Jake Donofrio: Let’s start from the beginning. What is suicide prevention education?
Meghan Diamon, LCSW, and MindWise Innovation's Program Director of Suicide Education: A lot of people think of suicide prevention as being an individual thing, like somebody who is struggling needs prevention and support. But really to do good prevention, you have to educate everybody on what to do if they’re worried about somebody.
Because when somebody is really struggling with major depression and suicidal thoughts, it’s very hard for them to reach out – and that’s just part of the issue. It’s very hard to reach out for help when you’re in such a low place, when you’re not even getting out of bed. So, it’s really important for us to educate everybody on what to do when they have a friend or family member that’s struggling like that – that’s the best prevention we can do, getting other people involved.
We know treatment works, but that’s only if people can get themselves to treatment. And it’s really hard to get yourself to treatment when you’re in that state. All this brings me back to the idea of global education so that there’s enough caretakers, friends, and family to get anyone struggling the help they need.
JD: What led you personally towards the field of suicide prevention?
MD: Before joining MindWise, I worked in dropout prevention. The kids my agency worked with were at risk for dropping out of school for various reasons.
There were a lot of issues my kids were facing including poverty, a lack of access to resources, and learning in a struggling school environment. So, we were giving them tutors, mentoring, food home on the weekends, and all the things that we could do to bolster them up and help them do better in school. But we were unable to do a good job of connecting the kids to mental health services, which had a huge impact on their ability to succeed in school. It’s a major issue that those students couldn't access mental health services. Kids that have gone through a lot in life and experienced trauma often need that support.
At that point, I had been a social worker in the field for years, but seeing the way that unmet mental health needs were impacting so many kids' futures, was eye-opening. Also, this wasn't supposed to be a clinical role. But I realized that mental health is such a pervasive need that suicide prevention is basically a part of any human service work. Then this opportunity came and SOS is such a cool program because it’s able to reach so many kids quickly and easily and help connect them to mental health services.
JD: You mentioned that you were unable to connect those kids to mental health services. Why was that the case?
MD: There are just so many barriers for kids and for people generally. I worked in a lot of under-resourced communities but it’s common in many areas– there’s not enough good mental health services, period, for people in America.
I’m a big advocate for in-school services, we need to put as many resources as we can into schools. The kids are already there, and it just removes so many barriers. School-based mental health staff remain very limited with hundreds, sometimes thousands of students on their caseloads.
Social workers are spread so thin they can’t do their job as effectively as possible. And many students need services beyond what school staff can provide. There are good models of community mental health staff working in schools to provide that next level of care. But we need more.
JD: What are some differences between now and when you started? How have the attitudes and prevention methods evolved throughout the years?
MD: When I started with SOS seven years ago screening for depression was still pretty controversial. The idea that we had kids filling out a depression screening form and that those questions specifically asked about symptoms of depression and suicide was considered "risky".
The research supported it and the academic community knew it was the right thing to do but in terms of actual implementation in schools, they were pretty uncomfortable with that idea. And that has changed a lot over time and even more so during the COVID-19 pandemic.
It was changing every year that I’ve done this work but it’s rapidly changed now. I think that schools are really opening their eyes to the fact that you have to ask kids how they are doing. The only way to find out how kids are feeling is to ask them. So that seems to have evolved a lot not just in suicide prevention but just generally as well.
"The only way to find out how kids are feeling is to ask them."
Parents’ attitudes seem to have evolved as well. Part of the reason why schools weren’t screening students was because parents weren’t comfortable with their kids being asked mental health questions, but I think the whole culture has evolved in that aspect. So now that parents are OK with schools getting a little bit more involved in their kids’ mental health, schools are providing more suicide prevention resources. Like I said, I’m a big advocate for school services so to me that’s a win for everybody.
JD: You mentioned COVID-19 as one of the driving factors behind the changes being implemented in schools. What were some other factors?
MD: I think the work that we, and a lot other organizations, are doing to get the word out about not being afraid to talk about suicide is working. I do think it is working to some degree and people are starting to feel more comfortable.
I even see it in my own life, when I started this work and I would explain to people what I did for a living, they wouldn’t really know what to say as suicide prevention wasn’t really something that was discussed back then. They were uncomfortable or overwhelmed by the idea, but suicide prevention is more common in our culture now and people are no longer as afraid of talking about suicide. That seems to have changed, the younger generation has made a huge difference talking openly about mental health awareness. It’s impacting their parents, and everyone else.
JD: What are the responses to these changes?
MD: I think once schools start doing it, they are usually pretty enthusiastic. There can be concerns up front and we know schools that we have talked to for years that haven’t been willing to take that next step – and other schools that didn’t previously implement screenings, then worked their way up to doing it. As soon as they did it, a collective wave of “we should have been doing this” washes over the school personnel. The schools identified so many more kids that needed help due to the screenings, and administrators and parents realized they can’t be afraid to find out what kids are actually thinking.
I’ve found that generally, once schools decide to teach suicide prevention education, they are so happy with their decision. Oftentimes they have fears that parents are going to be concerned, but even in brand-new schools that just start, I very rarely hear anything negative from parents. Sometimes parents are concerned and want to preview the video, but once parents review the materials, they generally agree that SOS will be good for kids.
"Once schools decide to teach suicide prevention education, they are so happy with their decision."
JD: Can you tell me something not commonly known about suicide prevention education?
MD: I think it’s not commonly known that tons of schools educate students in suicide prevention. I was a school social worker and I had no idea there was such thing as suicide prevention education. A lot of parents don’t realize that this is going on in schools all across America. Kids are getting trained to save other kids lives and I think that’s something that people don’t necessarily know.
JD: Are more schools and the general public taking notice of the ongoing issue of youth suicide? If so, why? Do you think it has anything to do with new legislation or state mandates?
MD: I’m certainly a supporter of state mandates, though I’d like to see more laws regarding kids’ education. Most laws focus on teacher training instead, which is very helpful, but we are also advocating for getting suicide prevention training into the students' curriculum.
However, these teacher training mandates are valuable, not only in schools but in their home lives as well. Schools are the largest employment sector in the U.S. and the adults who work there take their suicide prevention training home with them. This education is not just for students and schools, reaching teachers and staff means training a ton of different people in suicide prevention education, and they can use these skills with their friends and families in addition to the children at their schools.
JD: What’s the biggest fear people have in regards to suicide prevention?
MD: In terms of suicide education, the biggest fear is that if you teach about suicide, you can encourage someone. That’s universally regarded as the biggest fear by far. I’m not sure how that idea got into our culture, but it’s there. We all had some level of believing that. Especially with kids, people are worried about putting the idea in their heads.
We know from tons of research – from our own program but also from way before us and outside of us – that you can’t put the idea into someone’s head. If you talk about suicide with someone who is mentally healthy, that is not going to make them contemplate suicide. If you talk about suicide with someone who is not doing well, it opens the door for them to potentially talk about it. We know not only is it not harmful, it’s the best thing you can do.
"If you talk about suicide with someone who is not doing well, it opens the door for them to potentially talk about it. We know not only is it not harmful, it's the best thing you can do."
JD: What about suicide prevention makes you optimistic for the future?
MD: Definitely the kids. Kids are so open with mental health and with each passing year, they seem to be more open about it. You don’t even have to be in this field to see it, we see it out in public and on social media. There’s a huge generational divide but children are pushing adults to understand the importance of suicide prevention and reconsider what they previously thought about mental health. This generation is changing the conversation, and I think that’s something that brings a lot of hope.