Mental Health Awareness Month: A more accurate picture of suicide & suicide risk

May 20, 2017 | 2017 Articles, Mental Health

by Noah Whitaker

Noah J. Whitaker is the coordinator of the Tulare & Kings Counties Suicide Prevention Task Force, and the Community Outreach Manager for the Tulare County Health & Human Services Agency. He writes a monthly column for KRL on mental health and suicide prevention.

May is Mental Health Awareness Month (MHAM). This is a chance to learn about signs and symptoms of mental illnesses and help fight stigma that keeps people from receiving vital care. This month’s column won’t focus directly on MHAM, but upon a recent challenge in the mental health field, the Netflix Original series 13 Reasons Why, which since its release has generated a lot of buzz, especially from mental health and suicide prevention organizations.

Why is 13 Reasons Why generating buzz and being called dangerous? Well, this stems from a building body of knowledge over the last fifty years as to our understanding of suicide and the forces that drive it. A substantial body of evidence highlight common concepts about human behavior, learning, and decisions. This show and others like it should be combined with a discussion about improving mental, physical, and emotional health, resources available to make those improvements, and about how we can make a difference at our school, place of work, places of worship, and other social groups.

One of the simple drivers of behavior is imitation. We often learn and understand things by watching others. We then copy that behavior. If we identify with an individual, we are more likely to imitate that individual’s behavior. If an at-risk teen watches this show and identified with the character Hannah Baker because the person has experienced one or more of the thirteen reasons Hannah decided to end her own life, the at-risk person might conclude that they too should end their own life.

To help illustrate this point, please view the following video:

A desire to conform combined with learning by imitating can be a powerful force that increases risk. This is one of the reasons that suicide prevention professionals are concerned about 13 Reasons Why and the information it does and does not show. What they are warning against is that the show does not depict positive behaviors, school professionals and adults responding appropriately, and interventions taking place to save a life. It does depict an identifiable teenager that experiences both common and uncommon stressors and abuse, the failure of adults to respond, and a scenario in which the suicide death is intended to exact revenge. This is all troublesome. So the trouble is that the show displays only the negatives and not the positives, which can lead at-risk viewers to more closely identify with the main character and have a desire to imitate her behavior.

13 Reasons Why did explore multiple factors that led to the death of the main character, but it stopped short of providing a more fully accurate picture of the situation. Suicide is not simple. Stories and articles that try to simplify and reduce suicide deaths to a single cause, such as bullying, are misguided and do a disservice to us. Suicide is the result of predisposing conditions, long and short term risk factors, feelings, behaviors, actions, and almost always an untreated mental illness. Suicide is the result of those elements combining with the failure of multiple social systems to support an individual, recognize risk, intervene, and provide effective treatment for restoration and growth.

Well, where do we go from here? How do we counterbalance the risk created by content like 13 Reasons Why? Perhaps the best place to start is to learn a more accurate picture of suicide and suicide risk. We’ll start by exploring changes that signal struggle. These help us to better understand and identify early conditions that elevate risk.

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These changes can be relatively sudden, or can be gradual shifts over a long period of time. The main key to keep in mind is that these are changes from a specific person’s usual pattern. Many of these changes are also associated with hormonal changes common in teenagers, but if one or more of these changes are causing problems with daily living, a consultation with a medical professional should take place.

Changes in sleep can cause large problems in a very small span of time. After as little as 24-hours, our ability to concentrate, accomplish simple tasks, control impulses, and regulate our mood all become compromised. If you or someone you know is having sleep disturbances, you should speak with a healthcare professional immediately. Do not let this one slide.

Changes in usual patterns often manifest as common feelings that may indicate distress. Feelings are usually temporary, but when they persist it is a good flag indicating distress. These flags present a great opportunity to check-in with a physical or mental health professional. Some of these feelings could be early signs of a possible mental health condition, or can simply indicate that a problem is developing. The earlier these problems are addressed, the more successful treatment and recovery will be.

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When changes and feelings are present, we’ll also usually see actions that show pain as a result. Each person is different and might show all of these actions, a few, just one, or might mask their pain and make it invisible to those around them. If you witness or recognize any of these actions, you should take action to seek treatment or encourage the person making these actions to engage in help from a primary care physician or mental health professional. Often, faith-based organizations also provide peer support groups to help address healthy ways to address these issues.

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If we listen to those who are hurting, who have feelings of distress, or undergoing changes, they will likely communicate to us about what they believe the sources of their problems are. The key in speaking with them is to listen without judgement. If we make statements that create blame, cast a positive or negative value on the person’s statements, or otherwise make them feel bad about the way they are feeling, the person will likely shut down and cease communicating, or they might recognize that you are not interested in truly helping them, so they’ll simply tell you what they think you want to hear. Listening without judgement takes practice. If we do so, we might experience the person communicating risk.

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If the person you are concerned about has communication that is odd, paranoid, delusional, or fixated, these can all be signs that the person is experiencing psychiatric distress and needs help. People who attempt or die by suicide often communicate their intent to those around them. Youth tend to communicate that risk to peers and friends, not to adults. It is therefore important that teens are educated about what to look for and how to appropriate obtain help.

Statements can be direct such as, “I am going to hang myself tonight,” or they could be passive such as, “I wish I could sleep forever.” If you hear a statement like that, or some of the other examples in the image below, it is time to seek help.

Three Next Steps:

1. Learn more about suicide risk factors and warning signs. Do by visiting the American Foundation for Suicide Prevention’s website by clicking here.
2. Learn about warning signs of mental illness. This can be started on the website for the National Alliance for Mental Illness by clicking here.
3. Look up your local Mental Health or Behavioral Health Department, and find out if they have an advisory board. If they do, attend it. This can help you learn about local resources for help, opportunities to get involved, and help advocate for more resources.

If you or someone you know is at risk for suicide, please contact the National Suicide Prevention Lifeline at 1 (800) 273-8255.

If you would like to learn more about the SPTF, refer to the contact information below.

For Non-Crises Information Related to the SPTF:
Suicide Prevention Task Force
C/O Noah Whitaker
5957 S. Mooney Blvd.
Visalia, CA 93277
(559) 624-7471
Coordinator’s Email: sptf@tularehhsa[dot]org

Check out KRL’s Mental Health section for more mental health related articles, several of which have gone up this month because of Mental Health Awareness Month-and one more that is going up next weekend.

Noah J. Whitaker is the coordinator of the Tulare & Kings Counties Suicide Prevention Task Force, and the Community Outreach Manager for the Tulare County Health & Human Services Agency. He has been married to his high school sweetheart for more than thirteen years, is a father of five living children, and is a survivor of suicide loss having lost his father nearly eighteen years ago in winter.


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