Brought to you by the Depression Is Real Coalition, The Down & Up Show is dedicated to the reality of depression. Each week our hosts will talk with some of the world's top experts on depression, as well as people who have been impacted by this illness. The reality of depression is that it is a debilitating and potentially deadly medical condition that affects more than 15 million Americans every year. The other reality of depression is that there is hope.

Down & Up Show #16: Suicide Prevention

TERRIE WILLIAMS:
Welcome to the Down and Up Show on Depression is Real.org. I'm Terrie Williams your guest host filling in for Dr. Ellen Frank. Today we're going to discuss a very important topic that has not yet really been fully broached on this show, that is suicide. As we know most sadly, suicide can be a very real outcome of depression.

And our guess for this episode is Jerry Reed, he's the executive director of the Suicide Prevention Action Network USA or as it's commonly called, SPAN USA. Since 2003, Jerry has led SPAN USA in its efforts to educate Americans about the importance of suicide prevention, an advocate for public policies to help prevent suicide.

Jerry, thank you so much for joining us today.

JERRY REED:
Thank you Terrie, it's good to be here.

TERRIE WILLIAMS:
This is a hard one, Jerry, this topic. How do we begin to approach the topic of suicide appropriately? You know I think thatÉ I know that we all have experienced low points in our lives, I know I'm a depression survivor, but why suicide, what is exactly that triggers some people to take their lives when millions more go around the world to fight to save theirs?

JERRY REED:
Terrie that's a great question and I really believe the first place to begin is with the facts. Suicide really is a very tragic public health problem, in addition to an individual health problem and claims, you know, 31,000 lives every year in this country and another 1.4 million attempt to take their life.

Thirty-one million is probably a very conservative number because not all those deaths thatÉ that maybe suicide are classified as suicide for insufficient information or just not enough information to determine a cause of death. In addition to the numbers, I mean it's a very complex matter, there are social factors, cultural factors, biological factors and psychological factors that can all play.

So no two suicides, if you will, are exactly the same. So there's a lot of complexity in trying to understand it. But what we do know is that 90 percent of those who die by suicide have a mental illness or a substance abuseÉ substance abuse disorder. And so it's important to understand that you know while 31,000 people die by suicide, there are millions of individuals struggling with depression who do not.

So it justÉ really, knowing the basis and the numbers is a great place to begin to understand the complexity of suicide. And having said all thatÉ I believe deeply as do many of my colleagues and in fact the Surgeon General of the United StatesÉ Dr. David Satcher when he was the Surgeon General, you know, really lead the fight to determine if suicide is, in many cases, a preventable, public health problem.

And we have to be aware of the risk and the protective factors if we're going to make a dent and save lives and reduce the burden of morality and morbidity caused my suicide.

TERRIE WILLIAMS:
YeahÉ you know I think that it's really tragic. I think that so many people who take their lives just really believe that they're standing on that ledge if you will by themselves because everyone walks around with a game face on and so you think all is well.

JERRY REED:
That's exactly right and thenÉ

TERRIE WILLIAMS:
And so youÉ yeah, go ahead, I'm sorry.

JERRY REED:
I was going to say and tragically for 89 people everyday in this country, you know, they're not saved.

TERRIE WILLIAMS:
Yeah.

JERRY REED:
You know that's one person every 16 minutes, so we've got to do a much better job as a nation, you know, extending theÉ the helping hand and making access to treatment and affordability of treatment much more within reach of all those who struggle.

TERRIE WILLIAMS:
Yeah and that is a real, you know, issue that youÉ that you mention because of health care disparities and because so many, you know, millions ofÉ of Americans are not insured, you know. So it makes it even more difficult.

JERRY REED:
And when you add on top of that the stigma and theÉ and the loneliness of those who struggleÉ

TERRIE WILLIAMS:
Yes indeed.

JERRY REED:
It just becomes, as you can imagine, a very tough journey, but that I think is well worth taking.

TERRIE WILLIAMS:
No doubt. Tell me why did you get involved with suicide prdentÉ suicide prevention, is itÉ I know it's obviously that you're passionate about, what was there a compelling reason for you?

JERRY REED:
Terrie for me it was actually quite by accident. I wasÉ a legislative assistant on Capitol Hill for Senator Harry Reed many years ago and one day, in 1997 I believe it was, we were doing the hearing on the mental health and the elderly as part of the Aging Committee.

And as the staffer, when I called out to the State of Nevada where Senator Reed comes from and represents, I said to the aging folks, what's the number one problem facingÉ mental health problem facing older adults in Nevada? And without hesitation she said suicide. I looked at the data and in fact saw that Nevada led the nation in terms of suicide.

So began to do some exploration and really learned a lot about it by conversing with, you know, the National Institutes of Mental Health, Center for Disease Control and lots of other folks. Went to the hearing and that day Mike Wallace from "60 Minutes" was ourÉ one if our witnesses.

And he was sharing his personal story with depression and how, with the right medication, the right therapy, he's really very glad that he got the help that was available and unbeknownst to me, Senator Reed then says to the chairman at the time, Senator Bill Cohen, Mr. Wallace if you're brave enough to tell the American people about your battle with depression, I should tell the American people my pop shot himself.

TERRIE WILLIAMS:
Wow.

JERRY REED:
And I had no idea that Senator Reed himself was a survivor, having lost his own dad. And he turned to me and just said, Jerry, I think we really need to look into this and so I did. And that began, if you will, my public policy interest and my human interest in the topic.

And then after having left the Hill, a few years later saw that the SPAN USA was looking for an executive director and I applied and the rest is history. I've been here four years now and very, very blessed to beÉ to be in this position.

TERRIE WILLIAMS:
Wow, what a story. You know when you mentioned the high rate of suicide even amongst the elderly in Nevada, it just made me think about the fact that so many people go to Nevada, Las Vegas in particular, for medication of some kind, you knowÉ people are challenged and not really able to deal with their pain and so that's one wayÉ that they attempt to try to address it. Do you think so?

JERRY REED:
I think you know, I can tell you that you know one of the things I'm doing with my life on the otherÉ on the other end is getting my dissertation and I'm really looking at you know the regional variations in America for elderly suicide. And it's very interesting that you know seven I believe of the top ten states in the nation, are all west of the Mississippi.

And I think issues like rurality [sic] and you know maybe lack of resources in some of those rural communities et cetera, et cetera, maybe contributingÉ toÉ to a sense of desperation and hope for those individuals that may struggle. We have very low rates of elderly suicide on the East Coast, in New Jersey, New York, Rhode Island and Massachusetts.

So it'sÉ it'sÉ there's a lot of unanswered questions. Ten years ago people did not say the word suicide, it was just not a word you even discussed. Now today because we are smarter, we are wiser, we have data, we have research it isÉ it is being viewed asÉ as a public health problem and many of theÉ the individuals who struggle, are struggling from very treatable illnesses like depression.

So we just have to do better at the lifting the veil of secrecy. So I guess to answer your question, I don't think we know enough yet what causesÉ you know there'd be higher rates in the West then there are in other places, but I think you hit something very important.

For those who struggle, sometimes self medication, is a part of the equation.

TERRIE WILLIAMS:
Yes.

JERRY REED:
And that kind of medication is no substituteÉ

TERRIE WILLIAMS:
AbsolutelyÉ

JERRY REED:
For the medication and the treatment that's now available years later after much research and practice.

TERRIE WILLIAMS:
YeahÉ you knowÉ one of theÉ unfortunately the elderly population is not the only one to feel the dangerous effects of depression and suicideÉ I believe that suicide is the third leading cause of death for young Americans between the ages of 10 and 24 and college studentsÉ

JERRY REED:
You're absolutely rightÉ you're absolutely right.

TERRIE WILLIAMS:
And that's frightening.

JERRY REED:
Second leading cause of death for college age students, third leading cause of death for young folks andÉ and you know that is a startling statisticÉ

TERRIE WILLIAMS:
Yes it is.

JERRY REED:
And you knowÉ weÉ we have, thank goodness, we have people in Congress and they're practitioners all over the country who are trying to make a difference. One example is Senator Gordon Smith from Oregon who lost his own son to suicide, Garrett. And as a result of his lossÉ hisÉ his willingness to publicly share his loss and the struggles that Garrett went through, there's a now a law enacted, signed by the President.

And today 38 states are receiving grants to work on youth suicide, early intervention and prevention. Fifty-five colleges are now getting grants to enhance their behavioral health capacity for students who struggle.

TERRIE WILLIAMS:
And I'm so, so glad to hear that. I think it's a very, very difficult issue and it made me think about, I just read that the State of Illinois is one of the first states in the United States to start to have a curriculum that deals with emotional intelligence on the elementary school level, that is that there is a designated time to just talk about howÉ talk about feelings.

To get young people to speak about their feelings which I think is a great start.

JERRY REED:
Oh I think you're absolutely right and similarly in the State of Tennessee a law was recently passed requiring all those who work in the school system to have two hours of continuing education on suicide prevention. So we're really realizing that we're all in this, we're one nation, one community and we all have to be prepared to help someone who struggles and then lead them to the help thatÉ that is available.

TERRIE WILLIAMS:
For sure. You knowÉ Jerry, much like the Depression is Real coalition and its member, I know SPAN USA is one of the many groups working to reduce the stigma around mental health. But I wantedÉ well you shared with me many of your activities, but it made me think aboutÉ I hadÉ I had heard at one point and maybe you can correct me if I'm wrong, that there is some religious institutions that will conduct funerals for the people who have committed suicide?

JERRY REED:
Terrie, in former days that was certainly the case, I mean there were taboos that were cultural, there were taboos that were religious, but as we've learned more over the years andÉ and depression and other mental illnesses are recognized as illnesses more and more because so many people struggle.

The faith community has really stepped up and really tried to in many cases issue statements on behalf of their clergy and theirÉ and their congregants, you know, removing some of that really unfair stigma and bias so that, you know, they can be part of the helping network as well.

Because in many cases it's the clergy that a person who struggles with might visit first.

TERRIE WILLIAMS:

Yes.

JERRY REED:
And we need them, we need them as partners in this effort to get people the help.

TERRIE WILLIAMS:
Let me ask you a questionÉ can you give our listeners some advice on who to spot people who are in trouble and who may need help?

JERRY REED:
I'dÉ I'd be happy to and I appreciate you asking. I think the first thing that I would say is that if someone threatens to hurt or kill them self and make statements that things would be better off without them, you really must take those statements seriously. They're not passing, they're reallyÉ it's not something you say oh tomorrow will be a better day.

YouÉ you take those comments very seriously. If they're looking for a means to harm them self, you know suddenly purchasing aÉ a lethal or stockpiling pills or things of that sort. If they talk about or write about, you know, death and it's something that they don't do as a matter of theirÉ of their work or whatever, in terms of their (unint.) whatever.

But if they're feeling hopeless, rage or uncontrolled anger, things that are just totally out of the ordinary or starting to rely on substances where they never did before and withdrawing from people, those are all signs, dramatic mood changes, changes in sleep patterns, that something is wrong.

And we have never really learned to say are you thinking of hurting yourself and extending the question cause we think oh, I don't want to bring it up, it might encourage someone to do it.

TERRIE WILLIAMS:
That's right.

JERRY REED:
Just the opposite, in many cases we find that by asking that question you open the door and that person feels much more comfortable saying you know I am. And then once you know that, don't judge, listen lovingly and caringly and then help that person get to somebody be it your doctor, be it you know a mental health professional or someone that can help that individual through the struggle.

TERRIE WILLIAMS:
That's really very sound advice because I think so many really just don't know what it looks like, what it feels like, what it sounds like.

JERRY REED:
That's exactly right and I think what we know now that we just did not know years and years ago is, it does no harm to ask the question and in fact maybe the very thing that opens up the door.

TERRIE WILLIAMS:
And the specific places where people might go, you know, in terms of a crisis? You recommendÉ

JERRY REED:
I sure can and there are, you know as I said, there's been tremendous movement in Congress and in state governments all over the country, you know, reinforcing the value of suicide prevention efforts. But another thing that was done by Congress and operated through the Substance Abuse and Mental Health Service Administration, is a national 1-800 number.

So no matter where you are in the country, if you just dial the number 1-800-273-TALK, you will be seamlessly connected to a crisis center closest to where you're calling from of trained counselors who can help you through yourÉ your struggle and give you the suggestions and the information on what's available in your community.

Certainly talk with your doctor or your pediatrician if you're talking about youngÉ a young person, or a counselor in your behavioral health center at the college. Don'tÉ don't not talk, you have to go in and share what you're feeing because in many cases it's diagnosable, it's treatable and you can recover fully and enjoy the life you deserve to live.

There's always 911 if it's a very, very critical moment andÉ and the hospital emergency rooms areÉ are used to dealing with this kind of thing on a much more frequent basis, then I'm sad to say, that I wish they didn't have to. But there are very trained people in all those categories thatÉ that really can help if someone's hurting.

TERRIE WILLIAMS:
You know Jerry the thought occurred to me that you're really in the care giving business in terms of really helping to transform peoples' lives. And I know that it can beÉ I know it to be very draining you know when I shared my story of depression and everyone would come to share.

How do you keep yourself, yourself, healthy and whole? And like what do you do for fun?

JERRY REED:
Terrie I appreciate it, I'm a dad, two great kids, a husband but I really I think for me the inspiration and the nourishment to do this job comes from the survivors of suicide themselves. The people who've lost a loved one and most of the people whoÉ who comprise the SPAN USA family are people who have lost a loved one very dear to them to suicide.

AndÉ and I am just soÉ amazed that people who've lost a loved one can then turn their grief to action and try to advocate, try to educate, try to you know build community, build coalitions all with the goal of saving another family from having to go through what they went through.

So any struggle that I might have pales in comparison and I just admire the courage of the survivor who shares their story and then couples that story with data and policy objectives and then carries themselves to their state legislatures or their school administrators or the national legislator and say, we've got to do something about this very preventable public health problem.

TERRIE WILLIAMS:
Yes, you knowÉ what you're saying now I think isÉ is very concrete advice because I was going to ask you about the issue of blameÉ people who have lost a loved one to suicide and whether or not there's an initial state of blaming themselvesÉ

JERRY REED:
Oh I think absolutelyÉ any survivor would tell you that blaming, the shaming, the embarrassment, the guilt, the what if's or what could I or what should I? Those are questions that I think any of us would ask if we were touched byÉ by a tragedy like suicide. But I think, you know, literature bears out that you know there is no one thing that caused your loved one to take his life.

You know depression is a very serious mental illness and sometimes an individual who struggles can't even see the love and the concern that's right there because theirÉ their mental health condition is just not able to see it. And so we reallyÉ we believe very strongly in the healing journey.

We support postvention [sic] which is help after the loss of a loved one through support groups or therapy or just the bonding that comes when people join SPAN USA and recognize they're not alone and that other families like them have gone through what they've gone through and they're willing toÉ to fight for action.

And thenÉ then Terrie when they see results like the Garrett Lee Smith Memorial Act or mental health parity coming close to passage orÉ or a bill that was just introduced a few weeks ago to stop senior suicide act, they see that their work is yielding results. And that I think is very much a part of the healing journey for those that choose to engage in.

TERRIE WILLIAMS:
YeahÉ I'm reminded of a inspireÉ a couple of inspirational sayings about turn your mess into your message or to turn your test into your testimony.

JERRY REED:
IÉ I could agree more and I can tell you that the thing in this country, in my judgment personally that turned this country around with regards to its response to suicide, was the personal testimony of survivors of suicide. I can vividly remember after Senator Reed shared his story many years ago, a phone call came in from Marietta, Georgia and it was a coupleÉ Jerry and Elsie Wirerock (ph.) who had lost their daughter, their 34 year old physician daughter to suicide.

And their words were something like this, we just heard Senator Reed share that he's a survivor, we're survivors too, we'd like to come share our story and see how we can help. And the result of that has been this incredible movement 10 years later called SPAN USA and lots of other suicide prevention organizations that are working together to really try to change the way we look at this preventable public health problem in the nation.

TERRIE WILLIAMS:
YesÉ I think you, I believe you spoke recently that you're an organization that Donna Barnes with the National Organization for People of Color?

JERRY REED:
That's exactly rightÉ

TERRIE WILLIAMS:
On suicideÉ

JERRY REED:
I did, I spoke at a fabulous conference inÉ in Memphis, Tennessee organized byÉ a bishop down there, Bishop Young and his wife Pastor Diane Young who experienced the loss of a parishioner in their community and were so touched by it, they brought the entire community together.

TERRIE WILLIAMS:
Really?

JERRY REED:
There were over 200 people from Memphis, other churches, practitioners, survivors and they just had a wonderful, wonderful day-long conference bringing in experts and survivors and people from the community to really mobilize them to take action. So I mean it's a perfect example of a community engaging to try to help, you know, engage all the right partners to put an end to this.

And to make sure that if someone walks through your door and they're struggling, you know what to do to help them get that help.

TERRIE WILLIAMS:
AndÉ and is there a movement to encourage physicians to do more of checking with patients emotionally and mentally?

JERRY REED:
You know it'sÉ it'sÉ the National Strategy for Suicide Prevention was published in 2001 when Dr. David Satcher was Surgeon General. And it's 11 goals and 68 objectives. And many of theÉ the objectives outlined are exactly that, working with primary care practitioners toÉ to understand more suicide, to ask the question, to make sure you know the resources in your community that could provide help if someone say yes, I'm struggling.

And there's more research that is starting to suggest for example, two studies that I'm familiar with, actuallyÉ identified that if you ask an older adult if they're struggling with depression and then you monitor them once that determination is made, that group of patients does better then those who are just referred for case as usual.

TERRIE WILLIAMS:
I see.

JERRY REED:
SoÉ there is hope, you know there is help, there is promise. And I just think, you know, it's not often in life as I'm sure you could probably testify, that you get a chance to make a difference in a very real way. And this is one those ways for me.

TERRIE WILLIAMS:
Okay, do you have any closing thoughts that you'd like to share with the audience, something that's burning in your heart?

JERRY REED:
I just think that you know like depression, like suicide, like mental illness, you know, the first step we have to do Terrie is open minds. We have a lot of closed minded perspectives and most of that's due to just misinformation or lack of information. And all of us in the fields of mental health have an opportunity first and an obligation to open minds and destroy some of the myths.

And then second, you know, if weÉ if we have to change policies and we have to change practices, you know, let's mobilize to do it. And I truly believe we're on the cusp ofÉ of really lifting the veil of secrecy and normalizing health, whether it's health of the kidney, health of the heart or health of the brain.

We really have to go to the distance to make sure that at least in our generation, we can say we put that one to bed.

TERRIE WILLIAMS:
Well I really, you know, admire yourÉ your sense of compassion and your commitment andÉ just seems like to me that you're justÉ using your life to make a difference in the lives of so many and I encourage you to stay strong. Thank you for all of your work surrounding suicide prevention and we'll continue to follow the progress of SPAN USA.

JERRY REED:
Terrie I appreciate your call and your opportunity to share the story and I thank all the survivors who have had the courage to share their stories to make a difference for the rest of us.

TERRIE WILLIAMS:
For the Depression is Real Coalition, I'm Terrie Williams, join us next time for another segment of the Down and Up Show on Depression is Real.org. Stay strong.