Dismantling the stigma around suicide

TRIGGER WARNING: This article discusses suicide.

There are a lot of reasons not to talk about suicide and suicidality (the feeling of wanting to kill yourself). First, I do not want to glorify suicide. There is always the chance that someone in danger misreads the message here, which is one of hope. In fact, let me be clear that this is an article about the beauty of life in the face of terrible pain.

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Secondly, suicidality is not great on a resume. I have been advised many, many times not to talk about my story for fear of limiting my job prospects. I might add; however, that my current job has been wonderful to me and I have been open with them.

Lastly, I want to be careful that I do not reinforce any of the stigma around suicidality. Depression and other mental health challenges are part of life. There is a difference between how we treat people, and how we treat symptoms or conditions. Suicidality is dialectical (i.e. two things can both be true), it is both an unhealthy condition that should be treated, while recognizing that the person is not the problem. This is different from stigma that says people are their mental health and they are the problem. This is more dangerous than any diagnosis of depression. Ending the stigma and talking about these issues saves lives. Which is why I am talking. Individual survivors have enormous power toward ending the stigma.

Dismantling stigma means talking about suicide more openly, but carefully. For many people, however, it is hard to wrap their heads around what the issues are. What is suicidality?

To me, (and I can only speak for myself), feeling suicidal is like piloting a jumbo jet that has lost one engine, then another, and you find the weight of gravity pulling you down. As you glide and sink, you can see the clouds below you. It’s a sunny, clear day. You almost leave your head in the clouds and watch yourself fall. In the cockpit, you turn all the knobs and buttons desperately but nothing seems to work. You feel alone. Emotional gravity wins. So you fall closer to the ground and more distant from yourself.

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Like many, I never missed a day of work and I told very few people following a suicide attempt. Not telling people, not reaching out for help, letting the stigma misguide me and make me feel like there was something wrong with me as a person, made things monumentally worse. So let’s discuss breaking down stigma.

1.) Fighting stigma requires survivors to speak out. Here, we take an important page from feminism and women’s health that explains that sharing our lived experience is the way to educate the public and this experience makes survivors experts on this issue.

2.) Fighting stigma means workplaces and hiring committees need to understand that mental health management comes in all shapes and sizes. Yes, suicide is concerning but talking about it openly is a good sign not a bad sign, and it does not mean we cannot do work. In many cases doing work and having purpose is helpful. The best way I ever dealt with suicidality was by writing books. In short, we are not broken people, but we are going through a rough time. We are usually in therapy the same as many others.

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3.) Fighting stigma means supporting one another beyond suicide prevention hotlines. Sometimes, pushing hotlines to call can feel like suicidality conversations can only be had in specific circumstances. No one is a burden, and anyone can listen. Being open about suicide is going to mean having some uncomfortable conversations with friends who do not understand or feel unequipped. It can be scary when someone reveals they tried to kill themselves. It may feel like this is being put on the shoulders of the listener. But let me suggest that something else is happening here. Someone is telling a truth about their life and just needs to say it out loud.

4.) This is important. There is a difference between talking openly to fight stigma and normalize suicidality as one of many mental health challenges and talking about suicide as a cry for help. There is a crucial difference between someone talking about a past suicide attempt and talking about a future plan to commit suicide. The key question therapists ask is if there is “intent” to commit suicide. People may want to die, but there is no intent to act on this. Is there a “plan?” If there is intent or a plan, this is a moment for a trip to the Emergency Room for an inpatient evaluation. This is a moment for a hotline. This is a moment not to be left alone.

So let’s not pretend this is easy for anyone. But the answer is not to silence survivors and reinforce stigmas that only perpetuate isolation.

5.) Finally, fighting stigma around suicidality means pushing back against structural oppressions like ableism, homophobia, transphobia, sexism, and classism that push people down and make them feel worthless and alone. Suicide is not simply a deep feeling of despair, it can represent the feelings of worthlessness and escape that come from bullying, harassment, and abuse. Queer youth have higher rates of suicide, post graduate students report higher rates of depression and suicide, indigenous populations have higher rates of suicides, and rural men report higher rates of suicide. It is an epidemic and (again) not talking about this is not solving the problem. We need survivors to speak up without judgement from society to help address the stigmas that leave so many alone.

Dr. Christopher Pepin-Neff is a suicide survivor. He is also a Senior Lecturer in Public Policy. He holds a B.A. in political science (‘99), a Masters in Public Policy (‘07), and a PhD in public policy (‘14).

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