Breaking the Silence – Learning from the experience of Suicide Attempt Survivors

By Doryn Chervin, Action Alliance Executive Secretary

We live during a time, for better or worse, in which suicide is prominently covered in the media. Whether the story is a high-profile suicide, the ongoing fight to prevent military and veteran suicide, or other tragic stories of grief and loss, there is one voice that has been missing – the voice of the suicide attempt survivor. There is a movement underway to change this.  Suicide attempt survivors are emerging with a collective voice and a plan for re-shaping the delivery of suicide care in health care, strengthening community services, and improving suicide prevention efforts.

This Suicide Prevention Week, September 8 – 14, we embrace and support the suicide attempt survivor movement. For far too long, the perspectives of those with lived experience of suicide have not been integrated into treatment services and suicide prevention efforts. Whether this was due to fear, stigma, shame, or other reasons – the important fact is that this is changing.

For the many thousands of Americans who are now living as attempt survivors, their experience of resiliency and lived experience is an untapped resource that could potentially advance suicide prevention and save the lives of others in suicidal despair.  They understand better than providers or researchers how to find meaning in the midst of great darkness.

The National Action Alliance for Suicide Prevention (Action Alliance) is the nation’s public-private partnership advancing the National Strategy for Suicide Prevention and championing suicide prevention as a national priority. The Action Alliance’s Suicide Attempt Survivors Task Force, recently released a groundbreaking report, The Way Forward, which makes recommendations to improve our nation’s health systems, emergency services, and suicide prevention efforts based on the experience of attempt survivors. This report, which incorporates the lived experience of recovery and resilience, provides the missing bridge between suicide attempt survivors and treatment services, suicide prevention leaders, and policy makers.

The Way Forward marks the beginning of a new era, in which families, communities, clinicians, and health systems do not fear persons with a known history of suicidal thoughts and behaviors. Similar fears and concerns were once directed at persons with histories of mental illness, and alcohol or drug abuse; yet we have increasingly benefited and learned from the inclusion of persons with these lived experiences.

Let’s mark this week, 2014 Suicide Prevention Week, as the moment when families, communities, and organizations commit to fully supporting suicide attempt survivors in their recovery and in our efforts.

As the Executive Secretary of the Action Alliance, I welcome this movement. I welcome the stories of survival, hope, and recovery that suicide attempt survivors contribute to the cause of suicide prevention. The era of silence is over. Just as people once whispered about cancer, we will one day look back in wonder that we ever whispered about this.

If you, or someone you know is in crisis (no matter how small or big), help is available. By calling the 24/7 National Lifeline, 1-800-273-TALK (8255), you’ll be connected to a skilled, trained counselor who will help you find a reason to keep living.

Doryn Chervin, Dr.P.H., M.Ed.

Executive Secretary, National Action Alliance for Suicide Prevention
Vice President and Senior Scientist, Health and Human Development Division, Education Development Center, Inc.

Facebook & Suicide Prevention

By Joe Sullivan, Chief Security Officer, Facebook, Inc., Action Alliance Executive Committee member, and co-lead of the Public Awareness and Education Task Force

For many people the topic of suicide is hard to open up to others about. For some it brings up feelings unspoken, and for others memories unwelcome. But the more you learn about the topic, the more you appreciate the power of communication in reducing the likelihood of suicide. Communication builds emotional connections, exposes risks, leads to understanding, and gives opportunities for intervention.

Years ago, the employees at a fledgling Facebook discovered the power of communication as a means of intervention, when young people using the service started writing in to our customer support team to report when a friend had posted a status update that could be interpreted as a sign of suicide risk. Confronted with this new type of intentional or unintentional cry for help, we realized that we needed to do two things—to engage with the expert community to learn how to best address these situations, and to use the power of Facebook itself to mobilize friends and counselors to communicate with the at risk person.

Fortunately, the suicide prevention community embraced working with the Facebook team, establishing strong relationships that have helped us mature in our handling of these situations. One key partnership has been our participation in the National Action Alliance for Suicide Prevention. I’m proud to be a co-lead of the Public Awareness and Education Task Force. We fully support the Action Alliance vision of a world free from the tragic experience of suicide, and truly benefit from the rich blend of public and private resources the Action Alliance brings to bear. The Action Alliance has shown that partnership driven solutions can offer the best help in the places where it is needed most and helped us expand our network as widely as possible to make assistance available to everyone who expresses need on our site. Through this network, we have partnered with over 25 different suicide prevention agencies across the world to provide help to all our users, using resources appropriate for wherever they may be.

With the help of these partners, we have built a number of online solutions:

· We started by working with the Action Alliance, Lifeline, and the National Council for Suicide Prevention to create content for our Help Center to help the people who use our service identify those in distress and give them the help they need. Because there is no substitute for the care and concern of a person’s friends and family, we wanted to provide the advice necessary to help this natural support network recognize and respond to risk factors.

· We built on that by creating a robust reporting structure. To help those users who may be in distress we have Report links all over the site. When you click Report you can message your friend directly using our Social Reporting tool or you can report the content to Facebook to be reviewed by our Safety Team.

· And most importantly, using dedicated staffing and relationships with organizations such as Lifeline, we have done our best to pair the user with trained suicide prevention counselors. Initially that was through email connections, but recently we implemented a new solution that has worked even better. Since December last year, those users (in the United States) in distress receive a message from Facebook containing a link to begin a confidential chat session with a crisis worker from Lifeline. We rolled out this feature in partnership with the National Action Alliance for Suicide Prevention and Surgeon General Dr. Regina Benjamin.

· Building on these positive experiences, we have worked with the National Council for Suicide Prevention and SAMSHA to bring together (twice so far) a working group with other leading internet companies to build out a set of joint best practices.

We’re proud and humbled by the role we have been able to play in this team effort, and grateful to the Action Alliance for its important role in our growth. We look forward to the future of this relationship because together we can stop suicide by helping people find the courage to speak up whenever they see the signs a friend or family member is in distress.

A Hole in the Soul that Never Heals

It’s as if it were yesterday.

I was a college freshman studying in my room when my very best friend Pam walked in. She was ashen. I asked her what was wrong. In a near-catatonic state she told me her beloved brother John, a high school sophomore, had killed himself. In that instant Pam’s world collapsed. She immediately blamed herself for being away at school when he needed her. I watched the family blame themselves and go through all the stages of grieving – yet they never fully healed.

Even now, decades later, Pam and her entire family are still suffering from that tragic choice

Judy Cushing
President and CEO
Oregon Partnership
National Action Alliance Executive Committee Member

I had never been touched by anything like it. I decided that I wanted to do something that would help prevent other families from going through that level of devastation. It became a very personal mission.

Years later Oregon Partnership, the non-profit organization I direct, was able to add a fully certified Suicide Prevention Lifeline. Last year we received over 19,000 suicide calls to our Lifeline.

I can’t express how satisfying it is to be in our crisis line center and to overhear one of our team members help move a caller from a position of life-threatening crisis to one of safety. It’s literally life-changing. Not only are lives saved on the LifeLine, but compounded waves of tragedy and years of grief have been averted. 

Thousands of families didn’t have to go through what Pam’s did because of our skilled staff and volunteers.  The best news is that there are Lifelines all across the country quietly preventing people from taking their lives.

Suicide is the ultimate “elephant in the room” that our society doesn’t want to acknowledge or talk about.   I am so proud to be part of an initiative like the Action Alliance that is focusing on changing the way society thinks about mental illness and suicide.  I’m confident that some day we will discuss suicide and mental health issues as openly as we would discuss cancer. When suicide is moved out of the shadows of secrecy and shame – the twin enablers - we cast a bright light on it and, in so doing, foster prevention.

Suicide prevention needs to become a national priority. It must receive the level of attention and action of any other pandemic that kills people every day. The formation of the Action Alliance is a huge step in that direction. It’s an honor to serve with so many accomplished decision makers who are ready to influence national suicide policy. I’m also deeply touched by how many of my fellow committee members have been impacted by the devastation of suicide.

My personal area of emphasis on the Action Alliance is the Lifeline network across the country and Military and Veterans and their families.   An average of 18 veterans a day die by suicide in America.    We must come together to provide a safety net for them across all sectors of society.

We must take action to prevent suicide. For Pam, for John, and for all of our families.