Here is the text from the speech I gave at A Walk to Remember in Dekalb County, IN during World Suicide Prevention Day 2018.
Hi, my name is Nate Crawford. I run an organization called Here/Hear that works to give hope to those who have been affected by mental illness. We work a lot on educating people and pointing people to resources that are available to them.
The reason that I run Here/Hear, and that I recruited a group of friends to start Here/Hear, is because I suffer from bipolar 2 disorder and suicidal ideation. For those who are unfamiliar with the jargon that can so obscure our cause, bipolar 2 is a form of bipolar disorder. Except, I tend to suffer from more, longer, and darker depressions than people with bipolar 1, while only experiencing hypomanic highs. I also have suicidal ideation, which means that I have thoughts of dying by suicide. These thoughts are always present for me, always there, no matter how good I feel or don’t feel. Suicide is, literally, always on my mind. And it has been this way since I was roughly 11 years old.
But, I have survived.
I have survived when so many people have not. And I have no answer as to why that is. I have no answer as to why I am here and people that you love and people that I love are not. I have been asked this question and I have asked myself this question and I do not know. I do not know.
I’ve thought a lot about what we need to do to deal with the question of suicidality. I’ve done a little research. And, I think I’ve come up with three things, that I want to share with you right now. First, unfortunately, we still need to work to destigmatize mental illness and suicidal thoughts. This is, again, one of those words that people in the mental health field use that other people may not know. Stigma refers to the fact that people with a mental illness and with suicidal thoughts feel ashamed for having such, often because people and society make them feel that. For example, when I was 16, I told a youth pastor and some other friends that I was having suicidal thoughts. Instead of acting in a caring way, the youth pastor told me, “Don’t ever say that again. You can’t be a believer and have those thoughts.” Or, a few weeks ago, I was at a discussion on mental health in the life of refugees. However, in the discussion, no one was allowed to or even tried to use the words “mental illness.” No one talked about the very real statistics that discuss the increased levels of post-traumatic stress disorder, anxiety, depression, and suicidal ideation in refugees and other minority groups in the US. This was because of stigma, because of the fact that we do not want to talk about the very real dangers and issues associated with mental illness and suicidal thoughts. Stigma exists and it is prevalent in our society, almost ubiquitous (I know of no advocate for those with mental illness that would dispute such a claim). So, the issue is that people fear the reprisal that comes with talking of their own mental illness, their own dangerous thoughts and will not do it. Thus, it is imperative that we begin to destigmatize mental illness and suicidal thoughts so that people can talk openly about it, can share their feelings, can go on about what it means for them to exist.
Second, though, it is no longer enough to simply fight stigma. Stigma is not our main enemy, but we often feel like it is. No, our main enemy is the crippling effect that mental illness often has on a person who suffers. Our main enemy is the suicidal thoughts that become present when one suffers from certain kinds of mental illness. In this light, we must begin to offer hope to the suffering. We must not only legitimate the fact that someone feels depressed or anxious or is hearing voices or has bipolar, but must also begin to point to the resources that are around for that person. We must begin to listen to stories and then point the person to a counselor or therapist, to a doctor, to a psychiatrist. When someone cries out on Twitter or Facebook, we must not simply assume the best, but must reach out and say, “Are you ok? It’s going to be ok. I’m here with you.” You see, when one is in the throes of mental illness, it is almost impossible to feel a connection with anything other than what that illness tells you. We must do a better job of building those connections, not letting people fade into their own worlds where no one can penetrate. We have to build the resources and the tools, the friendships that will go into the darkest places to give someone hope. This is not easy, nor is it glorious. It is sitting in the muck with someone while they are severely sick, but also getting them the help they need to not be so sick. In my life, my wife is the person that sits in the muck with me. She goes into the deep, the hopeless and stays there with me until I can come back. And I can always come back, but I need help. She gives that help, she is there, she offers hope.
One of the hardest parts of doing this, though, is that suicide prevention and awareness programs are primarily geared to someone in the deepest throes of suicidality and crisis. We do not do suicide prevention when someone is not suicidal, but only when they are making a plan and are doing the things that are considered “suicidal.” Our suicide prevention is not preventative in the way in that we are not giving people the resources and the means of helping themselves and us helping them before they become suicidal. Let me explain a little bit. Sarah suffers from a mental illness but has never been told where or how to get help. Sarah’s mental illness makes her more and more depressed and she has some factors that occur in her life that exacerbates that depression. Her parents decide to get a divorce, she has to move, and her boyfriend breaks up with her. She has no idea where to turn and her mental illness makes it more and more likely that she will not turn anywhere. Now, up to this point, Sarah is outside the protocol for most suicide prevention programs, at least the ones I know. As she moves deeper into crisis, though, and as she starts having suicidal thoughts and then starts to self-harm, then she is closer to where suicide prevention programs may help. But, she cannot get real help until she makes a plan and is in serious crisis. This is where the “real” help comes, but our system does not usually offer real help apart from dissuading someone to make an attempt at suicide. The problem is that there is little follow-up and, more than likely, Sarah will make another suicide attempt, whether fatal or non-fatal.
What do we need then? We need a system that begins to recognize people as sick with a mental illness long before suicide ever becomes a possibility (over 90% of people who attempt suicide have a mental illness). We need a way of putting people on the path of recovery before that recovery is from a suicide attempt or suicidal ideation. I look back at my own life and I wish that people would have noticed the mental illness that was eating me away, whether that was by friends or school officials. I wish that teachers would have noticed when I turned in assignments and they were an obvious cry for help. I wish that counselors would have seen the problems that I had and intervened. But, they did not. And, on multiple occasions, I almost died.
There is hope, though. Some of you have surely noticed that I have tattoos up and down my arm. Some of you who know me know that some of these are new. I live with a real temptation to harm myself and I have scars. My tattoo is a way to cover over those scars, to give my life a new beauty if you will. But, it also acts as a preventative, because no matter what, I’ll never cut into that tattoo. I use tattoos as a way to cover over the old while also signaling a fresh start. That’s actually why, if you look closely, I have butterflies. I’ve been mocked for being a man with butterflies up and down my arm, but they signal new birth and new life. They signal something for my family that means life is here and it matters and we are growing into hope together.
And, can I just say, not as a shameless plug but as a future resource, Here/Hear is building work that helps you tackle these issues. We are developing curriculum that students and teachers can use to find those students who are at risk and we can begin offering them hope. And we can still offer training in suicide prevention and awareness that targets those people who are in crisis, helping people learn the signs and how to intervene. The idea is to put all of these things together so that people are trained, are aware and can offer more than a word, can offer more than simply saying, “Stay.” We want to offer real hope and ways that, locally, we can connect people, those with mental illness and those without, in a way that gives a renewed sense of life, allows people to emerge from cocoon into their own, unique butterfly. Thank you.