Understanding Mental Health & The Stigma

Reprinted from Southeast Daily Journal

It wasn’t all that long ago that many people wouldn’t say “cancer” in polite conversation. Because the disease was so deadly and so poorly understood, mentioning that someone had The Big C could seem to imply that the person had brought the misery of the disease on himself or herself.

Although that stigma persists in some ways—lung cancer, for example, is still culturally tied to tobacco use—things have gotten a lot better. People shave their heads in solidarity with loved ones going through chemo, and breast-cancer pink is the stuff of corporate-marketing legend.

Todd Woodfill, the executive director at the TW Foundation (DefeatSuicide.com), hopes Americans’ understanding of suicide is on a similar path. “Cancer was shameful to think about or talk about, which shows you how much things really can change,” he told me in an interview at the Mission 22 military suicide prevention dinner, co-hosted by the Tampa Warriors Hockey Team. “Mental health is just now undergoing that period of growth and transition that’s informed by science, but the average person doesn’t really understand all that yet.”

Even in psychiatry, Woodfill explained, suicide was “kind of an orphan topic, and from a clinician standpoint, it didn’t fit into any diagnostic category on its own. Suicide was not looked at from a lens of health at all, but like a behavioral thing that people did for unclear reasons.”

The TW Foundation and other advocates have been pushing to change this public perception at a crucial time. The American suicide rate has crept up year by year since 1999, with a total increase of 33 percent in less than two decades, resulting in more than 47,000 deaths in 2017. More than a million Americans attempt to take their own lives every year, and millions more have suicidal ideation.

Woodfill and many other suicide prevention experts think that the key to decreasing the American suicide rate is approaching suicide not like a series of nebulous personal tragedies, but like a public-health crisis. That means more training for medical professionals on how to treat suicidal patients, more funding for research into suicide’s causes and preventive measures, and more education for the public on how to support loved ones who are struggling.

Woodfill says it’s unclear exactly why the suicide rate has changed so much, but there are many smaller explanations that add up to paint a larger picture: the economy, harsh cultural expectations, social media explosion, a broken health-care system, and what Woodfill referred to as America’s culture of stoicism, which can push people to suffer alone. “We really celebrate self-sufficiency in our culture way too much. Everyone needs someone,” Woodfill said.

Because Americans have long been encouraged to keep their mental-health struggles in the shadows, many people lack basic skills for offering someone support. “If you see someone choking or struggling in some way physically, you probably want to offer a hand,” Woodfill said. But he pointed out that people often hesitate to do the same when a loved one is struggling with mental illness or suicidal ideation, sometimes out of a simple desire not to cause embarrassment by asking personal questions.

“It’s important to say, Okay, I might be the only one who is noticing. So don’t ignore it or write it off to the stress of the day or assume someone else will notice,” Woodfill said. Even among first responders and medical professionals, training on how to help people who are suicidal can be poor, and improving those responses is a chief concern among public-health advocates.

In the meantime, Woodfill recommends regularly checking in with friends and family who are having a hard time and asking them about what they’re feeling. “If you think about it, that’s what we all want—to be heard and to be seen,” he said. “To have a conversation like that, it requires a lot of resisting the impulse to jump in with a quick fix or to try to talk them out of what they’re experiencing.”

His recommendation might sound simple, but there’s significant evidence that it helps those at risk for suicide. In a health-care system with high costs and a dearth of trained mental-care providers, a conversation with a friend could make all the difference.

RESOURCES

If you or someone you know needs help, visit our suicide prevention resources.

If you need support right now, call the National Suicide Prevention Lifeline at 1-800-273-8255, the Trevor Project at 1-866-488-7386 or reach the Crisis Text Line by texting “START” to 741741.