Talking with Cathy Read-Wilson

How many people working on crisis lines have had their own experience with suicide? Cathy Read-Wilson’s suicide attempt came after she had started volunteering with one. She found that the organization didn’t panic, later hired her and has worked with her ever since.

Cathy explains the system, including how it keeps her supervisor informed when she has a crisis while keeping the record of the crisis relatively anonymous. She’s also free to mention her experience to callers. “I have had callers happy they had a person on the other end of the line who knew what they were talking about,” she says. “And they know I’m not calling 911 on them, because I know that sucks. But I tell them that if I need to, I will.”

She decided to speak out about her experience because she found it hard to find resources for attempt survivors, and she came across Yvonne Bergmans‘ group in Toronto.

Who are you?

I’m a mother of three kids, ages 22, 19 and 15. I live in a small town, fairly small, Elmira, Ontario. I grew up here. I went off to university in Hamilton, ended up coming back, getting married, raising a family. I’ve done all sorts of work in the meantime, working in a newspaper setting, washing windows, doing anything I could, until recently, I decided to move to a profession that I’m doing now, counseling.

What kind of counseling?

What I’ve been doing part time is working on a crisis phone line. A lot of work is either distress or crisis intervention. It could mean just listening to people as they needto vent, or helping keep them from grabbing a drink when they’ve been clean for a while. I’m moving into more front-line work. I’m working on the AIDS committee for Cambridge-Kitchener-Waterloo area. I’m working on the education end of things, reducing stigma.

In your work for crisis lines, did you disclose your own experience?

It makes it very easy for me to work with individuals. In some ways, it’s more easy to work with a suicidal person than a co-worker. I would disclose depending onthe situation. It’s supposed to be about the caller, but I found that sharing a bit about my experience has benefited. I have had callers happy they had a person on the other end of the line who knew what they were talking about. And they know I’m not calling 911 on them, because I know that sucks. But I tell them that if I need to, I will.

But did you tell the crisis line organizers when you joined them?

Actually, my attempt was while working with them. My first two attempts, I call them pseudo-attempts, were 10, 15 years ago. I started volunteering three, three and half years ago. I literally had quit my job as a part-time custodian, getting more into social services. What I could share then was my struggle at times with depression, how I ended up being on sick leave because of mental health, how I could relate to bereavement, PTSD, the kind of stuff relevant then. Literally two years ago, I actually had my major attempt. And so it was ultimately only since then that I disclose my attempt. I mean, I use my own services now.

You didn’t know about them before?

When I went through other struggles, I had no idea that a phone line existed. Now, actually within the last six months, I’ve phoned coworkers late at night. There’s a very political way of the organization in working with it, no backlash. I’m very fortunate. They have full respect for the fact that I am using it, really.

How does it work?

If I phone in, coworkers will make note of the call but make it at an anonymous level. And that way, volunteers can’t necessarily see it. If I choose, they could put my name in. My coworkers actually have a copy of my crisis plan right by their desk. I can access the schedule, so I know who I’m going to be talking to. It’s kept anonymous when it’s put in the computer. My supervisor is notified, though. So she is aware. If there’s any contact with the mobile crisis team, it’s kept relatively anonymous. The paper trail gets folded up, put in an envelope and given to the supervisor’s superior. So there’s a record, but nothing no one else needs to know about.

How does it feel coming in to work afterward?

I could show up the next morning at work, yeah. I’ve only used it a few times. At first, it was somewhat awkward. My first person on my crisis plan is my supervisor. So she knew prior. It just happened that the mobile crisis person that morning was also the union rep. He was actually the one, he saw us talking, came in, explained to me the confidentiality stuff. I had no idea. The call had to be made, I didn’t know how it would be processed. But knowing now, I’m OK with that. I’ve got a great support system. And I’m not the only one who used the services. We provide a service for others in need, and we should be able to offer it to our own employees.

Is this a private organization, or a governmental one?

It’s the Canadian Mental Health Association. Out of the Grand River branch. Which may not be standard throughout Canada.

(I ask about the difference in stigma around suicide in Canada and the U.S.)

There is stigma. I had been looking for work, with resumes out there like crazy. I know it’s a tough market. But I’m so open, I’ve been in newspapers, on TV, that a part of me wonders _ it also shows up on my police check _ to what extent I was not getting a job because of my openness about my suicide attempt. I don’t know. I speculate it might be some there. For the most part, I get a positive response. I don’t know what they’re saying behind my back. I guess I don’t really care.

How did it come about, your openness?

My attempt was July 7, 2010. I was in the middle of my master’s course. I went in on a Wednesday to the hospital, and I was able to get myself into crisis respite on Monday. I did stuff I wouldn’t recommend to clients to get through the system. Once I got there, I started Googling “suicide survivors.” Everything that started coming up was those bereaved by suicide, and I got rather ticked off at that. No, I’m a survivor, too. I’m not going to keep quiet about it. I was very open with my kids, my family. There was only so much I could hide already. With my kids, I had a counseling session, and the counselor asked, “How do you want me to do this?” I said to right out suicide, call it exactly the way it is. It does no one good to sweeten it up, to make false comments. As far as coming out to the public, it was a year later. I was open with close friends, within my work environment. I didn’t not talk about it. I’m actually a shit instigator: “What did you do this weekend?” “I attempted suicide.” The deer in the headlights response. The humor gets us through. But I was determined something needed to be done. On suicide awareness day, I had my own event in Elmira. Basically there was a newspaper article for all of Elmira to read about my attempt, like coming out of the closet, so to speak. The interesting thing is, my parents live in town and people would go to them before talking with me, comment how brave I was, blah blah blah. Now more people come up to me still. They actually bring it up in conversation. I always thank them.

They never go over the line? Is there no line?

I’m open to anything. I always have the right to not answer. I’ve been asked “Why,” “How could you possibly feel that low,” “What about your children,” if I ever got angry at God, so a more religious component. No, I’ll answer whatever. The most hurtful comment came from someone I knew fairly well, it had to do with it referred to as a selfish thing to do. That one hurt. But for the most part, no. And if I’m in the right frame of mind, if someone asks if I’m doing it for the attention, really, none of us do it for attention, right? You have to be in a pretty deep hole. If I’m not in the right frame of mind, I take it personally.

If you’re in the right frame of mind, what would you say?

I would say it’s more a cry for help than a cry for attention. The words are not there. You don’t have the words to speak for yourself. I’ve been trained, I know intervention, but if I’m in crisis tomorrow, will I know how to pull that stuff out of a hat? Not necessarily.

About the comment on being selfish, did you have any response?

I never did. It was someone I had greatly respected growing up. I just put it in the back of my mind. Sometimes you say things in the moment you don’t necessarily mean. And you know, if I were to see him now, I probably would say something to that effect. but at the time, I didn’t know what to say.

Is there any downside to being open?

Yeah. It’s the triggers. And I have to really be careful I’m not overdoing it in my suicide prevention promotion stuff. I suffer from emotional hangovers, so I can be go, go, go, go for a while but then pay for it after the fact. I slide pretty quickly. But do I ever regret my reason for sliding? No. And if I slide so far I have another attempt, would I regret it? No. Because I still would have accomplished stuff prior to it.

Is there any risk in you talking with me? You know there is the common concern about attempt survivors talking with each other about it.

That’s such a myth. The best group I ever sat in on was Yvonne Bergmans‘, sitting in as a peer. and being able to sit in on a room of fascinating, creative, intelligent individuals and hear their struggle, like yours. No, I still keep in contact. Our conversation is generally, “How can we continue to talk more about it so it becomes less of a concern and so more people reach out and get help?” There are times _ I was at my therapist’s yesterday, I was literally given the choice of hospital, respite or otherwise, and that was a little over 24 hours ago. I never know what will be triggered, to get to that certain point. I’m sure she’d cringe at a comment where I’d be willing to risk my life literally by talking about it, but she knows me well enough. I’m determined enough to talk about it. And, by the way, I didn’t end up in respite or the hospital.

How did you manage that? 24 hours?

Well, resiliency. I guess I just have a driven mindset. Ultimately, I think those with high ideation and behavior, they don’t really want to die of suicide, it’s in the moment, “I can’t take it anymore,” right? So I’m fortunate with the resources that I have. I have a crisis plan I’ve used regularly in the last few years. I put people on there specifically I know I can’t bullshit. So I hate them in the moment and would like them to go away. I know there’s a backlash on me right there because they’ll be reading this!

How do we make people more comfortable with the topic?

Starting the conversation. Every opportunity we have. The people I talk with from the group, my youngest is 15, their kids are a little younger. But we all believe in talking about it, going into the school system. It’s something we would like to do. Opening it up to youth groups. Any opportunity we have where we can share our story in a conversational kind of way, right? Because we could talk and talk and talk, but once you talk for a little while, people start to get curious and ask questions, and it becomes more of a conversation, and right there it just opened the door for them to be with a peer somewhere down the road who sends out a red flag, “I wish I were dead,” that one meeting could turn into saving a life down the road. That individual will be comfortable enough to ask, “Are you thinking of suicide?” Saying the word is the hardest, right? When I was in training for the crisis line, I learned how to say the word directly and not, “Are you thinking of hurting yourself?” Having them say the word “suicide,” they’re using it and they’re not going to get a negative reaction. There’s a few of us, we’re all to the point where we would much rather open up and try to share our stories than try to keep closed about it.

Is there anyone, any organization, leaning in and saying, “Talk, but tell it this way?”

I’ve never had anyone tell it to me, but maybe they did and I chose not to hear it. You know, one of the first things Yvonne says in the group is, she basically says the whole group process is a learning process. You are the experts, I am also a co-learner. So ultimately I have that dual hat, which helps. I spoke with a group of individuals, medical students. I was there because of my mental health and suicide attempts, but even in that context, it was interesting. There was no sort of guidelines, “You shouldn’t say this to medical students,” everything was up front. I can always learn from someone else. I like that expert stuff.

These are relatively smaller-scale efforts. What about talking on a bigger scale, through the media and such?

Maybe down the road? Maybe open the door to work organizations, a fascinating place to have maybe a day where you have someone come in and talk about it. No one is immune to suicide. I would say nine out of 10 people, if not 10 out of 10 people I’ve spoken to or in front of, have a story to share. The more we talk, the more the word will hopefully get out. I’d love to say one day I’ll be a big international speaker inspiring people’s lives, right? Yeah, grandiose and ideal.

I wonder if talking on a larger scale would change the response.

The domino effect, right? I go out and speak often with Tana Nash. She lost her sister and grandmother to suicide. Oftentimes we get together. If I had not had my attempt, I would not have met her, had those connections. I would not have met Yvonne. Not that I recommend that; I always put that in parentheses. Where was I going with that? Oh, I go out with Tana, and in going out with her, I recognize there may be 15 people, 50 people in the audience. The benefit of the smaller group we’ve seen is, there’s more disclosure in that group because of the comfort level. Whereas in group of, like, 150, you might have disclosure, but after and one on one. So ultimately, even if there’s just one person I’m talking to, I kind of look at it from that perspective. You’ve gotta start somewhere. But that’s OK. But we’re doing a television series, going for filming tomorrow. The local cable station is doing a series, “Mind Matters.” Canada AM had a big special on suicide. the potential is out there, right?

What about the people whose attempts are so quick, so impulsive, that there’s not much time to reach them when they think they’d need it?

How to get to them? First of all, they’re in the moment and don’t necessarily … You hear a lot about having plans, leaving notes and stuff. But if you look at the statistics, not many leave notes. It’s all a very individual thing. I guess you’ve just got to hope. We’re not talking about how we’ve tried it. I don’t even get into my means. I might sort of vaguely dance about it. That’s one of the rules in the group. We don’t talk about our means. Just the thoughts, how to control and work with those. The crisis plan, I’m a firm believer in that. In mine, I’m very open. For instance, in starting this job next week, I might give them a copy of my plan, though I don’t have to have it. I mentioned it in my interview with them. The more I mention it, the better chance I have at my own survival. right? We don’t do the group with the expectation that we’re going to come out without the thoughts or behavior. Even when you’re feeling good for a while, you have the “OK, it will never come back again,” but when it does, you just have to accept and contain it so not to have those spontaneous moments. I don’t ever expect it to be easy. And maybe I make it sound easy, and I had someone in the hospital who said, “How do you do it?” Another thing is, don’t compare yourself to that person and how you think they’re doing. She ended up dying by suicide. It was very difficult for me. We each have our own stuff. I never know when will be spontaneous or last minute. I don’t know. I hope I’ll have the right frame of mind to text. I’m big on texting. It was an email that saved my life. You just have to use the tools you have.

How did an e-mail save your life?

I sent out about 22 e-mails. I did not get up with the intention. I had major back pain and started trying to treat it. A combo of pills and alcohol. I knew I wasn’t in a good head space, I knew where I was going. So I sent out very vague messages. The last one I sent to two specific individuals. I found a poem online that said what I was doing, what my intention was. It was not “I love you, blah blah,” basically, “This is were I’m at, what I’m doing.” I sent one to my counselor and the other to someone at work. My counselor read it, where she never ever reads e-mails before going out to supper, but she read it that night. She didn’t second-guess it. She phoned me on my cell. I had charged my cell, done the laundry. I was literally playing the Russian roulette. If there was no intervention, it’s all right, I’ve got everything done. I was not willing to disclose where I was. I hung up on her. She made calls to find out where I was. She talked to my daughter. Somewhere in there I had texted a friend, who had already phoned my daughter to say something was wrong because I had spelled a word wrong in my text. My daughter and friends already were trying to find me. My therapist ended up phoning me back, tried again to use the kid card, saying my daughter was in tears. But it was not working. She hung up on me, called 911. I answered again, and the number showed up unknown. I thought it was her, but it was 911. A number of years ago, I did a 911 course. What saved me at that point was analyzing the job she was doing. I started thinking, “North, south, east, west” and told her how to get there. She kept me conscious until they got there. The therapist told me there was nothing short of miraculous that they found me

Is there any sort of pride in this? To look back over it all for the details?

It makes it scarier, to go back and find what went wrong. To others, it would be what I did right. But if I get determined again, I know what not to do to get that much closer.

Why?

I wish I could answer that. I think it’s just part of my way of thinking. It’s just a mindset the mind goes into. And it’s hard to draw it out, it’s hard to pull out of it. But at the base of it is the hopelessness and the wanting to end the pain.

Do others create crisis plans around you?

I’m sure they make phone calls behind my back. I set myself up, right? But I also have to appreciate that side of it, too. As much as I might be ticked off at my therapist in the moment, I’m grateful in the end. When i was house-sitting at my parents’, I had a neighbor call my cousin out of concern because I hadn’t taken in the recycle bin. To make sure he called, to make sure I was OK, right? I could look at it as the busybody neighbor, or I could look at it as they were concerned, wanting to make sure I was OK. There’s always two sides.

How are your children?

My youngest is very much my hawkeye. He was the one to check on me afterwards: “Mom, do I have to worry tonight?” He’ll be going out the door: “What are you doing today? So you’ll call me if you go out?” “I’ll leave a note.” “No, so you’ll call? I know they worry at times. My sister is trying like anything to understand, because she never experienced depression. Again, I don’t mind people asking, I don’t mind the conversation. With this intervention stuff, the people I don’t want to see me at my worst are my closest family, because I don’t want to scare them. Like the onion, layers of support. As I get to the external edge, the more and more in crisis, I’m gonna look more to the professionals then. I am one of these professionals. I know it will take a certain type of intervention to get through to me. Besides, I have certain people on that outside edge I can make comments to, and it’s OK. It’s a friend as well as a professional thing.

(I ask about professionals who have their own experiences with suicide attempts and whether they should be more open about them.)

I’m sure there’s lots out there. In some cases, unfortunately, their work environment is not so open to it, right? They’ve got a lot to learn in the workforce to deal with someone with mental health issues. A good chunk in the helping profession, that’s probably why we’re in it, right? So depending on whether it’s domestic violence or whatever,  there’s a clumping of individuals that’s where their specialty kind of lies. There’s an extent of disclosure. But when it comes to suicide, you probably wouldn’t get a lot as open. But there are. Because I’ve talked to individuals who’ve had suicide attempts, but even their co-workers may not know. In a sense, I wish medical professionals had more of that component to it, the lived experience. I wonder whether it’s not lacking a little bit because it’s so clinical. That’s why it was nice to talk to those medical students. It was not just me that day, there were people with chronic illness. They were learning what it’s like to live in those shoes.

(She asks me why I decided to be open about this subject, and I told her. I said it could be exhausting to try to hide it.)

Exactly, it’s exhausting to try to hide it. And it’s exhaustion that drives us to do it. My first attempt, no one knew it was an attempt. The second one, my one friend knew, she got me to go to the doctor and get antidepressants. But no one knew. At _ how old am I? _ at 47 years of age, my family only then found out, the depression, the thoughts I’d been living with since I was a teenager, if not earlier.

And? How did you approach it? How did they take it?

Even when I weaseled my way out of the hospital, I thought it would be fairly easy. I’m surprised at how draining an effect it was. It was a lot tougher than anticipated. My mother insisted on a group session when she found out I took my husband and kids in. I hear a lot of the time that “I don’t have support, I don’t have this, that.” I recognize how fortunate I am, but in retrospect, I did not have that support when I was hiding it. I was the happy-go-lucky citizen of Elmira, a member of the theater company, you name it. When I had the event at my church, they just couldn’t believe this was the same person who was Sunday school coordinator for four years, always being bubbly and bouncy.

Can you tell now, looking at people, that they have their own experiences and may be trying to hide it?

I never really thought about it, I guess it would depend on the conversation. Honestly, the poem I sent out as a help message, the individual who wrote that, I tried to track her down. I found different poems written by this young lady, I felt that was where she was. I’ve been trying to track down a way of contacting her. There is no way. My gut is, she may no longer be with us. Learning to go with your gut, right? That part of me has been strengthened. When talking with people on the phone, you don’t have body language, any of that stuff, right? Sometimes, yes, in the stuff they’re saying, the way they’re approaching things … I would not hesitate to question. I’ve got a friend who is generally good at getting back at e-mails. She’s not. She’s been going through stuff. I’m going to tune into her not responding right away. It was the death of a friend that really bottomed me out, watching the death of a friend at 46. So I kind of look into that whole loss thing, the loss of a job, a friend, endings, right, so when I hear people talking about the things they lost, yeah, I start to tune in a bit differently. Even if they say they’re OK, I might tweak in a sense of concern, but do I know? No, I don’t really know how a person is coping unless I ask.

(I asked about other signs she picks up on.)

A change in behavior is one of the biggest. Really, anything you notice in the other person that doesn’t quite seem like the person you are most familiar with. It doesn’t necessarily mean you jump to suicide, but it might be something on their mind. But this friend of mine, she lost her friend to cancer, she lost her mother, she’s not e-mailing, sure. I’m gonna start to bug her. Not necessarily because I’m thinking she’ll become suicidal, but I know she’s having a hard time coping. Suicide wouldn’t necessarily be in everyone’s line of thought. When a group like Yvonne’s, for those of us who struggle on an everyday basis, one of the common denominators is past trauma. That’s where the hard work comes in, I really do believe you have to do trauma work. I think to a certain extent there’s stuff to be worked on to start to be able to move beyond and cope differently. And yes, I avoid my own trauma work.

Wait a minute, you don’t do it at all?

No, not that, but if I can distract the counselor, get off kilter …

There’s a debate in Canada right now over the right to die. Is that a completely different topic?

They’ll be talking about that at the upcoming conference. There is a difference between someone being chronically ill and wishing to die and someone just wishing to die because they can’t take it anymore. I think they’re really looking at assisted suicide for those chronically ill, who are not going to live anyway. There is a distinction there. I personally, yeah, it would hurt if someone I knew died by suicide, I would definitely never consider assisting them in that, as I would never expect anyone to assist me. Yet on the flip side, I would understand why they maybe made that choice and maybe ended up dying by suicide. Yeah, it’s two different topics, right? And I think the whole, like, you’re looking at individuals who can’t look after themselves, function poorly, have no sense of life, that comes into that. It’s a debate, all right. It will be interesting to see how that conversation goes.

Are you speaking at conference?

Yes.

And finally, who else are you, aside from these experiences?

This is what has made me, really. To me, maybe this is who I am. I mean, I wouldn’t be having this conversation with you, right? OK. Photography, I love my photography. I played a lot of sports growing up. I  was a very active person. There’s not a lot that I wouldn’t do on a challenge, so I hope to jump out of an airplane next year. With a chute. I have my goals and my aspirations, and they keep changing. But really, I have to look at my experience with my suicide as my stepping stone for who I am now and where I want to go and who I want to be. And ultimately, I would like to help others.

I wish you luck with your new job.

Thank you. I’m excited and nervous.

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Talking with Yvonne Bergmans

“So many care providers only see people when they’re not well. They don’t get to see the other side. The gift I have, I get to see all sides.”

Yvonne Bergmans started a support group for suicide attempt survivors at St. Michael’s Hospital in Toronto more than a dozen years ago, and she has been pushing for more recognition of their voices ever since. She’s happy to report that this year, a national conference on suicidology for the first time will put a “huge focus” on attempt survivors and their stories. Her group has been featured in a documentary, which can be viewed online, and some members have posed for a series of portraits and interviews. A few have collaborated with Bergmans for published academic studies. They are fascinating.

Two group members tell their story, with strong advice for professionals, in a 2007 study. Anger, accusations and even eye-rolling don’t help in a crisis, they say. “Don’t punish me for being ill. Admit to yourself that you may not understand. Let me help you.” Even simple, practical things: Don’t lose their personal items. Keep their families informed. And this: “Call me by my name. … When I am in crisis and I feel that all is lost, I must remember that I am someone.” They remind the reader that they are educated, employed and high-functioning, but such things don’t mean a crisis can’t happen.

In a 2009 study, other group members talk about the risks and benefits of being open about their experiences. “When I naively disclosed (about suicide attempts) in my college mental health-related classes, I was shocked at classmates’ reactions, which were split between the morbidly curious and the physically repulsed,” one writes. And yet, “my clients with suicide issues or a history of attempts have appreciated the honesty,” another writes. “They tell me they can relate better to me; it gives me ‘street cred.'”

One of the support group’s first steps is to create a safe space not only for members but also for the topic of suicide and its effect on others. “We often go at it from the perspective of how to communicate your distress,” Bergmans says, “and have people hear it and not freak out.”

She also introduced me to the concept of the “prosumer,” the professional caregiver with his or her own experience with suicidality. Something to explore for later.

How did the group come about?

It came about 13 years ago when I was hired by the then-chair in suicide studies, Paul Links. Psychiatrists saw a lot of people with recurrent suicide attempts coming into the emergency department, and there was a definite gap in service for these people. There were very few places people could go. He hired me to create an intervention. I was hired in November 1998, and in February 1999 I started the first group. We started and just kept on going. It was sort of a situation where I initially was told we’d be doing a DBT (dialectical behavior therapy) program. It just didn’t work for me as a therapist, getting my tongue around the language. Clients were not terribly engaged. Together we started creating an intervention that they could engage in, and we have now had probably well over 300 clients.

Was the documentary a good representation of how the group goes?

Yeah. There were probably more men in that group than there are normally.

As the group grew, what adjustments did you make to help people open up?

It was not really an issue. Once it was safe enough to talk about suicide without getting into means and methods, and you could use the word and not have people freak out and rather ask the question “What does it mean for you?” and recognizing that it doesn’t always mean imminent death, and people coming to a place where there’s no judgment, this is your reality, and being with people who get it. That’s one of the most important pieces. People are not completely alone and adrift in the intensity and pain of experiences. So the way we approach it is in talking about suicidality. We often go at it from the perspective of how to communicate your distress and have people hear it and not freak out.

So, how do you?

We do a number of things. The first is, can you identify how safe or unsafe you feel? Can you identify what it is taking you to the place where suicidal ideation is so great where you think you can’t manage? Things like, “I called colleagues, I called friends, I tried distracting myself, and I still feel unsafe. I can’t deal on my own, I need help.” The other thing is, “I need to be in a place safe enough that I’m nowhere near the environment where this got triggered or started, I can’t be anywhere near my means, and I need someone to help me with that.” There’s a lot of work about developing a language of safety. Knowing early warning signs, knowing the tools to use. And being a teacher to the care providers you work with. We work from the perspective that everyone is a learner and teacher. They are experts by experience.

(I asked about the level of nervousness among therapists in working with suicidal people and whether it’s different in Canada.)

I’d say it’s about the same. You’re working with a person with a high potential of dying. It’s just scary. Yeah, so comfort is something we try to work on. When we do groups, I have many colleagues from various professions working with me, co-facilitating, so they develop a skill set. So they come to realize that when our clients are in good shape, they’re just a hoot and half, a human being you could meet anywhere, a cooking course or anywhere. And the difference between the acute phase and their normal lives. It’s a very different presentation. So many care providers only see people when they’re not well. They don’t get to see the other side. The gift I have, I get to see all sides.

What are their responses to seeing people on the other side?

I don’t think I’ve had any co-facilitator who hasn’t found it a useful experience, having learned something.

Is the group always a mix of people in their normal state and in crisis?

Yeah, and sometimes we get a group when all are in really rough shape. You take it as it comes every week. You certainly hope that people, even when feeling really vulnerable and fragile, they are still able to use some of the skills they were using, and whatever little energy they might have had to get themselves here. A skill called determination.

Have you lost people, or had people leave the program?

Yes, we have lost some people that I’m aware of, probably lost five by suicide. We had a few lost to various medical conditions. And there are people who said, “See you later, never see you again.” Others show up five years later. You can do two groups with us, and we’ve had some grads to come back and become peer facilitators.

How are you, doing this for so long?

It’s a gift. A real honor seeing people shift and change. As a care provider, I can walk with them on the journey, but I have to be clear I can’t do it for them. It’s a parallel process whereby I’m inviting them to participate in a safe place for themselves. I have to do the same professionally, ask others to be another set of eyes. So as a result, we always make sure to have weekly supervision with all facilitators so we can stay honest about our emotions.

What are your personal experiences with suicide? Or is it something where you know you’ll never have to deal with it?

I don’t think anyone can ever be sure they’ll never have that struggle. I think I can’t ever assume I won’t get to that place. I started this job in November, and the following August, my cousin died by suicide. It went from professional to personal.

Did you want to leave, or to work harder?

No, it just left me knowing where I needed to be at this point in time in my life.

Does the group address some of the root problems behind some suicidality, economic ones and so on?

I can certainly help get them to case managers who can help them. I do a lot of crisis management. There’s an expectation that they have a support system, because in the group, there are things they’re not going to share that have personal meaning for them because it’s a group. I can point them to directions and assume they follow up. I assume capacity and capability.

Are there cases where you turn people away?

We rarely turn away. Maybe because of a psychotic disorder. and sometimes the housing situation for people is so fragile they don’t know if they’re able to get to group, so sometimes that’s been an issue. I say that very, very rarely.

What have been the surprises? Any points of view you hadn’t considered before?

That’s really hard to answer. Because every day there’s something new. To say what stands out, I couldn’t name anything. It depends on the day and people in it. People’s persistence and resilience perpetually humble me.

Any examples?

Just the lives that people have to live, endure and survive. You just sit back and go, “Wow, have you got a lot of strength and courage.” Some people might think they have a great big black cloud over their head. A wide variety of different experiences.

Any way to make the cloud go away?

I’m not going to make it go away. I can give you an umbrella and show you how to open it!

(I asked about the openness around the topic of suicide in Canada vs. the U.S.)

Absolutely not. It’s SO not different. A stigma is a stigma.

That’s just the way it is?

Heavens, no. The AAS (American Association of Suicidology) is doing a great job giving people who have attempts, giving them a platform. We are trying to do the same in Canada. And a huge focus in our conference this fall is going to be on honoring the voices of those who’ve had the experiences.

For the first time?

It’s been an evolution. I’d say the evolution has been in the last 10 years. This year’s organizers made a very clear, a mandated part of the conference that more sessions will have first voices. And the AAS did that in their spring conference. I think it’s a general move now.

Why did it take so long?

Stigma. Fear. Prejudice.

But these are the therapists and researchers.

Yeah. Sometimes people have to get out of their own box. I’ve been jumping up and down for a loooong time. My role as a social worker and advocate, it’s been a long path. A very long path in terms of having the voices listened to without the professionals taking over in terms of the sound, shall we say. Because I think medicine has traditionally been quite hierarchical, “This is what you’ll do, what’s good for you.” Whereas social work has client-centered approaches. Nursing has jumped on the bandwagon of late.

(I asked about professionals having their own experiences but not saying so, or saying it quietly, and whether they tell her.)

I think it’s when I go to conference. There’s a small body of literature that talks about it with the “prosumer.” They’ve been able to say they have participated in both realities. And it’s an “and” as opposed to a “but.”

How does the trend move along to more openness?

I think persistently we plug along together. Raising awareness. That suicide is preventable in most cases. Recognizing that it’s very much as it used to be with cancer or HIV, these perceptions are what need to be blown out of the water. And alongside that, the resources. Right now there’s not a whole lot of resources for people struggling with suicidality. The resource allocation at the larger social level is imperative. A lot of myths-busting needs to happen!

Do you have a favorite myth?

Not really

The one about just trying to get attention, just a gesture?

Yeah, that’s where I get a frying pan … Just kidding. That’s so disrespectful. What we often have is, if a person is saying they want to die by suicide, there’s a need not being met. If you tell them it’s manipulation, you’ve missed the point.

How to make this a more comfortable subject in public?

It’s portrayed in the media in such a sensationalized way. There’s not a whole lot of understanding of the despair and compassion required. It’s everybody’s biggest fear, right? How to say, “This is a fear and we can talk about the fear.” I don’t know a whole lot of people who have made it through and can say, “This is what it is. This is how you can be helpful. This is a real struggle. And it feels like a life sentence. And it can be different.” It seems to be more deficit-focused. And if you focus on what’s wrong, you’re not going to get to what’s right.

Among the 300 or so people you’ve worked with, are any of them outspoken?

Yeah. Definitely there will be one, two, three, possibly four at the conference. And there have been a couple who have been interviewed in the Ottawa Citizen. They did a series. And the folks who responded to yourself or to Doug. That’s where there are openings.

Who else is doing what you’re doing?

There’s a group called SAFER in British Columbia. To the best of my knowledge, we’re the only game in Toronto.

What about the issue of involuntary commitment, does that come up with your group?

I can’t commit anybody. I don’t have that capacity. When I work with people, we start with the premise that we all have a right to feel safe,and a responsibility to ensure others feel safe around you. I also work with the second premise that behavior is a choice with an effect. If I’m feeling unsafe, I tell the client I feel unsafe and need help. I always work with the folks so they make their own choice. I’ll support them, meet them at the emergency department, whatever it takes. There are times I’ve had to call 911. I hate it and people get angry when I do it. But when comes to this, I’ll do it.

While they’re in the group?

Somebody calls me outside the group. If it’s in group, I’ve been known to walk with people down to the emergency department. Or to my office, figure out a strategy, talk every few hours with them, ask them to let me know how they’re doing. Sometimes going to the ER can be more traumatizing than their actual feelings.

How will people ever feel comfortable enough to come out? What else needs to happen?

Currently, if a person is brought into the hospital by police, it is on their record that they have has an interaction with police, It does not clearly state it was a contact only. As a result, if people need to have a police check done for work purposes, it comes in the report. This is traumatizing and stigmatizing, and many have lost employment opportunities because if it. Sadly, it does not get removed for five years, and then only if the person requests it. Currently, there is a coalition trying to work on changing this because it is so discriminatory.

Any other ideas in mind that you’d like to pursue if you had the resources?

I would have a Maytree. I would have a number of Maytrees. And it would have a dog, and a cat, and music therapy, and dance therapy, and art therapy, a little medication if needed. If you need meds, a doc would be on site who could do it. And no one on staff freaks out at the word “suicide” and you’re not dumped out if you have suicidal thinking. It’s pretty hard for folks to talk about it if they feel constantly under threat with no safe place to go. How can they heal and become advocates for themselves and one another?

How’s that idea going?

I have mentioned it for the past 12 years. I have invited many people to find me millions of dollars. Interestingly, everybody I’ve invited hasn’t been able to, so there you have it. That’s my biggest bugaboo, people being thrown out of programs at the thought of suicide. My biggest frustration, but hey, life happens.

What else would you like to say?

Nothing I can think of.

Who else are you? The group isn’t all you do.

You haven’t seen my workplace, have you? I started off as a youth worker, a special ed behavioral teacher, the guidance counselor at an inner-city school. Then I ended up here. Every stop prepared me for the next one.

When the word “suicide” first came up, what was your response?

I had basically called to say, “Listen, do you have any jobs for part-time casual?” and they said, “Paul has this suicide thing going on, he said it’s yet to be created.” I said, “Hmm, I’ve worked with high risk for all of my career. I’ve worked with groups. Suicide is the new factor here. Let’s go for it.”

Can the public come to the conference?

Absolutely! In October in Niagara Falls.