Behind the Mask: Silent Suffers and Issues of Suicide

Introduction:

Stephen Chbosky writes “That’s why on the back of a brown paper bag he tried another poem. And he called it “Absolutely Nothing” because that’s what it was really all about. And he gave himself an A and a slash on each damned wrist. And he hung it on the bathroom door because this time he didn’t think he could reach the kitchen”. This is an excerpt from a poem known as the suicide poem, seen above, which is featured in the book Perks of Being a Wallflower. Suicide is a mental health issue that is a taboo in American society, there are a lot of stigmas not just around suicide but, also mental health in general. Individuals refuse to believe that mental illness diagnoses are real and that the brain can “get sick”. It is an ignorant assumption that has allowed the number of suicides to increase yearly. So what can we as community members in our various roles do to decrease the number of deaths by suicide? What can family members of individuals who have died by suicide do? What can survivors of attempted suicides do? The answer, which can be found in the video below, which will introduce you to the themes of this blog post.

In this blog, I will begin by conceptualizing suicide and other related terms important to the discussion of deaths by suicide. Then I will talk about intervention strategies that are in the QPR model. From here I will talk about the effects of suicide and the stigma associated with suicide on survivors, families, and the community. Finally, To add something new to the discussion I will be discussing suicide within the LGBT+ community, highlighting the Trevor Project and The It Gets Better Project.

Conceptualizing Suicide

When we are talking about suicide, and deaths by suicide it is important to conceptualize what we mean. According to the Nation Center for Injury Prevention and Control, suicide is defined as “death caused by self-directed injurious behavior with intent to die as a result of that behavior”. According to the CDC “There were 41,149 suicides in 2013 in the United States—a rate of 12.6 per 100,000 equal to 113 suicides each day or 1 every 13 minutes. This makes suicide the 10th leading cause of death in the United States (May, 2017). Think about that for a minute, 113 individuals every single day. This is a serious mental health issue that can have devastating effects not only on the family and in some cases the survivors, but also on the community. Suicide used to be thought of as something that was centered on the individual, believed to be something intimate and personal (Vaccaro, 2017). However, we are now seeing that the social structures and culture determine suicide rates through factors such as social stability, social bonds, social interactions, social unity, and social regulation (Vaccaro, 2017). It is also important to note when we are talking about suicide there are four different types of suicide: altruistic, egoistic, anomic, and fatalistic (Vaccaro, 2017). Altruistic suicides occur in groups where social bonds are strong, making people motivated by the idea of bettering the group, while Egotistical suicides occur in groups with weak social bonds, and are motivated by personal reasons (Vaccaro, 2017).Anomic suicides occur when social institutions are undermined, while fatalistic suicides occur when social institutions are overdetermined (Vaccaro, 2017). No matter what the type of suicide though one thing that we know, specifically from the individuals who jumped off the Golden Gate bridge and survived was that, after they jumped they regretted it, they didn’t want to die. One instance of this is reflected in the following example “On the bridge, Baldwin counted to ten and stayed frozen. He counted to ten again, then vaulted over. “I still see my hands coming off the railing,” he said. As he crossed the chord in flight, Baldwin recalls, “I instantly realized that everything in my life that I’d thought was unfixable was totally fixable—except for having just jumped” (Friend,2003). Up until that 4 seconds of falling at 75 miles an hour, the individual with suicidal ideations sees suicide as their only means of escape from the demons that haunt them in their present realities, so they develop a

It is also important to note when we are talking about suicide there are four different types of suicide: altruistic, egoistic, anomic, and fatalistic (Vaccaro, 2017). Altruistic suicides occur in groups where social bonds are strong, making people motivated by the idea of bettering the group, while Egotistical suicides occur in groups with weak social bonds, and are motivated by personal reasons (Vaccaro, 2017).Anomic suicides occur when social institutions are undermined, while fatalistic suicides occur when social institutions are overdetermined (Vaccaro, 2017). No matter what the type of suicide though one thing that we know, specifically from the individuals who jumped off the Golden Gate bridge and survived was that, after they jumped they regretted it, they didn’t want to die. One instance of this is reflected in the following example “On the bridge, Baldwin counted to ten and stayed frozen. He counted to ten again, then vaulted over. “I still see my hands coming off the railing,” he said. As he crossed the chord in flight, Baldwin recalls, “I instantly realized that everything in my life that I’d thought was unfixable was totally fixable—except for having just jumped” (Friend,2003). Up until that 4 seconds of falling at 75 miles an hour, the individual with suicidal ideations sees suicide as their only means of escape from the demons that haunt them in their present realities, so they develop a plan and make a suicide attempt. What happens after the attempted suicide or death by suicide though? How are the families and in some cases survivors, and communities impacted by the individuals choice to end their life?

Impact of Suicide and Stigma

Death by suicide is one of those deaths that can cause a lot of emotional trauma to the survivors, families, and the community. A point constantly made on the panel was that “as humans, we always want to know them why. Why did that person commit this act of self-harm, but in some cases we never will know” (May et al, 2017). It’s important to remember that all of the feelings including the guilt are natural because if someone was determined enough to make an attempt to end their life, you can’t always save them. That being said these are some of the impacts that suicide holds on survivors, the family, and the community.

Survivors, Family, and the Community

Below is a video to introduce the concepts and themes in this section of the post it is the story of Mr. Hines who jumped off the Golden Gate Bridge and survived.

During the panel discussion, a mother shared with us the story of her daughter’s death by suicide. Her daughter was an amazing person, but one that had struggled for a long time. She was badly bullied at school by her peers, the effects of which were elevated by social media. Her daughter’s death was 5 years ago and she said: “You are never ok, life may never be normal again, but you learn a new normal” (May et al, 2017). She expressed that you live with an amount of guilt and blame, even if you do everything right, that you are worried about the contagion effect and fearful for other families. One of the men on the panel said if there are three things that you take away about suicide it’s that “Hopelessness + Helplessness + Worthlessness = Suicide” (May et al, 2017).

Sometimes but not always people survive their suicide attempts and when they do they have to find ways to transition back into their lives, and how to live a healthy lifestyle so they don’t relapse. Many of these survivors transform their pain into service (May et al, 2017). They go around telling their story about what led them to suicide and what their thoughts were after they made the attempt on their life. They share their journey to recovery, and how they refrain from relapsing (May et al, 2017). In doing this they are doing two things: building supports for people who are struggling and making an effort to debunk the stigmas associated with suicide. The big take away here though was that suicide is a mental illness and a medical cause of death. We have to treat the brain like any other organ, and we need to treat the mental illness like any other illness (May et al, 2017). How do we do that? What does that process look like? What interventions can we provide to prevent these things from happening?

Intervention Strategies: The QPR Model

The QPR model, introduced in the video above, stands for Question, Persuade and Refer. QPR is not a form of counseling but a way to offer hope through positive actions (Faish, 2017). In the training they mention that the strongest predictors of suicide include things like: previous attempts, talking about suicide, planning suicide, having a wish to die, depression, substance abuse, and the recent suicide of a family member (Faish, 2017). Knowing these signs you may be able to get an individual the help they need before they can inflict harm on themselves. Sometimes the clues that individuals will give you can be indirect or verbal clues so you really have to pay attention to what they say and be an active listener. (Faish, 2017). In addition to verbal cues, there are also behavioral and situational clues. One thing that was emphasized was that you have to directly ask the individual “Individual, are you going to harm yourself”, they say it’s not in how you ask it but it’s that you ask it (Faish, 2017). Also, if you disclose about the suicide to someone such as a console or administrative personnel you are not violating an individual’s trust, and if you are a medical provider you can breach confidentiality if a life is at stake (May, 2017). I personally feel as though everyone should be trained in this model as it is very useful.

Suicide and the LGBT+ Community

A topic briefly mentioned in one line of Dr. May’s presentation today was the prevalence of suicide in the LGBT+ community. This one line didn’t provide any statistics or numbers though so, due to a personal interest in Human Sexuality and the LGBT community I knew of some initiatives that were set in place to help LGBT individuals with crisis intervention and suicide prevention. I figured that they could provide those statistics. These organizations are: The Trevor Project and the It Gets Better Project. I first found out about these services through YouTube. Tyler Oakley one of my favorite YouTubers often talked about the Trevor Project. I stumbled across the It Gets Better Project when I worked for The Office of Housing Dining and Residential Living at IUP. It was my last year and I was a Head CA in one of the residence halls. One of the other CA’s from a different community spread a rumor not just in housing but in two of my honor organizations about my sexuality. I was bullied, stigmatized, and put in many awkward situations with the paraprofessional and professional staff. As a result, I spiraled. I withdrew from a job that I loved, I was depressed and I felt trapped because I knew that if I quit I had to pay back the cost of housing. I lost friends, and I ultimately left the honor organization after a long drawn out process with the advisor of the group and the national board. I was so hurt after four years of service I thought someone, anyone would help me. I was told that there was nothing that could be done because the whole situation was hearsay. I decided I no longer wanted to go into student affairs, and I questioned if I wanted to stay at IUP to continue my education.

It was my last year and I was a Head Community Assistant in one of the residence halls. One of the other CA’s from a different community spread a rumor not just in housing but in two of my honor organizations about my sexuality. I found out one night that November when my friend came over and told me about the rumor, and shortly after told me that he wished it was true. I had been trained on how to counsel residents through this issue but I wasn’t prepared to handle it when it was about me. I was bullied, stigmatized, and put in many awkward situations with the paraprofessional and professional staff. As a result, I spiraled. I withdrew from a job that I loved, I was depressed and I felt trapped because I knew that if I quit I had to pay back the cost of housing. I lost friends, and I ultimately left the honor organization after a long drawn out process with the advisor of the group and the national board. I was so hurt, after four years of service I thought someone, anyone would help me. I was told that there was nothing that could be done because the whole situation was hearsay. I decided I no longer wanted to go into student affairs, and I questioned if I wanted to stay at IUP to continue my education. Situations like this are hard to deal with and they can really impact an individual making crisis hotlines and other services really useful.

Trevor Project

The Trevor Project, founded in 1998 was made by the creators of the short film TREVOR. The organization serves as a resource providing crisis intervention and suicide prevention services to LGBT+ youth ages 13-24 (Trevor Project, 2017). Trevor a fictional character who faced unique challenges related to sexuality. The creators of this organization realized that in society there was no place for people like Trevor to get help. Peggy Rajski decided then to gather mental health experts and built a 24-hour hotline, and the Trevor Project was born. To give you an idea of how prevalent the suicide rates are in the LGBT+ community CDC data posted on the Trevor Project website reports Suicide is the 2nd leading cause of death among young people ages 10 to 24, and The rate of suicide attempts is 4 times greater for LGBT+ youth and 2 times greater for questioning youth than that of straight youth. In terms of the methods, the website reports Suicide attempts by LGBT+ youth and questioning youth are 4 to 6 times more likely to result in injury, poisoning, or overdose that requires treatment from a doctor or nurse, compared to their straight peers.To introduce you to the Trevor Project I have provided a descriptive video and the short film that the organization was created around.

The Short Film:

It Gets Better Project

Growing up gay is by no means easy. The stigma of being a member of the LGBT community is very powerful on an individual and many have a hard time identifying, and then exposing that identity to family, friends, and people in the community. The It Gets Better Project’s mission as states on their website “is to communicate to LGBT youth around the world that it gets better, and to create and inspire the changes needed to make it better for them”. In September 2010, Dan Savage and his partner Terry Miller wanted to inspire hope for young people facing harassment. In response to a number of students taking their own lives after being bullied in school, they wanted to create a personal way for supporters everywhere to tell LGBT youth that, yes, it does get better. The project took off and became an international movement supported by everyone from students to celebrities.

Big Idea:

Don’t just say nothing, do something. If you feel like someone is going to endanger their lives, directly ask them. If they respond in a way that concerns you talk them through where to find resources. Be persistent and engage in active listening skills. Act to eliminate stigmas. Suicides are medically caused deaths (May, 2017). Suicide is a mental disorder and having a mental health disorder isn’t bad. Finally, the Brain is an organ it can get sick like anything else in your body (May, 2017).

References:

Chbosky, S. (2012). The perks of being a wallflower. New York: MTV Books/Gallery Books.

Faish, C.. (2017). QPR Gatekeeper Training: Question Persuade Refer [PowerPoint slides]. Retrieved 7/11/2017

Friend, T. (2017, June 19). Jumpers. Retrieved July 11, 2017, from http://www.newyorker.com/magazine/2003/10/13/jumpers

May, R. (2017). Suicide, Mental Illness, and Substance Use: Current Issues [PowerPoint slides]. Retrieved 7/11/2017

May, R., Faish, C., Seaman, M., Morrow, K. (2017). Impact of Suicide Panel discussion. Indiana Pennsylvania.

The Trevor Project. (n.d.). Retrieved July 12, 2017, from http://www.thetrevorproject.org/pages/history

Vaccaro, C. (2017). Suicide [PowerPoint slides]. Retrieved 7/11/2017

What is the It Gets Better Project? (2016, August 17). Retrieved July 12, 2017, from http://www.itgetsbetter.org/pages/about-it-gets-better-project/

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