Young suicideSuicide is still a taboo subject for many, but increasing numbers of attempt survivors in the US are now speaking out about their experiences to help improve public understanding of the issue. Mary O’Hara reports:

Four years ago 31-year-old Brooklyn-based photographer Dese’Rae L. Stage decided she wanted to find people just like her. She didn’t know anyone else who had been through a similar experience but believed “there had to be people out there” she could talk to.

She began searching online for others who had tried to take their own lives and survived but instead encountered an information void. There was plenty about people who had lost someone through suicide including support groups but it was as if suicide attempt survivors were “invisible”, she recalls.

Now just a few years on, Stage, who tried to take her own life in her early 20s, is one of a growing band of suicide attempt survivors who are speaking out across the US about their experiences. Alongside others she has become a vocal campaigner for a wider public understanding of suicidal thoughts and for reform of suicide prevention strategies so that they take into account the views and insights of survivors. Stage describes her approach as being from “an artistic” as well as a survivor perspective having drawn on her photographic skills and a background studying psychology to establish the groundbreaking project Live Through This.

The project, which has a website at its hub has morphed into a network of like-minded individuals and led to Stage travelling the country giving talks, telling the stories of a diverse selection people who have made a suicide attempt and come through it. There are currently more than 100 stories accompanied by striking portraits – photographs taken by Stage – with the aim of “putting a human face” to a phenomenon that the wider public are uninformed about and which society as a whole continues to shun and stigmatise, she says.

“As attempt survivors we’ve always been anonymous, we’ve always been reduced to statistics, we’ve never had names and faces,” Stage adds, explaining the centrality of first tackling the invisibility of attempt survivors. “If you don’t have that human connection then how the hell are you supposed to get a lot of people to care about it?”

Greater visibility
Stage believes that during 2014 the US has reached a kind of “tipping point” in the momentum towards greater visibility of attempt survivors and their inclusion in initiatives to prevent deaths. “It’s been a really big year” she says. “The breakneck speed at which things have been happening is amazing.”

She’s referring to a combination of developments. One element, as with Live Through
This, is the proliferation of grassroots efforts that have been garnering national interest from the media and mental health professionals. Journalist and attempt survivor Cara Anna is an example of the trend. At almost exactly the same time as Stage and with similar motivations Anna went in search of suicide survivor support networks only to find almost none. In response she set up her own support website, Talking About Suicide (http://talkingaboutsuicide.com), through which she has reached out to and interviewed hundreds of people – and has even guest-written for Alistair Campbell’s blog.

Anna’s site made such an impact so quickly – an indication of just how much demand there was for something specifically for survivors, she says – that it led to her being asked by the American Association of Suicidology (AAS) to manage a similar site for them, Attempt Survivors (http://attemptsurvivors.com), on which she mostly curates the contributions of other survivors. Both sites direct visitors to established organisations such as Samaritans should they need help in crisis. Both Anna and Stage stress the importance of this as they are not mental health experts, therapists or counsellors. Rather what they are offering – forums for people to reach out and speak out – have their own value, they say.

The two campaigners speak eloquently about “the ‘S’ word” and how survivors should not have to feel confined to the shadows of society. “Is [attempted suicide] just so terribly shameful that we all have to walk around in silence after something so traumatic and dramatic?” asks Anna, describing why she decided to use her spare time as an advocate. “We’re just supposed to zip it up and pretend it never happened?”

Increasing issue
Hundreds of thousands of Americans attempt suicide each year, according to the Centre for Disease Control (2012). In 2012, the latest year for which figures are available, 40,600 completed suicides were reported, according to the American Foundation for Suicide Prevention.

After a number of years in which deaths by suicide were in decline they have been steadily rising since 2000. As with the UK, men are much more likely to take their own lives and, similarly, suicide ranks as a major cause of death – its the 10th most common across the whole US population and accounts for a fifth of all deaths annually for 15-24 year-olds.

Vigorous networks of people speaking publicly about living with mental illness have emerged in recent years in the US just as they have in Britain. However, there hasn’t been a corresponding movement for people who survive suicide attempts in either country and creating one has been a crucial driver of the new US grassroots movement.
It is against this backdrop that the tipping point Stage refers to is unfolding. In part because of the actions of the new breed of activists lobbying for suicide prevention experts in health and academia to take them seriously some significant developments have occurred. Earlier this year a national suicide summit took place while for the first time the AAS (http://www.suicidology.org) created a division specifically for survivors.

Another initiative spearheaded by the National Action Alliance for Suicide Prevention’s ‘Suicide Attempt Survivors Task Force’ resulted in a landmark report, ‘The Way Forward’, published in July. Among other things the report proposed radical action to ensure that the first-hand experience and knowledge of survivors is made central to suicide prevention research and strategies nationally. Meanwhile, a slew of films and video projects have emerged including a documentary due for release in 2015, The ‘S Word’ in which Stage has been involved.

Changing the system
For mental health campaigner and suicide attempt survivor, Leah Ida Harris, the progress currently transpiring is not a moment too soon. A regular public speaker who works with a range of organisations including the National Center for Trauma-Informed Care, (http://www.samhsa.gov/nctic) Harris comes from a family where a number of members lived with mental health problems.

This inspired her to devote herself to improving suicide prevention while highlighting “the drastically” underfunded mental healthcare system in the US. “There’s been a huge shift not just about survivors telling our stories but in the very idea that we would have a say in changing the whole system,” she says, talking about what might lie ahead.

Part of the problem so far she suggests is that mental health professionals have been “fearful” of directly engaging with people who are suicidal or those in recovery. “It’s the elephant in the room. There are concerns about liability or being sued if a [patient] takes their own life.”

This has been a long-standing stumbling block to progress that would otherwise enhance “our understanding of suicide,” she insists. “There was nothing like what we have now [in terms of momentum] a few years ago,” she concludes before cautioning: “There is much more still to be done.”

Stage agrees. Pointing out that there is “no mandated training for [physicians] in suicide prevention except in two states,” she says the key thing now is to maintain the energy behind the grassroots movement and to cement their broader accomplishments. “As for me? At heart I’m an activist. I hope to go on changing minds one at a time.”

References
Action Alliance for Suicide Prevention’s Suicide Attempt Survivors Task Force (2014) The Way Forward: Pathways to hope, recovery, and wellness with insights from lived experience (The Way Forward). Washington: National Action Alliance for Suicide Prevention.
Centre for Disease Control (2012) Suicide Data Sheet. Available at: http://www.cdc.gov/violenceprevention/pdf/Suicide_DataSheet-a.pdf

About the author
Mary O’Hara is a freelance journalist and the author of Austerity Bites: A journey to the sharp end of cuts in the UK. Published by Policy Press, 2014. http://www.austeritybitesuk.com