“Let’s get people talking about mental health.” It sounds good in principle, but like many turns of phrase that sound virtuous, in the wrong hands and in the wrong context it is advice that can be anything but helpful.
[I wrote most of this article shortly after the death of actor Robin Williams. It has sat in draft for a few years for no particular reason, and I have brushed it up and published it now.]
Another man has killed himself, this time another entertainer. Although more women than men harm themselves, more men than women kill themselves. News stories that carry the story are, as always, including contact details for youth mental health services, and the story is being associated with the fact that we need to talk about depression and suicide. That message is loud and clear: We need to talk about it. It’s great that we’re getting people talking. We need to talk more. We need to get the issue out there more and get people talking. Talk!
That’s good and bad. Not all exposure to the issues of mental health and of suicide is healthy. Not all conversations about mental health and suicide should be had, and some people, given their own personal circumstances, are not helped by being shown a story about a well-liked celebrity who has ended his life, they are certainly not helped by the conversations and culture into which they are drawn as a result, and they need less talk about it, because the people who are talking about it around them really don’t know how to talk about it. Some of that is unpopular stuff to say, I know. I don’t want to take away from the genuine grief of people who are saddened by the loss of someone. I’ve been publicly devastated by the loss of entertainers in the past (I think of Gary Moore and Ronnie James Dio, for example) and there’s nothing wrong with that. But let me try to explain what I mean.
First, I know I could be wrong, because the question of how people actually respond to any event tragic or otherwise is an empirical one, established by data. We don’t know what the data is, and it would be pretty hard to obtain because we all mislead ourselves about ourselves. People who respond by wallowing in an unhealthy way aren’t going to describe their response that way, and people who contribute to a particular subculture that needs to “talk more about depression and suicide” with an unintended consequence of getting people to consider the possibility of suicide when they otherwise wouldn’t have aren’t aware that this is what they are doing. So this is the perspective of just one person.
But I’m a person who knows what mental unwellness is like, who has known people who ended their lives, and who has family members with mental health struggles, self-harm habits and a history of suicide attempts. I like to think I’m also pretty smart and also pretty loving. I’m concerned about my fellow human and my opinion is worth something.
I don’t worry that we want awareness of mental health struggles. I worry about how we’re doing it.
I don’t worry that we want awareness of mental health struggles (being made aware, for example, that men are more likely to suffer depression for longer and for it to not be identified has been very good for men). I worry about how we’re doing it. I worry about the immediate association of depression with suicide, for example, so that the conversation we encourage is one of “depression and suicide.” Most people who suffer from depression are not suicidal and have no desire to end their lives. In fact even in severe cases of depression, depression alone is unlikely to make a person commit suicide. We have to be careful about simply passing on these news stories along with the unfiltered, unqualified statement that we need to get people talking about depression and suicide, sure that we are positively contributing to the great cause of the day. The conversations that we have create a culture. There are people who struggle with poor mental health who have not seriously considered suicide but who will consider suicide because of this conversation that is being encouraged. That’s a fact, and it’s one you might not be considering when you click “share.” These are people who would, of course, benefit from talking to competent, careful people about their mental health, but that’s not what is happening when these stories are shared along with the chorus of “let’s talk about it” and their labels of “distressing content” (which function somewhat like the “Parental advisory: Explicit content” stickers on CDs to make you buy them).
I’m aware of circles of teenage friends consisting of people who are generally pretty mentally healthy but who are attracted to a depressed culture – emo music (with which I have no problem), memes about how unhappy I am, and attention-seeking conversations – in which people have proposed “depression support groups,” a label that sounds wonderful in principle, except everyone involved is someone who is certain they’re mentally unwell (whether they are or not), knows more or less nothing about actually assisting people who genuinely suffer poor mental health, who really have no constructive, well-defined goal in mind, and who would actually be doing nothing more than creating pity parties of otherwise healthy young people who are now going to spend time mutually wallowing in how depressed they say they are, with nobody who could actually offer any assistance or cut through the crap. They need to talk a lot less, and talk a lot better. Far be it from me to say that people in these circles can or should be *sheltered* from news about famous people who have killed themselves. But we need to be careful in our focus.
Don’t just *talk* about it as though talking about it is the goal.
Sure, let’s talk about it. Carefully. Wisely. Responsibly. With the right people and in the right context. Don’t just *talk* about it as though talking about it is the goal. It’s not. Getting help if you need it and getting better (or at least learning to manage) is the goal – and for you, that goal may be found without saying very much to many people at all. Some talking is good, but some is not because it doesn’t get you any closer to that goal. When these stories appear in the news here in New Zealand, they are usually accompanied by contact details for organisations that are able to offer assistance with mental health issues. Talk about it with them. Or talk about it first with someone who will not encourage and enable you to just talk, and talk, and talk, and talk without any constructive action. Your parent, if they are someone who might have an idea of what to do next. Your pastor or priest. Your counsellor if you have one. Your doctor. But don’t just encourage “the conversation” so that we’re all talking about it, as though that’s a worthy end in itself.
Take it for what it’s worth
Glenn Peoples
Christine
I’m a social worker who works mostly with people dealing with mental health issues, where sometimes suicide attempts and self-harm is a factor, and sometimes it isn’t
I think in essence you’re right, Glenn. It’s a balance – wanting to get people to talk to the right people, to people who can actually help, but to recognise and avoid the kind of conversation and culture you’re talking about. But yes, just talking endlessly with people who are feeding off each other (and assuming that all exposure to the issue is good exposure) makes things worse. Talking well and to the right people is what is needed. It’s not about more conversations, many of which can be unhelpful but it’s about the right conversations.
Glenn
Thanks for your input Christine. It’s appreciated!
Christine
You’re welcome. What prompted me to comment and endorse what you’re saying here is the fact that I’ve seen a number of cases where people have really been sucked down the rabbit hole of those peer conversations you refer to, Glenn, and it can take some undoing.
Thanks for the post!
Rob
Hi Glenn, I’m a qualified counsellor and while I laud efforts to de-stigmatize talking about mental health issues also think your caveats are important.
Glenn
Thanks Rob. I’m encouraged by the comments from various sources that I’ve had about this admittedly brief post.
Stephen
Appreciated these helpful thoughts. Thanks for posting.
Glenn
Thanks for reading. 🙂
Roy Soliman
It may even be worse than encouraging people to talk about it. It’s basically promoted with netflix series like 13 reasons. It’s also discussed in US schools under the guise of “suicide prevention”, but those conversations end up giving youngsters the concepts and the methods.
Gary
As a primary care physician, I agree with you that teenagers should avoid joining “clubs” for depressed people. If they are depressed, they need to talk to a therapist, doctor, or join a support group facilitated by a professional mental health counselor. However, I would encourage your readers NOT to avoid discussing suicide with someone whom they believe is depressed and potentially suicidal. It may save their life. Here is an excerpt from an online source, “Psychology Today”:
Experts emphasize that the best thing anyone can do for someone who seems unusually depressed or is showing other warning signs of suicide is to initiate a conversation, and that showing up at all is important regardless of whether you say exactly the right thing. If you want to ask a loved one if he or she is feeling suicidal, here’s what to keep in mind as you get started.
Don’t be afraid to start the conversation. “People think that by asking [if someone is suicidal], they’re suggesting suicide,” Turner says. But the vast majority of suicide-related research—including a comprehensive literature review published in 2014—suggests that open conversations about suicide are unlikely to increase suicidal ideation and may actually decrease it.
You don’t have to use terms specific to suicide or self-harm if they make you uncomfortable, Turner says. Often, it’s easier to start by pointing out other possible warning signs—withdrawal from normal activities, for instance, or frequent crying spells—as a way to open the door to a larger conversation without jumping directly into questions about suicide.
“Not talking about it reinforces that it’s not OK to talk about,” says Elana Premack Sandler, an associate professor at Simmons School of Social Work. “If someone is thinking about suicide, and no one asks them about it, there may be no one to whom they feel safe raising the topic. Not bringing the idea of suicide to the surface maintains silence,” which increases overall risk, she says.
Gary
Here is a link to the full article in “Psychology Today”:
https://www.psychologytoday.com/us/blog/brainstorm/201806/what-know-when-asking-about-suicidal-thoughts