Suicidality begins in childhood (or how we incentivize suicide)

Folks, this is what I bring to light when I teach mental health and general practice clinicians. I ask them to try to fight the conspiracy of denial that is so prevalent and so inscrutable – because it is born out of empathy and love. The conspiracy is a need to believe that our youth (or anyone else) are somehow protected from the pain of trauma simply because we cannot tolerate the helplessness we feel when we do not have any definitive answers for them. We try to make it tolerable or better and often times make it worse in doing so without realizing it.

Suicidal ideation does not begin with lost relationships or any of those listed vulnerabilities in early, mid or late adolescence. In all my work and research the reality is that it begins in childhood. The paucity of research on this age population is the clarion of the conspiracy – because there is little to none since the 70’s and 80’s, when epidemiologic studies revealed that approximately 3 out of every 25 kidlets in elementary school admitted suicidal thought, plans and some had already attempted. That means if you translate that into a contemporary average elementary school, when you drive past the local primary school in your neighborhood, you could look out onto the recess yard and see 30 kids who are already contemplating suicide as an answer to untenable problems in their lives.

And The Adverse Childhood Experiences Study of 17,000 participants showed that trauma in childhood is common in those who later attempt suicide.

The realization  that suicide is a feasible option to alleviate those untenable problems comes early – usually the first time a youngster hears of someone (from their own family or someone they admire like Robin Williams who dies by suicide). That’s because, in a desire to assuage their pain, we tell children, “Robin is in a better place; he’s free of his pain now; he is in the arms of the Lord.”  When I heard that explanation at age 6 when my girlfriend’s father killed himself, I said to myself, “Wow, sign me up, I want to be free of pain and with Jesus.” And that sealed the deal.

Do you think in anyone’s desire that they would have thought that they just incentivized suicide for me? Of course not. That is why I teach what I teach. We are so clueless about suicide. We do not listen and we study all the wrong people. One of my patients told me…no one listens to me when I tell them what I know because they think, “She’s mentally ill, what could she possibly know?” She is no more bipolar than the man and the moon but she has that label and she cannot find any credibility because it speaks before her and completely drowns out her brilliance and amazing insight.

We unknowingly incentivize suicide in many ways. Teaching that and alternate ways of speaking the age-appropriate truth is one of my missions in my work with clinicians and the public. I go next week to teach a four hour “Community Response for Suicide Prevention” to the Port Gamble S’Klallam Tribe because they are willing to look at how they might be able to return to the village raising their children. They are willing to look at what they might be doing to incentivize suicide. This takes the strength the S’Klallam are known for.

The Boys and Girls Clubs, the YMCA’s, and the PTA’s have yet to garner that much courage. Those doors are still closed to me, as hard as I try to spare their children from starting that “I don’t want to be here” neural pathway in second or third grade.

I pray that someday we will all have the courage to look at what we might really be doing with all our best intentions. My colleague tells me I’m too hard on people. My message is too hard to take. For years we believed that bleeding people helped them get well. When we learned it did not. We quit doing it. We just needed to learn that we needed to quit. What would have happened if no one ever said that what we are doing is weakening and possibly killing people? We need to stop.

We keep looking everywhere for answers. We need to look in the mirror. Like Pogo said most insightfully, “We have met the enemy and he is us.”

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