Jason was happily married and a proud father of three who seemed to have everything to live for. So, his family was shocked when he died by suicide. They had no idea he had been struggling with depression.
Because admitting mental illness still carries a stigma in many circles, Jason’s story is not unique. The highest proportion of suicides in America is among middle-aged white men. They die by suicide almost four times more often than women, accounting for 69 percent of U.S. suicide deaths in 2020. But the number of Black teens of both sexes who have attempted suicide rose 73 percent between 1991 and 2017, and suicide is the second leading cause of death for youth between ages 12 and 18.
“Generally, when people don’t talk about depression or suicidal feelings, it’s because they don’t feel safe,” says H. Jean Wright II, PsyD, Deputy Commissioner of Philadelphia’s Behavioral Health and Justice Division and Department of Behavioral Health and Intellectual disAbility Services.
“Often people say there were no signs,” Dr. Wright says. “That’s an indication we may be having conversations, but it isn’t specific, so we don’t always realize the person is reaching out or feeling out whether this a safe person. They might be talking about challenges, but not saying, ‘I’m feeling depressed.’ They may not name it, and most of us are not looking to hear it, so we don’t pick up on hints. So, a lot of times, paying attention to changes in behavior is more of a red flag.”
Of course, being able to detect changes in someone’s personality or other common symptoms of depression, such as changes to their sleeping or eating habits, requires a close relationship.
Learn to Recognize the Signs
Mental Health First Aid can help teach us what to look for and what to say. Philadelphia was the first big city to bring the program to scale by offering it widely, with the goal being to teach people the signs and symptoms of behavioral health challenges, including mental illness and substance use disorder, so that people in need can be referred for professional help. The class is both online and in person, with versions tailored to people who work with veterans, children and youth, public safety, colleges/universities, and faith-based organizations.
When talking with someone about suicide, be genuine and lead with concern, Dr. Wright says. “Use ‘I’ statements – ‘I’m concerned’ and back it up with examples: ‘Normally, we have coffee together, and I haven’t seen you coming in. Is there something you’d like to share with me? I just want you to know I care about you, and I’m here to talk.’ They might be testing the waters to see who is willing to go down the road with them. Then you have to be there when they need you.”
Bringing up the topic of suicide isn’t likely to introduce the idea to a person in pain. “They’re actually relieved that people bring it up,” Dr. Wright says. “I wouldn’t go there immediately. Start with concern, and the next questions might lead up to it. Ask, ‘Have you thought about suicide? If they respond with a ‘yes,’ then ask, do you have a plan? Do you have the means to carry it out?’” You’re assessing how serious the plan is and whether they have the means to carry out a plan. If so, then you know it’s an emergency.
Public Discussion Helps Erase Stigma
Public conversations are also important because they can encourage and give strength to people who might not have close personal relationships. One study of the effectiveness of an anti-stigma social marketing campaign in California found that social media posts led more individuals to interpret their symptoms of distress as requiring treatment.
Fortunately, stigma around seeking help for mental illness is lower among younger people. A 2020 national survey found that 90 percent of teens and young adults experiencing symptoms of depression are researching mental health issues online, and most are seeking out other people’s health stories through blogs, podcasts, and videos.
Numerous celebrities, from Michael Phelps and Demi Lovato to Dwayne “The Rock” Johnson and Lady Gaga, are sharing their struggles with depression, highlighting the issue and helping to spread the message that depression can affect anyone — even those who seem to have it all.
“Suicide is not a respecter of a person’s age, race, or religion — it impacts all of humanity,” Dr. Wright says. Families, organizations, and faith communities can all be safe spaces to talk. “People need to know it’s okay to not be okay.”
If You Need Help
If you or someone you know is in immediate distress or is thinking about hurting themselves, call the National Suicide and Crisis Lifeline toll-free at 1-800-273-TALK, (8255) or call or text the new 988.
- Mental Health First Aid
- Philadelphia Department of Behavioral Health and Intellectual Disability Services
- Healthy Minds Philly
For more information about self-care strategies for mental health and where to find help, visit ibx.com/knowyourmind.