention efforts.

Every single day we choose to remain silent, another 100 people die to suicide in America. These are lives we could be saving if we starting speaking up. Donations to organizations that provide suicide prevention directly saves lives. The money often goes to pay counselors and other front-line prevention efforts. You have a chance to save a life today, if you chose to. Will you accept the #DoubtfireFace Challenge?

If you or someone you know is having thoughts of suicide, there are people who can help. Call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255) or visit the website by clicking here or to make a donation to the American Foundation for Suicide Prevention visit their website by clicking here.

Watch the University of Kentucky Counseling Center participate in the #DoubtFireFace Challenge at the Wildcat Wellness and Suicide Prevent Fair on September 30, 2014. Please feel free to share your videos with me at

*Author’s Note: The American Foundation for Suicide Prevention was asked to provide a comment for this article, they declined.

Sketty Productions: Tackling Mental Illness Through Sport and Theatre


Every two hours, someone in England takes their own life. Suicide is a leading cause of death amongst young men in the UK and it is estimated that 90% of people who commit or attempt suicide suffer from mental health problems. 850,000 children and young people in the UK currently have a diagnosed mental health problem. However, mental illness amongst young people is still, sadly, somewhat of a taboo subject. Research shows that 75% of the people who successfully commit suicide were not receiving support from a mental health service prior to their death.

Result is a new theatre production from Sketty which hopes to get young people talking about mental health. It focuses on the lives and experiences of six young men training in a Football academy and documents the emotional impact of their consequent successes and failures. Sketty is an English theatre company co-founded back in 2005 by brothers Alex and Toby Clarke. Football is not an area commonly associated with vulnerability and so I was intrigued as to how it could be used as a means to discuss mental health stigma. I met up with Sketty’s co-founders, Alex and Toby, to find out more.

Rebecca: What was the purpose of creating Result and how did it come about?

Toby: Our older brother has a little girl. I have a little boy and we all get together some weekends. One weekend, whilst the kids were upstairs cooking fake food, he began telling me about his new job as Consultant Sports Psychologist for under 18s at a Premier League Football club… He gave me an overview of the kind of training process youngsters are put through in youth training academies and how important his role was in supporting them throughout the two years they are in the academy. I got goose-bumps as he told me about the lack of mental health provision there was in the game (but reassuringly not in the club he is based in).

He shared his concerns at the youngsters lack of a plan B and how part of his role was preparing them to deal with success as well as failure, how to approach the game mentally as well as physically and how to channel criticism in to something more positive. The more he spoke, the more I wanted to write this play.

Alex and I then went away and did a bit of research on the game… and came across stories of depression, stress and suicide with some cases directly linked to the surmounted pressure that is placed on players at such a ripe age. We knew from the first sharing that we were creating a vital play that will raise awareness of the strain that is put on youngsters. It is set in the world of football but it chimes with all adolescent pressures.

Rebecca: What do you hope to achieve from this production?

Alex: We hope to produce a show that encapsulates and informs. Our aim is to take this accessible play in to schools and colleges in order to begin a debate on how to prepare yourself for the future. I spent three years working in the youth sector and have experienced first hand the transformative nature of theatre and its ability to challenge opinion and perception. Football is such an accessible subject matter. We could use it to stir discussion around ideas of racism, homophobia (still not a single player has come out in the game), peer pressure and ambition.

Rebecca: What are the central themes of Result?

Toby: Communication. I started to look for a common theme in all the boys’ stories and the word ‘communication’ came up each time. David who sustains the injury can’t talk to anyone and is suffering alone, Lofty can’t have it out with his Dad about his affair and relies on the game to hide away from it. The Coach is too proud to ask the Psychologist for help and the Psychologist is trying to communicate and connect with the boys through terminology only he understands.

Alex: The only suicide in the piece comes from the person you least expect since he is Bi-polar and a master of disguising his real emotions. We are working with a young actor who has had first hand experience of this illness and we hope to capture it with honesty. Ultimately, the message of the play is ‘Got a problem? F*****g talk to someone.’

Rebecca: Who do you hope will come to see the production?

Toby: We hope the appeal will be universal. We intend to generate a young audience who can relate to the themes and stories in the hope that it informs their own lives and choices.

Theatre holds up a mirror to the world. In my opinion, it can do two things. Firstly it can transport you to places that thankfully you’ll never have to go to so you get to experience trauma and suffering without actually having to go there but still finally helps you consider others’ plight.

Secondly, it can reflect your own life and here’s where I believe theatre is at its most powerful; when it creates enough truth for its audience to associate with the narrative: “That’s me.” Or, more importantly: “That could be me if I don’t…” The best plays I’ve seen or read have helped me to make sense of my own small world even if it was dealing with a much bigger one.

Rebecca: Why do you think mental health is a difficult discussion for young boys?

Alex: I think mental health is difficult to discuss no matter what age you are. If you discover, for instance, that you suffer from depression then it doesn’t matter at what age since, that moment, the discovery is still the same.

Toby: Young boys (and girls) have great lives these days. They go on cool holidays, have the best friends, the most loving boy friends and girlfriends and go to the most amazing parties. But then once you log off Facebook, once the self promotion is taken away you’re still left with reality. Sometimes that reality consists of having to pick up your sister after school everyday because your mum has to work/can’t work/can’t be bothered to work. Often reality is struggling to make it in to school on time because your EMA has been cut and now you have to run because you can either afford the bus or lunch that day.

Reality for some young people is sleeping with someone or stealing for someone because that’s the only form of love and attention they can rely on. For others, it’s simply that horrendous feeling of not fitting in since deep down you know you’re different. But all their Facebook statuses show them having a wonderful time and they tweet about how awesome their lives are. So after maintaining the charade on social media…where and when do they get the chance to tell someone “I’m not coping.” Everybody else is, I saw the pictures, I read the statuses so why am I the only one struggling? Why am I the only one who’s different?

I recognize there are charities and individuals out there doing invaluable work with youngsters and I’ve been incredibly lucky to have worked with some of them. But talking about mental health issues is scary and sometimes it needs sugar coating or camouflaging. Sometimes it doesn’t need the words ‘therapy’ or ‘seminar’ attached to it. I believe a ‘silly play’ is sometimes enough to get people engaging with their own inner conflicts, and even sharing them with complete strangers in a safe and creative environment; a first step towards coping before they’ve even realized it. We need more creative platforms for young people to talk.

Result is due to be shown at the Pleasance Theatre London in October 2014. To find out more about the show and Company please visit Sketty Productions or email

Stand Up and Speak Out: No Bullying Allowed

In recent news, a Florida teen was cleared of a felony charge of third-degree aggravated assault stalking  from bullying that led to the suicide of a 12-year-old girl in September. Rebecca Ann Sedwick had been ‘absolutely terrorized’ by the other girls before she climbed a tower at an abandoned concrete plant and hurled herself to her death. The bullying apparently started over a ‘boyfriend issue’ at Crystal Lake Middle School.

Katelyn one of the girls accused stated, “No, I do not feel l did anything wrong.”Katelyn and a 14-year-old girl were charged last month after Polk County (Fla.) Sheriff Grady Judd saw a derogatory post on Facebook that he claims was written by one of them. The Facebook post said, “Yes ik [I know] I bullied Rebecca and she killed herself but IDGAF [I don’t give a f—].”

Bullying is becoming a huge problem in today’s society.

  • Over half of adolescents and teens have been bullied online, and about the same number have engaged in cyber bullying.
  • More than 1 in 3 young people have experienced cyber threats online
  • 1 in 7 students in grades K-12 is either a bully or a victim of bullying.
  • 56 percent of students have personally witnessed some type of bullying at school.
  • Over two-thirds of students believe that schools respond poorly to bullying, with a high percentage of students believing that adult help is infrequent and ineffective.

What can we do?

No_BullyingTeaching kids and teens that bullying is not cool is one of the first steps we can make in educating our youth. As adults, we should model the behavior we want our children to exhibit as well as encouraging them to report if they see bullying happening. By encouraging them to speak up, it recognizes that not saying anything is just as bad as participating.

Bullies are often victims of abuse themselves or are lashing out because of  low self-esteem and other personal issues in order to make themselves feel better. Bullies can also be the”popular” kids or teens that are liked by many of their peers and teachers. No matter who it is it should not be tolerated. Joking with your friends is one thing, but teasing someone to the point where they’re afraid to attend school, ride the bus etc is unacceptable.

Teachers should also take bullying serious and intervene when possible. Managing their classrooms, investigating and knowing their students, recognizing relationships between their students, creating rules that allow victims to confide in and trust them are all major steps in confronting this epidemic.

As hard as it may be, I think encouraging victims to speak up for themselves and tell someone they trust about the bullying is necessary to begin addressing the root of the problem. One of the most important things a person should demonstrate is respect for themselves and others. Identifying ways to increase self-esteem is the first line of defense against bullying which results into lower self worth and inferiority.

Early years are an important time for parents, teachers and other forces in the child’s life to enlighten them on how to relate with their peers. If we start there, I think we can make a difference.

Target Practice On The Mentally Ill: The Death of Miriam Carey

by Mike Tikkanen


America seems to own the market of mistreating people with mental health problems.  Whether Tasering 12 year olds in Chicago or shooting disturbed people in just about any circumstance, we just don’t seem to care enough to make health services available to stop the carnage. When it is your family or friend that is visited by violence or other forms of insanity, the sensation is unbelievably painful. Miriam Carey was led to rest after a high speed chase with United States Capitol Police which ultimately resulted in her death.

According to,

About 90 people gathered at a chapel in Brooklyn on Tuesday morning to say their last goodbyes to Stamford resident Miriam Carey, nearly two weeks after she was shot to death by law enforcement officers during a high-speed chase in Washington D.C.

Speakers at the funeral painted a picture of her life and personality.

The 34-year-old single mother was a generous, loving sister — one of five — who was a passionate, fun-loving cook who made meals for an extended family in Brooklyn that she considered the most important part of her life, Amy Carey-Jones, one of her sisters, told mourners.  Read Full Article

Miriam Carey died after being shot by police following a car chase between the White House and the US Capitol building. Carey is reported to have tried to ram through barricades at the White House, hitting at least one officer as well as a squad car. She then drove her vehicle into barriers in front of the Hart Senate Building before being fatally shot by law enforcement officers. She was unarmed. A child identified as her daughter — a little more than one year old — was in the car the whole time.

News outlets reported that Carey had a history of traumatic brain injury and postpartum depression, the latter of which may have been severe enough to send her to the hospital at some point in the past year. Nobody knows what, if any, effect this may have had on what happened yesterday. But it’s led to plenty of speculation, and the spread of bad information that stigmatizes women suffering from an incredibly common mental illness.

For instance, on NBC’s Today Show, psychologist Jennifer Hartstein declared that “postpartum depression (PPD) has led mothers to kill their children” — a statement that conflates PPD with a different disorder AND overstates the risk that other disorder poses to kids.

As you reflect on this event, keep the following facts in mind:

1. Postpartum depression is a spectrum and it affects a lot of women 
It’s not entirely clear exactly how many women get postpartum depression. Partly, that’s because there’s not a universal screening system in place (we’ll talk more about that in a minute) and partly it’s because depression isn’t a binary on-off switch kind of thing. It’s a collection of symptoms. If you have enough of the symptoms for long enough (and you have a personal support system and financial/healthcare access to back it up) you’ll get diagnosed. But there’s a lot of grey area — especially considering the fact that caring for a newborn can be incredibly exhausting, isolating, anxiety inducing, and all-around stressful. On the low end of the spectrum, you might just feel a little overwhelmed and sad for a couple weeks. At the high end, you could be having problems that interfere with work and relationships for months. A survey done by the Centers for Disease Control and Prevention found that between 8 and 19 percent of women reported frequent symptoms of postpartum depression. But as many as 75 percent of new mothers experience milder “baby blues”.

Postpartum depression isn’t some super-rare disorder that only affects mythical “other people”. It’s common enough that you could even consider it part of the range of normal human experience following the birth of a child. That doesn’t mean women with postpartum depression should just “suck it up” or anything like that. It simply means that PPD is real and it’s not something you brought on yourself. Most importantly, it’s not something you should feel embarrassed or ashamed about having, any more than a new mother would feel ashamed of, say, having torn her perineum during labor. (Oh, and men get it, too.)

2. Postpartum depression is different from postpartum psychosis 
The average woman with postpartum depression does not have hallucinations. A very small minority, however, experience a much more serious disorder called postpartum psychosis, which can cause you to hear, see, or smell things that aren’t there (as well as causing paranoia, mania, or catatonic states). Only about 1 in 1000 women get postpartum psychosis and their symptoms tend to kick in quickly, often within a couple of days after birth. Postpartum depression, on the other hand, can occur up to a year after the birth of a baby. These are very different disorders. As different as depression is different from severe bipolar disorder. If you conflate the two, you’re going to miss very real cases of postpartum depression and you’re likely to blame events (like, say, a young mother leading cops on a car chase through Washington DC) on postpartum depression when other forces are at work.

It’s also worth noting that even women with postpartum psychosis shouldn’t be thought of as flailingly irrational and inherently dangerous to the people around them. Neither postpartum depression nor postpartum psychosis can be described as making you want to kill your children. The biggest risk for women with postpartum psychosis is that they will kill themselves, not their kids or anyone else.

3. For such a common disorder, screening and treatment of postpartum depression aren’t handled very well
Only 15 percent of women who meet the criteria for having postpartum depression get treated for it. That’s a big deal because, while some people’s symptoms lessen over time, you can’t rely on postpartum depression just going away on its own. In fact, it can get worse. Again, you can be a year out from having a baby and still be struggling with the effects of postpartum depression. And there’s no reason that should happen to anyone. Between medication and therapy, this is a very treatable illness. It’s something that you absolutely can make better. But it takes having access to financial and healthcare resources necessary to receive treatment. And it takes getting diagnosed in the first place, which isn’t always easy.

There’s still a lot of misinformation out there, and the doctors that postpartum women are most likely to deal with on a regular basis are pediatricians who aren’t well-trained in spotting it. On the other hand, at least the American Academy of Pediatrics recommends doctors screen all new their new moms. The same can’t be said for the American Congress of Obstetricians and Gynecologists. So, even if you have insurance, there’s a decent chance of falling through the cracks when it comes to diagnosis especially if you don’t immediately recognize the symptoms in yourself, or if your doctor is inclined to write those symptoms off as “no big deal”.

Some resources
• Postpartum Progress — a blog and community with lots of great information and support
• Postpartum Support International — which will help you connect with local treatment, diagnosis, and support options.

6 Risk Factors for Suicide

Recently, three people have died by suicide in downtown Greensboro, North Carolina in less than a year by jumping off the top of a parking garage.  If three people have died just in one small area within Greensboro, how many die annually in North Carolina? The answer is a figure that is historically higher than the rest of the nation which averages of over a thousand suicides per year. reported on the latest suicide committed by a 35 year old local woman on June 18, 2013:

This is the third suicide from an eight-story parking garage in downtown in less than a year. On Aug. 4 one man jumped from the Bellemeade Street parking deck. A second man jumped from the same parking deck on Sept. 1. That parking deck is about a block away from the Marriott parking deck. Read More

When faced with suicides that make the local news or impact a loved one, we often ask ourselves how this could have been prevented.

Here are six factors that can help identify who is at risk for suicide.

1. A previous attempt:  It is estimated that for every completed suicide, there are anywhere from 11 to 25 attempts.  Hospitals see at least eight times more patients for self-inflicted injuries than the average number of suicides per year.  In the case of suicide, past behavior can be a predictor for future behavior.

2. Family:  Those with a family history of suicide are at higher risk.  Not only are genetic factors inherited from family, but maladaptive patterns of coping can be learned.  Some people may feel they are destined for suicide if those in generations past died from suicide.  Those who have experienced physical, sexual or emotional abuse in their families are also at risk.

3. Depression: Not all people who die by suicide are experiencing acute mental illness.  However, having a history of depression or other mental illness can make coping with everyday life difficult and is a risk factor.  Some studies cite that up to 90 percent of those who commit suicide have been diagnosed with depression or bipolar disorder.

  1. Substance Abuse: A 2009 study showed that 25 to 40 percent of suicide victims had alcohol in their bodies at the time of death. About 69 percent of suicide deaths occur by prescription drug overdose. The use of drugs and alcohol can cloud judgment, enhance impulsivity and
  2. Sexuality and gender issues: Individuals who are lesbian, gay, bisexual, or transgender can be outcasts in society and face stigma and discrimination on a daily basis.  This, along with negative family reactions, conflict with spirituality/religious affiliation, higher rates of violence and substance abuse make this population vulnerable. Suicide among LGBT youth is particularly high, with up to 30-40 percent attempting suicide.

6. Access to means: An immediate risk factor for suicide is one’s access to the means used to commit suicide.  Are there guns and knives in the home? Is medication being stockpiled? How likely is it that someone could access these things?

These are just a few risk factors.  Others include being bullied, PTSD/Military involvement, being male, incarceration, living in a rural community, physical illness, lack of treatment, hopelessness, and grief or loss.  As a graduate school professor once told me, “Suicide happens when the world throws a situation at you that you don’t have the resources to cope with besides death.” Any stressful situation may lead to someone considering suicide.

How to help:

Be a good listener. Be non-judgmental. Offer hope that things can get better with help. Pay attention to mood and the risk factors listed above.

Don’t be afraid to ask “Are you thinking about suicide?” This shows you are not afraid of the situation and clears up any gray areas.

Offer to find local resources and help. Find a licensed mental health professional who can help.

Call 911 if situation is imminently life-threatening.

More about how to help a suicidal person here:

Slut Shamed Teens: The Amanda Todd Story

by Sarah Devine

I have encountered several stories recently about slut-shamed teens who have taken their own lives, including Amanda Todd, who was harassed through Facebook and other social media after exposing her breasts to a much older man. Obviously, these stories highlight the continued need to address bullying and harassment–and to take it seriously, not dismissing it as a “phase” youth go through–and to teach young people how to protect themselves online (Amanda Todd’s harrasser found much of her personal information online, including where she lived and what school she attended).

Despite the internet’s centrality to many young people’s lives, some youth remain unaware of the dangers of posting personal information and photos to social networking sites–or even sending them to friends. Images and words can “live” on the internet forever, facilitating long-term bullying and harassment that the victim is powerless to escape.

Of course, there are larger concerns also, including how a 30-year-old man who could bully a 7th-grader and distribute a topless photo of her without punishment, or how she could suffer such extreme bullying at school without the intervention of parents, teachers or staff. And, perhaps largest of all, how patriarchy continues to enable slut-shaming in our society.

None of these concerns are going to disappear anytime soon, but as someone who works with teenage girls they are always present in some form or another. Many of the girls I work with can describe slut-shaming to a T, but they wouldn’t call it that. To them, it’s how life is; a girl expresses her sexuality somehow (or simply has rumors spread about her to that effect) and her peers come down hard on her with oppressive, shameful comments. I think that the first step is to help youth recognize how inappropriate and misogynistic these actions are. So may girls are growing up without a feminist vocabulary to help them make sense of the sexist and oppressive dynamics they are inevitably being exposed to at school and in the media. Here is a video of Amanda Todd made days before her suicide.


To view archive visit this link:


Do You Know What to Do If You Think Someone is Suicidal #SWUnited Live Twitter Chat 11/19/12 at 8PM EST

by Deona Hooper, MSW

On November 19, 2012 at 8PM EST, we will have a  live twitter chat to discuss suicide prevention and the social work response. I have attached the link to the National Suicide Prevention website for information and tools for use in practice. Here is the link as follows:

@swhelpercom will be moderating the debate using the hashtag #SWUnited with guests @harperlevy and @drbillschmitz

Here is an excerpt from Psycentral entitled “What to do when you think someone is suicidal“:

Suicide is the 11th leading cause of death in the U.S., and the third leading cause of death for 15 to 24 year olds. Still, suicide remains a taboo topic, is highly stigmatized and is surrounded by myth and mystery.

One of the biggest — and most destructive — myths is that if you discuss suicide, you’re planting the idea in someone’s head, said Scott Poland, Ed.D, the prevention division director at the American Association of Suicidology and associate professor at Nova Southeastern University. Clinical psychologist and suicide expert William Schmitz, Psy.D., likens it to talking to someone who’s recently been diagnosed with cancer. By mentioning cancer, you’re not forcing the topic front and center. “If someone is diagnosed with cancer, it’s on their mind.” Bringing it up shows support and concern. Similarly, by talking about suicide, you show the person that you truly care about them. In fact, lack of connection is a key reason why people have suicidal thoughts; isolation contributes to and escalates their pain. Do you know what to do if someone is suicidal?

Read More

Update  The Live Twitter Chat on Suicide Prevention and Identification brought to light some interesting perspective. Here are few of the tweets and the full archived discussion is attached.

View Archived Chat:

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