Suicide Awareness Month

September is Suicide “Prevention” Month. September is immediately followed by October’s Breast Cancer “Awareness” Month. My family and I are survivors of both of these diseases. We have survived breast cancer and suicide loss. Have you ever considered why one is called Prevention and the other Awareness? Is suicide preventable in a different way than cancer?

I have seen some organizations, such as the Alliance for Hope and The Trevor Project, call September Suicide Prevention Awareness Month in order to acknowledge the complexity of suicide and the fact that much of the current prevention messaging is difficult for survivors of suicide loss. I very much appreciate this.

As a survivor of suicide loss, many of the simplistic sounding messages surrounding suicide prevention are often difficult for me. I see suicide as a disease, similar to cardiovascular disease or cancer. They are diseases fed by society and environmental pollutants. Can we do things as individuals to minimize the risk of death by suicide? Yes. Is it possible to prevent all suicide deaths? Unfortunately, I don’t think so. Do we have a collective duty to work together to make our world better in order to minimize the deaths caused by all of these diseases? Also yes. When the government pours cancer causing pollutants into the river, it is responsible for the cancers caused by the contaminated drinking water, and it is also responsible for cleaning up the river.

I have struggled with my own suicidal ideation, I have helped others manage suicidal ideation in a professional capacity, I did everything humanly possible to save my child from suicide, and I have spent countless hours listening to stories from others who have lost the most precious people in their lives to suicide. I believe I have a lot to offer others on this topic. These are a few things that I would like to share during Suicide Awareness Month. 

It’s not always depression. The complexity of suicide is not typically acknowledged. Suicide is usually seen as the end result of depression. While this is sometimes true, it is not always the case. Suicide can be the result of unsupported or unidentified autism or ADHD, and in many cases (particularly with child suicides) the decision is very impulsive.¹ Suicide deaths can also be the result of a deleterious medication side effect or another underlying illness. Just like chemotherapy, sometimes the intervention is not tolerated and makes things worse. Suicide deaths are complex. 

Telling people to Call 988 is not enough. 988 is a great resource and I am thankful it is there. I encourage people to use it. I love that it is now three digits and that you can text or chat anonymously via a web browser. Sometimes, a nonjudgmental listener can save a life. Putting time and distance between a person and a plan is critical. However, why are we putting the onus on the one who is suffering to reach out? Do we tell someone with a broken leg who is lying in the street to get up and call an ambulance? Someone who is suicidal is the equivalent of a stage 4 cancer patient. They have a life threatening medical condition. Who has the burden here? The patient? The doctor? Society? There is no easy or one size fits all answer. Please, reach in when possible, and as early and often as you can. We have a duty to care for each other. Always.  

Messages can feel shaming for survivors. Those of us who have lost a loved one to suicide are at high risk ourselves. We are much more likely to die by suicide. We are suffering from significant trauma and grief that is lifelong. I don’t say this to be morose, I say this because it is a reality that is largely unrecognized by society. I say this because when on top of our own trauma, grief and immense and never-ending pain we also receive simplistic messages that if only we had had a conversation with our loved one or [insert other seemingly simple thing] we could have prevented our loved one’s death, the message feels shaming. It feels awful. We would have moved heaven and earth to save our loved ones. Many of us did. (See next point:)

Most resources are insufficient to treat suicidality. Most of our “treatments” for suicidality are geared towards short term safety. We “hold” people. We make them create a safety plan. We have treatments for depression and anxiety. But chronic suicidality? (And there are many people who suffer from chronic suicidality.) The treatments are few and far between. Many times the resources available are not only insufficient, but create even more trauma. For Suicide Awareness Month, I might suggest that you do some research on chronic suicidality. Talk to people who live with it. Ask them what it is like. Ask them what treatments are available and whether those treatments have been effective for them. Talk to the caregivers of those people and ask them what life is like. Talk to those of us who have lost loved ones to suicide. You might learn something. You might become more aware that suicide is indeed very complex and society needs to be doing more and different things. 

With these criticisms above, you might (rightfully) be asking, what would be helpful during Suicide Awareness Month? What would l like to see? I would like to see more of:

• Stories from survivors. Survivors of suicide attempts and suicide loss.² We have a lot to offer, as we have lived this nightmare and will live it for the rest of our lives. Survivors can offer hope. We have touched great darkness that most will never know, but only through that have we found some light and a life that we can experience as worth living.

• Understand that suicidal ideation exists on a spectrum. This is something that is not often discussed because we don’t often have open conversations about suicidality, which is something else we need. Open, honest and non-judgmental conversations about suicidal ideation. People who are struggling with suicidal ideation need to be able to talk about it.

• Campaigns to fund research. We need to know more about what is causing death by suicide in order to lower suicide deaths. We need to fund real research, including and especially brain research.

• Support for high risk groups, including neurodivergent people, LGBTQ+, veterans, homeless, survivors of trauma, abuse, suicide loss and other minority groups. There have been many studies on autism and suicide risk, including a large study last year, yet autism is rarely mentioned in suicide prevention materials. Why?

• Recognition of autistic burnout as a real contributing factor to suicide deaths and something that is distinct from depression that needs different intervention.  

• Recognition that suicide deaths are very much a societal issue. Sometimes when fish are sick and dying we need to look at the water that the fish are swimming in. We need to clean our environment, literally and figuratively.

Thank you for reading this. It will take some vulnerability, a willingness to be uncomfortable, and all of us working together to make the world a better place for our children. 

1. Multiple studies show that there is not a lot of time between a decision and an attempt.

2. If you don’t know any survivors personally, you might spend some time reading stories in online forums. If you do it this month, you may also get a good sense for how many of us feel about the messages we see during Suicide Awareness Month. This is a quote from a survivor of multiple attempts. “Anytime I see folks posting about suicidal awareness I feel they never make an effort for it. Posting an image about feeling loved with a suicide hotline number doesn’t do anything. Suicide awareness just makes me feel more suicidal than anything.” Please understand that I am sharing this because I want for people to know how these messages land for many survivors. I understand that the messages are shared with love and good intention. However, people who are actually suicidal may need very different things. We need real action, measured change and funded research. I encourage you to lean in, read and learn more.