The Message Matters – How to Talk About Suicide

hope-in-focusIn the wake of Robin William’s death from suicide, there have been many posts and messages circulating about suicide.  While most of these sentiments are well-meaning, it is possible to actually perpetuate certain misconceptions and stigmas about mental illness and depression, leading to a negative impact on those who may be most vulnerable.  The  Action Alliance for Suicide Prevention offers some great pointers on “promoting the positive in the form of actions, solutions, successes, or resources” as seen below:

What is the National Action Alliance for Suicide Prevention’s Framework for Successful Messaging?

Framework GraphicThe Framework is a research-based resource that outlines four key factors to consider when developing public messages about suicide:

The central resource for the Framework is this website, (link is external).

The Framework was created by the National Action Alliance for Suicide Prevention as part of its priority to change the public conversation about suicide. For background on the Action Alliance priority, see How does the Framework “Change the Conversation?”

Who is the Framework for?

It’s for anyone who is messaging to the public about suicide and suicide prevention. This includes, for example:

  • Suicide prevention organizations and projects
  • Government officials
  • Mental health organizations
  • Researchers
  • Community-based organizations
  • Institutions conducting suicide prevention activities, including colleges, schools, workplaces, and faith communities
  • Advocacy groups
  • Individuals speaking to the public about their personal experiences, including survivors of suicide attempts, survivors of suicide loss, and consumers of mental health services

The Framework initiative complements important and ongoing efforts to promote safer coverage of suicide in the news and entertainment media.

What do you mean by “public messaging?”

“Public messaging” is defined broadly as any communications released into the public domain. Examples include:

  • Education and awareness campaigns or materials (posters, PSAs, flyers, giveaways, etc.)
  • Organizational websites
  • Newsletters
  • Fundraising appeals
  • Publicity for events and observances
  • Social media
  • Press releases, media interviews
  • Public presentations
  • Publicly-available advocacy materials
  • Any other public-facing messages or materials

All of our messages and materials contribute to the public’s perceptions about suicide and suicide prevention.

What isn’t public messaging?

The Framework addresses only public messaging. It is not intended to address other important types of communications that relate to suicide, including:

  • Private conversations
  • Doctor-patient interactions
  • Interactions with individuals in crisis or who you think might be suicidal
  • One-on-one conversations with legislators or policy makers
  • Talking in support groups or other therapeutic settings
  • Training delivered to professional audiences, e.g. clinicians
  • Reporting by the news media

Not looking for guidance on public messaging? See resources for other types of suicide prevention communications.

Why was the Framework developed?

The background research section summarizes the research literature and background work that led to the Framework. In brief, we found that:

  • Resources exist to improve news and entertainment coverage about suicide (“the media”), but little guidance has been available for others communicating publicly about suicide (“the messengers.”) The Framework fills that gap.
  • Some prevention messages violate safe messaging guidelines, such as portraying means or talking about suicide in a way that normalizes it, i.e. makes it seem more common than it actually is.
  • Public messaging about suicide often has focused more on describing the problem than on conveying concrete actions or solutions. This unbalanced picture contributes to a harmful social narrative suggesting that trying to prevent suicide is hopeless  and no one recovers from suicidal thinking. Because the media often perpetuates these negative and inaccurate narratives, it is even more important that the prevention field counter them.
  • Suicide prevention messaging would benefit from adhering to recommendations from the broader communications literature, including:
    • Defining a clear purpose for communications before  crafting the message itself
    • Designing messaging as one component of a broader suicide prevention plan
    • Promoting specific behaviors in defined audiences
    • Using information about the audience to design more effective messages
    • Choosing delivery channels that match the message and audience
    • Assessing message success
  • The suicide prevention field is not taking advantage of the many extant best practice guidelines that can and should be used when developing messaging related to particular goals (e.g., stigma reduction), populations (e.g. LGBT populations), channels (e.g., social media), and other areas. The “Guidelines” section of this website provides links to many such resources.

What is the purpose of the Framework?

Our background work revealed that the most successful messaging will be shaped by at least four key factors. The Framework brings these together:

  • Strategy involves planning and focusing messages, so they are as effective as possible.
  • Safety is avoiding content that is unsafe.
  • Positive Narrative means ensuring that the collective voice of the field is “promoting the positive” in the form of actions, solutions, successes, or resources.
  • Guidelines means using any existing guidance or best practices that apply.


The Washington Post also offered some great insight into how to prevent a phenomenon called Suicide Contagion  that can be particularly prevalent amongst teens who are suffering from depression.


Ultimately the goal is to save lives through raising awareness and promoting resources that send a message of hope to anyone affected by these treatable illnesses.





Why Do I Blog About Mental Health? – A 2-part Question

Blog for Mental Health

Part A – I love to write

child-writing-credit-istock-91513956-630x420I am obsessed with writing I still remember my first diary that I kept tucked under my pillow.  I remember how it smelled, how it felt to put the tiny key into the shiny gold key hole, unlocking a space where I could write down all of the things that were swirling around in my head.  I remember thinking that my brain was like an attic, and every time I wrote it felt like I was sweeping up its dusty corners.  I felt like the little mermaid swimming into her secret world under water, safe from everything above the ocean’s surface.

sisters at beach

Writing gives me something to do with all the memories that pop up unexpectedly at inappropriate timesI have learned from experience it doesn’t pay to impulsively spout off a random story about my mom’s propensity to hear voices at the dinner table, when others are sharing their stories about family mealtime.  The awkward silence and puzzled looks on people’s faces quickly taught me to refrain from this type of sharing.

Writing is an acceptable way to deal with my obsessive thinkingMost days I wake up with a bunch of thoughts coming down the shoot, like chocolates on a conveyor belt.  I have found that it is easier to write them down than to engage in the many other unhealthy outlets that I have experimented with over the years.  There are the words I share here in my blog, and the ones I reserve for my journal.   Both venues provide an outlet to release the thoughts and feelings that visit themselves upon me every day.

Part B – Mental Health is Important

Mental illness impacts all of our lives – Since I have opened up and shared with people about the mental health issues in my family, many people have begun to share their experiences with me.  It turns out that at one time or another most people have experienced a mental health issue or have had a family member or close friend who has grappled with depression, anxiety, eating disorders, bipolar, alcohol or substance abuse, or any of the many other neurological imbalances that can affect the human brain.


Relief from symptoms and recovery are possible – We can’t give up on searching for the best treatment options. These things are within our reach if we support organizations, legislation, research, and individuals’ efforts to seek optimal mental health.

em skatingBlogging provides a positive outlet to cope with my own personal experiences –  Although it has been many years since I had an eating disorder, the underlying issues of anxiety and depression must always be managed.  I still live with the scars left from living with my mom’s mental illness (schizophrenia), and still strive to learn from my daughter’s struggles with depression, a suicide attempt, and an eating disorder.  For some reason, my life has been defined in part by these experiences, and I want to maintain a positive outlook.

Blogging is a great way to connect with other people who feel passionate about mental healthI appreciate and celebrate all of the many wonderful mental health bloggers who open up their lives, hearts, and souls, giving a glimpse into the many facets of living with mental illness.



“I pledge my commitment to the Blog for Mental Health 2014 Project.  I will blog about mental health topics not only for myself, but for others.  By displaying this badge, I show my pride, dedication, and acceptance for mental health.  I use this to promote mental health education in the struggle to erase stigma.”


Stop Minimizing Mental Illness: Worst Things to Say | Breaking Bipolar

Stop Minimizing Mental Illness: Worst Things to Say | Breaking Bipolar

I read this on the website and thought it made some excellent points about the importance of providing support to those with mental illness in a non-judgmental way.


Focus on Gun Control and Mental Health Issues

Blue hillsThere has been a lot of discussion about guns lately in the media.   Many questions arise from reports of people opening fire in movie theaters, the workplace, schools/universities, and other public places.  What prompts people to do such things and what can we do about it?  This debate seems to spark two distinct camps of opinion – one consists of the individuals who feel they need to rush out to purchase a gun in case they find themselves in a similar situation and need protection.  The second group argues strongly for stricter gun control to keep guns out of the hands of people who could potentially become dangerous.  This group is in favor of  developing criteria to prevent unstable and dangerous people from obtaining guns, and this isn’t always easy to determine.

I’ve become acutely aware of  how the majority of popular movies, television shows, video games, and books (many directed towards the younger audiences) send the message that guns can solve problems.  These are packaged in such a manner that the reasons for using a gun are clear-cut.  Bad people deserve to be shot.  It is okay to kill someone if he/she is bad, or threatens other people’s safety.  It is okay to protect oneself.  The problem is that not everyone shares the same criteria for what might warrant shooting and/or killing someone.  Some people feel the need to buy guns because of their mistrust of the current government.  The teen that goes into a high school and shoots the classmates and teachers that made him feel alienated may believe he is as justified to do so as the person in the convenient store that is being robbed.  As more of these types of incidents create a new reality, we are forced to take a closer look at how to address these problem.  The immediate solution is to protect ourselves, and it has now become routine practice in some grade schools to have periodic drills to prepare for the possibility of a shooting rampage.

In my line of work, I have the opportunity to get to know people from a variety of backgrounds, some of whom I may not otherwise encounter.  Many of them have experienced the death of a close loved one, shot down on the street because of turf wars or simple disagreements.  One woman lamented that in “her day” fights were solved on the street by physical fighting.  That step is now skipped for a more immediate and permanent solution, and many consider having a gun as their only real hope for protection.

Guns can be found in many middle class homes as well, for use as a means of defense against potential intruders, as collector’s items, or as a form of recreation via hunting or target practice.   When these guns are not locked and stored properly, they may fall into the hands of the innocent child, a despondent lover, or someone who carelessly mishandles or uses them as a means of intimidation, often leading to grave consequences.

Many people want the right to carry a gun, but how many would you trust to handle them appropriately.  There are far too many accidents and senseless deaths caused by carelessness and lapses in judgment, and this warrants a serious look at how to deal effectively with the new issues we face.  We live in a time when, with a click of a button via social networking, people can organize large group events of a violent nature, stockpile weapons for an extremist cause, and derive a false sense of security about their personal protection without taking proper responsibility.

As with many other social issues, those with mental health issues are often singled out as the biggest threat to their community.  The National Alliance on Mental Illness (NAMI) posted a thought-provoking article (click on NAMI article below) which raises concerns about the over-simplification of who should be able to possess guns.  In reality, those with mental illness  are no more likely to commit a violent crime than the general population, as this recent NAMI article clearly illustrates.   Ultimately the issues of gun safety are much more complex and require a closer look to determine the best way to ensure that the responsibility is shared by everyone.

There Are No Casseroles

A phenomenon that is familiar amongst those who have experienced the psychiatric hospitalization of a family member or themselves, is what we’ve come to joke about as “there are no casseroles”.  Unlike with other serious illnesses that require hospitalization or an extended absence from one’s normal routine, there is a noticeable void when it comes to support.  The usual flowers, casserole dishes delivered to the house, cards, visits, and phone calls that are commonly extended to those in crisis are replaced by a tentative awkwardness.

This isn’t because people are uncaring or unsympathetic.  Often the illness is kept such a secret that only the closest of friends/relatives even know about it.   When people do find out, they may want to avoid bringing it up because they don’t want to say the wrong thing or cause anyone to feel uncomfortable.   This is reinforced when we are too afraid or embarrassed to talk about it.  We may also feel protective of our loved ones and want to shelter them from being stigmatized.

I look forward to the day when mental health issues are considered to be no different from any other type of illness.  As hard as it may be, this can only happen when we are willing to open up to those around us, even if we start with just a few trusted people.  I’ve been surprised to find that once that conversation has been initiated, there are many others who have experienced a mental health problem either in themselves or a loved one.

There are times when it may be more prudent to maintain one’s privacy, especially when experience has shown that certain individuals’ reactions may cause additional stress or result in negative repercussions.  In fact, we are entitled to privacy when it comes to our health care.

Nonetheless, we don’t need to go through this alone.  In addition to opening up to a few trusted friends, there are many support groups available where you can speak freely and listen to others facing similar issues.   Your mental health professional will be able to refer you to an appropriate group, and there are many online resources such as NAMI as well.

As fellow human beings, it seems natural to seek comfort in each other during difficult times, and ultimately that is what gives us the hope to continue on this journey.

Hope is the thing with feathers
That perches in the soul,
And sings the tune without the words,
and never stops at all.

Emily Dickenson

Recent News

Last week, speculation about a story in the news made its way into conversations in the work place and amongst friends and acquaintances.  Everyone wanted to make sense out of what could have caused a man to begin beating his newborn niece when handed to him by the infant’s mother.  What kind of person could have done such a thing, and why?

Sadly, it was reported that the man had paranoid schizophrenia, had recently been released from the hospital after a 72-hour hold, and was not taking his medication.   Public reaction is understandable, given the heinous nature of what occurred.  It appears that in this case, his actions were most likely the result of a severe delusional state.  However, despite what is often portrayed in the media, this kind of violent behavior is rare in those with schizophrenia or severe mental illnesses.   In fact, the greatest challenge they often face is managing symptoms that can be debilitating, and obtaining proper medication and treatment in order to alleviate these symptoms.

My heart goes out to everyone in this family, as they struggle to deal with the loss of their precious baby and make sense of it all.   It is clear that the parents were actively seeking help for their son prior to this incident, and I can only imagine how they must feel now.   The pain of their loss must be multiplied by the fact that there is only so much they could do to help their adult son manage his illness.

Families assume many of the responsibilities of finding the appropriate help and treatment, and this can be a huge challenge.  There can be many obstacles along the way, including convincing someone to seek treatment when the person doesn’t believe that he/she is ill.    Balancing their loved one’s legal rights as an individual with the need for treatment can present a seemingly impossible dilemma.  It can be an exhausting and heart-wrenching process, and a strong support system for the family is essential.   Because of the stigmas associated with mental illness, many families choose to keep their struggles private, and this leads to a sense of isolation and helplessness.  The only way to ensure progress is to break the silence and open up to others so that they can have a better understanding.

A stronger voice is needed to advocate for these highly misunderstood illnesses.   I am optimistic that with current research and increased knowledge, the outlook for mental illness treatment and recovery will continue to improve.   It is easy to get disheartened when we hear about a treatment “failure”, but that is all the more reason to continue the search for answers.  I am hopeful that by examining the misconceptions about mental illness, people’s attitudes will continue to improve as well.

A Closer Look

When you think about mental illness, what words come to mind?  Crazy, insane, dysfunctional?  What images come to mind?  A homeless person pushing a shopping cart, mass shootings at a college or high school?  Movies such as One Flew Over the Cuckoo’s Nest, Sybil, or Mommy Dearest?  Or perhaps one of the newer movies such as A Beautiful Mind, Fisher King, or As Good As It Gets.  Whatever one’s images and perceptions of mental illness may be, they often rely on stereotypes.

If someone with a mental illness were one-dimensional, it would be easy to sustain certain opinions, but as I have learned from my own experiences, there are as many dimensions to someone who has a mental illness as any other human being.  Just as those who have an illness such as diabetes, cancer, or rheumatoid arthritis are not completely defined by their illness; ultimately it is just one aspect of their life.   If left untreated and as any illness progresses, it may come to consume more of that person’s existence, but never does it completely consume every aspect of their being.

Granted, an illness that affects one’s brain can be more challenging because it becomes a filter through which one views the world.  Yet, as I learned from living with my mom, who had schizophrenia, there are good days and bad, and one cannot discount all of the good because of the trying moments.

I’d like to first share a few of my favorite memories of my mom.  When I was little she had a few songs she liked to sing to me….”You Are My Sunshine”and “Hush Little Baby”   She loved being outdoors, and grew the biggest pumpkins I’ve ever seen, along with berries, herbs, and a variety of exotic flowers.  She loved taking drives in the country, and whenever we passed a barn with Mail Pouch Tobacco written across it, she would start singing “Chew Mail Pouch Tobaccy” and we would join in loudly.

I’ll never forget when my mom found out she was pregnant with each of my sisters and danced around the kitchen with excitement until the floor was dotted with scuff marks.   When we went camping at Houston Woods and she was pregnant, her cravings for peach ice cream led her to buy a huge tub of it which we all devoured at the park, sitting on a soft bed of pine needles under a canopy of trees.

She was one of the first people to see my daughters after they were born, and she loved showing them her favorite rock collections when they got older.   She loved spending time with them and sharing her interests in gardening and nature.

I think I inherited my love of birds from my mom, as she often had pet parakeets.  She also loved turtles, and it wasn’t uncommon to see one bathing in our bathroom sink at some point during the day, or eating a dish of scrambled eggs she made specially for it.

When I was away at summer camp, I looked forward to receiving my mom’s cards and a few trinkets thrown in with them, including my favorite lady bug necklace.  One Easter, she went to great lengths to hide clues around the house, leading to small treats and ultimately the beautiful Easter Basket she had prepared the night before.

Her favorite Christmas album was by Andy Williams, and I remember sitting up with her late at night during one Christmas season in the glow of the Christmas lights, listening to that album and having a heart to heart talk.  She loved reading and learning, and there was always a copy of the Reader’s Digest sitting out with the word of the day highlighted or underlined.   She loved eating nuts and hot, spicy foods, and our favorite quote of hers was “it’s super good with hot sauce”.   She loved riding her bike, and could outride me and my sisters any time, with her hands held high above her head as she cruised along.

I’m grateful for all of the ways my mom managed to enjoy life, despite her illness.    It taught me how important it is to savor the good times.

Exploring Mental Health Issues

I grew up in a household with many blessings and many challenges, though none so extraordinary to make me truly unique.  After years of thinking I needed to protect and guard certain family and personal secrets, it is a leap for me to begin blogging about those experiences.

I have come to the conclusion that it is important for me to examine these stories more closely now, with the small hope that it may help others who have been affected by any type of mental illness, and the larger hope that I may help myself to gain more understanding of the issues that have impacted my life and the lives of those I love.

I want to use this forum to examine a variety of mental health topics in an effort to dispell the stigmas that are associated with mental health issues.  More importantly, I want to use it to celebrate the advances that have been made in improving the treatment options and quality of life for many who have been affected, and to offer hope that with perseverance, advances can continue to be made.

I am dedicating this blog to my mother, Shirley, who lived with schizophrenia for many of her 58 years.  I hope that in heaven, she has found the peace that she deserves.