Tuesday, November 22, 2011

Running to Pole 69

Eduardo Vega is the Executive Director of the Mental Health Association of San Francisco and a California Mental Health Services Oversight and Accountability Commissioner. In addition holding a seat on the Executive Committee of the National Action Alliance for Suicide Prevention, where he leads the task force on suicide attempt survivors, he is a member of the Steering Committee of the National Suicide Prevention Lifeline.

Exercise is crucial medicine for me, as it is for many. I feel certain, for instance, that training over many years in yoga, martial arts, and now running, has saved me from the worst effects of recurrent depression that were part of my life since childhood. Whenever possible on Tuesday mornings before work, I run to the center of the Golden Gate Bridge, to the landmark of light-pole 69.
More people die by suicide off the Golden Gate Bridge on Tuesday than any other day. And it seems possible that at Pole 69 more people have jumped to their death than any other single place in the world.

You get accustomed to it, of course, but the beauty of the Bridge can still strike you on a given day--the dramatic rise of the red towers through shawls of fog, the infinite vista of ocean, and the powerful detachment from land and city.

As I run on it I think about the people who come here in despair, people who are feeling that death is the best way, or maybe the only way, to wrest power, dignity or simply relief from a life that seems unendurable; people in a place similar to where I once was.

When I get to Pole 69 I spend a quiet moment. Sometimes I think about the four friends I lost to suicide, or the parents, brothers, and sisters I've met whose lives were devastated by loss in the wake of such a death. I look at the water and feel the rails and try to connect with the many people who have come here seeking a resolution, however tragic, to their sense of utter desolation. Sometimes I reflect on my own suicidal moments and attempts. The seemingly endless months where I felt so far from hope, the years in which I yearned daily for an accidental decisive death. I think of the time I took actions to do the same, the fleeting feeling that I was no longer a victim, that in planning to die I finally had taken the power away my pain.

When you look out on most days from the center of the bridge you see Alcatraz island very clearly. It seems lugubrious as a metaphor, but I can’t help but think how that might affect me, if I was planning to jump.

Like it or not, we live in a society that prizes individual freedom above all, one in which punishment is meted out in terms of lives without it. One in which many people see being identified as mentally ill as worse than being a criminal, and some see it as worse than death. For some, the first time one goes through the doors of a locked psychiatric facility, that sense of self is forever altered. For people who struggle and are hospitalized repeatedly, the undermining messages, the insults to personal dignity, and the cuts at hope can be intensely magnified.

People who advocate for such things as mental health services, myself included, sometimes lose perspective on how powerfully such things as hospitalization can affect those on the receiving end. How, ironically, one’s conception of oneself may be shaken, weakened, even damaged by something designed to support it. 

As I stand on the Bridge, I know that somewhere in the world there is someone asking themselves --what is worse, to be a mental patient, or to die? 

Our biases about mental illnesses run deep--cultural prejudice, stigma, and shame are pervasive in our media, our conversations, and our dinner tables. They are alive within the system of mental healthcare, too— even though mental health providers feel professional stigma they also pass it on to clients through slights on individuals’ dignity, mistreatment or low expectations that diminish people’s hope for their lives.

That does not mean that we should not promote good mental health services and supports. Treatments and therapies make a huge difference in saving lives and in helping people grow into their own resources for recovery, self-care, and wellness. But it does mean that, if we want to reduce death by suicide, we have to combat stigma, silence, and shame associated with mental health conditions and treatment.

There is a very good reason the US Surgeon General identified stigma as the biggest barrier to progress for our country’s mental health overall. In order to really eliminate stigma as a barrier to mental health, and thereby as a contributor to death by suicide, we must change no less than society’s view of people themselves. We must embrace the reality that living with mental health problems is a challenge to many, that debilitating mental illness can affect us all, and that its experience is part of being human. To free our society from the tragedies of suicide we must make personal dignity more powerful than symptoms or disability, we must foster communities that believe in and support their people, not regardless of, but especially when they are facing personal struggles. 

I believe we can make this evolution happen-- we can challenge our history of fear and judgment and build on our resources of compassion. We can take the side of people when they are suffering, seeking to understand, rather than label, to help without depriving anyone of the strengths that come with overcoming hurdles.

The course back from the Bridge is tougher. A large part of it is up a steep hill and not too pleasant. Some mornings it can be hard to keep going, even to put one foot in front of the other.

I suffer much less and less frequently now from symptoms of mental illness. But there are still days when getting up, going to work, talking or even walking down the street can feel unendurable. There are moments I feel crushed under a paralyzing weight, when everything real retreats into bleak grey clouds.

Sometimes in those moments, the desire to die returns again, a specter of deliverance emerging like a boat out of the fog.

That boat will take me nowhere, will help no one. There’s just too much work to be done.

It is the work I so often come back to on these little journeys. If we were successful in eliminating stigma, I know people would not be jumping from this bridge twice a month. We would not be dying at Pole 69 because we would be able to prevent mental illness or to manage it successfully; we would have the resources to create enduring wellness in our mental and emotional lives, and an atmosphere of acceptance. We would be healthier because we would have the right kinds of support from our communities and families, from professionals that see people before diagnoses, from helpers who know that dignity is more important than medication, that hope is more powerful than pain.

As an attempt survivor, a loss survivor, and a mental health advocate, I am convinced that preventing death by suicide is the result of many minds, many hearts, and many hands. I’m honored and feel grateful to contribute in my way and to join with the leadership of the Action Alliance in this mission.  As we move forward, I’ll continue to add some legs and feet to the mix, to take your thoughts and good energy with me on the road to Pole 69, where we can all make a difference together.