Talking with Lilly Glass Akoto

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.

Advertisements

Talking with Alexis Wortley

Alexis Wortley is coming out, here and now. In the eight years since her attempt, she has been embarrassed about giving up on herself and has been seeking atonement for what she did. Seeing another attempt survivor speak openly helped her decide to do the same. As she started sharing with family, friends and colleagues over the past week, a weight began to lift. And she was surprised to find that her parents had long forgiven her.

Now Alexis, an elementary school teacher in Washington state, is working on finding ways to be happy and realizing that maybe people do care, if you let them. “Maybe the human spirit is also being strong enough to say, ‘I’m not as strong as I thought,'” she says.

Who are you? Please introduce yourself.

So, who am I? Um, well, and it’s interesting, I read previous interviews and wrote stuff down, and now I’m looking at it thinking, “No, I don’t want to say that anymore.” I’m just another person in the world, a teacher, I wanted to be one since I was 5, and I used to come home from school and want to play school and had this dream of standing up in front of a classroom of kids and giving them knowledge and learning and facts and stuff. I’m a military brat, both of my parents were Marines, and it’s kind of funny that both are from the same state and met in Hawaii, and here we go. And I’m a daughter, a sister, a stepsister, everything that most people tend to be, and I’m someone who really cares a lot about people, I wear my heart on my sleeve, which sometimes gets me in trouble and is a factor in why I get depressed.

And I’m not good at describing myself because I don’t usually like to draw attention to myself, but I would like to think I’m funny, pretty smart. I like to read. I’m an animal lover. I do everything for other people but rarely for myself. And I’m gonna have to start learning for myself, make myself a priority, because I don’t know how to do that. I’m an introvert, I can spend so much time alone, I could go into my room when I was younger and spend hours by myself, reading or whatever. I never needed somebody around. I’m still like that. I’ve been living on my own for about 10 years now. At the same time, when I need to be around people, I need it right then. Sometimes they’re not always available, and sometimes that gets me down, too.

I guess I’ll go with how other people describe me. Those people say I’m beautiful and smart and caring and care about kids and empathetic and sympathetic and would give anybody the shirt off my back if I needed to. And I just don’t like to draw attention to myself, which is hard because at 5-10, it’s hard to hide. So I learned to start crouching, hiding myself, I didn’t want people to notice me, not realizing that 5-10 is a gift. That’s kind of where it all started. I like to think I’m someone people can come to. I didn’t realize I needed to go to people.

How old are you?

I will be 34 in April.

How has the past week gone, and how did it get started?

Well, very emotional. A lot of crying, but also a lot of happiness, which is a word I have a hard time using. I discovered I wasn’t happy. I think three things made this happen. One of them, I will be vague, but it was a man I dated in January. I could tell he had issues, too. I decided to ignore those issues. Maybe being with me would help him. It turns out that he decided he couldn’t do it anymore. He unfortunately had had marriages end because of infidelity. He’s been overseas with the military, so probably there are some issues there. I don’t talk to him anymore, so I’m not sure it’s ethical to speak of that. He ended it with me, so I started wallowing: “I don’t want to get out of bed, why me, why am I being rejected again?” It’s something that’s been going on my whole dating life. I’ve been rejected a lot. I discovered I’ve been finding the wrong guys, I’ve been dating those wounded guys and trying to make them happy, but I’m not happy myself.

My sister, I love her to death, she’s 26, one of those people who can just let things go. If it bothers her, she doesn’t show it. I have no idea how she does it. She came over last weekend, and I was in my pajamas, wallowing and upset. At first she was like, “OK, I’ll accept it,” then she was like, “Look, you’ve got to stop being unhappy. You’re never going to be happy with someone if you’re not happy with yourself.” I remember thinking, “Do you think I like being like this? I wake up and think, ‘OK, I’ll be depressed today?'” She laughed, and I started thinking, “What makes me happy?” I couldn’t think of one thing. I’m 33, I’ve got a great life, but I couldn’t think of one thing that makes me happy. I started sobbing, then I realized that I don’t allow myself to be happy because I feel I don’t deserve it because of what I did to myself and my family eight years ago. And I said, “I can’t do this anymore. I need to be open about what I did.”

The third one was really how I found your website, Attemptsurvivors.com. I liked the TED Talk on Facebook, the one JD Schramm posted. I was watching and, oh my gosh, this guy had all these successes in life and admitted he tried to kill himself. And I was like, “Thank you!” I was like, “Maybe that’s what I need to do, admit that I’m ashamed and embarrassed of what I did and look for ways to make it better.” At the same time, I’m tired of hiding behind it. And it’s been, like, a weight has been lifted off my shoulders, honestly.

I went to my dad and my stepmom. I talked to them: “This is how I’m feeling.” They listened and were very supportive and said whatever has to be done so I find happiness. They knew I was upset a lot, was still depressed, but they didn’t now how to bring it up. And I went to my principal and said, “Look, this is what I plan on doing, there’s a possibility of it getting out publicly, and if so, I have to do something about it, because I teach kids.” Also I told him, “I’m going to start doing this, I want to be an advocate, speak out in the mental health community. I want people to know it’s a problem.” And everybody I talked to so far said, “I’ve got your back,” and then they said, “Yeah, my friend is bipolar” or “Yeah, I know somebody.” People just don’t talk about it because they’re uncomfortable.

How will you do this?

That’s the good question. That’s what I’ll have to find out. This is my first interview. A good way to get started. I looked into getting training with ASIST in Seattle. I’ve been looking at NAMI websites on how to get involved. I’ve been on the AFSP website, they have the Out of the Darkness walks, they have one in Seattle, maybe I could sign up for that and get people for that. I could advocate in my state, get public policy going for people with mental health issues. I’ve been on the Waking Up Alive website and talked with Sabrina. She emailed me back saying, “That’s so great, here’s how you go about it, just take classes and be knowledgeable, and if you want to help people, you have to have that training.” She also said, “You have to be into your recovery process because this will trigger emotions.” She was really helpful. And I’m talking to spiritual leaders. I have a weird relationship with God. There’s times I’m totally religious, yeah, and there’s times I want nothing to do with religion and God and spirituality, and maybe it’s time to start fixing that. I want to look into a new relationship with God. I’m seeking grace and atonement, and maybe I need that from God, too. I’m looking into all these possibilities. I’m trying to find some way to get my voice heard.

What has been your experience with recovery?

Well, it’s been eight years, actually this week, and I thought I was fine. I thought, “OK, I’m out of the hospital now, I’m going to start some heavy therapy, meds, life is good, I’m alive.” I spent the rest of my 20s thinking life is good, but I kept trying to fill a void. I was filling this void, I was trying to be happy, but I was doing things that actually were not making me happy. I thought, “OK, if I can get into a great relationship and get married, I’ll be happy.” Well, that’s not true. I got in the habit of dating guys with issues like me, wounded. I was going through this cycle of constantly finding these guys. I went through a process of buying stuff. I went through bankruptcy because of it. I was buying material items. I got that under control. I’m doing well financially. I’ve decided to take myself out of the dating pool and strictly focus on me because I don’t think maybe I am completely recovered. This last week, I discovered I don’t like who I am. I’ve been telling people I’m ashamed and embarrassed. I haven’t asked for forgiveness from anybody, hiding behind what I did in hopes it would go away, maybe it didn’t actually happen. What I really need to do is address this act.

So to answer, no. I don’t think I’m fully recovered. I never did it again, I won’t do it again. I continue to see counselors, take meds, but every couple of months I get into some times when I get really down, and I know it won’t last, but at that moment in time, my brain is telling me, “I don’t think it will get better and I don’t know how to be fine,” and I think, “What if I decide to do it again? I don’t know what I’ll do.” My parents and sister said their first thought when I get down is, “Oh no, will we get a phone call again?”  I decided I need to start addressing it and talking about my experience. Luckily, I now recognize the triggers that get me down.

Did they know when it happened?

Yes, the only people that knew were my mom, my stepmom, my sister, my dad, just very immediate family members. And I had two friends that knew. I work at a really wonderful school, it’s like a second family there, I’ve been there seven years, very supportive, caring. They know I have anxiety issues, I can get depressed, but they don’t know my past. I’m ready to start telling them, I guess.

My parents knew. They were there. I have some fuzzy memories of that week: ” You guys didn’t visit me at the hospital,” and my dad’s like, “No that’s not true. I distinctly remember talking to a doctor who was saying, ‘Should we put her on a liver transplant list? How do we know she won’t do it again?'” Instead, I was put on an experimental liver program to clean out my liver and kidneys. The only person I remember being there was my mom. I never asked her how she felt. The other night, she came over, and I was explaining what I’m doing. She looked at me and said, “Alexis, I forgave you a long time ago. You’re my daughter. I was upset and angry, but you’re my daughter.” I was like, “Wow, she forgave me.” I was kind of stunned.

Since then, you’ve talked to other family?

Yeah, my dad and stepmom said they had never forgotten about it but forgave me. The reason they swept it under the rug is because they thought I had. So they never brought it up. My uncle and aunt were very supportive. I went to them and said, “I have issues,” and they said, “Yeah, we’re praying for you.” I honestly can’t remember who knew aside from my immediate family and a couple of friends. Other than that, I’m gonna have to feel it out and see.

You mentioned feeling embarrassed and that you have to atone for what you did. Why? If it’s a health issue …

Well, I don’t like upsetting people, and I do understand that it is a health issue, but I feel that I should’ve been able to make a better choice and instead, I gave up. I very rarely give up on anything or anyone, and I gave up on myself, which is not the human spirit. I allowed my disease to take over, and I succumbed. I lost my pride. That’s where the embarrassment comes from. My cousin died of cancer two years ago, and he never stopped fighting, and he never gave up his will to live. How come I couldn’t do that? Waking up and being alive and continuing to live and make improvements should’ve made up for the embarrassment and shame, but it didn’t. Now, I’m admitting I’m not always strong, I am human, I make mistakes, and now I want to come out from that and let others know that hiding only makes the inner pain worse. Maybe the human spirit is also being strong enough to say, “I’m not as strong as I thought.”  I’m not sure if any of that makes sense.

Do you still live in the same community, the same location?

Yes.

What kind of response do you expect to get in the community?

I would hope it would be positive. One thing that really bothers me is that the media portrays people with mental health issues like we’re crazy and unstable and violent, we snap and go shoot up schools and all this stuff, and every time I read the comments and see what the media does, it makes me so upset. They’re lumping us into a category that’s completely not true. Unfortunately, with social media our lives are everywhere, and there are going to be some negative responses … But the majority, I think, will be supportive, will say, “Hey, that’s brave of you” and start telling their own stories, “Hey, sometimes I get really down” or “Hey, I have a mom or grandpa,” and the stories will come out because finally someone says something. I guess time will just tell. It’s not like I’m going to go on Facebook and say, “Hey, everybody, guess what I did eight years ago?” Some parents of my kids are on my friends list. I’m starting very slow, with my inner circle, and I hope to branch out from there.

What steps are needed to really open this door?

I liken it to the fact that the civil rights movement, how long that took for Martin Luther King and Rosa Parks and all of those great people that finally got the discussion going about civil rights. And I think about how in the ’80s with AIDS and how long it took to get the word out and prevention and those living with HIV or AIDS are not bad people. And you think how long it’s taken all these issues. Honestly, something like this is not gonna happen tomorrow. Like with the media, they badmouth it so much and portray it in a light that’s not fair. The stigma and taboo that go along with it: “I don’t want to say anything until someone else comes out and has the courage to say it.” Maybe that was the issue for the past eight years. I didn’t want to be called crazy and have people think I was violent or something. And I’ve been called crazy, for real, and it hurts. Even when people are joking and don’t know my past, I kind of laugh but think, “No, I’m really not. I have a disease. You can’t see it, but it’s still there, and I deserve to get as much help as someone with cancer or other horrible disease.”

I don’t know. That’s why the only thing I can do is reach out and get myself out there. I hope people will say, “Wow, I can’t believe you’ve been suffering for that long and didn’t say anything.”

What been useful in your treatment, and what hasn’t been useful and should be changed?

I was diagnosed when I was 19. I had my first panic attack. I thought I was having a heart attack. I went to my regular primary care doctor, and she was like, “OK, we’ll put you on pills” or whatever it was. Then it was like, “OK, see you later.” She didn’t say counseling or anything. I went on this medicine, things were fine, but as I was getting into my 20s, the pressures of life honed in on me. I graduated college, tried to find a job, my parents divorced, and I decided, “OK, maybe I need to seek out counseling, too.” I’ve been through many different counselors, I’ve been through many psychiatrists who say, “OK, maybe we up your dosage or reduce it or put you on another one.” And I say, “OK, you guys are the experts” and I go with it.

I think it’s good to have that there, to have someone to talk to, but I think they need to be on the same page. Some just let me talk but give no suggestions. The one I have, she’s very good, she lets me talk but gives me suggestions. Journaling, exercise. She wants me to get better. Apparently, she didn’t know what I tried to do, and I told her the other day. I started telling her what I want to do and she said, “That’s great, we need more people like you to start talking, and helping,”

But to answer your question, yes, the drugs have helped. I don’t get the horrible panic attacks. I don’t get into as deep, dark holes I don’t think I can climb out, like eight years ago. I know there’s a light at the end of the tunnel. The one thing that doesn’t help is the friends who say, “You know, happiness is a choice. You just have to choose happy.” I would give anything, I’d give everything I have if I could just choose to be happy and let it all go, but I can’t.

There’s just no money out there for those programs. To get appointments even with my counselor, it’s just weeks out. That’s how busy they are. I couldn’t find support groups in my area for after suicide attempts. I would have absolutely no idea how to start a group. One thing my principal suggested, I guess there’s a program called Celebrate Recovery, like a church-based 12-step program, basically like AA but for anybody who feels they need to recover from something, just anything. I said, “That’s great, how come they don’t put it out there more? It’s free, with churches. There’s just nothing out there to advertise it. Plus, you have politicians who say, “Cut funding for health care, cut veterans benefits.” They think if you get rid of it, it just goes away, but it’s just making it worse.

Oh, I just thought of something. Other things that help is just knowing people care. When I do finally start talking to people, say, “Hey, I’m having issues,” I have people who say, “Hey, if you ever have to talk” … I put on Facebook that I was having issues, and a colleague messaged me out of the blue and said, “Hey, I’m here.” And I said, “Yes, I’d like to talk. You’re taking time out of your life to help me?” It just felt really good to see people care. I’m really hard at accepting help: “No, I don’t want to bother you, I can take care of myself,” but maybe they’re offering because they really do care. I’m starting to realize that now. My dad, my principal, say, “If you need to talk, come talk to us, please!” And that is very comforting.

I’ve always been that person: “I you ever need to talk, please call on me.” We live in a world where people just want to think they can take of things by themselves. That’s how I am. They don’t want to look helpless, I guess. They want to look like, “Hey, I’m strong.” But when it comes right down to it, everybody, some of us are just dying inside and putting on a happy face. If we knew people cared, maybe people would start talking.

I think about bullying, being an elementary school teacher, bullying is such a huge deal. They’re projecting what they don’t like about themselves in an effort to make themselves feel better, not realizing they’re hurting the person they’re bullying, like a vicious cycle.

Do you ever see anything in your students, issues that concern you?

Yes. I can’t go into too much detail, but I have students who don’t get any support at home, don’t get nurturing, and they get attention anywhere they can get it, any attention is good. I think about those kids as they get older, what will they do, will it be good or bad? I have kids who already suffer from anxiety, and wow, they’re already suffering from anxiety from the pressures of life, to perform, and I feel for them because I know exactly where they’re coming from. I just let them know I’m here. Being the child of divorced parents, I say, “Hey, I’m here for you.” Most probably won’t take me up on it, but just being able to tell them they know somebody who really cares about it …

With your other issues, is 5th grade the place to connect?

Unfortunately not. Even though I am their teacher, I still … And I know it’s out there, I was doing some statistics-searching and it’s the third leading cause of death from 10- to 24-year olds, and I was stunned by that. That a fifth grader would think about that. But I don’t think it’s my place to talk about that unless I got permission from my parents. I think it’s more likely in junior high and high school. But as a teacher in 5th grade, I would feel uncomfortable because I don’t know what I could say, liability issues involved. That’s why we have counselors, school psychologists and, to be honest, why we have parents. We live in a society where everything’s out there. Parents really need to have that dialogue with their kids. I can honestly tell you I know of students at my school who unfortunately suffered the loss of parents because of suicide. And I could never say anything to them because I don’t know how they’d react. I mean, divorce is fine because everybody knows about it. But there are still some things these days we can’t touch upon. Maybe in 5,10 years that will change. Eventually the dialogue maybe needs to be there. Just not right now.

What will you do for yourself? To change?

Actually … Gosh. I don’t know how to go about that. I spent most of my life taking care of others, helping others. I have to figure out what makes me happy. Teaching makes me feel good, being around kids, laughing. Feeling successful makes me happy, but those are all fleeting moments. I’m not sure how to do “happy.” I think if maybe I get my story out, someone will say, “Hey, I heard your story and I decided not to go along with my plan. I’m going to try and get help.” In a way, I guess, that could make me happy.

I like being there for other people. But for myself, I just need to learn to be selfish. To me, selfish is a bad thing. I need to start taking care of myself, exercising … Gosh, I don’t know. I just need to stop being afraid. There are times I don’t like going out in public because I’m afraid if they’re looking at me, judging me. I have to say, “Hey, they look at you and then they’re gone.” That’s what I think this journey is. I need to find that inner peace and go to bed and say I’m happy. And I can wake up and say, “I’m good, this is who I am, and I’m dealing with it the best I can and helping others in the process.” I need to be able to be content with that. I have my support group. I’m not sure how to get there. Maybe a better relationship with God. Maybe recognize the warning signs that get me depressed and get away from that situation. That’s a loaded question. But I do know just in the past week I’ve felt better than I’ve probably felt in a really, really long time, and that’s the first step.

Where I was eight years ago and where I am now, it’s a complete improvement. Back then, I was in a dark hole. I really felt just there was no way out. If I took myself out of the equation, the world would be a better place. I had all these issues going on in my head. It just mushroomed. I didn’t plan it. I know a lot of people do. I didn’t. I snapped. I remember driving home sobbing, thinking, “Please, a car just take me out, something.” I remember swallowing Tylenol by the handful and thinking, “OK, it’ll be done.” But now I can say, “Yeah, I’m much more content than I was.” But I know I still have a long road, and I know I will never, ever do that again because I know I can pick up my phone and talk to somebody, and I know now in the past week that people will say, “Great, let’s talk.” And I thought eight years ago nobody gave a darn. And I know now it’s wrong. I just wasn’t willing to ask for help. And now I’m willing to ask.

I’m sitting here looking at my apartment. I have pets now. After my attempt, I got a cat and thought, “OK, that’ll help.” And that was the greatest thing I’d ever done. Then I got more. They are therapy, too. They need me like I need them. I started improving my job, getting better as a teacher, and now I’m an awesome teacher. Everything is good, and now there’s this one thing I have to do. I have to say, “I’m Alexis, I suffer from depression, I tried to take my own life and, you know what, it’s going to be OK because now I’m willing to admit it. And if you need to talk, I’m here for you.”

Who else are you?

I feel that I am somebody whose journey is just beginning. I’m gonna be 34 in April, and I thought my life started when I graduated from college and got my first teaching job. It turns out that’s a great part of my life. I can look in the mirror and say “Wow, you’ve made it,” but maybe my life is starting right now. I’ve questioned that a lot, asked, “What is my purpose in this world?” I thought it was to be a teacher, and it is, or half of it is, and maybe the other half is I need to help other people like me, and maybe this sounds like a cliche, but changing the world in some small way. Everybody changes the world in some way, either they do it quietly or with a lot of show. Maybe I’m just finally realizing what I’m going to do with the rest of my life. And maybe it’s not what i thought it would be, but that’s OK.

Maybe in another year I can give another answer to this question, a better answer, but now it’s completely new and scary, and there will be times I will ask, “Why did I decide to do this?” but at the end of the day, I’ll say, “OK, this is me and I’m doing the right thing.” But you know what, I don’t want to be that person who gets down by that and retreat into myself. I know now there are places and people I can talk to and be more open. So yeah, it’s a hard question to answer. I think I’m gonna be … I’m gonna be different. I’m gonna be a new Alexis, and now I have renewed hope and faith for the future.  Yeah.”

Talking with Sandra Kiume Dawson

The Canadian activist who tweets at @unsuicide has built a peerless guide to the online world of crisis response, and she’s done it on her own time with zero budget. Here, Sandra Kiume Dawson discusses suicide hoaxes, what Twitter does wrong, the need for transparency, why hotlines are outdated, and how to walk the oh-so-careful law enforcement line between tracking people down for help and scaring them away.

Sandra also makes a special note about why trained peers like herself are crucial online. “We’ve seen the darkness, and it can’t get any darker,” she says. “I’m not afraid of it. I can hold someone’s hand and guide them out of it. And I think there should be more safe spaces like that.”

Who are you?

My name is Sandra Kiume Dawson. I’m a suicide attempt survivor, living with bipolar and other conditions since I was 7. I’ve had multiple attempts. Through treatment and self-education, I’ve learned a lot about suicide prevention, both from the standpoint of suicidology but also from more grassroots efforts. I have a part-time job as a mental health blogger at PsychCentral that helps ensure I keep current with mental health news.

Suicide is not the only topic, but I often write about it. I also have a wiki, Online Suicide Help, which is a directory specializing in e-mental health services, crisis IM chat services, social media supports, peer support forums and more. There’s quite a lot out there and more all the time. I’ve collected these resources into one place so people can find them easily. Another thing I do, I’ve been on Twitter since 2009 as @unsuicide, a peer support suicide prevention account. I’m not a trained counselor, but since I have lived experience and a lot of knowledge of the mental health systems, I can help people navigate both online and off to find supports.

A typical conversation with someone on Twitter is something like, “I have a plan to kill myself.” I’ll say, “Do you want to go to the hospital?” “No.” “Do you want to call a hotline?” “No, I don’t want that. I’m afraid the police will come knocking at my door.”

Or, “I have anxiety; I don’t want to talk on the phone.” That’s where online services are helpful: texting or IM chat services. It’s great to see more and more available. But I also refer people to peer support, because often people are more interested in peer support than professional help, or they want both. People want to know others really understand them; they can talk to someone who’s been where they are and have recovered. That provides a lot of hope, makes people less alone. Feeling suicidal is a very isolating experience, and so anything that makes you feel less alone is helpful.

Where did you come up with the term “unsuicide”?

I thought it was catchy and reflected my goal of people proactively preventing their own deaths. Unsuicide as the opposite of suicide.

When did you start pulling all these resources together?

I started on Twitter in 2009, and created the Online Suicide Help directory in 2011. I had already been bookmarking resources for over a decade.

Do you have everything?

No. I don’t pretend to be completely comprehensive. I’m continually searching for more, and asking people to share links. And there are always more services coming on board, especially with crisis chats.

Do you have measurements of users, traffic, etc.?

I do keep track. I get about 6,000 hits a month and have 15,000 Twitter followers.

Who comes to you?

With the wiki, it’s really worldwide. I’ve had visitors from 158 countries. The tragic thing about that is that while I’m aware of the worldwide need for online services, they’re not always able to access services because of geoblocking – restricting services to one country or even a single town. There’s a huge need to create an international network so people in, say, Mongolia or Malaysia or Ecuador or, you know, any country that doesn’t have the money to start their own services, can access help. People are desperately searching, and it’s devastating when they find there is a service but it intentionally won’t serve them.

Do you get paid at all, and how much time does this take?

No. I don’t get paid for this at all. How much time is really variable. I will check usually every day to answer tweets, share links. I would guess an average of maybe an hour a day, two. If someone contacts me to talk, it can take more time.

What has been the response from organizations you reach out to?

The IASP at least wrote me back. A lot of organizations don’t. I’ve tried writing to organizations that completely ignored me, like the Samaritans in the UK. It’s been frustrating because I don’t have a Ph.D, I’m not a suicidologist, am not employed by an organization and I don’t have credentials. And because of that, I think they’re not willing to engage with me.

You mention that you’ve had the experience?

Yes. It doesn’t make a difference. There have only been a handful of organizations that have taken me seriously. Crisis Chat is one, in the US.

A big exception happened recently with a petition I started to ask the American Foundation for Suicide Prevention to change the language of “survivors of suicide” to “survivors of suicide loss” or “the bereaved” in their events and literature. Once it reached 100 signatures, I contacted the CEO, Robert Gebbia, and he was very responsive and respectful and agreed that the language needed to change. I look forward to that happening soon.

What more would you like to see?

An organization that involves and includes users, by which I mean Internet users and app users who are also mental health service users. I see sometimes that organizations will engage stakeholders and say, “Oh, we’ll bring in a couple of people with lived experience and see what they think, or do a focus group,” but those consultants are not always on social media and seeing what triggers people in that realm. It’s people who don’t necessarily know the online landscape. Without mentioning an organization, I saw this just recently and it was really discouraging. I think people with lived experience who are brought on board need to have certain qualifications. Not academic, but the right experience.

In terms of diagnosis? Or what they lived through?

What they lived through, and what type of services they’ve engaged with in the past.

Have they used online services, do they know what they’re like, the barriers involved?

Just pulling someone out of the hospital randomly doesn’t mean they know how a crisis chat operates, or what kind of supports are on Twitter or Reddit, or the pros and cons of texting vs. IM chat.

Do you have a roll call of favorite resources?

Yes. There’s a service called Youthspace.ca for Canadian youth under age 30, which is actually problematic as a lot of online and texting services are just for youth and adults are often left out. They’re a great site, with texting, chat, a forum and trained counselors. IM Alive is now available 24/7, which is fantastic, and I’m also fond of Crisis Chat. But both those services are for Americans only. I wish I could recommend a peer support service, but I only know a few services that aren’t specifically for suicide. Real-time, peer-led suicide prevention intervention online almost does not exist! There’s one tiny service in the UK, but that’s all I’ve found beyond social media, and those people are lacking organization, training and support. There’s such a need for this. The professional peer support specialist community has not seemed to recognize this need yet, or has not acted on it. Professionalized peer support is only available offline.

How much do you think traditional nervousness around suicidal thinking affects not innovating?

I think it causes a rift because traditional services are hesitant to bring lived experience on board. I think in America it tends to be even more split: peer-led groups tend to be doing their own thing, as often they have a history of antipsychiatry activism. And possibly for that reason, the peer-led organizations – I don’t know, I’m just guessing here – but they’re maybe not privy to the same research that other suicide prevention organizations have access to. So maybe they’re not as up with changes in technology and demographic trends. I’ve noticed, too, that not only have I had trouble engaging with the traditional organizations, I’ve had even more trouble getting cooperation from peer-led organizations. There’s a schism that they’re suspicious of anything to do with psychiatry, and they want to do things their own way, and if you’re working within or advocating the medical model at all, you’re suspect. At least, I’ve been shunned before for that reason.

So that’s why I’m kind of doing things on my own here, you know? It’s frustrating. But if suicidologists don’t want to work with me and peer support activists don’t want to work with me, it hasn’t stopped me from doing a lot on my own.

But you’re on a national consumer group in Canada, right?

I’m a member of the Mental Health Commission of Canada Advisory Council. It’s not a consumer group, but I’m one of three members with lived experience on the council. It’s really exciting because I’m now included in high-level strategic discussions for national mental health policy. People with lived experience are not often involved at that level.

How did you come across each other?

I was already on their e-list. They put out a call, and I was one of almost 200 applicants.

Again, are you being paid?

For the advisory council, I receive a per diem plus travel expenses, yes. For the work I do on my own, no. I can’t expect to be paid for something that’s my own initiative. But I don’t mind, I can do a lot on my own. I went to an e-mental health conference last winter and showed a researcher my wiki, and she was just amazed I had a budget of zero. They spend millions to create a website, and to me, that’s such a waste of money. I can make a
site for nothing. So I did.

Where else would you like to take this?

I’d like to see what I’m doing expand into an international network with the cooperation of Twitter, as well as law enforcement. That’s beginning to happen now, but I’d like to see more peer involvement in the design and operation. When people have already announced they’ve ODed, they need immediate medical attention, and there’s no way to get them care if you can’t track their IP, which only law enforcement can. It’s really frustrating when people leave suicide notes and you can’t do anything else. Twitter is not helpful, all they do is send an automated DM telling the user to call a hotline. A new approach involves cooperation with social media companies, law enforcement and professionals who do counseling online. But it’s also critical to have peer support and lived experience advocacy in that equation. I see a lot of people afraid to talk to nurses and doctors, and even more afraid to talk to police. Peers have empathy, they’re not as scary, they understand and they can have intervention skills training. The right person with the right training and experience can be even more effective as a crisis counselor than someone who doesn’t have that lived experience.

What’s the ideal way to involve cops?

I think there needs to be rational discussions between people with lived experience and the police to see what those boundaries are. For example, many people don’t know the difference between self-harm and a suicidal act. They see a tweet “I just cut myself” and see that as a suicidal act, and if they brought in police to knock on the person’s door, it would be inappropriate. To have that knowledge, to know when intervention is warranted, is vital. Otherwise, you just scare people off, and they don’t trust you anymore. Phone hotlines have this problem, they have a reputation as being untrustworthy because they call police, and it’s a big part of the reason people I talk to refuse to call a hotline. It’s hard to know when to make that call.

Are online crisis services more transparent about their policies about contacting police?

Some are, but generally not that I’ve seen, no.

How do you work with law enforcement?

I’ve only called police a few times since 2009. I don’t involve police unless an attempt has already taken place and the person is unresponsive. One was an example of someone who left a suicide note and left enough clues on their timeline that I was able to figure out where the person lived. I called police, they checked it out, and it turned out to be a hoax. It’s surprisingly common. Another time, a girl, a teenager I had been talking to for over a month, was really depressed. She was saying how she was going to kill herself on her birthday. It was coming in three weeks, two weeks, one. I kept trying to get her to go to a school counselor, any kind of option, but she was not willing to do anything. She just kept coming back at me with, “I’m going to kill myself on my birthday.” When the day arrived, she left a suicide note on her timeline. That was it. I called police. They tracked her down at her school, and she was super mad at me. She deleted her Twitter account, and I never heard from her again.

She was OK?

She was alive.

Did law enforcement get back to you?

No. But she had made so many threats repeatedly, and she was so unresponsive that I felt involving police to get her to help was warranted. There was a similar incident with another girl but not enough clues about location, and when I phoned police, they said no, because it’s on the internet they can’t do anything. They brushed it off. That’s been a barrier to working with police. Unless they know an exact street address, they don’t respond. They don’t have access to Twitter’s user data. Fortunately, that’s changing now with the new Real Time Crisis service.

Why are suicide hoaxes surprisingly common? Why would someone do it?

I can only guess, as I’ve not read any research on the topic. But basically, it’s for attention, it’s to gain more followers or specific followers and get sympathetic messages encouraging them to live.

“Celebrity blackmail” is one very common reason behind a suicide hoax, especially among youth, but I’ve seen it happen with fans and stalkers of any age. The person will send a tweet to a celeb saying, “If you don’t talk to me/follow back/RT me, I’ll kill myself,” and it’s purely to gain the attention of their idol.

Another category of hoaxes comes from people who are genuinely disturbed, trying to gain attention for a personal issue in which they’ve felt silenced. They may tweet repeatedly to mass media accounts as well as anyone who will listen about being victimized by something, and sometimes make suicide threats.

I think someone who creates a hoax does have issues to look at, it’s not something a healthy person does just for fun.

You say Twitter isn’t responsive. Is that the same for other social media companies?

They all have different policies.

How hard would it be for them to make the changes you’d like to see?

It’s a technical issue, isn’t it? On one hand, you don’t want just anyone to say, “Oh my friend says she doesn’t like her life,” and send the police. That would not be a good approach. But if it’s a matter of, there’s a safety team already online and doing outreach and identifying when there’s a real, bona fide crisis and there’s a life in danger, an attempt has happened and a person needs immediate medical care, that’s where I would like to see Twitter and other services working with police and peers. And it’s coming, slowly.

What are the risks involved?

Of service users becoming less trusting of people like me. Right now, people trust me because I’m one of them, I have empathy and I’m not a police officer or a doctor. I don’t want people being afraid to contact me. Transparency is really important. One problem with hotlines is people being afraid of police being dispatched. Some hotlines have different policies. Some will send police and some have confidentiality policies. It would be better to know up front, because people have been quite traumatized by police showing up at their door unexpectedly.

Have you reached out to crisis lines on that issue?

No.

Here’s a question I’ve had a lot: What is a good suicide forum online?

It depends on the kind of support you want. I have close to 100 mental health forums linked in my wiki. Specifically for suicide, there are a couple I don’t recommend, but Suicide Forum is a good one. I also like PsychCentral’s forum, it’s a major one, but it’s not for suicide talk. It’s good for issues of depression or anxiety. You can dance around it, but you can’t mention suicide.

Why tiptoe around the subject in forums like that?

I wish they didn’t! It’s because of the fear of triggering, but where do you go if you can’t talk to peers, right? That’s why projects sometimes turn up on their own with their own rules. And that’s where my Twitter service comes in. People can say anything they want to me. I don’t get triggered. I think those who’ve had attempts are less afraid of talking about it. We’ve seen the darkness, and it can’t get any darker. I’m not afraid of it. I can hold someone’s hand and guide them out of it. And I think there should be more safe spaces like that. I guess that’s what hotlines are for, but they’re so outmoded, and they’re not peer services.

One thing I’d like to see, if we’re talking about alternatives: safe places to go and talk about suicidal feelings without the risk of being forcibly taken to the hospital. 24/7 crisis respite services with peer support and clinicians where people are free to talk about their feelings and not afraid of being institutionalized, even though that fear is often based on stigmatizing old stereotypes and not the reality of modern hospitals. It would be good to see that concept online as well. If you’re going to build a peer crisis service, with warmlines, etc., why not make them online services as well? Demand is there.

I’m not afraid of hospitals myself, and am not anti-psychiatry. Medication works very well for me, and I’ve been in hospital many times without any abuse. It kept me safe and saved my life. But I recognize that there are a significant number of service users who are afraid of hospitals or who had bad experiences and don’t want to go back. They should have an alternative.

How do you protect and take care of yourself when working with people in crisis?

For one thing, when I hear some of the negative things commonly expressed, I can recognize them as symptoms of depression, bipolar, whatever the person is dealing with.

A lot of people I talk to have borderline personality disorder, for example, which I used to have but recovered from. So I know the symptoms. When someone says a statement I recognize, I encourage perspective and insight.

I’m also very good at self-care and managing my moods and reactions to triggers, and when I feel fragile I simply don’t log into @unsuicide. I take a break from it for as long as I need to. I have the flexibility and knowledge to do that.

How did you get better?

It wasn’t simple. It was a multi-stage process. Finding the right medication combination and adjusting when needed, with the help of my doctor, was essential, but that’s not the whole answer. Lifestyle changes were critical: regulating my sleep cycle, getting fresh air and sun, lots of nature. Parks and trees are good for me. Moving to a quiet community that was a less stressful environment was helpful. Whatever I can do to lower stress is good. I also went through both CBT and DBT therapy, which were very helpful. I practice gratitude, and really like mindfulness meditation. I have a lot of apps as well. My mental health toolkit is a formidable arsenal. And last but definitely not least, love and support from my wife has been amazing and so helpful to my stability.

Where are you today?

In a pretty stable place. I still have occasional episodes. I can still get triggered, but I’m careful about self-care and pulling back from things when I’m feeling vulnerable. I’m not on @unsuicide every day if I’m in a low mood. If I’m just feeling kind of jaded about things, not feeling very supportive, I’ll just say, “I need some self-care, I’ll be offline today.” People understand. I leave the link to the wiki: “Here are others who can help you.”

Who else are you?

I do jewelry design as a hobby, and I don’t know, I’ve been many things in my life. I’m an Air Force brat, I grew up all over the place. Then I lost and gained a lot of different jobs, so I can’t say, “I’m a (blank)” because I didn’t have one career. There was so much chaos. In the last 10 years or so, since going on disability, things have calmed down.

I’m a mental health advocate, though I don’t like that phrase so much because it’s so vague. I’ve been on the board of a mental health housing nonprofit society, I’ve worked for a homelessness and mental health research project and I have a part time job at PsychCentral. Never just one thing.

Anything else to add?

I see so much peer support available online in forums and chat rooms, but I see damaging advice being given, flame wars sometimes. And I think there’s a real need for people giving peer support to have some skills training, and I don’t know how that could happen in an unmoderated internet. On one hand, you have certified peer support specialists working one-on-one with people offline. On another hand, you have millions of informal peer supporters online, but those people have no training at all, and sometimes they’re giving really bad advice. They don’t have an ethics background, or trauma-informed care skills, and they often can be triggering to people. I just wish those certified peer specialists would merge with the informal peer support. Set up a free mass training system for mental health literacy and intervention skills, a free webinar, or a site where you can get a mini-certificate. If peer specialist trainers set it up, that would be the most logical thing to do. But right now, I basically see them ignoring the internet and not integrating it into their work. They’ve got to get over that. Mental health professionals are now routinely offering e-mental health services, and it’s time professional peer support specialists were doing it as well.

Talking with Tom Kelly

In this era of creative business titles, there’s something pretty cool about being the manager for recovery and resiliency. That would be Tom Kelly, whose life reflects his work. He’s been through a period of homelessness, the questionable interstate shipping of mental patients known as “Greyhound therapy” and more than one suicide attempt. Now he works for a major mental health provider as one of its peers.

He’s also moved from being scared of mentioning his attempts _ what if he was the only person with the experience? _ to being absolutely open. And after he tells his story, he often finds people who reply, “Me too.”

Here, Tom talks about his transformation, his work and the question of whether peers one day will run the mental health organizations that now offer them welcome. He thinks that it will take a lot to overcome entrenched perceptions.

“In my opinion, the professionals that work in the field only see people when they are doing poorly and in need of attention, help etc.,” he says. “They do not see people when they are doing well! When they see people such as myself, they say, ‘But you’re different!’ I am no different than the person who walks in off the street today … ’cause I was that person 20 years ago!”

We spoke by Gchat:

 Tom:  hi
 me:  aha!
 Tom:  Finally
 me:  sweet. thanks for being available!

Tom:  no problem my pleasure

 me:  ok then. is it all right to use your name?
 Tom:  Yes
 me:  great
 Tom:  First and last if you wish
me:  very nice. OK, then, and we’re off …

my first question is always to please introduce yourself. who are you?

Tom:  Well my name is Tom Kelly and I work in the greater Phoenix area for a managed behavioral healthcare company.

I am their Manager for Recovery and Resiliency.  In that role it is my job to help get the voice of individuals receiving services and family members to the table.  As a person with bipolar disorder with psychotic features and as a person who has attempted suicide on more than one occasion (three serious attempts) I am able to use my lived experience to help others understand what it is like for individuals such as myself.  I am able to help coach, mentor, train and educate not only staff members but also community stakeholders and individuals receiving services and show them that recovery is real and possible for everyone … no matter where we came from.

Anything else?
me:  how did you decide to talk openly about your own experience?

 Tom:  I decided to speak openly about my experience after a series of different events that have happened throughout my life!  It was a process.  I remember having challenges with mental health issues going back to kindergarten … throughout elementary school and high school and college I suffered from depression and the resulting desire to end my life.  After going through several hospitalizations and spending some time living on the streets I ended up in Arizona where I started getting the proper treatment. I was misdiagnosed with depression at that point but I knew there were other things.  When I started to understand the swings of bipolar disorder and get the proper diagnosis and treatment my life started improving.

Tom:  When I started getting that proper treatment and my life started taking a turn for the better I thought that it was my turn to share my story to help others who may have gone through what I went through.  I didn’t disclose everything at first – it was some of the things that happened to me! I would talk about the mental health challenges but not the suicide attempts.  It was not until I met others who shared a similar experience with suicidal ideation or attempts that I was able to say … Me Too. I guess there was hesitancy because of what people would think of me if I told them I had attempted to end my life.  I’ve come to the point where I am not ashamed of anything that happened so if I can share and help one person than I’ve helped one person!

me:  Where did you bump into others who talked about their experience?

 Tom:  When I first got introduced into the Arizona behavioral health system I started going to a support group for people with depression and bipolar disorder.  I was referred to the group from I was referred to the group from my hospital social worker at Good Samaritan Hospital.  I thought I was alone, I thought that no one went through the things that I went through … but in that group I found some shared and similar experiences.  From there I started advocating in the system and would meet others throughout the state.  Eventually I began meeting people from all over the country.  It’s interesting in that I can talk to a group of individuals wherever they may be and usually without hesitation there are always one or two people who open up and share their experience.  I wish I had bumped into these people decades ago as opposed to years ago!

 me:  How to make it easier for everyone to find each other, by the way? Any ideas?
(And why has it been challenging to find them?)

Tom:  Let me tackle the “why has it been challenging to find them” first!  Stigma, discrimination and prejudice!!  People who have attempted suicide have shared with me that they were ashamed, that they felt guilty, and that they became disconnected from themselves and others!  I can understand why some choose not to talk about their experience.  I was ashamed and couldn’t even tell my family what I had tried in the past because of the “perceived” belief on how they would treat me – so I just kept it bottled up!  I think we could make it easier for people to find one another by sharing resources and information throughout the “health community”!  Primary Care Physicians should have information about mental health and suicide in their waiting rooms.  They have information about high blood pressure, heart disease and how to get better sleep.  If they had information about suicide, suicidal ideation and behavioral health issues perhaps that would help people find a connection to a professional who could connect them to the community.  Education is also important – we need to start education individuals in kindergarten!

 me:  Did you ever tell your family, eventually? And how was the response?

 Tom:  I was in a hospital in Iowa and transferred to a hospital in Canada (where I grew up) – my doctor thought being around my family would help in my recovery! My sister flew down to Iowa and we drove back to Canada.  I shared with my sister and that was well received.  I have a great baby sister!!  When I got into the Canadian hospital I was able to tell my parents about what had happened and my second suicide attempt (but no one knows about the first or third).  They response was supportive from my perspective – I still have one sister that doesn’t quite understand what I go through – but my family is understanding!

me:  What’s your advice on how to tell family members about an attempt, or about thoughts of suicide? And what’s your advice on how they should respond?

(This being a big concern out there.)

Tom:  I wish I had an answer to that question as it is a big concern!  I guess I would take a matter of fact approach and describe the signs and symptoms of what it going on in a person’s life!  Paint a picture to help the family understand and empathize what their family member may have been going through.  After painting that picture by trying to educate the family about the signs and symptoms of depression, bipolar, etc … and explaining that some people with mental health challenges sometimes attempt (and share
those statistics) …I would suggest that they disclose their attempt.  If family members could understand the underlying issues going on in a person’s life perhaps they could understand the attempt.  I can not imagine what it was like for my mother to hear that her only son tried to kill himself.  My mother could not imagine what it was like for her only son to want to end his life!  By understanding the diseases, illnesses, disorders – whatever it is we want to call them, perhaps family members could understand why someone would attempt to end their life!  How should they respond – truthfully, honestly, and openly!

 me:  I want to go back to something you mentioned, about living for a while on the streets. Can you talk a bit about how you got there and how you got away from that … or at least how you got away?

 Tom:  I was married for about six years and after my divorce I became seriously depressed and decided to end my life!  I ended up at a hotel and took an overdose – about thirty or forty pills – can’t remember what they were and I started to become sick and I wanted to die – I didn’t want to be sick (weird I know) so I called 911.  I ended up at a private psychiatric hospital.  After a few weeks of care I was transferred to the State Hospital where I spent about 18 months.  After my release from the State Hospital my home was the streets of Waterloo, IA. They basically dropped me off on the streets with no plan of action – except the address for a homeless shelter and the name of a behavioral health outpatient clinic.  Well there was no room at the shelter and I spent the next few months on the streets of Cedar Falls/Waterloo Iowa.  I ended up back at the State Hospital and once again after another year or more at the State Hospital I was offered “Greyhound” therapy.   I was given a bus ticket to Florida – I had secured a place to live with my father at his trailer in Fort Lauderdale.  I was given the name of an outpatient clinic but
didn’t follow up. Eventually I left the trailer and spent a few months on the streets of Florida!  I ended up in Arizona in August 1998.  It was here in Arizona that I finally got introduced into the public mental health system.  The public mental health system gave me the support I needed to get back onto my feet.  They helped with vocational rehabilitation, medication, therapy and most important ‘housing’!! I ended up on the streets because I didn’t have any hope, I ended up on the streets because I didn’t care … well the AZ public mental health system offered me that hope and caring at a time when I had none!

 me:  And how did you move from being helped to helping?

Tom:  When I was introduced into the Arizona mental health system I thought I was the only person who went through what I went through.  When I found out there were others I started to socialize with them and attend a few support groups!  The one I mentioned earlier!!  From that I learned about the Arizona Behavioral Health System and a friend mentioned a County Advisory Council.  I didn’t know anything about advocating or speaking on my behalf let alone the behalf of another but there was a person that my friend thought I should meet.  That is the only reason I went to that meeting.  From that meeting someone heard me share a little about my story and said they wanted me to talk to some case managers. After sharing my story with those case managers in the system on thing led to another to another. I met people who were interested in helping me (because I started to want to help myself) and from there ended up doing some contract training for the local managed care company.  I say that I am blessed for what I have gone through (the good, the bad and the ugly) because I would not be where I am unless I went through what I went through.  I’m helping or attempting to help others today because I want to give back to a system that saved my life.  I want to give back to those who helped me get to where I am today!  In all honesty though – giving back is selfish for me –  for when I give back and help others I get the opportunity to let others know that there is hope … the more hope I can give … the more hope I get back in return!

 me:  Do you think the approach in Arizona is pretty representative of the approach in all areas of the country? I suppose this is a way of backing into the question of what changes are still needed to the system at large …

Tom:  I have had the opportunity to do some work around the country and I do not believe that the Arizona approach is representative in all areas of the country.  I was discharged to homelessness in two other States (Florida and Iowa) – I was given transitional living services when I was discharged from my only hospitalization in Arizona back in 1998.  The behavioral health systems throughout the country state that recovery and peer support are some of their overarching principles … Arizona followed Georgia into the peer support world within a few months!  I think some states are strong on peer support – many need help.  In my experience where there is strong peer support, the behavioral health system is a little stronger too!  Maricopa County through Magellan Health Services offers support groups for people who have attempted suicide that are peer-run and peer-led.  There are only a handful of support groups for people who have attempted suicide across the country … there needs to be groups such as this throughout the country.  Funding is a big challenge within the behavioral health world as many programs and states are underfunded.  I think funding would help improve the system at large – I think helping develop programs and including those individuals who go through what they go through need to be part of that program development!

 me:  You mentioned “Greyhound therapy,” and that reminds me of a story about a similar case that made the news earlier this month. Any idea how widespread that practice is? And surely it’s illegal, or at least unethical?

Tom:  Getting a bus ticket from one part of the country to another is cost shifting.  But other states offer that same service!  I do not know how widespread that practice is but to me it’s unethical.  In retrospect when I was given a bus ticket from Iowa to Florida, I did have an appointment with a counselor at an agency in Florida.  I didn’t know where they were, didn’t care, didn’t really plan on meeting anyone because of the ‘mental’ state I was in but the hospital did their ‘due diligence’.  If something happened they could have said “Well we gave Mr. Kelly the name and address of the Henderson Mental Health Clinic and he had an appointment!!”

 me:  Still, it’s amazing that people are just put on a bus. Have you seen any programs that do a really good job of addressing not only mental health but the underlying economic issues?

Tom:  There is one agency in Maricopa County that really focuses on employment for the people they serve.  Throughout the country the average rate of employment for people with serious mental illness is around 10%. This one agency in Maricopa County has an employment rate of 26% for people with serious mental illness.  Help put a job into someone’s weekly list of things to do and not only does it help the individual financially it helps the system because the individual becomes a tax payer and gives back to the community!!  The programs that focus on Housing First and Employment First are those that are doing a really good job of addressing the mental health and helping to improve the underlying economic issues!!

me:  This may be an ambitious thought, but how long will it take to move from peers being part of the system to peers running, or helping to run, the system? And how long will it take for many in the system to be comfortable saying openly that they’re peers as well?

Tom:  What is the saying about a cold day in …

Tom:  There are a handful of agencies across the country that have “peers” on their executive teams.  I was in such a position for a few years with another managed behavioral health agency.  There are many agencies that are non-profit agencies which are governed by Boards of Directors.  Many of those agencies have peers that serve as Board Members. I think that the peer voice is at the table to a better extent today than it was in 10 years ago!  I think that because of the belief that peers can recover and do in fact have knowledge, skill and abilities to move forward in the employment area many of them choose to stay within the behavioral health world. There are two National Managed Behavioral Healthcare Organizations that have peers who are serving at the Executive Team Level …

Tom:  I think the other question about how comfortable people are in disclosing their lived experience is a challenge!  I see more and more when I present that someone will come to me after the presentation and open up and say “Me Too” … when I ask them if others know about their lived experience they say “I can never tell people that I’m a peer – what would they think?” … there is still a lot of stigma, prejudice and discrimination going on … one day my friend … one day!!!

me:  I’m always curious about the more striking or surprising questions and responses people get when they talk openly about this. Does anything stick with you?

 Tom:  Please elaborate a little not sure what you are looking for ….

me:  You’re open about your experience. What are some of the more surprising questions or responses you’ve had about it?

Tom:  I guess I share so much about my experience and I am an open book that I don’t get too many surprising questions.  The responses I get, to be honest, are things people don’t say or ask!  Here I am, an open book willing to let them ask me
any question they want and … nothing!

I will have to think more about this particular question … I think I can find something that is surprising … just cant think about it now
 me:  What would you love to be asked? I don’t mind being guided along here!

Tom:  Once again … I don’t really know!

Tom:  Discrimination and prejudice seem to be more prominent within the behavioral health world and suicide prevention world than in the general community … How do we really get to the heart of the matter when it comes to understanding the damage that fear, ignorance and malice does in the work we do!

Tom:  I think it’s important for people to share their experiences and not feel ashamed to tell their stories.  Every civil rights movement started with a few people who had the courage to move forward … we need to develop courage and character and support folks for sharing their stories!

 me:  Why in the world would discrimination, etc., be stronger within the very field that talks about breaking down stigma?

Tom:  That’s the million dollar question!  In my opinion the professionals that work in the field only see people when they are doing poorly and in need of attention, help etc.  They do not see people when they are doing well!  When they see people such as myself; they say – but your different!  I am no different than the person who walks in off the street today … cause I was that person 20 years ago!!  When they don’t see that recovery is real and that recovery is possible they use “dark humor” and other defense mechanisms to protect themselves from “those people”.  It is funny that there is more stigma in the very field that is trying to eradicate it!!

me:  Interesting that you mention humor … Is there any way to talk about this issue openly with humor, dark or otherwise? I’ve seen a few interesting projects, like cartoons or documentaries …

Tom:  I think that the program coming out of Vancouver, British Columbia – Stand Up for Mental Health – is an interesting program.  David Granirer who is a therapist and has some stand-up comic experience travels around the continent and trains people with serious mental illness to deliver stand-up routines.  Victoria Maxwell does a one woman show about the ups and downs of bipolar disorder at different conferences around the world (I think she has three different shows).  I heard of another gal that does a one person stage presentation on the lived experience of bipolar too … but I forget her name!

Tom:  With the proper funding and support I think developing an Improvisational Comedy Troupe would be a good idea.  That way they could react to what the audience was giving them to work with!!

me:  Those people are good to know! I’ve spoken with David before … And here’s a change of subject. Let me know if you’d rather not go here, but why does it seem like the topic of assisted suicide is completely separate from the usual mental health world?

Tom:  A topic for another discussion for sure!!  Perhaps it should be called Assisted Death …

 me:  And for that matter, there doesn’t seem to be a lot of philosophical conversations in this field …

Tom:  I think the topic of assisted suicide is separate because the person has to go through lots of different things in their decision and are they not being challenged by whatever challenges those who do die by suicide without the assistance!

Tom:  I don’t really have a stance on anything in life … I really try to be a non-judgmental person … if push comes to shove … I would support someone asking me to pull the plug if it were in their living will!!  How about you?

 me:  I think I agree. It was startling to watch my father pass away and have no inrush of nurses because he had a DNR order, but he had declared his wishes and had been very open about his long fight, in his case with cancer. I just think there’s a lot of ground for very good discussions out there.

Anyway … here comes another change of topic:
 Tom:  Sure but you only have me for another 10 minutes …

 me:  Got it. Two more questions, then. This is question I often ask, because it was something that certainly stopped me from a more serious attempt: What if suicide prevention messaging emphasized the idea that no method is foolproof? That you can wake up in far worse shape? I think many people think, “Maybe this will work” and take huge risks in their attempts …

Tom:  I believe I have seen some messaging in that people could wake up and be in far worse shape.  To me it’s kind of interesting, I didn’t think of that at all when I was in a position where I wanted to die!  I didn’t want to jump because I was afraid of heights – not because I didn’t think it was NOT going to kill me.  I know people (two friends of mine today as a matter of fact) that survived bullet shots to their head – so that was out of the question.  With me it was always medication overdose.  I just wanted to end the pain, go to sleep and die in my sleep.  I’ve heard people have ended up in worse shape from all three of those different types of attempts!  I’m blessed and lucky after putting more than 150 pills into my system that I made it out of the coma relatively mentally healthy with no brain damage (that I know of LOL).  Those that think “Maybe this will work” are at a place where they need connection to something, someone in my humble opinion.  Perhaps the messaging would touch them – in my personal situation – I would not have thought anything about messaging around that thought!!

me:  Good points, and I’m scared of heights myself! OK, I like to end with this question: Since this experience most likely doesn’t define you, at least completely, who else are you?

Tom:  I am intuitive, perceptive, fun-loving person that enjoys helping others!  I’m a friend, brother, son, athlete, dancer and all-around nice guy!!!  Do you know anyone looking for someone like me … I’m single too!!

 me:  Ha! Let’s see what happens when that’s posted for the world to see!
Thank you so much for taking the time to do this!
Tom:  Hmmm maybe I’ll need to edit that last comment!

Talking with Jim Atkisson

Many people can hide the evidence of their suicide attempt. Jim Atkisson can’t. What happened when he was 16 years old has trailed him ever since, disqualifying him for the Army and for law enforcement and other jobs.

He believes that anyone who attempts suicide in the violent way he did has had this thought in the split second afterward, whether or not they survive: “Oh god, what have I done?” And he doesn’t want that happening to anyone else.

But he knows the challenges in even starting the conversation. “I think people are unwilling to accept the fact that people they know are contemplating suicide right now,” he says. “It’s OK to have the conversation, as long as it’s nobody you know. If it’s the guy down the street, it’s OK to talk about him. But if it’s a son, a husband, it’s unacceptable. Because that would mean something’s wrong.”

Here, Jim talks about his father’s anger at him over his attempt, the need for suicide prevention groups to be far louder and the unexpected power of a cup of coffee.

Who are you? Please introduce yourself.

I’m 43. I am married 13 years, with three kids. I’m a writer, and like many writers, I’ve been job to job. Everything from health care to a bouncer in nightclubs. I just started telling my story by accident. My wife said, “You need to write about the night you pulled the trigger.” I gave up talking about it because of the social backlash. When you tell people that you intentionally shot yourself, the looks you get. I was a kid. There was no one to help me cope with that. They never rejoiced that I was alive. They were angry that I shot myself.

What happened?

My parents divorced when I was 4. I didn’t see my mom after that. My dad remarried. I never assimilated into the family. I was on my own. My father was violent. I grew up fearful. I was 8, 9, 10 when I began to experience depression, anxiety. I noticed that whenever there were problems, if I imagined myself flying away, I’d feel better. If my dad was screaming, throwing things at me, if I was flying, he was not hurting me anymore.

Then in June 1985, I had a really bad semester. School was always my sanctuary. I was looking at a bad summer. I went from thoughts about flying and suicide to saying, “Yes, I’m going to shoot and kill myself.” It took seven months to work my life into that position where I had the nerve to do it. I demonstrated the classic symptoms, gave things away, talked of a future without me. They never picked up on it. I was dipping my toe in suicide waters, trying to get a feel for it. I think it happens to a lot of people. I think it’s crying out for help. They’re trying to desensitize themselves to the fear of death.

And when I pulled the trigger on Jan. 24, 1986, I had made a mistake. I remember laying in the field dying, thinking, “I made a mistake.” When you shoot yourself, it’s impossible to undo. A year after I shot myself, my vice principal and a fellow classmate shot and killed themselves. I thought, “Surely they had had the same thoughts I did: ‘Oh god, what have I done?'”

How were you rescued?

I lived in a rural community where the nearest ambulance was 18 miles north and the nearest hospital was 18 miles south. Pastures and hills. The only people home were my 9-year-old brother and grandfather. When I left home, I was wearing my best shirt and tie and carrying my rifle, and I grabbed the Bible. I felt I needed it for inspiration. I drove a quarter mile into the woods. I sat for an hour. I couldn’t do it. I unloaded the rifle.

Then I remembered I had been threatened the night before, and I said, “I can’t do it anymore.” I sat down by a creek and put the gun an inch off my sternum. I took the safety off and pulled the trigger. I had tried to prepare myself. There was so much blood, I wasn’t prepared. Then I thought in my head, I simply said, “Name one reason to hope for.” At this point I was still alive. “It doesn’t have to end like this. I grew up in a crappy home. I want to provide a loving home to my kids. I want to be a dad.”

So I engaged in the battle of getting myself out of the woods. I called for help. I cried and called. I don’t know how long. When I’d wake up, I’d start calling again. My brother felt a tugging sensation, an urge to go in the woods and stack firewood. He saw me bleeding to death. He got my grandfather, called an ambulance. Another few minutes, and my life today would not be a reality.

People are gonna die today and tomorrow, and their last thoughts are gonna be, “I shouldn’t have done this.” And they’re not gonna get that second chance.

What were the reactions to what you did?

It happened almost immediately. I remember lying in the field. I woke up and was faced with a deputy sheriff looking at me. “Who did this to you?” “I did this to me, sir.” He scowled at me, shook his head and walked away. I didn’t want to die alone. I thought he left me to bleed to death. I wished he could kneel next to me, be with me.

A few days after the shooting, they closed the curtains and wheeled up next to me to talk about the shooting. One thing jumped out at me. They said, “It would have been better if your legs had been cut off, if you had been burned in a fire than to have those scars from suicide.”

I remember thinking, “I’m so glad to be alive.” But then there was this condemning: “You. Shot. Yourself. You have to create a lie about how you got shot. You can’t say you did it on purpose. Tell them you were hunting and fell on your rifle.” Later, I was at a conference for teens, and there was an open mike for people to share stories about how god helped them. I got up and told my story. And I remember the kids, they wrote me for months, telling me they had been suicidal and got help. I repeated this a few times at different camps. I was helping people. But then they told me, “Don’t ever share this in public again.”

I tried to get into the Army. I’m standing in front of the doctor, and they see the bullet hole. “Did you put that there?” They said, “You’re unfit.” I was like, “I’m sorry. I was a kid! 16! It’s not like I was 35 and did this.” It was so bad that I could never be forgiven for what I’d done.

So I fell into a depression in my 20s, and I became homeless when I was 28. I can never escape my suicide. I said I would never talk about it again. Then my wife said, “You have to tell.” I can cope with it. I can deal with the stigma. There’s nothing they can say I haven’t heard 20 times.

You wife, why did she urge you to speak out?

I got to the point where I thought that if I have a relationship with someone, I brought it up. I told her, and she wasn’t bothered by it. Occasionally I would share it at Sunday schools, and she saw people’s responses. When I started writing, it popped in my head. “You can tell this story. You were inside of it. You know how it entices people.” I get calls from counselors, ‘Will you talk with my client who’s suicidal?” When you deal with death, you can’t walk away from it. If not for her, I never would have talked about it again.

How did you start putting yourself out there?

So far, it’s been limited. I’ve sold 100 copies of my book. Amazon offers resources now for anyone to publish to different platforms. The self-publish movement has taken off. I had thought about traditional publishers, but I’ve sent 200 e-mails out, with maybe a few responses. I think my suicide prevention platform is to write, like, 100 books in my lifetime and link every book back to my suicide prevention book. If I want to write a horror book, a science-fiction book, and if someone reads about the author, they say, “Oh my goodness.” And I’ve wanted to be a public speaker, but it’s difficult to break into the market.

But you’ve tried?

Yes. I’ve driven places, knocked on the door, even handed out fliers, and then three people come out. If you know suicide, for every death there’s 25 people trying. How many people in my area are contemplating this? It’s rampant, and it can be avoided. It’s not like cancer, with no cure.

Where are you again?

In Maryland.

Did you say gun safety is a motivation?

The guns I had access to, they were actually safe. I had grown up around firearms. Had they not been around, I know I would have … There was a mountain with these rocks, and I had thought about climbing up and throwing myself off. Guns are so prevalent because they’re so lethal. If the Golden Gate Bridge was in every community, that probably would be the top route to go. People like to make a statement. The Golden Gate Bridge is a statement, this romantic air about it, I suppose. But guns, it’s done. I never wanted to get caught up in that platform. So many of my friends own guns, I didn’t want to lose their support.

There’s other ways to cope. More and more people are stepping out, not afraid of stigma. “If we can, maybe you can get help.”

How has your family taken this?

Not well. It became brushed under the rug. I’ve had no contact with them til this day. I was an embarrassment. A year after the shooting, I was dragged into the woods and made to stand in front of the tree. “Boy, you did this to yourself. You have to own it.” I had to touch the tree. My family told me how pissed they were that I did this to them. It was never why I did this. It was always the aftermath. The crime of shooting myself was greater than the abuse I was enduring at home.

Why did they make you touch the tree?

To get over it. To confront my fear. I could not go into the woods. I could see them from my bedroom window. My family is active in the woods. I had an issue with them, PTSD. My father was always needing help in the woods. For a year, he gave me grace. One day I had a biology report to collect bugs. I went into different woods. As I was coming out, he saw and said, ‘It’s time for you to go down there.” He dragged me down, made me touch it. I thought the ground was gonna swallow me alive.

I was under a psychiatrist’s care for eight to 10 months. I enjoyed it. It made me feel better. I could talk openly. But it was such a shame to have to see a shrink, and I was told, “When you’re 18, you’ll have to hide this.” Whenever you fill out a job application, there’s the question, Have you ever had psychiatric issues? Have you ever been convicted of a crime? No. Have you been hospitalized for a suicide attempt? Yes, I have. It’s humiliating. I’m still a criminal. I try to tell recruiters. I wanted to be a firefighter. “Yes, sir, I attempted suicide.” When I told the story that I shot myself, it was like I was done.

They would have been OK if you had taken pills instead?

I think so. Based on the responses, when I talk to others who have said they’ve been suicidal. They said, “I’ve been suicidal.” I said, “So did I.” “What did you do?” “I shot myself.” And then they say, “I’ve been suicidal, but I’ve never been able to shoot myself.” I’ve had people say, “You are the real deal.” That’s why it’s important to try to fight and save lives.

The people I talked to were further up the road than me. Thinking, taking some pills. I said, “But both you and I attempted suicide.” Then I thought, “Maybe we’re not equally committed.” They were being dragged down the road to something they would regret. I just watched the video on YouTube of the man who had shot himself in the face and survived. The people who jump off the bridge. I think that frightens a lot of people. Just an observation. I’ve heard it more than one time. Since I released my book, talked to people who said, “I’ve thought about killing myself, but I never thought about shooting myself.” There’s a disconnect there.

And again, it starts with a thought. If you can interrupt the process early, like a progressive illness. If you can reach them sooner, before they have had several attempts of suicide. Because the odds of trying again are so high.

Has that ever been a thought for you again?

Good question. Twelve years after the shooting, I had gotten a divorce. I had nowhere to go, living in my car, penniless, sleeping in a parking lot. All my possessions in a bag. In the middle of night I thought, “What am I doing? How did I crawl out of the woods and have my life end up like this?” Having shot myself, I wasn’t afraid to do it again. I had broke something in that. But I vowed to myself that day, “Never do that again.” There’s always things to live for. And I enjoy coffee. And I looked at that and thought, “If I take my life, I won’t have another cup of coffee. I will deny myself the chance for another cup of coffee.”

I started inching forward. The next day, I rewarded myself with a cup of coffee. Within two years, I was married, I had a house. That’s what I write about in my book. I acknowledge a higher power. Like if I had been in the woods, if I had laid there, I would have died. But I thought I wanted to be a father.

Some people are addicted to drugs, alcohol. For me, it was thoughts of taking my life. But I know it’s not the way to handle life. I always find a way. Now I have children. I could never do that to them. I’d be denying myself a chance for a better tomorrow. The crap we think is worth taking the life for, it always burns away. So I’ve moved forward.

The stigma, has it gotten better over the years?

I’ve noticed … I can’t imagine trying to get a job right now. That’s why I’m a writer. The overall culture, I think, with younger folks, 35 and younger, I think, is more open. Probably the boomer generation is unwilling to talk about it. There’s a strong state of denial in our churches and schools. I think people are unwilling to accept the fact that people they know are contemplating suicide right now. Either they won’t see it or they’re fearful. It’s OK to have the conversation, as long as it’s nobody you know. If it’s the guy down the street, it’s OK to talk about him. But if it’s a son, a husband, it’s unacceptable. Because that would mean something’s wrong.

My book came out at Junior Seau‘s death. My friends put an online a link to WebMD on how to recognize symptoms of suicidal thoughts. They asked friends to share the links. No one did. I wrote this post, “There will be people in your life, in 12 months, someone will die of suicide.” Within 90 days, three people I knew had already lost somebody in their circle. And I asked, begged, “Please, just share this. Demonstrate that you’re willing to be that person they can talk to.” I’ve posted photos of 10-year-olds who have taken their life. Everybody assumes it’s a guy in his 40s, jobless in a trailer, who takes his life. What about a 10-year-old?

Where I live, there’s not one billboard recognizing what to do if someone feels suicidal. There’s nothing, no public awareness to say, “Hey, life has really taken a dump on me. I’m reduced to living hour by hour. I’m ashamed of saying this, but life is not worth living anymore.” How to reach out to someone like that? The megachurch pastor whose son died by suicide. It’s out there. But it’s a lot better than in 1987.

You mean, people willing to talk about it?

Right. You could not talk about it back then. I remember thinking, “The police are going to arrest me,” while I was in the hospital. People were whispering about me. Again, I was so glad to be alive. The air was so sweet to be able to breathe after fighting that violent death. To be able to enjoy life, to walk out of the hospital. But then I was met with this monster! I didn’t know what I was dealing with. It was that stigma.

On job applications, do they really ask about a suicide attempt?

On certain jobs, it will. If you want a job with government. I had tried law enforcement. I would imagine for a government security clearance. It’s on there, on some applications. “Have you ever been hospitalized for depression or issues related to suicide?” If I had taken some pills, I could lie about it and say, “No, I’ve never had issues of suicide.” But when they take off my shirt for the physical, there’s the bullet hole and all the scars. “Well, how did you come by those?” My lie I came up with was so weak, people with firearms experience would say, “That doesn’t make sense.” The last time I went through this was 2001. After the attacks. I tried to get a job with police. I filled out the application and never heard back.

The suicide prevention messaging, is it working?

If I’m an average guy that has been laid off, unemployed two years, my home in foreclosure, a college education, never had problems with the law and suddenly have thoughts of ending my life every day, if I struggle to get out of bed, my friends are people I play golf with, go to church with, as far as I know, they never talk about suicide, they’d think I’m crazy … I have no idea there’s groups out there like that Out of the Darkness. I did not know these groups existed until I published my book a year ago. I started reading about these national groups. Where have they been? What they’re doing is a godsend, no criticisms, only I wish they were louder. I think in time they will reach that place, and they’ve come a long way. But for a guy who’s never been initiated into the world of suicide, they don’t know they exist.

A year ago, with PTSD, I had a breakdown and went to the ER. I had no insurance, and they told me to go to the local county mental health department. They laughed at me and said it would be a year before I could see anybody. I broke down and sobbed in the lobby. Then they stopped laughing. I dealt with it on my own at home. I found stuff online. It’s atrocious the way they treat mental illness. You know?

When that gun went off, I saw it for what it was. I wanted to live. I would not have fought that battle to get out of the woods. I wanted to live. I wanted to run into the arms of society, enjoy my life.

What would you like to see changed?

At a minimum, there should be billboards in every county. A billboard. So it’s not fearful to talk about. So everyone from a 10-year-old to an elderly person knows they’re not alone, that its not crazy to think about taking their life. With a 1-800 number. What happens is, you get in this crisis. I had been under the pull of suicide for so long, I just needed that one crisis to push me over. If I could just call a 1-800 number and call someone to calm them down, encourage them to get to a hospital to get care. Start with a billboard.

What more would you like to do?

I would like to visit high schools. Have psychiatrists send me a study. I’ll fill out every clipboard, questionnaire. Start asking us, interviewing us. Maybe you can study enough of our experiences so you can better educate yourselves to save lives. It might open your eyes. People ask me, “Why did Joe kill himself?” I say that’s the wrong question. How did he kill himself? We aren’t born to want to kill ourselves. That’s a hard wall to overcome. How did someone override their fear of death enough for them to take their life? How did they overcome their fear of dying?

Billboards. Invite survivors to speak, to talk to military people. I shouldn’t have to pull teeth to talk to anybody. I want to share my story. If I can save one life, that’s one less life I have to read about in the newspaper. It’s become a personal thing to me. It felt like a monster pulled me down, like a crocodile, that grabbed me, pulled me under. Oh my god, I could not have imagined. I understand what it feels like.

What have I not asked that you’d like to add?

The last time I talked about this was when Reagan was president. The last time I looked at the statistics, they’d gotten worse. The 10th top cause of death? At least half of those people probably deep down don’t want to do it. Think of all those human beings we could give their life back to them. It’s unacceptable. Why are vets dying every 65 minutes? Why do you have to have this blog to address this issue? Where’s the humanity? We can operate at a higher level of compassion and understanding to fellow man. And then we can save more lives.

Who else are you?

I would say I am, without a doubt, a dad, through and through. My kids don’t just go to bed and get tucked in. Seven days a week, we have a 30-minute process of getting tucked in. We wrestle. Stuffed animals come alive. I treasure it. My wife is my best friend. I love spending time with her. I love to write. I love my family.

How old are your kids?

9, 7 and 6.

Will you ever tell them what happened?

Good question. Last year I had a tent rented where I was selling the books, discussing the topic in my community. Some people came, talking. And my little girl said, “My daddy shot himself.” I remember the looks people gave me. I said these words to them, “I can’t hide it. When Daddy doesn’t have his shirt on, they see the scars. So she knows about it, as much a 9-year-old can know about death and dying.”

If it’s hereditary, I watch them. I’m very active. If there are any issues with mental health, I will fight tooth and nail to make sure they get the care they need. I know they’re very proud of what Daddy’s doing.

Talking with Cathy Naughton

It was the most simple of requests: “I would be happy to have you interview me regarding my experience with being suicidal.”

Cathy Naughton approached me after I reached out to the tiny number of peer-run crisis services across the U.S. in an effort to learn more about what they do. A soon-to-come post will focus more on those details.

Cathy is in the rare position of working in both a peer-run center and in a more traditional crisis center in California, where she’s the only staffer who’s “out” about her personal experience. “I feel like in the peer-run place, I can be more like somebody that has faults,” she says. “Whereas in the more traditional crisis respite house where I also work, I feel like I have to be more of, you know, a staff person.”

Here, she talks about some of the weaknesses in the mental health system, from overcrowding to non-inspiring environments, as well as what she’s told her three children.

Who are you? Please introduce yourself.

My name’s Cathy, and I’m a single mother. I have a BA in psychology, and I work at a crisis respite house. I’ll be starting full time in a week. I’ve been on call there and at 2nd Story. 2nd Story is a respite house where the people who work there are also people who’ve experienced mental illness issues in their own lives. It’s run by peers.

I feel like I have to go back for background. I was born in Hawaii. I’m white, I was teased a lot, and I also have a deformed hand. I was teased a lot in junior high. I think that was the foundation for a lot of my depression and being unable to deal with people. So that went on a daily basis for a couple of years. That was before bullying became this big deal. Back then, it was a non-issue, completely ignored.

I started using drugs back then, and alcohol, and I got clean and sober at 16 for the first time. I had seven and a half years clean and sober, and over that period of time I experienced huge depressive episodes but had no idea that’s what it was. I just knew I was fucked up. Yeah, I was trying to get through college and would, like, sit in class trying not to cry the whole class. I just knew that wasn’t normal, something was wrong with me. I never sort of linked the thought of any sort of diagnosis with myself. So after I had seven years clean and sober, I finally said, “Screw it, I’m not getting any younger.” I was like, “If this is sobriety, being this, like, emotionally depressed, then screw it.” And so I made the decision I was going to try using drugs again. And I started using some meth, which was just wonderful for a while because it was exactly the feeling that I was missing. You know, the up feeling.

OK. So, at 25, I became pregnant for the first time. And that’s when my life just collapsed. I made the decision to move in with the man, the father, and he became really abusive. Mainly emotionally. I was sort of trapped there. I wasn’t working anymore, I was pregnant, it was a horrible situation. That’s when I truly wanted to kill myself. Constantly. That was all I thought about. But I never really did anything because I was pregnant. If I tried, it would cause, like, premature labor, you know, the baby might try to be born as I was dying. I envisioned scenarios that were just horrible. So it wasn’t until the baby was born that I started cutting on myself. Some people do that as a drug, for an endorphin release, but for me, it was kind of practice. Every time, I went a little bit farther, bled a little bit more. And the point that I truly tried to kill myself was when my son was about 1 and I was fully convinced that he would be better off without me around. That just seemed like the truth. In depression, it’s like, it feels like it has always been and will always be. Like a physical pain. I just felt I completely screwed everything up.

So my son’s father took him away for a day. I got a razor blade. We just had a shower, not a bathtub. I just sat on the floor next to the shower with my hand under the water and proceeded to try to kill myself with, like, a slow kind of a slow process. And I remember as I went along, your body starts to shunt blood away from the non-crucial parts of your body. I got really nauseous, started throwing up. I had to go to the bathroom. I was trying not to pass out. I’m not sure how long it was. I would keep re-cutting if it stopped bleeding. I could have been there an hour or two, I don’t know. Eventually, I passed out. And they came home and found me and called an ambulance. And so I went to the hospital and was in the ICU overnight. I needed four units of red blood cells. I don’t know how many pints that is. And then I had my first experience being 5150ed after that. In the behavioral health unit.

And and in a way, it was like a big relief, because finally everybody knew how screwed up I was. I’d been sort of trying to be normal, trying to survive and not telling anyone how bad things were. At that point, it became apparent, obviously. And for some reason, after that time of trying to really kill myself, I came to the realization that, you know, the worst thing you could possibly do to a child is try to kill yourself, because they could never really come to terms with you, with what happened. It’s like the ultimate, what’s the word, abandonment. And it’s like, you can be a fucked-up parent, but as we grow into adults and can come to terms with our parents as we become adults ourselves, we can sort of work through that stuff. But if you kill yourself, your child never has the opportunity to do that. It’s like you just left them. So that knowledge and belief was at that point what kept me from trying to kill myself again. And there were times, I have had times, where I felt totally trapped: “Oh my god, I can’t kill myself,” you know, like it was just a terrible thing I couldn’t kill myself because I have these children. So when I’m in depression, that’s where I can’t go.

I have seven years clean and sober again now, and this time around I’ve been on medication, anti-depressants. And I still have ups and downs, but it’s not as down as it was without the medications. You know, it’s more manageable. Life is more manageable, now that I’m seeing someone and am on medications. Not everyone believes in medications, but I do personally for myself. There’s a big trial-and-error factor, just trying to find what’s right for you.

How old are your kids?

My oldest is 15, and I have an 11-year-old and a 3-year-old.

What do they know? What do you tell them?

I don’t. You know, I’m pretty honest with my kids, but at the same time I don’t want them to be afraid that I’ll do something. They know Mom has depression, takes medication for it. I try to keep an eye on them because it can be genetic, although there usually needs to be trauma along with the genetics to kind of kick into gear.

How were you treated in the emergency room? Sometimes the treatment of attempt survivors isn’t the most comfortable.

They just kind of, like, rolled me into a quiet corner and ignored me, which was kind of weird. I took an EMT class long ago, and I know the first thing they do is assess the scene, figure out how much blood was lost. Since I was losing my blood down the shower, they just saw, like, a pint and thought it wasn’t that serious. So it wasn’t until they had done a blood test that they realized how much blood I had actually lost. I was in and out of consciousness, feeling nauseous. And then I didn’t remember anything until I woke a day later.

What made you decide to study psychology?

They always say the fucked-up people go into psychology, right? I just, I always wanted to help people. From when I was young, when I was clean and sober at 16, I thought I would be a drug and alcohol counselor. Now I sort of ended up in mental health, which, mental health and drug and alcohol are very intertwined anyway.

How did you decide to be open about your experience?

I feel like, as someone who has been there in the behavioral health unit, I feel like it’s good for people to know that I’m not viewing them as, like, less than or stigmatized, you know what I mean? I’m not looking down at them. I’m on par, we’re all equal. And I think it can be hopeful, you can give people hope that someone that used to be there has been able to move on, that life can get better. At the same time, I don’t want to, like, I mean, it’s about them. I don’t want to be doing the, “Oh, it reminds me of me,” to be one of those people bringing it back to themselves. It’s not about the staff, it’s about the client.

I work in two places, one peer-run and one more traditional. It’s kind of interesting going back and forth. The peer-run is just a lot more egalitarian. I feel more relaxed when working there. I feel like I don’t have to act like I’m a professional, which would be hard to do sometimes. A part of me feels like I’m acting a role in my job, trying to portray myself as someone who has my shit together. I feel like in the peer-run place, I can be more like somebody that has faults. Whereas in the more traditional crisis respite house where I also work, I feel like I have to be more of, you know, a staff person.

Isn’t it possible that other staff at that more traditional house have had their own experience?

Yeah. Thinking of all the staff, though, I’m the only one there right now with major depression. It’s only me who’s “out” about it.

Should there be more encouragement to be out?

I think so. It would make it less of a stigma. But at the same time, you don’t want to weigh people down with your own shit. There’s got to be a happy medium somewhere. A case-by-case basis type of thing.

What’s the difference in your approach to someone when working in these two places?

I don’t know that I really am different when it comes to a one-on-one talk with somebody. You know, fairly often I do let them know that I’ve been there.

Is there anything you’d like to see changed in addressing and treating people who are suicidal?

The main thing that comes to mind is the lack of basic funding. One of the buildings I work in desperately needs paint. This dingy place is falling part. It’s depressing, you know, and you’ve got people coming straight out of behavioral health and trying to go back to some kind of life, and it should be more uplifting. Instead it’s this environment that’s, like, ugh. It would be so nice if it could be more put together. I think your surroundings do matter. And then we’ve got people who are being sent home when they shouldn’t be sent home. There are not enough places for them. It’s just sad to see sometimes.

Sent home from a psych ward?

Yeah, we’ve had people let out, people who can’t stay at the crisis respite house or 2nd Story because they’re stable enough to not be in the hospital, and the hospital releases them, but we’re not equipped. We aren’t a locked facility, and we don’t have a high staff-to-client ratio. So they just end up on the street or at home, if they have a home. So they end up back in the hospital, or worse.

What’s the trend like in funding these days?

I think it’s just, every year a little bit more gets cut.

How to make the conversation more comfortable about suicide?

The only way is to do it, talk about it. The more you talk, the more OK it becomes to talk about it. People have this fear of mental illness. You know, like people killing people, like the danger factor. And you know, depression, it’s like I’m only a danger to myself. I don’t know, it seems like some people think that there’s more to it, that I’m going to take a bunch of people out.

But that would take so much effort when you’re depressed.

Yeah.

How about coping, avoiding especially bad days?

I can talk to people, I can write, but honestly, my mind, it does go back to, like, “I wish I could” … I get these urges to hurt myself. And I just don’t. But the desire, you know, it’s almost like the first place my mind goes. Like a reactive response to stress, sadness. And then I just have to move beyond that and do something different.

How do you protect yourself in your work?

Sometimes I talk to people. You know, outside of work. Anonymously. But somehow, I’m just able to keep a split between work and life. It’s like I have this, yeah, you can’t get too involved because it’s not effective at all, you’re just another patient, you know? To do a job, it has to be a job.

Is there any reason why peer work isn’t as widespread as any other mental health service?

I think people with mental health issues are stigmatized, so who wants to put them in charge, right? You know, we have to see that we are everywhere, we are everyone. And we can be at different places, you know. And just because I, that one time, was cutting into my wrists with a razor doesn’t mean that I can’t be safe, happy, healthy 10 years later and be helpful to others. I mean, change is possible.

You’re a completely different person.

Right. Also, as a recovering drug and alcohol addict, that’s also a big stigma. People like to keep bringing it up. Like my kids’ father. Even seven years clean, they’re still like, “Are you using?” It just keeps getting brought up.

Finally, who else are you?

At this point in my life, I’m just trying to be quote-unquote normal, to just be a good parent and have a job and go to work. I’m dating again after, I guess, four years. I’m just trying to be a normal person.

And outside of work?

Right now, I’m doing the “Drive the kids to baseball, drive them over here” … There’s not a lot of down time outside of work. So. I try to get enough sleep.

And your youngest is still at home a lot of the time. Your answer might be different in a couple of years, when everyone is at school.

Totally.

A seat at the new Death Cafe

Here’s one of the more unexpected chances to talk about suicide. National Public Radio reported this month on the new Death Cafe, a series of events in the UK, the U.S. and elsewhere where people meet for tea, cake and some comfortable discussion about a sometimes uncomfortable topic. Founder Jon Underwood welcomed a post about the recent moves to give attempt survivors a voice and the need to be open to the issue. You can read it here. Early responses on the Death Cafe Facebook page were positive. “Those who have attempted suicide certainly don’t deserve the stigmas that get attached to them!” one person wrote.