National Action Alliance for Suicide Prevention Tackles LGBT Suicide

By Kellan Baker and Josh Garcia

Kellan Baker is a health policy analyst with the LGBT Research and Communications Project at the Center for American Progress and a member of the Action Alliance for Suicide Prevention LGBT Task Force. Josh Garcia is an intern with the Project. 

Before he completed suicide at the age of 26 in 2010, Joseph Jefferson recorded his final words on Facebook: “I could not bear the burden of living as a gay man of color in a world grown cold and hateful towards those of us who live and love differently than the so-called ‘social mainstream.’”

Though LGBT suicide is frequently portrayed as a wholly youth phenomenon, Joseph was an LGBT activist who had built a life for himself as an adult after getting through what many people assume to be the only tough part of an LGBT person’s life—adolescence.

The National Action Alliance for Suicide Prevention, the public-private partnership aimed at saving the more than 34,000 lives in the United States lost every year to suicide, has taken a lead in changing public misperceptions about LGBT suicide. In particular, the Action Alliance task force that concentrates on the LGBT population has changed its name from the LGBT Youth Task Force to the LGBT Populations Task Force, acknowledging the struggles with suicide ideation, suicide attempts, and death by suicide that many LGBT people confront at different points in their lives.

The reasons that suicide is a lifelong concern for many LGBT people are complex and dynamic. These risk factors include family rejection, lack of social support, lack of access to culturally competent healthcare providers, and the stress of living with discrimination and prejudice.

Because of family or employment obligations, many LGBT adults, like most LGBT youth, do not get to choose where they live and work—often leaving them trapped in hostile environments with family members, co-workers, or neighbors who do not accept them.

Certain protective factors may mitigate these risks. Such factors include family acceptance, affirming and culturally competent mental and behavioral health services, and policies that extend legal protections and promote acceptance.

Indeed, the past several years have seen several advances across the country on behalf of fairness for LGBT people. New York state passed marriage equality for same-sex couples in 2011, and Washington state and Maryland followed suit in 2012. And, recently, the federal government has taken an active role in implementing LGBT-inclusive laws and policies.

But much remains to be done to help eliminate suicidal thoughts and behavior among LGBT individuals. In addition to increased legal protections and working to change stubborn social prejudices, there is a particularly pressing need for further research and data collection regarding mental health and suicide among the gay and transgender population.

Currently, there are no national data regarding suicidal ideation or suicide rates among the LGBT population as a whole. Nor are there sufficient data regarding the experiences of specific segments of the LGBT population, including LGBT youth and elders, transgender adults, and LGBT people of color, who may be at increased risk because of the multiple burdens of discrimination they bear.

Thus, as part of the implementation of the upcoming National Strategy for Suicide Prevention (NSSP), the Action Alliance must take the lead in pushing for nationally representative data on suicide rates among the LGBT population. These data will inform the development and implementation of evidence-based interventions that can help protect the lives of LGBT people.

Such interventions may include initiatives fostering resilience and help-seeking behaviors among LGBT people, connecting them with providers who are both familiar with mental and behavioral health issues and comfortable accepting and respecting their LGBT clients, and promoting supportive school, work, and other environments.

In addition to driving research that can guide efforts to prevent LGBT suicide, the ultimate purpose of the Action Alliance is to save lives by decreasing the rate of suicide in our country. And to do this, each one of us—whether LGBT or ally, pastor or policymaker, researcher or activist—must respond to the moral imperative to help build a world where LGBT people count and are counted, and where they can live their lives free from discrimination, harassment, and the violence of suicide. 

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.

Self Built Lonely Walls

The first I heard of suicide was a story about my great uncle told by my parents when I was a child. He was a Navy Seabee, loved by many, and then gone. He took his life. I wondered why? Another story told to me, a threat of suicide during my college days…my friend talking her roommate down from exiting via the window of a high-rise dorm building, lots of screaming, tears, then hugs, and then off to the college pub to party…it will be ok? Then as a high school substitute teacher hearing rumors among students about life-threatening behaviors, they were just high. Everything was fine? Attitudes and behavior merging to silence often so lonely, and so quiet, suicide not to be spoken of, yet almost deafening noise created by loss, pain, and anguish.

Brian Dyak
President and CEO
Entertainment Industries Council, Inc.
National Action Alliance Executive Committee Member

Finally out of college ready to tackle the world, I was young, married, and energetic. Opportunity abounded, she a trained crisis intervention teen counselor and me an activist organizing and creating youth crisis services for runaway youth. I heard stories of dysfunctional families, physically abusive family circumstances, alcohol abuse and drug addiction, rape, incest, violence, and suicide. My path became clearer to help make the community aware that compassion was necessary and services such as hot lines and crises centers were essential. The challenge: to somehow stop the cycle of discontent and to work to make things better by finding like-minded people who cared and promote services that can assist.

Then, what seemed to me out of nowhere, I came home to find that my wife compromised her life and her service to others by ending her life. The same friend who talked her roommate out of jumping. I took solace in a note that spoke of love and life and her trials to be a part of this world. She spoke of her own “self built lonely walls” and vindicated those who loved her clearing the blame, guilt, suspicion, and doubt. She put forth a challenge to discover how strong one must be to go on. A challenge she chose not to accept for herself. I went forward with great confusion. What could I have done?

Unfortunately it did not stop. My friend and college roommate, a talented musician, decided he “had enough” following in the footsteps of one of his good friends who permanently left his children and family to fend for themselves. I wrote his parents to lend what support I could, explaining all the good that their son had bestowed on so many and his high standard of friendship. Other suicides surfaced in my life among close family, friends and acquaintances, the most recent a friend who just lost his son a few months ago. How can anyone really understand that split-second of decision to actually leave life behind?

Suicide, creating wounds and then scars for life, challenges the power of optimism that the world can be a better place. Yet, like a huge human experiment of life, I have been fortunate finding compassion and support from loved ones early on, learning the importance of sending out love, unconditional love, and finding like-minded people. The havoc suicide does to relationships may be countered by love and time. Working together towards understanding and openness is essential…hiding only contributes to the loneliness and the confusion, a consideration I made when I said yes to writing this blog. I also deeply considered the contributions that the media could make to suicide prevention.

The National Action Alliance for Suicide Prevention is an amalgamation for me of what has been, what is, and what can be. It is an honor to participate as a member of its Executive Committee. The Action Alliance is a gift that permits many people with varied life experiences and vast expertise to work together on behalf of others and unselfishly themselves. The notion that shaping public policy, service to others, raising awareness, and educating about real-life circumstances of suicide is a power that states,” I am not alone, we are not alone”. Feeling the support of others, communicating the caring for the purpose and mission, and, most importantly, showing love of life and optimism creates opportunity that together we can truly make a difference. I believe we can set a course that can break down “self built lonely walls” and let life be the gift it is intended to be. The Action Alliance is a vehicle for that belief to come true and I am grateful to be able to play a small part.