The Power of Shame: Obstacles to Care

My first suicide attempt was in high school.

I didn’t know how to manage my mental health; we had a lot of violence at home, and I wanted a way out. But after my attempt, I felt ashamed. My family did too. There was such a stigma attached to suicide for everyone involved. Like most people when they hear about such things, my family did the best they could at the time, but they didn’t know what to say and were ashamed to seek help. I had an in-patient hospital stay and received a referral for additional treatment after I went home, but my parents and I never talked about my attempt again, so I never had follow-up care.

I needed support, and I had more attempts. But I didn’t have anyone to talk to about why I wanted to stop living.

In college, I went into the behavioral health care field carrying the stigma of having attempted suicide. After graduation, I worked in an addiction treatment program and in crisis services but never talked about my own experience. I knew the way I would have wanted to be treated when I was in care. I knew that different treatment would have mattered to me, and I used my experience to help others but never revealed that I had been there too. I thought I would be seen as weak and unwell. I thought that having made an attempt would stigmatize me. It’s something that’s always with you.

I had never shared my experience, not even with my husband and kids. But when my son was 11, he was learning about mental health in health class. I realized then that if I shared my experience, I could show others that it’s possible to get better and come out on the other side. I could have an impact, but I’d have to tell my family first.

My son’s reaction to my story was everything to me. “Wow! Look at you! You have a great life,” he said. “It’s awesome that you can be OK after that.”

He helped me see the whole picture: That I’m doing really well. That’s the story.

At the time, I was working as the executive director of a nonprofit that provided crisis services, such as the 988 line, emergency youth shelters, and mobile crisis counselors. I decided to tell one person at work, and she was very supportive, so I decided to openly share my story. The staff never knew what happened after counseling people who were thinking of taking their own lives. And here I was—a living, breathing example of someone who was OK. And it allowed others around me to say, “Yes, I’ve had a similar experience.”

I know there’s fear around talking to people who are thinking of ending their lives. But I also know that if someone had talked to me at my low points, it would have helped. I needed someone to know how much pain I was in and to be understood.

It’s OK to ask really direct questions when you suspect someone is at risk. People who are thinking of killing themselves are also afraid that they’ll have to go to the hospital, have restrictions put on them, and that they’ll lose everything. But not wanting to live anymore or thinking about suicide doesn’t always mean action. It just may mean that life hurts and living is hard.

The stigma is really about misunderstanding.

The conversation in this country really is changing. People want to know more. Some very public suicides, such as that of Robin Williams, have opened up the opportunity to talk more, and that reduces the stigma. But we’re not fully there yet.

We need to do more to change the conversation. We can all have a role in reducing the fear and stigma that surround suicide. Using different language is one place to start. Rather than using the phrase “committed suicide,” which associates suicide with “committing” illegal acts, we can say “died by suicide.” It can be hard to remember to be kind to yourself, and, if you use the old phrase, to go back and make the correction. But when I do that with people, it opens the door for me to share why I am doing it, which opens the door to say more about suicide and care for those who have suicidal experiences.

Another step we can all take is to refer to suicide care, and behavioral health care overall, as “health care.” There is no shame in seeking professional care when your heart is ailing or when you have a limp. The same is true for our brains. When we talk about physical health care, we don’t say someone “committed heart failure.”

Talking openly about suicide is suicide prevention. Take some time to understand the issues concerning suicide, find out about risk and protective factors related to suicide, and find resources that provide suicide care. This will help reduce the fear that many of us have when we or those we care about think about suicide, and it prepares us to offer support. Be someone who will start the conversation, share resources for treatment—such as 988—and offer to be a partner on the journey to recovery.

Barb Gay, associate director of the Zero Suicide Institute at the Education Development Center, is a certified prevention specialist and expert in suicide prevention and behavioral health.