Man Therapy Goes Global!

MEN’S MENTAL HEALTH CAMPAIGN GOES GLOBAL AND WINS NATIONAL AWARDS

The Innovative Man Therapy™ Campaign Flourishing in First Year

Denver, Colorado. July 10, 2013.  One year after its launch, Man Therapy, a successful online campaign developed in Colorado to improve men’s mental health, celebrates many exciting milestones including two major national awards and an international expansion. The Colorado Department of Public Health and Environment’s Office of Suicide Prevention, the Carson J Spencer Foundation and the Cactus advertising agency launched Man Therapy in Colorado in July 2012 to overcome the stigma men associate with mental health treatment in the last month the campaign reached almost 300,000 people in its first year, launched in Australia and won the American Advertising Federation National Gold Addy Award and the Safe States Alliance Innovative Initiative of the Year Award.

The Australian version follows the approach of the Colorado campaign, substituting Dr. Brian Ironwood for Dr. Rich Mahogany and Australian cultural references for American, but continuing the man’s man, no-nonsense, tongue-in-cheek approach to getting men to talk about their feelings and get treatment.

Mantherapy.org is the centerpiece of the campaign. Colorado men who visit find they have a virtual appointment with Dr. Rich Mahogany, a man’s man dedicated to cutting through the stigma of mental health with his rapier wit, no-nonsense approach and practical advice for men. His office is open year-round at any hour, and he often sees five men at a time. Visitors navigate through Dr. Mahogany’s virtual office, finding useful information, taking an 18-point “head inspection” and receiving a list of possible therapies.

The site has generated almost 600 unique visitors a day since its inception, over 30,000 people have completed the self-assessment, and 90 percent of them reported they are very likely or likely to take the advice and recommendations prescribed after their exam.

The Australian Department of Health and Aging and men’s mental health organization beyondblue studied the effectiveness of Man Therapy, found evidence to support licensing the campaign and began a multi-million-dollar media campaign to introduce www.mantherapy.org.au/  and Dr. Brian Ironwood to Australians.

“Dr. Brian Ironwood is a quintessential Aussie bloke, except he understands the importance of good mental health,” said Kate Carnell, chief executive officer of beyondblue. “We hope Man Therapy will help us make depression more understandable and less embarrassing in Australia, so men will talk about how they feel and get help if they need it.”

In addition, in June the Man Therapy partners were awarded the 2013 Safe States Alliance Innovative Initiative of the Year Award, in recognition of a truly unique and creative initiative with the potential to substantially decrease injuries and violence. The Safe States Alliance is a national membership organization of injury and violence prevention experts and practitioners from every state in the US.

Finally, Man Therapy was also awarded the Gold ADDY Award for Public Service: Digital Advertising by the American Advertising Federation. The ADDY Awards recognize the highest level of advertising excellence in all forms from anywhere in the world.

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About the Carson J Spencer Foundation - Sustaining a Passion for Living

The Carson J Spencer Foundation (www.CarsonJSpencer.org) is a Colorado nonprofit, established in 2005.  We envision a world where leaders and communities are committed to sustaining a passion for living. We sustain a passion for living by:

• Delivering innovative and effective suicide prevention programs for working-aged people
• Coaching young leaders to develop social enterprises for mental health promotion and suicide prevention
• Supporting people bereaved by suicide

About Cactus

Cactus is a full-service brand communications agency providing business solutions for companies and causes through brand strategy, advertising, design, interactive and media services. Cactus has been nationally recognized for its breakthrough creative executions by The One Show, Communication Arts, The Webby Awards, South by Southwest, Favourite Website Awards, Advertising Age, Creativity and Print’s Regional Design Annual. To learn more about Cactus, visit http://www.sharpideas.com.

About Colorado Office of Suicide Prevention

Office of Suicide Prevention, a legislatively mandated entity of the Colorado Department of Public Health and Environment, charged with serving as the lead entity for statewide suicide prevention and intervention efforts, collaborating with Colorado communities to reduce the number of suicide deaths and attempts in the state.

Suicide Bereavement and After Death Communications: Preliminary Findings from Our Research

By Sally Spencer-Thomas
AAS Survivor Division Director

At the International Association for Suicide Prevention Congress in 2009, Tony Gee, a suicidologist from Australia said, “…when we closely look at the bereavement literature we find that it tells us time and time again, that the ‘lived experience’ of the bereaved has a range of dimensions, some of which may in fact be quite different from what some of the traditional theories (really coming from that ‘objective’ realm) have been prepared to recognize….”

He went on to explain that the continuing bond between the deceased and the living seems to continue on two levels:

1) “an internal representation, living on in memory, being part of the internal self-structure, being a sort of constant internal companion,” and

2) “an actual sense of presence of the deceased as a separate individual identity who is still around in some way after death and this presence may be experienced in a number of different ways.”

He described the two as not mutually exclusive.

This past spring Danielle Jahn and I, with support from Texas Tech University, conducted a survey asking people bereaved by suicide about these types of experiences.

Our recruitment efforts stated “People bereaved by suicide needed for research on spiritual experiences subsequent to their loss,” and we sent requests for participation to members of or visitors to the following:

·         American Association of Suicidology

·         International Association for Suicide Prevention

·         Survivor Support Networks

·         Social Media (Facebook, Twitter)

We got a strong response: almost 700 people completed our questionnaire. While it will be months before we have a published report of our findings, I wanted to give the membership a sense of what we discovered initially:

·       About 70% of our sample experienced some sort of “spiritual experience” with their loved one who died by suicide.

·       The most common manifestation was dreaming of the deceased (72%), followed by feeling the presence of the deceased (51%) and experiencing profound coincidences (41%).

·       About one third of our sample experienced their first “sign” immediately after death and another third experienced it within the first month.

·      About 90% of our group told another person about their after-death communication, and most found that the person they told was supportive or intrigued, but a few felt discounted. People most often told included:

o   Friends and family

o   Support groups

o   Faith leaders

o   Mental health professionals

o   Psychics

o   The most common emotional reactions to these experiences were love (60%), peace (55%), and sadness (47%).

Some of the survey responses that people wrote were deeply moving:

·       “My son came to me in a dream about 2 weeks after he died. He said mom, ‘I'm sorry, I can't get back.’ I said, ‘It's okay, I will see you again.’ I felt his hug and then I woke up. A few weeks later I had another dream. I went to hug him and I knew he was gone. He has moved on to another place.”

·       “The dream was most profound. It seemed so real. My son, who I found after he shot himself, came to me in dream as a toddler. He was wearing a striped shirt that he wore as a child. The following day, an old friend, who lives I'm another state, sent a photo she found of him with my deceased father. He was wearing the same shirt as in the dream. My friend and I had not spoken since his death and she had no knowledge of the dream. I had cried all morning after and even described the shirt to my husband before we received the photo. My only son was 28 when he died.”

·       “Initially, I 'lost' my faith, not sure I really 'believed' anymore. The Spiritual experiences were gentle, if not shocking reminders that God wasn't going to abandon me because I was doubting my upbringing and teachings. In fact, it was expected, and I knew 'God' would wait and be patient as I struggled on my grief journey. I was approached by total strangers in moments of need…music with specific messages at crucial times…. I even had one 'visitation' by the Holy Trinity (Father, Son, Holy Ghost), unmistakable, and life-changing, in all places, in the Washington DC Metro. I am a physician, a scientist, and also an advocate social worker, with expertise in mental health and emotional conditions. My perspective on mental fitness is totally changed, with a new-found realization how much we avoid dealing with ‘Spiritual Fitness.’”

Michelle Linn-Gust has often said, “The bond is not broken; the bond is changed. People really need to know that their loved one is still part of their life. There is so much fear that if we move forward we are letting them go.”

If you have experienced an after-death communication that you would like to share with me, I invite you to contact me at Sally@CarsonJSpencer.org.

Reposted with permission from the American Association for Suicidology.

COLLABORATIVE EFFORT PRODUCES MANAGER’S GUIDE TO HELP WORKPLACES WITH THE AFTERMATH OF SUICIDE

See guide at: http://carsonjspencer.org/ManagersGuidebook.pdf

Denver, CO – In the U.S., the majority of people who take their lives are working-aged people, and yet workplaces are often unprepared to deal with this crisis. Today the American Association of Suicidology (AAS) and the National Action Alliance for Suicide Prevention (Action Alliance) announce the launch of a collaborative publication, in partnership with Crisis Care Network (CCN), and the Carson J Spencer Foundation entitled A Manager’s Guide to Suicide Postvention in the Workplace: 10 Action Steps for Dealing with the Aftermath of Suicide.

For every suicide death, an estimated minimum of six people are affected, resulting in approximately six million American “survivors of suicide” in the last 25 years. The creation of the guide came as a logical step for the collaborators. “The demographics of suicide inform us that the working-age individual, in particular working-age male, is most at risk for suicide,” explained Dr. Alan Berman, Executive Director for the AAS. “A sizeable proportion of these deaths by suicide occur on the worksite, or otherwise affect the worksite, pointing to an increased need for postvention in the working population. These guidelines are most important for systems of employment, in the worst case possibility that such a tragedy occurs.”

The guide provides clear steps for postvention, giving leadership a sense of how to immediately respond to the traumatic event, have a plan in the short-term for recovery, and consider long-term strategies for helping employees cope down the line. Dr. Sally Spencer-Thomas, CEO & Co-Founder of the Carson J Spencer Foundation, explained: “We collaborated to create succinct procedures with checklists and flow charts to be a go-to guide for people dealing with the crisis of suicide. Our goal is to help to reduce the impact of the suicide event by offering a blueprint to handling these challenging situations. The guidebook allows for immediate access to clear steps to take for moving forward, and helps workplaces plan to move from a solely reactive position on these issues into policy development and trainings.”

“In many postvention responses we saw business leaders forced to operate well outside of their training and expertise, grappling with unanswered and unanswerable questions,” said Bob VandePol, President of CCN. “When there is a death by suicide, all eyes turn to leadership and people take their cues based upon how leadership responds. It’s also true that people under the influence of traumatic stress look to leadership and make assumptions about their own personal worth within the company, so there is tremendous power in a calm, compassionate presence by management during this time.”

The collaborators worked to create a set of guidelines that are useful across varied types of workplaces, and they expect a range of individuals within these organizations and companies to find the information immediately helpful. “This guide can be useful to managers at all levels–from the CEO of a large business to a front-line supervisor of a small organization,” asserted Action Alliance Executive Secretary, Dr. David Litts. The Action Alliance played a key role in bringing these groups together to develop this resource.

To download your own copy of these guidelines and to review others, please go to http://carsonjspencer.org/ManagersGuidebook.pdf.

American Association of Suicidology

Founded in 1968, AAS is a membership organization for all those involved in suicide prevention and intervention, or touched by suicide. AAS leads the advancement of scientific and programmatic efforts in suicide prevention through research, education and training, the development of standards and resources, and survivor support services.

Contact: Alan L. Berman, PhD, ABPP, Executive Director, 202-237-2280, berman@suicidology.org

National Action Alliance for Suicide Prevention

The National Action Alliance for Suicide Prevention, a public-private coalition, works to advance the National Strategy for Suicide Prevention by championing suicide prevention as a national priority, catalyzing efforts to implement high priority objectives of the National Strategy, and cultivating the resources needed to sustain progress. Launched in 2010 by Health and Human Services Secretary Kathleen Sebelius and former Defense Secretary Robert Gates, the Action Alliance envisions a nation free from the tragic event of suicide. For more information, see www.actionallianceforsuicideprevention.org.

Contact: Katie Deal, Deputy Secretary, 202-572-3722, kdeal@edc.org

The Carson J Spencer Foundation (www.CarsonJSpencer.org) is a Colorado nonprofit, established in 2005. We envision a world where leaders and communities are committed to sustaining a passion for living. We sustain a passion for living by

·         Delivering innovative and effective suicide prevention programs for working-aged   people.

·         Coaching young leaders to develop social enterprises for mental health promotion and suicide prevention.

·         Supporting people bereaved by suicide.

Contact: Sally Spencer-Thomas, PsyD, CEO & Co-Founder, 720-244-6535, sally@carsonjspencer.org

Crisis Care Network

Founded in 1997, Crisis Care Network (CCN) is the EAP industry’s premier provider of Critical Incident Response for the workplace. CCN helps individuals and organizations return to work, life, and productivity following critical incidents. We mitigate the human and financial costs of workplace tragedy such as workers' compensation claims, low morale, employee attrition, and litigation. CCN has established the nation's largest network of master’s- and doctoral-level clinicians trained as Critical Incident Response Specialists, responding more than 1,000 times per month to workplace incidents for EAP’s, insurers, and employers in communities throughout the United States and Canada.

Contact: Judy Beahan, MSW, Clinical Manager, 888-736-0911, Judy.Beahan@crisiscare.com

On Being Bold in Suicide Prevention: Innovative Approaches in Innovative Places

Windows by Nina Matthews Photography

     I had been in the field of mental health 16 years before my brother Carson took his life in 2004, and I would say that since then I have learned much about the “gaps” that need to be filled in the field of suicide prevention. In the aftermath of his death, our family and his friends came together in our grief,  as many people do, with a strong sense to “do something” and formed the Carson J Spencer Foundation (CJSF).                

     From CJSF’s inception, what quickly became obvious was the huge “gap” between the target population of most suicide prevention efforts and population that most represented by those who were dying.. We were shocked to learn that most people who took their lives were just like Carson: white, working-aged men. We made the commitment to be bold and try to fill this “gap” with innovative approaches in innovative places.

     Innovation is critical in the field of Suicidology because it helps us engage untapped resources, explore new partnerships and ultimately expand our capacity. Without innovation, we will just keep repackaging the same methods and will be limited in our ability to create the significant change we all envision. Innovation begins with an idea to take a radically different approach – especially if it’s difficult.

     In hindsight, we can usually see the benefits of innovation, but at first they are sometimes considered radical ideas. Where would we be if that first crisis call center had never emerged or if the Air Force had decided like so many others had before, that there was nothing that could be done to prevent suicides? Often because innovation challenges convention of how things get done, initial backlash and doubt ensue.               

     Inevitably, trial and error cycle as the innovative idea evolves. Sustained change comes as the context of discovery moves into the context of justification, and rigorous evaluation helps us better understand the cause and effect cycle of change.

     Since my brother Carson was a gifted entrepreneur and not afraid of risk-taking, the founders of CJSF not only dedicated our mission to preventing what happened to him from happening to others, , but also to celebrating his gifts as a dynamic and bold visionary.  

     When taking an inventory of existing suicide prevention efforts, we noted that very few people were addressing suicide prevention in the workplace, and this gap became ours to fill. In 2007 CJSF launched the Working Minds program (www.WorkingMinds.org) and in 2009 we published the Working Minds Toolkit, which was accepted to the National Best Practice Registry in 2010. The goal of these efforts is to build capacity in workplaces so that they are better able to implement comprehensive and sustained suicide prevention programs.

     Today, with the help of the National Action Alliance for Suicide Prevention’s Workplace Task Force, workplace suicide prevention efforts are better able to leverage the influence of leaders from across the country and create a “tipping point” of change. We are bringing together executives and industry leaders to be spokespeople for the cause; we are pulling together resources to outline a blueprint for change; and we are partnering with the Public Education and Awareness Task Force to “Change the Conversation.”

     The Workplace Task Force in partnership with CJSF and others, has launched three new innovative resources for workplaces:

•  A Manager’s Guide to Suicide Postvention in the Workplace: 10 Action Steps for Dealing with the Aftermath of Suicide
• A Comprehensive Blueprint for Workplace Suicide Prevention
• Video: Firefighters Coping with the Aftermath of Suicide

     In addition, we need innovation to reach those at highest risk for suicide – men of working age with multiple risk factors who are also least likely to seek care. For years, the same message – “if you are depressed, seek help” – was repackaged with little success in reaching this demographic.  What the effort needed was a brand that was compelling to high-risk men. In 2007, the Carson J Spencer Foundation, Cactus Marketing and Colorado’s Office of Suicide Prevention – a public-private-nonprofit partnership – came together to find a new way to reach high-risk men by using “manspeak” and humor.

Hope Lights by Nina Matthews Photography

     On July 9, 2012, after four years of research, development and planning, the partnership launched the one-of-a-kind Man Therapy™ campaign (www.ManTherapy.org) with an article in the New York Times. While the unconventional approach raised a few eyebrows, our initial results look promising so far – the campaign seems to be reaching the target audience and having the intended effect. In just nine short months, the website has experienced over 200,000 unique visitors averaging over 6 minutes per visit. More than 60,000 people have completed the 18-point head inspection (a self-screening tool) and 15,000-plus have accessed information on crisis services. The qualitative feedback we have received from men and therapists alike is that men’s thinking about mental health shifts during their interaction with www.ManTherapy.org  and they are more likely to do something different about their problems as a result.

     While innovation is particularly unnerving in a profession where lives are at stake, we must “be visible, be vocal, be visionary. There is no shame in stepping forward, but there is great risk in holding back and just hoping for the best.” (Higher Education Center)

Wellness: A Holistic Approach to Suicide Prevention

           Why do people burnout and find themselves spiraling into hopeless despair? Part of the answer lies in upstream preventative maintenance, or “wellness.” In our very busy world, we all need to figure out how to take better care of ourselves. When people hear the term “wellness” they often just think of physical wellness:  sleeping eight hours a night, drinking 64 ounces of water a day, working out for at least ½ hour three times a week, eating five fruits and vegetables a day, etc.  Physical wellness is important, but it is only one dimension of overall wellness. Mental, social and emotional, and spiritual aspects of wellness are also key and highly related to each other.

I remember my first run after the death of my brother. I had been running as my main form of exercise for almost 8 years before he died. I found that running was the sport for me – someone who valued exercise but didn’t bring many athletic gifts to the table. I started doing marathons in 2002, and found myself hooked. I was training for the Little Rock Marathon in Arkansas when Carson’s suicide literally knocked me off my feet. I was barely able to get out of bed and function each day, let alone train. But somehow, one day I put on my running shoes and headed out the door. Thoughout the whole run, I had tears on my face. For the next 10 weeks, running became my therapy. My time alone, away from all the trauma; my time to grieve and to think. I ran the marathon and dedicated each mile to a memory of our lives together. Today, I continue to run almost daily, and find it is a critical part of my mental health practice.

A large body of research shows a positive association between physical activity and psychological well-being.^[1] New research is supporting a connection between exercise and suicide prevention. Even after adjusting for confounding variables such as demographics, depression, alcoholism, and more, the risk for nearly lethal suicide attempts was five times greater among those who had not been physically active in the past month than for those who were.^[2] Another study compared athletic and nonathletic adolescents and found that the most athletic felt depressed less often and were much less likely to report suicidal thoughts or attempts.^[3] A more recent study found that aerobic activity provided a distinct protection against suicide by reducing the risk of hopelessness and depression. There was one exception to this finding: women who combined frequent physical activity with deleterious dieting behavior had a greater risk for suicidal behavior.^[4] So yes, physical wellness is a very important contributor to overall health, but there is much more to wellness than this.

Mental wellness is about always sharpening our skills and committing to lifelong learning.  Mental wellness comes from a sense of inner responsibility to always finding ways to improve – increasing knowledge, asking critical questions, trying new things, advancing skill sets, and so on. Social and emotional wellness is about keeping our relationships and our emotional well-being intact. It’s about conflict resolution, self-esteem, and coping skills. Finally, spiritual wellness is about committing to something larger than us – whether that is participating in our faith community, volunteering to serve the common good, standing up for injustice, or appreciating nature.

As with any preventative maintenance process, each wellness component needs attention over the long term so that we can sustain high performance over time. Unfortunately, when we are in crisis mode, these wellness practices are often the first to go. We cut out sleep, skip our weekly faith services, and drop out of therapy because we are just too overwhelmed with our lives. And just like when we neglect to change the oil and rotate the tires on our car, these decisions come back to haunt us.  

In order to self-assess your commitment to wellness, track the amount of time and money you spend in crisis mode – cramming for exams, dealing with drama in their relationships, tending to illnesses and injuries, and so on – and how much time and money you spend in true wellness practices (escape behaviors like hours of video games and excessive drinking do not count). When you do this, you often quickly realize that one of the reasons you constantly feel in a state of distress is because you are neglecting yourself.

Research tells us that pro-healthy-lifestyle attitudes matter greatly.^[5] Those who see health as a value and have an optimistic perspective have built-in buffers against psychological distress. Optimism was actually the best predictor of both psychological well-being and decreased levels of distress. The researchers explained that this positive outlook helped students persevere during difficult times. “Health as a value” was seen in students who are likely to refrain from health-compromising behaviors like substance abuse and who are more like to engage in health-promoting behaviors like working out. This stable, enduring characteristic was linked to psychological well-being.

In closing, sometimes all you need to get through the bumps in life is a little reminder of an Irish proverb, “A good laugh and a long sleep are the best cures in the doctor's book.”

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[1] Taliaferro, Lindsay, Rienzo, Barbara, Pigg, Morgan, Miller, M. David, and Dodd, Virginia (2008). Associations between physical activity and reduced rates of hopelessness, depression and suicidal behavior among college students. Journal of American College Health, 57, 427-435.

[2] Simon, T., Powell, K. & Swann, A. Involvement in physical activity and risk for nearly lethal suicide attempts. American Journal of Preventive Medicine, 27(4), 310-315.

[3] Ferron, C., Narring, F., Cauderay, M., & Michaud, P (1999). Sport activity in adolescence: Associations with health perceptions and experimental behaviours. Health Education Research, 14(2), 225-233.

[4] Taliaferro, Lindsay, Rienzo, Barbara, Pigg, Morgan, Miller, M. David, and Dodd, Virginia (2008). Associations between physical activity and reduced rates of hopelessness, depression and suicidal behavior among college students. Journal of American College Health, 57, 427-435.

[5] Burris, Jessica, Brechting, Emily, Salsman, John, Carlson, Charles (2009). Factors associated with psychological well-being and distress of university students. Journal of American College Health, 57(5), 536-542.

Marathoning is about Resilience: “A Tough Blow – A Tougher Town” – Tougher Sport

As an avid marathoner and a former Bostonian, I found myself like so many around the world crushed by the news of the devastating events of the Boston Marathon bombing this week. I spent countless hours going through news websites and listening to NPR trying to get my mind to comprehend what happened.

Although I am thousands of miles away, I can see it. I will never be able to achieve a qualifying time for this premiere race, but I can imagine what it might have felt like to be a 4:09 finisher. To see the finish line and anticipate the cheers and hugs from family and friends – all you can think about is crossing that threshold. I have an eight-year-old boy, the same age as Martin Richard, one of three people killed in the blasts. I can imagine looking for him and my other sons and husband in the crowd. I can feel the confusion of the thousands of runners who were told to stop in the middle of a race that many of them had probably prepared for over months or years. I can remember the celebration of a city and state so proud of this iconic event they actually take a holiday so everyone can take part.

As the events unfolded, I read an outpouring of tweets from the international marathon community, stunned and disturbed by the news, as the images of the worlds’ flags blowing from the blast were seared into our consciousness.

The next morning I poured through the Boston Globe, I was reminded about the special bond between runner and spectator. Very few other sports let spectators touch or feed the athletes during the competition. Spectators, with their cow bells and goofy signs, often provide the energy that lifts the runner through the difficult parts of the race. And yet, at this tragedy, it was the spectators that suffered the most damage.

So tragic, so senseless all of this. And yet, “in the night of death, hope sees a star and listening love can hear the rustle of a wing” (Robert Ingersall). What we all saw and read that day and since gives me great hope about our humanity:

·         The first responders and medical teams who signed up for the event thinking they would be handling traffic, dehydration and blisters who then found themselves in the middle of a war zone and just did what needed to be done

·         The residents who took so many stranded runners into their homes and gave them comfort and a way to connect with their families

·         The runners themselves, some of whom gave blood after running an exhausting race

·         The Bostonians who refused to let this stop their city. As Scot Lehigh of the Boston Globe stated in his editorial, “…We won’t be paralyzed by fear. We’ll take reasonable precautions, yes. But we won’t take cover. And we won’t cower. This, after all, is Boston.”

The Boston Marathon will continue to be the iconic event for runners and spectators everywhere. Boston will continue to pull together, recover and thrive. It may have been a tough blow, but as Lehigh said, “it’s a tougher town” with a tougher sport that won’t be brought down.

Suicide Risk and Children with Disabilities

Written Originally on March 22, 2013

This morning I was interviewed by the Mary and Melissa Show, a call-in advocacy radio talk show led by two mothers living in the Nation's Capital who share the hurdles of raising kids with disabilities.

http://www.blogtalkradio.com/themaryandmelissashow/2013/03/22/a-tough-one--suicide-and-disability

Before I launch into this difficult topic, I want to emphasize that people with disabilities who are supported and celebrated for who they are will have a high likelihood of successful and happy lives and rarely, if ever have problems with suicidal behavior.  For many people with disabilities, the suicidal thoughts are less about the direct consequence of the disability and much more about the negative social expectations, exclusion and bullying that can result from the misunderstanding rampant in our society.[1] So while I may be presenting some information today that is concerning for parents about the safety of their children, I want to reassure them that there is a lot we can do to build protective factors for kids and prevent the escalation of despair by knowing what to look for and what to do when warning signs emerge.

That said, here are some concerning statistics on the topic of disability and suicide:

·         Teens with a learning disability such as dyslexia are ten times as likely to die by suicide as someone without a learning difficulty.  One study from Canada examined the suicide notes left by 267 teens, and an alarming 89% of the notes had spelling and grammatical errors indicative of learning disabilities.[2]

·         Childhood ADHD can linger into adulthood and suicide may become a concern. In a recent study cited reported by CNN, 200 adults who had ADHD as children tracked for mental health challenges. A stunning 57% had some type of psychiatric disorder (alcohol abuse, anxiety, depression) and were 5 times more likely to die by suicide. The reporter concluded that people with ADHD don’t tend to grow out of it and a combination of depression and impulsivity for an ADHD adult can have deadly consequences.[3]

·         A recent report on Disability Scoop that shared that children with autism were 28^th times more likely than typically developing kids to contemplate or attempt suicide. Those who were bullied, male, black or Hispanic, age 10 or older and those with lower socioeconomic status appeared to be at highest risk.[4]

What can parents of children with disabilities do?

As a mother of a teen with severe dyslexia and as someone who lost her brother to suicide after his struggle with bipolar disorder, I am very concerned about this connection. Fortunately, I feel confident that there are things we can do to be effective advocates for and supporters of our kids to help them flourish and thrive while managing the challenges they endure.

·         Challenge the social barriers. Our first step in this process is to overcome the social barriers to this difficult topic. Knowing that social barriers also exist for issues related to living with disabilities, we have a double-duty piece of work cut out for us. For the issue of suicide, there are many misperceptions we can work toward dismantling with effective dissemination of stories and science. When we share powerful stories of hope and resilience, we let others know that suicidal behavior and struggles with disability ebb and flow and that people who experience these life challenges have much more in common with others than they do have difference. These stories help people create roadmaps for recovery and coping and are critical in shifting the misperceptions that can lead to marginalization. The second strategy is science. We need to present solid, credible data that helps shape the case for understanding that disability and mental illness concerns are not about moral failings, but about complex social, psychological and biological functioning that can be affected with treatment, accommodation, and coping.

·         Know the model of suicide risk and suicide warning signs. If I am going to recommend one book for people interested in learning more about suicide risk, I encourage them to read Thomas Joiner’s Why People Die By Suicide (2005, Harvard University Press). In this theory, Joiner says that those who kill themselves not only have a desire to die, they have learned to overcome the instinct for self-preservation. That is, wanting death, according to Joiner, is composed of two psychological experiences: a perception of being a burden to others (perceived burdensomeness) and social disconnection to something larger than oneself (thwarted belongingness). By themselves, however, neither of these states is enough to move a person to act on the desire for death, but together with an acquired capacity (or fearlessness) they result in a high risk state for suicide. Acquired capacity can come in the form of innate temperament (risk-taking/impulsivity), learned conditioning from provocative and painful experiences, or access to and knowledge of lethal means. Understanding this model can help parents look for themes in communication and patterns of behavior with their children.

Additionally, parents should be aware of the expert consensus  guidelines for suicide warning signs (summed here with the mnemonic IS PATH WARM):

I               Ideation (suicidal thoughts)

S              Substance Abuse

P             Purposelessness

A             Anxiety

T              Trapped

H             Hopelessness

W           Withdrawal

A             Anger

R             Recklessness

M            Mood Change

For more on this mnemonic: http://www.suicidology.org/c/document_library/get_file?folderId=232&name=DLFE-31.pdf

·         Screening and surveillance for suicidal behavior. Training and screening tools are important weapons in the fight against suicide. Parents, teachers and others who come into contact with youth can quickly learn the warning signs of suicide and how best to link others to care by going through national best practice “suicide prevention gatekeeper trainings” like QPR (stands for Question, Persuade, Refer – for more information: www.qprinstitute.com). Within one to two hours, lay people can be given the basic skills on what to look for, how to ask the difficult “suicide question,” and how to refer people to qualified mental health and crisis services (see below). Screening tools like those supplied by Mental Health Screening can help parents, educators and primary care physicians quickly assess risk for any number of mental health conditions: http://www.mentalhealthscreening.org/

·         Link children to qualified mental health and crisis support when warning signs are identified. Identifying youth at risk is the first step in the chain of survival; linking them to care is the next. Those at risk for suicide and the people who support them need to have quick access to qualified services. Two of the best resources I am aware of are:

o   National Suicide Prevention Lifeline – a free and confidential emotional support to people in suicidal crisis or emotional distress 24 hours a day, 7 days a week

§  1-800-273-TALK (8255) and http://www.suicidepreventionlifeline.org/

o   HelpPro -- HelpPRO, the oldest, most comprehensive Therapist Finder, to help people find qualified suicide intervention mental health professionals

§  http://helppro.com/default.aspx

So in conclusion, I have observed tremendous passion in both the disability advocate world and the suicide prevention world. Both fields are fraught with marginalization and misunderstanding, and in both there is a lot of hope fueled by tireless family and friends and people living with these conditions and experiences. I say, let’s pull together and unite in our effort to be heard, be understood, and create change so that people can get back into a “passion for living.”

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[1] Disability and Suicide: The Social Factors that Put People with Disabilities at Risk (2/28/2013 by Amanda Lunday) http://www.theindependencecenter.org/blogs/independence-times/2013/2/28/disability-and-suicide

[2] Dying To Read http://www.dyslexicsuicide.com/

[3] March 4, 2013: ADHD may continue in adulthood, lead to another psychiatric disorder – Elizabeth Cohen reports http://earlystart.blogs.cnn.com/2013/03/04/adhd-may-continue-in-adulthood-lead-to-another-psychiatric-disorder-elizabeth-cohen-reports/?iref=allsearch

[4] Michelle Diament (2013, March 12). Kids with autism face increased suicide risk. http://www.disabilityscoop.com/2013/03/12/kids-autism-suicide/17483/