I have been to 14 funerals since turning 17 years old. Fourteen people who were friends, co-workers, crushes, debate partners, school mates and amazing members of the world's community. Fourteen people whose families and friends I sat next to at funeral services, whom I heard whisper "If I would have known," "How could I miss the signs?" and the awful "How could they do this to us?"
As the first of my friends took their lives and I attended their funerals, I felt an overwhelming sense of guilt. I wondered what I was missing, what I wasn't doing right.
Was it because I didn't answer that 4 a.m. Facebook message? Was it because I wasn't open with them about my own struggle? Was it because I didn't try hard enough somehow? Didn't love enough? Wasn't there enough?
I beat myself up for a while. I blamed myself and tortured myself. I sought to better understand mental health, suicide and what resources existed to support people feeling suicidal. I made it my mission to take action, and I read, spoke, researched, met, supported and loved the best that I could. I learnt about hospitals, communities, education systems, treatments, interventions and technology.
I found people with the word "doctor" in front of their name and talked their ears off for hours. I thought if I somehow understood the world that the professionals worked in, I could help my friends get treatment within it. I enrolled in and attended all the suicide prevention and mental health training I could find. I wanted to make sure that if people talked to me about suicide, I would feel ready to help them.
Fast-forward to today: I still find myself standing at the crossroads in people's lives, as the more I have become involved in this mission, the more people I see at the crux of their struggle. I find myself encouraging them to seek help and try for a happier life. That is my goal, and what I truly wish for them to find, and I do my best to help them find the resources to get there, or direct them to where they can find this information.
But while I am directing people towards this goal, at the same time, I find myself scared of, concerned about and oftentimes angry about the system and the resources I am leading them towards.
The mental health system is basically inaccessible
Despite the fact that the people who are lost to suicide in my life knew about the services and that many of them even worked in the mental health system, accessing services when they (or anyone else) need them is nearly impossible.
Appropriate services have wait lists more than six months long, and emergency services are not trained to properly deal with suicidal people. Often times, suicidal people are sent away from Emergency Departments due to lack of resources or beds.
When they are admitted, oftentimes I hear from people that their time in hospitals was sometimes more traumatic and made things worse than before they were admitted. I have not heard any word or progress on a solution to this.
Some people in helping roles still don't think suicide is a real issue (e.g. hospitals and schools)
"You are just seeking attention," "You did this to yourself, why should I help you?" "I think suicide is such a selfish thing," "You just need to pick yourself up and be happy." These quotes (and many more) represent all the things doctors and nurses have said to me while I was suicidal.
My friends and schoolmates used to make fun of the crisis lines and mental health talks we had at school. As someone who was suffering and asking for help, hearing these things just made me more suicidal, and it is still happening in our system despite more research and more education. People who hold these beliefs are still talking to our at-risk youth.
Young people around me keep dying, despite the progress that has been made
One of the scariest things about this journey is to learn that we still have a long way to go to understanding and preventing suicide.
Even with all the discussion of mental health and suicide over the last few years, the suicide rate has been increasing around the world, with one million people dying by suicide last year and the suicide rate has increased by 60 per cent in the last 45 years. Rates among young people have been increasing to such an extent that they are now the group at highest risk in a third of all countries.
While research is ongoing, there is clearly something we are missing, and it scares me that this will continue until we figure out what that missing piece is and how we can help. And then I worry if our system is too broken to even adjust itself in a real way to new information that comes in.
We put all our eggs in one basket
Where resources do exist, we tend to put the most resources behind one model or solution. Whether it's the NHS in the U.K., HeadStrong in Ireland or HeadSpace in Australia for the leading mental health system, people still tend to think that one solution will work for everyone.
The truth is that people who live with mental health issues are as diverse as the rest of the population. One answer (usually the ever-popular cognitive behavioural therapy) does not work for everyone. We need to have multiple therapy types, models and solutions funded to better accommodate people's needs. One solution will not fit all, and this tendency to try to find that "one solution" worries me.
The best brains don't work together
We have a lot of amazing people working to prevent suicides, but they tend to work against each other. Why? Two reasons: ego and funding structures. Everyone wants to author the model that helps the most people, rather then owning it with other people. Our funding structures don't help this, and instead they reward organizations for saying they are the "first, best or only" and don't reward true collaboration.
This makes me so mad, because in order to solve a problem this broken and this tricky, we need to work together. Sometimes it feels like I need to just lock everyone in one giant room and not let them out until they have a workable, truly collaborative solution.
We don't have money to solve this problem
Worldwide, mental health only gets an average of 2.8 per cent of health funding. In places like Canada and the USA, this means that even though more people will live with mental health issues then cancer and heart disease combined, mental health receives only seven per cent of the funding that cancer and heart disease receives.
When you look at all the above concerns, there doesn't seem to be a viable solution in sight, and it keeps me up at night thinking about when the real support will come.
Each of these concerns together makes me understand why so many young people are still dying, and it leaves me really mad. I know that people living with mental health issues often struggle so much before asking for help. They see asking for help as the end of a long battle, but in reality, it ends up being the start of a much bigger and sometimes even more painful struggle working through the system, trying to get support when mental health concerns don't wait around for the system to meet an individual's needs.
Mental health and suicidal thoughts -- the same as many physical illnesses -- need immediate and appropriate care, and this kind of care is becoming harder and more complicated to access as the years go by.
Here is the thing: Things will only get better if we talk about suicide, if we demand more innovation from our mental health experts and governments, if we properly and appropriately fund it, and if we let people know that we care about it. Innovation is stagnating, and meanwhile, while the politics play out, people are still dying.
I have been to 14 funerals, don't you think that's enough?
(Thanks to my awesome friend Cheryl for helping me create this piece after I had been hitting my head against it for weeks. Check her out here .)
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After helping my sons Alex and Sammy reach recovery from two different mental disorders that hit them in adolescence, I spent a decade looking into what is known about preventing mental illness in children and teens for my book, A Lethal Inheritance, A Mother Uncovers the Science Behind Three Generations of Mental Illness. Here's the best advice I got from leading psychological researchers around the world about how you can protect your children from mental disorders. If symptoms of psychological distress are already present in a child, there are things you can do to stop them from getting worse. Take 10 minutes now to review these ten steps. You'll make a solid investment in your child's future and your own peace of mind. <HH--236SLIDEFREESTYLE--219069--HH>
Include all known or suspected mental disorders and addictions. If relatives baulk at your digging into the family's possibly murky past, point out that it's for the good of your children, and grandchildren. Use the US Surgeon General's online form for recording and storing your family's mental (and medical) history and make it a shared ongoing family project to maintain. Take a print-out with you to any mental health evaluation and insist that it be a part of your own or the child's diagnostic process.
The source of fetal risk may be a disease such as chickenpox, a prescription drug, or a chemical -- including oil-based paints, mercury and certain chemicals in plastics (phthalate and bisphenol A or BPA), used in some toys, cosmetics and water bottles. Sensitivity is highest during periods of intense brain growth--in the first and second trimesters. A good web resource for things to avoid is the March of Dimes. If you are currently on antidepressants, speak to a doctor about the relative risks of getting off vs staying on them. Severe depression may raise your child's risk for later disorders more than your medication.
There are known paternal occupational and lifestyle factors that can harm a pregnancy and put a child at higher risk. Work sites with prolonged exposure to radiation, anesthetic gases, and other toxic chemicals can alter a father's chromosomes, increasing the risk of miscarriage or genetic defects. A man's alcohol intake and drug use is linked with higher miscarriage rates. Older fathers are associated with higher rates of schizophrenia and autism in their offspring. As is the case for a mother to be, age, lifestyle and occupational risks should be weighed along with other factors, such as family history, to understand your complete risk profile. What you do with it is entirely a personal choice. But it's better to know than not know where a child's vulnerabilities may lie--so you can be prepared to help mitigate them.
You may have put off getting a diagnosis but now is the time to make an appointment with a mental health professional and seek treatment if you have symptoms of a common adult mental disorder such as depression, anxiety or addiction. A bout of postpartum depression affects many new moms, but it can hit a woman with severe depression or bipolar extra hard. Think of your actions as an act of prevention for your child's mental health. If your child already has similar symptoms, research has shown that by treating the mother, a depressed or anxious child will get better too - without direct treatment.
If there is a lot of any single mental illness (diagnosed or not) present among your relatives, learn about the early signs for that disorder. Some examples include social withdrawal for depression; irritability for depression, anxiety or ADHD. If you see early signs like these, closely monitor your child's behaviors. If symptoms are present for a month or more keep a daily log to document them. If the problem behaviors continue or worsen, bring this log to your pediatrician or mental health professional that treats children. If you have a family history of mental illness or suicide, do your best to keep teenagers away from cannabis; it raises the risk of psychosis five-fold in genetically vulnerable adolescents.
As soon as your child begins to recognize and name his own thoughts and feelings and those of others, start an age-appropriate conversation about how our human emotions and minds work. Explain that feelings and thoughts exist on a broad spectrum (compare it to a rainbow). Within reason (which excludes tantrums or aggression against others), make it clear that unusual thoughts and strong feelings are not right or wrong; more often, they simply represent individual differences. This "normalization" of differences makes it more likely that your child will confide any future psychological problems to you and be less inclined to stigmatize others.
Whether your child is the victim or the bully, do whatever it takes to stop it. This is not a "wait and see" option. Even if your child begs you not to make a fuss, understand that the potential psychological damage (including suicide) for him or her if the abuse continues is far worse than any temporary embarrassment. Pay special attention to warning signs that your child may be the victim of cyber-bullying.
Self-esteem has gotten a bad rap because it's been confused with having an outsized and incorrect sense of one's positive qualities and abilities. Self-esteem in a child comes from parents who model empathy, honor individuality and reward real effort, not false achievement. True self-esteem is the basis of emotional resiliency, which gets severely tested at several points in childhood - especially around early parent-child separations and the tween years. As a resilience building strategy, bring back family dinners as many nights as possible, divide up chores and use the time to communicate and enjoy each other just as you are.
Motherhood can be lonely. Social isolation isn't good for mother or child. Before giving birth, take stock of who you can call on for emotional and practical support among physically close-by friends, neighbors and family. Then check out any of the hundreds of web-based communities of new mothers from whom you can count on finding a friendly ear and a good laugh at virtually any time of the day or night. Find the right fit for you.
Follow Alicia Raimundo on Twitter: www.twitter.com/asraimun