LEARN WITH MENTAL HEALTH COMPASS
Same Page, Same Book?
“Are we on the same page?” …that’s an expression many of us have either said or heard when you are trying to determine whether we are in agreement with someone. I would argue that the first thing we need to establish prior to our page number is whether we are even reading the same book. We must mean what we say and say what we mean in order to ensure that both parties are truly on the same page for what is being discussed. This is even more important when we are trying to prevent a suicide. The action of asking someone if they are having thoughts of suicide needs to be clear and direct. There cannot be room for grey area or personal interpretation. If you want to know if someone is having thoughts of killing themselves, we need to use the words suicide or killing themselves. Often, due to our own discomfort, we “soften” the question by asking “are you thinking of hurting yourself”. The issue with this wording is we think we are on the same page, but in reality, we aren’t even in the same book.
The person who is having thoughts of suicide can answer honestly in their mind, “no”, maybe because the means isn’t going to hurt or the pain they are in is so great that it doesn’t compare to the hurt/pain that they may inflict on themselves. Our language leaves room for interpretation and an ability to say “no” when the person is indeed having very real thoughts of killing themselves. Yet we as the caregiver feel as though we just asked them about suicide and are comfortable with their negative response. But in the end, this does not truly help the person in their suicide ideation. However, if we directly ask, “are you thinking of killing yourself”, there is no room for interpretation. This is clear and direct and conveys to the person that we are willing to have a difficult conversation without judgement. If we as caregivers cannot ask someone about their potential thoughts of suicide in a calm and accepting manner, how could we expect them to answer in a way that allows us to talk about suicide.
Why Mental Health Compass?
We want you to become part of a vibrant learning community at Mental Health Compass. Take a look at some of these brief articles, written by our trainers, to get a glimpse of our philosophy and values.
Rethinking Mental Health
We see it all the time. A family looking for support for their child or adolescent. A previously happy, healthy teen has become withdrawn, refuses to go to school and no longer wants to participate in the activities that they used to enjoy. As a parent, it can be heartbreaking to watch your child suddenly start to struggle and change. It can be particularly confusing when, from the outside, everything appears to be fine in your child’s life. A young person might have a loving and stable home, a strong support network of friends and relatives, stellar academic performance and an active life in the community. Yet, at the end of the day, that young person might still show signs of depression or anxiety.
Yet, mental illness can be a tough call. Adolescence is a time of great change and pressure. It’s a time when young people develop their identities and experience dramatic social and physical changes. Often, outside factors can complicate an already complex time of life. These changes can make it hard for a parent to determine whether shifts in a young person’s behavior or mood are the result of a mental health challenge or disorder, or if they are parts of a routine growth process. Withdrawal, for example, can be a symptom of mental illness, but pulling back from their parents is something that many teenagers go through as they strive for greater independence. Leaning away from parents and towards friends and other social outlets is normal. Pulling back from everyone is a sign of a deeper issue. Understanding these nuances can be tricky for even the more vigilant parent.
This does not mean though that parents should feel like they have no control to affect their teenager’s life or provide position support when they struggle. If you’re a parent, your teen should know that they can talk to you about anything, and you sometimes have to broach concerning-sometimes even awkward-topics directly and openly. In some cases, this is the only way to know what’s really going on.
When a teenager’s challenges are routine, turning to a therapist for additional support can result in positive change. Even in the event that a more serious mental health issue or development disorder is confronting your family. It’s important to know that these conditions can be treated.
Language Matters
Long gone are the days where sticks and stones break our bones and words will never harm us. Words matter; language matters. Our words have the power to lift people up or tear them down. The words we use have the ability to shape our actions, and our actions have the ability to help others. At Mental Health Compass we are focused on lifting people up and supporting them in their lives. In our workshops, we are challenging ourselves to think about mental health differently and build awareness and the impact we can have on each other.
In our daily interactions, we want to be cognizant of using person first language. With this in mind, when referring to someone with a mental illness of any type, we state the person first, then refer to any illness or condition they are experiencing. For example, we would state “someone with bipolar disorder” or “an individual with depression” – not a bipolar individual or depressed individual. As it relates to suicide prevention, if someone is suicidal or having suicidal thoughts, their suicidality would come after them as an individual. For example, we say “an individual who is suicidal”, or “a person who is having suicidal thoughts”. First and foremost, the person is still a person, and the suicidal ideation is something they are experiencing, not something that defines them.
One of the more commonly used phrases, has been that someone “commits” suicide. As we move forward in evolving and growing in our understanding of suicide prevention, the field of suicidology has moved away from the language of “commit”. Saying someone commits suicide implies that they have committed a crime or a sin. Instead, there is a movement to encourage language such as “died by suicide”. We also do not recommend common language that has been used referring to a successful suicide or failed attempt. No death is a success, and an attempt that is not completed is not a failure. Again, it is the belief that words matter and changing our words can be the beginning of breaking down the stigma and opening conversations to save lives.
Means Matter: Reducing Access to Lethal Means
When it comes to preventing suicide, many people focus on the why—why does this individual want to kill themselves. However, as it was learned in the Harvard School of Public Health study, known as “Means Matter”, https://www.hsph.harvard.edu/means-matter/ --what is most important when trying to prevent a suicide is to ask “how?”. How do they plan to kill themselves and what means do they have access to?
When we work to increase someone’s safety during the heightened period that they are experiencing thoughts of suicide, it is important to have the conversation regarding their access to lethal means. Although someone’s thoughts of suicide may have been taking place over time, we know that many suicide attempts occur with little planning during a short-term crisis. When we focus on the “how” someone would kill themselves, we can determine how to help support increasing their safety during a heightened crisis should they decide to act upon their thoughts.
Reducing someone’s access to lethal means, can look different for each person, depending on their circumstance. What remains constant is the objective to limit someone’s immediate access to lethal means when they are in a state of crisis. If we can increase the time and distance between someone deciding to act on their thoughts, and their ability to obtain their means, we can potentially save a life. To do this, working to establish a safer environment is key prior to the crisis and desire to act on one’s thoughts. Establishing a strong and thorough safety plan can help support this. A safety plan is the equivalent to a fire drill-you need to know the steps to keeping yourself safe when emotionally on fire in the same way that you need to know how to locate the exit in case of a physical fire.