The Simple Gift: Reaching Out and Renewing Hope at Work

Reprinted with permission by the Colorado HR Association

Photo by mmlolek


After my brother died by suicide in 2004, my workplace gave me the most amazing gift – the gift of their support. As many of them reached out to me, their kindness made all the difference in my ability to cope with this devastating loss.

First, there was Jerene, my direct supervisor. Just two days after my brother’s death, Jerene called me up, “Sally where are you? I am coming over to give you something.”

She drove from our workplace up to my parents’ home and delivered a huge vat of chicken soup. During a time when my family could barely choke anything down, that soup sustained us.

Then there was Tom, my Vice President. On the day of the memorial service, Tom joined many of my co-workers at the church. After the service was over, he found me and gently cupped my face in his hands to express his sympathy. This tender gesture was so heartfelt and kind; I will never forget it.

Finally, my bereavement leave ended, and I found myself facing the reality that I needed to return to work and some level of functioning. When I opened the door to my office on my first day back, my desk was covered with cards, flowers and well-wishes. From co-workers I knew well, and from folks I didn’t know at all. I instantly knew that the support I was going to get was going to carry me through this very difficult part of my life.

Belonging

Humans are hardwired to be in relationship with others. For some these are vast connections and broad social networks, and for others just a few intimate bonds are all they need. Workplaces that are mentally healthy cultivate a sense of belonging. Work teams and social groups can sometimes evolve into friendships that last a lifetime. Belonging fosters a sense of trust and interdependency that can help distressed workers find hope during tough times. When workmates pull together around difficult assignments, the encouragement they give one another can be the protective factor that decreases the impact of high levels of stress. For these reasons, workplaces that foster genuine belonging will find they have more mentally resilient employees.

A Little Goes a Long Way

While we can all think of some people that are constant drains in relationships because their needs are so great, most people do not need much. A little caring usually goes a long way. For example, in one study, hospitals sent caring letters to people who had recently been discharged after a serious suicide attempt. The letters just said something to the effect of, “We’re so glad you came in for treatment. Please, call us if we can help in any way.” Each letter was personalized to a small degree and signed by the attending care provider. The research found that the patients who received the caring letters were significantly less likely to have a subsequent suicide attempt than those who didn’t get the letters. If that wasn’t enough, the study was replicated using computer generated postcards – no personalization whatsoever. The same outcome resulted. If a computer generated postcard can have this level of impact, think about what is possible when people who know each other reach out and say, “I see that you have been looking down lately. I am here for you.”

Reaching the Unreachable

Another known fact is that people who have multiple risks for suicide are also sometimes the least likely to seek help on their own. Because of this, caring work communities need to be intentional in reaching the “unreachable.”

Mother Teresa was known for helping those that no one else would. In a story she wrote in her book, In the Heart of the World, she talks about finding an elderly man who had been ignored by everyone and whose home was in complete disarray.

She told him, "Please, let me clean your house, wash your clothes, and make your bed." He answered, "I'm okay like this. Let it be."

She persisted and he finally agreed. While she was cleaning his house, she discovered a beautiful lamp, covered with dust.

She asked him, "Don't you light your lamp? Don't you ever use it?"

He answered, "No. No one comes to see me. I have no need to light it. Who would I light it for?"

She asked, "Would you light it every night if the sisters came?"

He replied, "Of course."

From that day on the sisters committed themselves to visiting him every evening. They cleaned the lamp and lit it every evening.

Two years went by and Mother Teresa had completely forgotten that man when she received a message from him: "Tell my friend that the light she lit in my life continues to shine still."

Re-Gifting

One of the great things about the gift of reaching out is that we can re-gift it and people don’t think it’s tacky. It turns out the idea of “paying it forward” is both a gift to the receiver and a gift to the giver. When people who have been helped through a difficult time are able to help another, they often find meaning in their earlier struggle and value the wisdom gained.

This notion of “reciprocity” is one of the cornerstones in what make programs like Alcoholics Anonymous work. When people successfully go through the 12-steps of the program and maintain their sobriety, they can become sponsors and support others who are just beginning. The work of being a sponsor helps many maintain sobriety because it strengthens positive self-regard. Furthermore, sponsors find that being there for someone else makes them hold themselves accountable to being a worthy role model.

If people who are resistant to seeking help see an opportunity to pay it forward by mentoring another down the road, they often become more inclined to receive the gift of help. Peer support and mentoring programs offer these opportunities at worksites, but other opportunities can exist within communities.

In summary, reaching out is a great gift – one size fits all, and it’s easy to exchange.

For more information on suicide prevention, intervention or postvention training visit www.WorkingMinds.org or contact Sally@CarsonJSpencer.org.


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What have you noticed about how others do or do not give each other support at work?

Tsunami: The Aftermath of a Suicide Crisis

My brother Carson died by suicide December 7, 2004 -- the anniversary of the bombing of Pearl Harbor, two weeks before Christmas, and two weeks before his 35th birthday. It was also two weeks before the Asian tsunami. As the world reacted to that disaster, the aftermath of Carson’s death similarly hit our family, as we too were flooded, overwhelmed, and left helpless. The news of his suicide crashed tsunami-like around us – totally engulfing us in despair and darkness. Frozen and in shock, we fought for every breath, thinking “This cannot be happening.” I confused night with day, day with night. I remember feeling very, very vulnerable. I would be driving to the airport to pick up a guest for Carson’s memorial service and I would look up and have no idea where I was or what I was doing. Then I would be hit by a wave of panic as I were sure everyone on the road was going to hit my car.


After the birth of my third child in September, I had been on maternity leave for the months leading up to Carson’s death. I had burned up all my sick and vacation time, and the three days we are given to grieve a first degree relative. I needed to resurface and go back to work. I remember coming up for air and looking around; the landscape had changed because my brother was no longer in it. Everything looked and felt different. Things that were so desperately important at work before no longer mattered. I both dreaded and welcomed my first day back to the office. Dread because I just didn’t care anymore; desired because I missed the structure and sense of purpose my workplace provided me. I remember the first day back. I opened my office door to see a pile of cards and flowers on my desk. My inbox was filled with well-wishes, many from people I didn’t even know. I knew with this level of support that I would be okay. My workplace gave me the flextime to access our Employee Assistance Program and attend support groups, which I did. They told me to do what needed to do to get back on my feet, and I am forever grateful for their kindness during this very trying time in my life.

Just like the tsunami, the ripple effects of Carson’s death spread deep and wide, and to this day still continue to affect others. Thanks to social media, I am still connecting with people Carson knew who are just now learning of his passing. His co-workers and business partners established a scholarship in his memory designed to help young entrepreneurs get to college. This loving affirmation of my brother’s life carries on his gift of helping others and gave many of those connected through his work a chance to honor his life.

The aftershocks of the trauma were severe at first, some of them predictable like on Father’s Day, his wedding anniversary, his birthday, and certainly his death anniversary. Others caught us off guard, like the time I was digging through a box of photos. I found a picture that I had forgotten about, of us dancing at my wedding. Not many brothers and sisters dance to their own song when they get married to another person, but Carson and I had a song: Whitney Houston’s “I Will Always Love You.” Whenever we heard it on the radio we would belt it out to each other at the top of our lungs as silly as possible. At my wedding, Carson and I twirled around the dance floor – my hair coming out of the up-do, his shirt hanging untucked from his tuxedo. And someone snapped a picture as we joyously sang the chorus, eyes locked and laughing. When I found this picture, I wept and wept. Then I made a copy of it to hang next to my computer at work, so I would never forget.

As with the tsunami, the rebuilding process has been long and hard, requiring many systems of support. In this sense I often feel lucky, because unlike many survivors of suicide I had a workplace that was supportive, a faith community that understood his suicide as the fatal outcome of a mental illness (not a crime against God), and a network of friends and co-workers who did all the right things.

I don’t tell this story because I want pity or because I need sympathy. While losing Carson has clearly been the most difficult experience of my life, I have been given many gifts along my grief journey. I was reminded of this by the leader of the rock group Seether, who lost his younger brother to suicide and wrote a song called “Rise Above This” on the album Finding Beauty in Negative Spaces. This too has been my experience in grief. I have found depth in relationships and spirituality and an unwavering calling of vocation. No, I don’t want anyone to feel sorry for me. I tell this story because so few families do, and thus, people think it can never happen to them. While I am humbled by this experience, I am also hopeful. Suicide is arguably one of the more preventable causes of death, so I also share this story in hopes that others will come forward and say, “I too have been affected, and I want to make a difference - how can I get involved?” And finally, I share this story because people who are in a suicidal crisis often think they those who love them will be better off without them. I am here to tell them that suicide causes a legacy of trauma and pain that continues for generations. No matter how hard it gets, you never know what is waiting for you around the corner.

Bridging the Gap: Interview with Author Jack Jordan

Reprinted with permission from the American Association of Suicidology's Surviving newsletter

Jack Jordan, co-author of Grief After Suicide (available on Amazon.com)

As I was pulling together my syllabus to teach a course on Suicidology to graduate level clinicians, I was searching for a text on suicide postvention when one arrived at my doorstep. Dr. Jack Jordan, a clinical psychologist from Pawtucket, Rhode Island, had sent a copy of the recently published book Grief After Suicide: Understanding the Consequences and Caring for the Survivors. Jack co-authored the book with Dr. John McIntosh and sent it to me for my review. After flipping through the pages, I was impressed with the depth and breadth of the book, and called him immediately to thank him and interview him about this work. The following conversation transpired on December 3, 2010.

Sally: Who is Jack Jordan?

Jack: I’m sort of an odd duck. I’m a clinical psychologist in private practice, but I also function like an academic. Twenty-five years ago, I became involved in the “Family Loss Project” – a group of practicing clinicians who were interested in the impact of loss on family systems, especially multigenerational impact.

Sally: How did you get into the work of studying grief among survivors of suicide loss?

Jack: Thirteen years ago, I had an epiphany. We were working with survivors of suicide loss in our practice and I thought, “They should be talking to each other.” So, we started a support group and it ran for about 13 years. To me, this was an inspiration. I saw their suffering, but I also saw their resilience and how they helped each other.

Sally: What came next?

Jack: I became involved with the American Foundation for Suicide Prevention and co-wrote the manual for their facilitator training program with Joanne Harpel. I took the training for the Suicide Prevention Resource Center’s Assessing and Managing Suicide Risk curriculum. Now I train and consult around the country and the world.

Sally: Has suicide touched you personally?

Jack: I am a distant suicide survivor – my great uncle took his life in 1987, but it was not a life-transforming loss because I only knew him in my childhood. It was my Dad’s death due to cancer when I was in my 20s that pulled me into grief work.

Sally: What is the inspiration for the book?

Jack: The book comes out of my interest in bridging the gap between research, academia, clinical work, and survivors. It has been apparent to me for a long time, somebody needs to do this; so finally I decided, maybe it’s me. I invited John [McIntosh] to work with me because he has researched and written about survivor issues for a long time.

Sally: What are the goals for the book?

Jack: Our target audience is really researchers and clinicians, and to a lesser extent activist survivors. This is not a self-help book; it’s really meant to say, “What has happened in the last 20 years in the field of survivor studies?”

Sally: Tell me about the book’s journey. What have been some of the challenges and celebrations?

Jack: I have gone from despair – was I actually going to survive this? – to some revelations. Everyone connected to you endures some of this. I pay homage to my wife for her patience. The revelation came because this work helped me see even more clearly how much is going on simultaneously around the world. Suicide awareness and prevention have been coming out of the closet. Now survivors are too. I hope the book accelerates this. All this amazing stuff. This work also helped me understand that despite some obvious cultural differences, the themes of survivor grief are similar around the world. I expected more differences, but at the heart of it all, losing someone to suicide transcends cultural difference.

I had a great partner in this. John loves to do the stuff I loathe. The APA references made me completely nuts. Thank God John could do this. My forte is about broad strategic thinking and writing.

Sally: What has happened since the book was published?

Jack: I went to a conference in October [2010] and had not seen a hard copy yet. There it was, and someone asked me, “Would you autograph these?” Strange experience. Surreal. I thought, “Oh, the cover came out pretty good. Maybe I’ll buy a copy.” Hopefully, the book will serve as a catalyst in the field, stimulating more research and clinical theory.

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For more resources for Survivors of Suicide Loss visit the American Association of Suicidology: click here.
 
The Carson J Spencer Foundation offers families recently bereaved by suicide iCare Packages (semi-customized resources packets). For more information: click here.


What are your thoughts on what is needed to support survivors of suicide loss?

How to Develop Mental Health Awareness Programs

I love dreaming up innovative and engaging suicide prevention and mental health promotion programs with students and communities. When I am with a group in the brainstorming phase of what is possible, I get really excited about cool programs that might reach people in new ways. When we generate our list of ideas, and narrow down on what we THINK might work, we then ask ourselves, how will these ideas fit into a comprehensive and sustainable approach?


Here are three key steps to developing a successful mental health program:

STEP #1: Develop a Circle of Evaluation – we all know that resources for mental health promotion are precious on our campuses and in our communities, so we must make sure we are maximizing positive change. In order to do this, we need to find ways to measure our outcomes along the way. Throughout the process of the program’s development and implementation we can figure out what is working and what’s not by:

• Conducting a needs and strengths assessment to determine where the gaps on our campuses are

• Piloting our campaign or program before we implement to make sure we are on the right track

• Measuring immediate impact beyond just “numbers of people who attended” – what are we hoping happens after people have been exposed to our program? For ideas look into best practices in program evaluation.

• Evaluating longer-term outcomes – what is the ultimate purpose of our programs and are we meeting those goals?



One effective tool to use when developing a mental health program is a LOGIC MODEL. This process helps you think through the above questions and how they link together.

STEP #2: Look at All Levels of Prevention

When I ask folks which groups we need to focus on when we develop our suicide prevention and mental health promotion programs, I inevitably hear “everyone!” While it’s true that everyone can potentially benefit from some piece of a larger mental health promotion effort, I find when you try to reach EVERYONE, you end up reaching no one. As you develop your mental health program consider these three levels of prevention:

• Primary prevention is designed to reach a whole community by promoting general strategies that we can all benefit from (e.g., knowing the Suicide Prevention Lifeline 1-800-273-8255)

• Secondary prevention is targeted at high risk groups such as people with pre-existing mental health conditions or LGBT students. These strategies look at minimizing risk factors and bolstering protective factors for these groups.

• Tertiary prevention strategies focus on individuals who are already distressed and are designed minimize the impact of mental illness or suicidal behavior (e.g., promoting mental health services or support groups).

STEP #3: Research Evidence-Based Practices

When you are developing your programs, you should consult the Best Practice Registry to get some guidance on where to start. Because there is so much emerging research in the fields of mental health promotion and suicide prevention, you may find there is little research in your specific area. If this is the case, you can also look at respected theories like Dr. Thomas Joiner’s Interpersonal Theory of Suicide or Dr. Patrick Corrigan’s work on stigma reduction to help guide your decisions. Be sure to also consult the safe messaging guidelines before you get too attached to an idea, because sometimes what we THINK helps people, actually can increase risk.

Resources for Next Steps

Please visit the following resources to research what we know works in suicide prevention:

http://www.sprc.org/
http://www.peoplepreventsuicide.org/

I have a draft of a mental health programming booklet – please email me (Sally@CarsonJSpencer.org) if you would like a copy.

Be creative! Be strategic! Have fun and let me know how it goes. If you want to share your programs with me, I would love to include them in the booklet.

For a more in-depth presentation of these topics, please listen to my podcast:

PODCAST



Man Up! Suicide Prevention and Men of Working Age Part I: Men at Risk

photo from Velvettangerine

• Suicide is the second leading cause of death for men 25-34 
• Males are four times more likely to die from suicide than females
• The majority of people who die by suicide in Colorado are white (non-Hispanic) men of working age   

Source: WISQARS, Centers for Disease Control

Gender role socialization theories offer a perspective that helps explain these statistics. Cultural codes of achievement, aggression, competitiveness, and emotional isolation are consistent with the masculine stereotype; depressive symptoms are not.  Cultural ideals of rugged individualism lead to social fragmentation and fewer coping alternatives.  In fact, when we look at gender roles a double jeopardy emerges.  That is, those men who are in the most need of psychological help are the least likely to use them.

            According to Mansfield, Addis and Mahalik (2003), when men consider seeking help, they often go through a series of internal questioning:

1)      Is my problem normal?  The degree to which men believe other men experience the same problem affects their decision to seek help.  A prime example of this psychological process is erectile dysfunction.  Before Senator Bob Doles’ public disclosure, many men thought they were the only ones suffering from this highly common and highly treatable problem.  After the public campaign, many more men sought help.

2)      Is my problem central to who I am?  If the mental health symptoms reflect an important quality about the person (for example the hypomania in bipolar disorder that impacts creativity or productivity), then the person will be less likely to seek help.

3)      Will others approve of my help-seeking?  If others, especially other men, are supportive, then the person will be more likely to go.  Help-seeking is particularly likely if the group is important to the person and unanimous in their support.

4)      What will I lose if I ask for help?  For many the biggest obstacle for asking for help is fears losing control: losing work privileges or status, being “locked up,” or losing one’s friends or family.

5)      Will I be able to reciprocate?  Usually, the mental health services offered do not allow opportunities for reciprocity.  Because of ethical standards, the mental health practitioner is often not allowed to share personal information or receive favors, thus maintaining a position of power over the client.  For some men, receiving help is acceptable only if they can return the favor later on; in the relationship with a mental health provider, this is often not possible.  One exception is Alcoholics Anonymous (AA).  According to their mission, “Alcoholics Anonymous is a fellowship of men and women who share their experience, strength and hope with each other that they may solve their common problem and help others to recover from alcoholism.” According to the AA fact file, men make up 65 percent of membership in AA, indicating that this model of reciprocity is appealing to men. By contrast, among persons with any recent mental health disorder, a higher percentage of women (16%-26%) made mental health visits than men (9%-15%).

Thus, as we begin to this of how to reach men at risk, we need consider alternative ways to reach those who might be the least likely to seek help. This requires a paradigm shift on our part. Stay tuned to the second part of this series to learn more.

What are your thoughts on men and help-seeking?

The Gift of Secrets

As we find ourselves in the season of gift giving, I recalled a great lesson I learned from a man with a simple but profound idea.


“We keep our secrets in a box. Sometimes we bury them deep like a coffin. Sometimes they are like a gift that we open up and share with others,” Frank Warren, founder of PostSecret, said to a packed audience of college students who participated in this year’s Active Minds Annual Conference in New Jersey.

Frank Warren at Active Minds Conference

As a mental health speaker, I love to hear other speakers share their ideas on how to help people thrive. I was especially transfixed by Frank Warren, America’s most trusted stranger, talk about the power of secrets in our lives. Frank started with a simple idea: letting people unburden themselves of their secrets by encouraging all to send their anonymous secrets to him on postcards. What has evolved over the years is a compelling project with a strong suicide prevention message.

Frank has had secrets mailed to him on sea shells, a potato, even a death certificate. Of the millions of secrets he has received from all over the world, he has learned a few things about what we hide about ourselves and how we are very curious to know these potent pieces of information about each other.

“At the center of these secrets there is a kernel of wisdom we can grow from,” Warren states. “When we think we are carrying a secret, sometimes it is actually carrying us. Blocking us from what we might otherwise be.”

Frank has learned one of the important tenets of my resiliency talks – sharing our personal struggles helps us to create intimacy and community with others. When we go beyond “the mask” we wear each day, we create a deeper channel of knowing and a stronger bond. This sense of belonging can help us withstand future challenges we might face. Frank closes his talks by training students on some basic suicide prevention skills: ask the direct question “are you thinking about suicide?” and know your resources for mental health help, like the 1-800-273-8255 Suicide Prevention Lifeline.

Frank has also witnessed how we can overcome our brokenness and become more resilient by rising above our hardships in live, “the children almost broken by the world become the adults most likely to change it tomorrow.”

Thank you, Frank, for a wonderful example of how a simple idea can move the world to action.

What are your thoughts on the power of secrets?

Social Entrepreneurship Part II Working Minds for Youth: Social Enterprise for Suicide Prevention

The other night our high school social entrepreneurs were amazing. After serving them pizza, we gave them a 20-minute challenge: to work together to develop a t-shirt or mural idea that would help prevent suicide in their community. We mixed students from different schools into small groups, gave them pens and paper and let them go.

Social enterprise students brainstorming ideas for suicide prevention

Now these students aren’t new to the ideas of suicide prevention or social enterprise. They have been working with the Carson J Spencer Foundation and Junior Achievement since September to gain mastery in both areas and have been thinking about how the two missions might best work together. Every week for at least an hour they receive coaching on business skills like marketing, finances, and product development and on suicide prevention skills like how to be a suicide prevention gatekeeper, how to conduct a needs analysis and how to promote safe messages to increase awareness. They are a passionate, dedicated crew.

The challenge this week was just a warm up, and you can see some of their excitement and creative ideas by viewing this 3-minute video montage.

In February each school participating in this project will have developed a viable business plan for a social enterprise for suicide prevention. In other words, they will have dreamt up a sustainable product or service that will raise money and create a positive change for this life-saving cause. They will then pitch their ideas before the Carson J Spencer Foundation’s Board of Directors, competing for seed money to launch their business. Winners will go on to use the money to implement their plans during the spring semester. At the end of this second semester another round of competition will take place – this time the winners will be rated on both the financial profit and the social profit earned through their work. They will be rated on: innovation, effectiveness, sustainability, and revenue.

Green Mountain High School students cheering after winning business plan competition

I love this project because it just works on so many levels. By partnering with Junior Achievement, we are engaging a new audience for suicide prevention: our future business leaders. Students are passionate about suicide prevention because even at their young ages, many of them have already been touched in some way – either their own mental health crisis, or someone they love. The project is also just plain cool. Social enterprise is a great new trend – a creative blend of the efficiency of the business sector with a heartfelt mission of the non-profit sector. Students are empowered to use their creativity and be leaders in their community. Win, win, win.

Check back in February to see how they did…