Lilly Glass Akoto is a licensed clinical social worker, and in the course of this conversation she said something startling: “I never got any training, no specific training on suicidal thinking. … there’s nothing to do with helping someone with suicidal thinking. There’s nothing to do with how to talk with somebody, give somebody hope.”

If social workers aren’t being trained in working with suicidal people, who is?

Here, Lilly talks about the risks of speaking out about suicidal thinking as a professional and her work to address them, her thoughts on whether someone needs to be “cured” before taking on public speaking about their suicidal experience, and how she, as a strong Christian, found it hard to have support in her own church on mental health issues.

Who are you? Please introduce yourself.

I think you asking me that, versus someone else, obviously I would give a different answer. For wanting to know where I’m coming from and why I’m part of the task force, where I’m coming from is 30 years of battling depression. I’m an adult adoptee, I was adopted into a white family and grew up in a white world. The depression started not because something terrible happened to me but because I couldn’t figure out my existence. As a 7- and 8-year-old, thinking why I was on this earth was a kind of weird thing. It makes one feel quite different. So I battled depression. I would cut on myself. I attempted suicide five times. My last was six years ago. And when I tried to kill myself the last time, I got myself into counseling, EMDR. And for whatever reason, that worked so phenomenally well for me. Literally within two months, I was a completely different person. I’m already in the field, and I’d been in counseling for a long time, been doing therapy for others for a long time, and I like to understand how things work. After my very first session, I immediately started feeling better, and I was questioning the process: “Why does this work?” By the second session, I didn’t care. I felt so phenomenally better, I just didn’t care.

And so, pretty much since that healing process, I stuck with her for two years, six sessions of EMDR, and by the end of it, I was a completely changed person. But one of the interesting side effects is that I then had this sort of diarrhea mouth syndrome, where I sort of went around telling people how great EMDR was and how everybody could get healed. I went to extremes: “Hey, yeah, I tried to kill myself, but now I’m doing great!” It was not great. I ended up losing clinical positions because of it. I went through a bit of that. But in my life now, I’m very centered, very clear about it. Now I have a great passion for suicide attempt survivors, a passion for people to heal from brokenness. I don’t know about you, where you’ve been, but for me, a lot of mental health agencies, programs, have been “Yeah, you’ve got a debilitating mental health issue, and we’ll help you manage.” I think that ‘s OK, I want to promote teaching skills, how to deal, but I’m about the next step, healing. That’s really lacking. So that’s one part of who I am, you know.

What will you pursue for professionals?

Right now, I’m thinking about … I’ve been working with NAMI and have a great girlfriend there, and we talk all the time. There’s a couple of things going on with our NAMI here, peer-to-peer and family-to-family, but there’s no professional-to-professional. So one idea is following the same format and introducing to NAMI professional-to-professional, so that professionals have a safe place, a free, safe place to go to process through. And I’m thinking about, like, educating folks about how to talk to their employers, the supports needed in place, how talk to your family when you’re struggling at work. And how do you best manage the duality you feel as an employee. Meaning, you know you’re doing good work, but also you’re now struggling. So how to balance those two so the depression or whatever doesn’t get the best of you. And you’re able to gain some skills on how to get things done. I know a lot of professionals won’t talk about struggling. Instead of that, they sit and suffer with it, and things get worse and worse. I fortunately happen to be someone who, I would run to work because it was safe for me, the one place I felt successful, but lots of people, they don’t even realize the slew of mistakes they’re making on the job. So having a safe place to talk this out without the threat of somebody else, a boss or colleague, reporting them, is sort of what I’m thinking about right now.

And NAMI is pretty receptive?

Oh yeah, they would definitely take that on. Our NAMI is, anyway. The other thing I talk to my girlfriend about all the time is, they’re not good with cultural issues. Our NAMI is pretty white. And you know, you need to pay attention to culture. I’m biracial and navigate the white world better than the other world, but at the same time … I don’t believe in this whole “Make all those exceptions and special things for people of color,” but I do believe that culture matters. So whether you’re a white country boy or a hip-hop whatever, it doesn’t matter. The culture has to be recognized and acknowledged, I guess. And I think NAMI is not doing a good job at that at all. And they just now, now they have LGBT, they have developed a NAMI group for that, so that’s good. But in terms of like, for example, you’re not gonna find a lot of black people here in Oregon who utilize NAMI, and NAMI isn’t doing anything about that.

Why is there such stigma in the mental health and suicide prevention world about suicidal thinking? You’d think here, of all places …

Honestly, I really don’t know. But in my journey, the mental health field was the absolute worst and most painful to me. The question is the exact same question I’ve pondered. How is it that in the mental health world, the world that should understand these things, they are the worst and most persecuting? I don’t get it.

What’s with the liability fears in this field? If this is a potentially fatal health condition, like cancer or heart disease, I don’t understand why medical professionals can accept such risks and treat people while mental health professionals back away.

Yeah! I don’t know how to answer that! I like the analogy you gave. It’s a question that just, every day I’m asking. And again, you know, that’s why I really speak up and promote in my practice that I will work with you if you have suicidal thinking.

I never got any training, no specific training on suicidal thinking. All they do is teach you how to assess, this idea that you assess every session for stability and use a form to ask questions, but there’s nothing to do with helping someone with suicidal thinking. There’s nothing to do with how to talk with somebody, give somebody hope. We were never given lectures on that. But I also went to a school for social work. Maybe in a counseling program, they do. But in a school of social work, it’s not one of things they teach you about.

That’s odd, because I’ve heard some people say they prefer social workers over other therapists.

Yes, and I think the reason is because social workers are trained to think more holistically. I started off on the psychiatry track, but they tried narrowing me into something, and I needed something broader, and social work provided that for me. The reason why folks seem to to do pretty well with social workers is because we are trained to think about your spiritual health, emotional health, all of those different things. Versus just, “Here’s your thinking, and here’s how we can change it.” You know what I mean? I’m biased, but that’s why I think you hear that. And we’re resourcers. You can talk all day to somebody, but if you don’t, you know, you have to give people tangible things, concrete things to work with.

What needs to change?

You know, I think a large reason of why I was so excited to join the task force, I think working on this document personally has given me a lot of hope. I can see the potential of how this document really will begin to change people’s thinking. Just for AAS to go through what they’re going through, “If you sign up and say you’re an attempt survivor,” they’re finally making way for that … I think we’re expanding our conversation about suicidality in general. I think we’re pressing forward.

I also think, and I don’t know, this is just baby thinking right now, but in my experience sharing my story, I’ve been doing it more and more, I’ve been asked to speak. And I’ve noticed the impact my story has is amazing. I’ve never been a person who toots my own horn, but I am in a place in my life where I can recognize the fact that my story does change things. So I was so excited when you said, “Hey, want to talk?” Yeah, certainly! I know putting my story out there, being a professional … I have this funny image in my head of dressing in the most expensive ladies’ outfit, with my jacket and my pumps and everything else, looking very sharp and professional, and then speaking my story. To make the point that I look put together, and I am together in my life now, I’m a professional, but there’s the reality of my story. And I feel like, the more speakers bureaus we can get on board, that’s another way to really begin to change people’s thinking.

Someone had mentioned creating a website. My thinking is, how great would it be to have video vignettes of people telling their story on the website? We live in such a media world, you know, I just think these things are powerful and can make an impact. So I don’t know if I answered your question, but finding people to speak out and doing more and more … Obviously, at some point there has to be people fighting for policy change. There needs to be clearly stated laws within the job contract that say, “If I need to get mental health help, my job is secured.” It’s really clearly written out. We have EAP, but not every place has it, and some EAPs are good, and some are not. Who trains them?

Ideally, what protections would you like for people who are open about this in the workplace?

The basic thing is job protection. I think that’s the greatest fear. You share your story, you’re open about it, and then you lose your job. I think job protection is one. But there’s also this element needed of … I’m trying to find the right language, but … I recognize that, to share my story, not everybody is ready to hear it. So let’s say on the job I share my story, and maybe someone gets triggered. And I’m not saying I caused it, but I am saying that a policy put into place has to not just be for me but for the agency. Does that make sense? I want the right to express whatever I need to express, but also I want safety for myself and my colleagues in the work setting. Lets say I’m working and have worked for two or three years at a place and get depressed and try to kill myself. And that information came out. One, I’d want protection. Two, I’d want the ability to process it with my boss. What about a work plan that’s about your emotional safety? I don’t think there’s anybody who would consider that because they would see it as a threat: “You’re emotionally unstable?” But I would like to see a work plan that doesn’t just involve technical things but also emotional support for people. EAPs give you, what, three sessions a year? Maybe if I’m really struggling, I get an additional three sessions. Tons of people never use EAP. The number one thing is not losing your job. And if a safety plan is in place, to make it safe to talk about it with your boss. If a colleague finds out about it or has to know about it, maybe they also need support.

You mentioned public speaking. Do you think people should be open about still having bad days? Some people have said they feel pressure to come off being “cured” when they speak.

Sorry. I’m only laughing because I think it’s a fabulous question. I’m just thinking how to formulate this answer, because I have an immediate and definitive answer. I believe that anyone at any particular level, meaning two weeks after it happened or 10 years after, I think anyone at any level can speak if _ so here’s my if _ if they’ve had the proper training and are at a proper place to be able to deliver the presentation. Does that make sense? If you and I were having this conversation four years ago, I really wasn’t ready to go speak. There has to be some sort of, and I don’t know what the process is, but I believe people need to be properly trained on how to properly deliver and after-deliver.

For example, Sally, who tried to hang herself, goes to a speaking engagement but hasn’t planned out her day for afterward, self-care things. If she hasn’t been able to think through these things, she’s probably not ready. But if you have researched it and exactly what to do after the speaking, and you know how to respond to different questions that come up, you’re probably ready to go and speak.

Your question though, should people admitting it’s not a done deal speak? Yes, 100 percent, because that’s the story of our lives, our reality. I’ve been in this profession over 20 years, and I’ve always done really good work. But 14 of those I was vastly depressed. I would meet with clients and go home and think about killing myself. But I would still deliver very good services. That duality is there. I’m married, I have two beautiful children, I’ve always been successful in my work, but that didn’t stop me from thinking of killing myself over and over. I definitely think people can talk about it, and I don’t feel that pressure at all to hold back anything, and I’m thinking maybe that’s a problem. I’m way too open. I say it like it is. I also realized that every presentation has been impactful because that’s how I am. And I’m OK with that. It doesn’t work for everybody, but that’s who I am and I’m not going to change it.

Since you mentioned your children, I wondered how you address this issue with them.

Well, this would then be another 20 minute conversation. My older son was 13 at the time … He saved my life. He came down the stairs, in the middle of me hanging myself, and screamed for his father. What a horrible experience, and one that took me a long time to process through. He and I have talked about it a few times, and finally he was old enough to tell me to never bring it up again. My younger son was asleep, and we have never spoken about it. My husband and I have never really processed through, since I attempted right after an argument with him. It is still a lingering issue within our family that I hope, one day, can be resolved. I know that my younger son, for a short time, went through a season of making statements like, “I am going to kill myself” when he would get upset about things. I can only conclude that even though he was asleep, he did overhear various conversations that followed. He and I did talk about issues but more in regards to his feelings, not about what Mommy did.

What else would you like to say on this topic? That’s a pretty broad question.

Yeah, really! Honestly, like I said, I’m at a point in my life where I want to speak my story, and I’m really … Let me back up. Let me share something different. Part of what happened in my healing process is, I got to this point of understanding in an extremely powerful way that I’m on this earth and one day I’m not gonna be. And that’s how simple life became for me. A lot of people that I initially started expressing that to kind of thought that was morbid, “I don’t want to hear that,” but for me, in my now-life, as I often refer to it, my life is just not that important that I … I’m not saying I’m not important, but I’m here on this earth and one day I’m not gonna be. It’s just that simple. So I give everything every day because it could be my last.

What I mean by that is, I want to speak my story and honestly, because I don’t know if someone in that audience is gonna be someone I touch that day and starts to change something in their life. I take every opportunity to make an impact. I don’t know what else to do with my life other than that. Whatever wisdom I have at this point in my life, I’ll share with whoever needs it. It’s so awful, my husband, he’s a very private person, and I’m not. It’s hard for him because of that, but I have nothing to hide, no secrets.

The whole other level for me is I’m a Christian, very strong in my faith. I pray a lot. And so, you know, back to who am I, I would say … To me, honestly I’m Lilly, and I’m a Christian first, and the whole life revolves around the Lord. Everything revolves around that. It’s not that I’m not important, I know I’m important, but my life is not. For my belief system, my life is in God’s hands, and I know he has beautiful and perfect plans for me. And I know there are challenging things going on, but they will lead to something great. But yeah, for what’s it’s worth, that’s kind of the reality of who I am. I’m a child of God, and I live my life that way.

And ironically, that was another area that was not a support to me in my healing journey. The church wasn’t a support to me because the church I belong to, there are a lot of misunderstandings about the work I do in the mental health world. There’s never been a thought to do Christian counseling. I’ll always work in the secular world. The church was like, “Just pray over it. Just pray and heal.” I was like, “Well, if that was the case, I would have been healed long ago.” They didn’t understand the issue, the fact that I’ve struggled with depression. And yes, I’m a Christian, but I’ve tried to take my own life. If just knowing God and praying would have solved it, I would be healed long ago.

I had had a therapist card in my wallet for a year before the incident. And it came out of my wallet, and I started counseling with her. And my whole life changed. That’s about God, keeping a counselor’s card in my wallet for a year. And that’s hard for my church friends to understand. Again, that’s the church I was connected to. I’ve since spoken my suicide story in other religious settings, other churches, and I’ve had a much different response. So yeah. it was really hard for members I went to church with to be supportive.

You kept the card in your wallet for a year. Were you trying the church approach first?

No, it was just deciding to get help. I’d seen counselors but for like three months, whatever. My true friends said, “You need to stick with a counselor at least a year.” When I started with the counselor after the incident, I did it for a little over two years. I made that commitment for myself. No, I didn’t want to get help and didn’t ask for help.

The mental health field must think we’re incredibly stubborn, always telling us to get help and having us refuse.

It’s a cycle, right? You’re depressed, troubled, you know you want help, need help, but you’re too tired or too ashamed or too sick to get the help you need. It’s a horrible, horrible trap, so to speak. Yeah. And I mentioned a few times about the duality that happens, too. I was really super-great at work, and had really good friends and things like that. On the outside, I looked really spectacular. But there was the inside that people didn’t know about, that I didn’t want them to know about, this shameful, ugly, pitiful person. How dare I ruin this image of me?

That was well put. Who else are you?

So I have this name, my name today is completely different from the name I grew up with. I legally changed it in 1994 before my first son was born. My parents adopted me and named me Brenda Joe, which makes me cringe, but my birth mother had named me Gail Celeste. Then I was in a foster home and my name was Muffin. Joy, joy. Then I was adopted. Then, when I was in college, I changed it to Brenna. Then when I went to Ghana, I had been writing about a deaf girl named Lilly. When I went to Ghana, I said people could call me Brenna or Lilly, and Brenna was hard to say and Lilly was easier. When I came back, I legally changed my name to Lilly. Glass comes from when I found my mother. I met her in college, and Glass is a representation of my reality of all my fantasies breaking in meeting my birth mother. I seriously had convinced myself that Oprah Winfrey was my birth mother. Meeting my birth mother, she was no Oprah. Glass represented how my world collided. Akoto is from my husband.

What’s the point of all that? Today, I just feel I am who I am. My current name is who I am, and I feel like up to this point, I was always what everybody else would tell me to be. They had given me these names, had these expectations, trying to make me somebody I wasn’t. Today, I get to just be me, Lilly, a Christian, biracial, adopted, married woman with two kids who works in the field of mental health.

So, yeah. I’m involved in a lot of volunteering, with the Dougie Center, Suicide Bereavement Support, and the task force, of course. And I’m a little bit connected to Eduardo because he asked me to be on the advisory council for his center. And NAMI. So I do lot of volunteer work, sticking within my field. Other than that, in terms of just being me, I love the outdoors, I love the country, I love athletics and all that. And I’m an easy person, you know? My husband doesn’t think so, but I’m an easy person. I get it: I’m here, and then I’m not.