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Preventing Suicide One Note, Email or Text at a Time

posted in: Depression | 0

I’m sure by now many of you have seen a link to this article, The Best Way To Save People From Suicide. It’s a lengthy read by modern internet standards, but I encourage you to go and read the whole thing for yourself. There is a lot to consider in it, but I wanted to talk about something that I have been thinking about since I read it.

In it, and again, go read it yourself, there is a story of a study done years ago in which suicide attempt survivors were given the “normal” medical treatment at the time, and discharged as they would be after a long interview with a therapist. Then they were broken into two groups. One was released as they always were, the other released and then sent notes at specific times after their release by the therapist they had interviewed with. The notes did not contain any instructions, were designed to be non-judgemental, and set no expectation that the recipient do anything. In fact, they even went as far as to send a self-addressed envelope to the patient so they could write back, but not include a stamp for fear of creating a guilt motivation to reply so as not to waste a stamp.

No matter what, if any, reply they got, they just kept sending the notes. And over the course of a couple of years, they discovered that the death rate for that group was vastly improved over the rate of the other group, or the rate for attempt survivors that had existed previously. The study, however, didn’t grab huge international attention, because in the 70s it was still taboo to even talk about suicide, let alone how to prevent it.

Flash forward to modern day, and the article discusses some anecdotes of a therapist trying to bring that work into the modern age, with emails and text messages. (Have I mentioned that you should go read the whole thing?)

However, the article then goes on to talk about some of the challenges, indeed the risks, of trying to do this at scale as a treatment option. There’s the risk of breaking confidentiality, should someone else see the texts, or the risk of the relationship being misconstrued with all of that “outside of session” communication, the risk of a careless text that sends someone spiraling instead of helping, and the ensuing wrongful death lawsuit, etc. I’m not here to minimize those risks, for therapists the riskiness of changing the normal boundary of “in session”, vs. “out of session”, are a serious consideration.

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On the other hand, the success shown in the study got me thinking about the role friends and family could play. We don’t carry those same risks, we have a different relationship with the attempt survivor, or even the person struggling with depression and suicidal thoughts. We can, indeed should, be thinking this way. If, as the theory holds, the thing that improved these patients odds was knowing that someone was thinking about them, and keeping them attached to the world, why can’t we do that for people?

After my breakdown, and attempt, the one thing I wanted more than anything from my friends, was to just treat me like they did before. As I was reading the article, it occurred to me that what I really wanted was just to know that someone, anyone, would notice if I wasn’t there. Instead, I got a whole lot of people who seemed like they might be relieved if I wasn’t there. My presence anywhere made them uncomfortable. They didn’t want to reach out, for fear of saying the wrong thing, or being in an awkward situation. That hurt.

Think about how that could have been different. What if those friends had simply sent an email saying hi. Or passing along a joke they heard, or mentioning an event that I might be interested in, with no expectation or judgement? Just a way of showing that they were thinking of me, and staying connected with me, no matter how I was doing that day. I think that is something that makes a world of difference. I also suspect it’s something we’ve lost, even as technology has made it so much easier to stay connected.

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The more I thought about this reality, and the more I become convinced that I do a terrible job at this too, the more I saw social media as part of the problem. Not the technology itself, but how we use it. Personally, I use it to keep in touch with people, letting people know what’s going on in our lives, seeing the same about their lives. But it’s not a one to one communication. It’s almost broadcast. When I share something on Facebook, I’m sharing it to all of my friends and connections. There’s a place for that, but I’ve been using that in place of texts and emails to individual people. It’s that one to one communication that I feel is missing, in my life, and I suspect in the lives of many people. (Loneliness is at an all-time high, after all). Seeing photos from someone’s family gathering is great, but without the one-to-one communication, we’re not letting people know that they, that one single person, is worth our time and thoughts.

It's that one to one communication that I feel is missing, in my life, and I suspect in the lives of many people. (Loneliness is at an all-time high, after all).Click To Tweet

That’s a shame. I’ve been guilty of it. I’m not proud of that. Personally, I’m going to take some time to figure out how to be a better friend, and how I can send emails, texts, FB Messages, Snapchats, etc. to individuals, especially the ones I know are struggling. Not to fix things for them, or tell them what I would do, but just to let them know that they matter. That someone saw a penguin gif and thought they might like it. You never know how much it might be helping.

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