Samantha Nadler once told her therapist she wouldn’t live to be 18 years old. Six years past that deadline, she now supervises a crisis program and talks openly about her experience with suicidality. She recently went home for the first time in a decade, revisiting a world where she had been seen as the hospital patient, the troubled one. Her transformation was greeted with happy surprise and even tears.
Here, she talks about the limitations of mental health coverage, the very cool rise of social media in suicide prevention and the way her work has created a buffer for her past.
“A lot of people, including myself, expected I would not survive that part of my life,” she says. “Now I’m being able to contribute in my own way _ another reason for it to be very healing.”
Tell us about yourself.
I came into this field because I wanted to get firsthand experience, and a full-time position opened. I answered phones full-time for a crisis line, and also for 211, for social services. I did that for about three years. I also was offered the opportunity to start facilitating a survivors of suicide support group, for those who lost someone to suicide. So I’ve been doing that ever since, for about three years. Then a year ago, I had the opportunity to be promoted to crisis program supervisor. I’m currently working on my master’s in social work at the University of Tennessee. And that’s everything I can think to tell you.
Sure. When I first started here, I was not open about my history because of stigma. I didn’t want to raise concerns about my stability. I did tell them here I had personal experience with suicide, but with family members, which was true. After a couple of years here, I had the opportunity through the Tennessee Suicide Prevention Network to facilitate an attempters group. This was a Suicide Anonymous group. It was a 12-step model, but we never had anyone show up, so we stopped having it. At first, my job was concerned that I may not have had enough experience. I was fairly young. I’m 24. And that’s when I had to be open about my history. That’s kind of how I came into the field.
I’m very lucky. My job has been very supportive ever since. People get something from me talking about my experience. I have some sort of professional and personal authority on the topic. Our survivors of suicide group has been helpful for me and others. I started attempting suicide when I was 12. And I have a history of eight or nine attempts, and the last was five years ago.
I grew up in a pretty dysfunctional household. A broken marriage, my parents remarried, a very difficult transition. Depression and anxiety run in my family, so I have that going for me. I came to know about suicidal ideation when I was 12. I didn’t understand it. I just didn’t want to live. Nobody had ever talked about it, that people experienced that. The first time I was hospitalized, I hadn’t even attempted, I just verbalized it. That’s how I found out it was a serious thing.
I never talked to anyone directly about my feelings. It was basically professionals talking over me. I never had a chance to know why I was feeling that way. I had multiple attempts from feeling trapped in my house. School ended up not well for me. I think I ended up cutting most of my sophomore year. I ended up with a diagnosis of bipolar, with a lot of changing medications, trying to find out what works. It was not consistent. I had no chance to find out what worked for me. I had battled depression for the majority of my life at this point. I still experience ideations, but I don’t act on them anymore.
There was a transition from when I lived at home in New York to being in a troubled teens program for two years in Tennessee. When I was at home, I remember saying to the therapist that I wasn’t going to live to be 18. So just merely being able to leave my house, see that I can make it out of high school, that I do have that ability to go to college, that was what kind of pushed it. I always knew I wanted to major in psychology or social work. I’ve been really enjoying it. I’m very lucky I got my job here while working on my bachelor’s. I’ve been able to have really cool experiences firsthand.
Has stigma in your field ever been a concern?
Well, not since I’ve been open professionally about it. I went through my whole adolescence being the identified patient in my family, always the one going to the hospital, having attempts. So, of course, I had that label there. But coming here _ I went from New York to Tennessee _ I was hesitant because I was afraid people would think I wasn’t fully capable. I did hold back for a while. It would be understandable to think that way. I was only a year out from an attempt. If we were to interview anyone here who recently had attempted suicide, it would raise concern for us. If the opportunity had not presented itself …
After coming out of the closet of mental illness, it’s been fantastic, actually. I’ve received nothing but support from every direction. It’s been really comforting and surprising for me. I think people understand me and my position more. My knowledge in this field is not based on just what I read in books, which has been helpful.
In your field, how many people would you say have experience, and how many have just a book background?
I met a lot of people at the AAS conference. I’ve attended ended two of those. And I connected with a lot of people who had that history. But I met a lot more who were suicide survivors. But there’s a movement now to have attempt survivors talk and be a part. I think I saw that more than four years ago. I’m someone who over the years has opened up as well. But I have to say I’ve met more survivors of suicide than attempters. I only know one other person in the Tennessee Suicide Prevention Network who has that kind of history, the only one who has opened up about it.
Have you had any unusual reactions?
From sharing my history?
Well, usually in my survivors of suicide support group, I will sometimes mention it. I know that I have observed group members changing their tone about someone attempting. I don’t want people thinking they have to be more sensitive to my experience. I offer my knowledge about what happened when someone was in that frame of mind. I can offer that validation of whatever they think might have happened. Sometimes people in my group get relief from that.
Another setting is if I choose to share in our call center training, three times a year. I cover the suicide assessment portion. Sometimes I get questions about something they heard about suicide risk, a lot of stereotypes. So every once in a while, I have a back-and-forth with someone about a theory, and sometimes I throw out, “Well, I attempted suicide this many times, and I did not experience this.” That usually gets an interesting response, because until that point the trainees know me as a supervisor. I always get more in-depth questions about suicidality because they know someone who’s experienced that. But I haven’t really received anything wild, because I’m so involved in this field that people aren’t surprised.
Should people in the field disclose that they’ve had this experience, and should people with experience be given priority in the field?
Well, yes and no. Yes, because having that understanding definitely gives you an edge and depth of understanding that the average person doesn’t grasp. That’s why so many people say, “It’s selfish” and “How weak of them,” when it’s the opposite. But on the other hand, there are people out there who are very empathetic and, while not experienced themselves, they may have had a best friend who tried to kill themself and understand having someone in their life with that experience. That’s how I was with the survivors of suicide group, because even though I had not lost someone, I felt connected. I think people out there don’t necessarily have to be in my shoes, but if they have some exposure to it …
You have to have this kind of understanding to have the job. I think people in my shoes should be looked at more seriously for these positions instead of, “Oh geez, they might be more unstable for this job.”
Since you work inside the system, what changes would you like to see?
I definitely feel there are not enough resources for people who chronically deal with suicidal ideation. Our call center is working on starting an attempters group, and I know there aren’t many out there. Basically, the options are individual therapy or going to the hospital, and there’s nothing really in between. I feel there’s a gap in services there. For people who are feeling suicidal, without the fear of working with them. A lot of people fear because they think they’re encouraging an environment where people become more suicidal or plan suicide together, which is ridiculous. You don’t get cancer any more than the average person if you discuss it. And I don’t think people understand. Over 90 percent of people who die by suicide have a mental illness, and that speaks for what that means when someone tries to take their life.
I definitely would like to see more mental health initiatives in health care. I recently had to seek out a therapist and get anti-depressants for the first time in a while. I’m paying for the cheapest health care, but I can see no one but my primary health care doctor. I should be able to see a therapist under that plan if I needed to. I don’t go to a doctor for anything else. A therapist is expensive, and I see how people end up not getting help. I definitely feel there needs to be more services. I think a lot of people are scared to work with those with a history of suicide.
Also, I would like to see more professionals trained in how to assess for suicide. I think those working in the health field don’t really have a well-rounded understanding of how that works. For example, when I saw my doctor, the question was, “Are you suicidal?” “I have been.” She said, “You don’t have a plan, do you? Because if you do, I have to hospitalize you.” That’s not a tactful way to ask. What if I had a plan? I wouldn’t have been honest. She pretty much set me up to say “no” to her. I said to her afterwards how I heard that question and how others might hear it, and she’s like, “Yup, that’s great, thanks. Next patient.” It just demonstrates the lack of experience in assessing for suicide, and in a way that makes that person feel they can talk to you. And not being afraid to ask those questions and have a conversation, because a conversation could mean everything.
So the only person you can afford to go to under your health plan is your general practicioner?
Correct. It’s the high-deductible plan.
I’m no expert on this, but I’ve heard people talk confidently about changes coming with Obamacare, mental health parity …?
To be honest, I don’t know a whole lot about that stuff yet. This was about two months ago. I could have gone to a psychiatrist, but some were not taking clients, and if they were, it was going to be like $120 to go see them. Yeah. And there wasn’t a huge selection, either. I had tried to see my old psychiatrist, but he wasn’t taking any clients. It’s just a very complicated process.
What about alternatives to the usual system, through social media or such?
Good question. I’ve seen, like, listservs. There is a clinician survivors of suicide e-mail list through AAS, for people who work in the field and have lost someone personally or professionally. So I know they have listservs for people like that, I think because when they tried to do it in cities independently, people didn’t come because of stigma, and professionals don’t want to be seen grieving over clients. But honestly, I haven’t seen too many things for people in my shoes.
But I know people are using social media a lot for, especially, suicide prevention. I have an Instagram account, and a few weeks ago I tried looking up the suicide prevention hashtag. It’s so cool because that could pull up pictures, etc., from all over the world. One photo I found was someone saying, “There is hope,” and they listed our Nashville crisis line! Out of all the numbers, they found ours. It was so neat because, you know, I wonder how many people saw that, and what are the odds? I mean, there are lots of crisis lines. The fact they had our number, and I was able to find it, shows how social media can reach out to people they don’t necessarily intend to each out to.
I know our call center does a lot of outreach events, community fairs. What’s cool about that is if someone comes up and sees that we answer the crisis line, they say, “I had a friend and gave her this number, she made it through the night” or “I used it” or “I need this number.”
And something we recently started doing, we had Fort Campbell, they reached out to us because I have a survivors of suicide support group, and they wanted people from the group to talk to their soldiers to deter the behavior, since it’s been very high on base. They also wanted an attempter. So I went, and that was really neat, since the Army used us instead of “death by Powerpoint.” We had two or three soldiers come up after each session and say they had been feeling suicidal and hadn’t told anyone yet. It as just us talking about it. I guess the stories were impactful enough that they felt they could come forward. It really was a neat experience. We got to go back last Friday to do it again.
Did you feel any sense of not trusting you because you’re not in the military?
Well, they reached out to us. That’s the most interesting part. They were looking to reach their soldiers in a different way. We weren’t trying to train them how to assess suicide risk. We were just four people with stories. Very easygoing. We were really impressed with Fort Campbell. We spoke to about 1,000 soldiers that day.
The people who knew you when you were younger, what do they think about you now?
I have to say that’s one of the coolest things about going into this field. I recently had to go home to New York last week, and I hadn’t been there in probably 10 years. A lot people had not seen me since I was very sick. It’s funny you asked that question. A lot of people found it very cool. I ran into a teacher who was really a guardian angel for me, and she teared up seeing I was alive, I hadn’t killed myself, and things were going well. And it’s especially neat when people know what I’m doing now. A few days ago, someone posted a letter I had wrote from the hospital. She said I had come such a long way, it was neat to watch how I had come from that place to this place. I have to say that’s one of the biggest rewards. A lot of people, including myself, expected I would not survive that part of my life. Now I’m being able to contribute in my own way _ another reason for it to be very healing.
What more would you like to do?
When I grow up? I feel like I have my dream job right now. I feel what I’m doing right now is so perfect for me. I have such a supportive job and supervisors, and what a great environment: ‘”I have this idea, what do you think?” “Great!” They’re very supportive. And I want to stay at my job as long as I can. I want to be an LCSW. I want to eventually be a clinician, but I’m not sure in what capacity. I’m interested in trauma, but I’m not sure how far I want to move from suicidality. But I enjoy my niche and plan on being here for a bit.
Who else are you?
Well, I’m a wife, I’m a daughter, a friend, a sister. I’m really enjoying music. I mean, that’s everything I can think to say on that. Here in the last few years, I’ve been trying to draw that line on “I am not my mental illness” and use it for good. I’m a student and, I don’t know, enjoying life, I guess.