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Child Psychiatrist /Adult Psychiatrist

The Suicide Police: Harm Disguised As Help

A man with his mind fighting with depression.

I wiped away tears and stared down at a deep gash in my arm as I typed. What I wrote would eventually become a blog post about my struggles with postpartum psychosis and suicidality. Even though I was in immense pain, I was hopeful that somehow my words might make someone else feel less alone. At least one in seven new parents develop postpartum depression and nearly 80% will suffer some form of depressive episode immediately following the birth of their child. Yet we continue to perpetuate the myth that new parenthood is universally the happiest time imaginable. For me, new parenthood was anything but. I nearly died. It was one of the hardest times of my life, and just when I was seeing light at the end of the tunnel, CPS came knocking at my door.

In the saddest of ironies, the person who read my blog seven years ago and was responsible for Child Protective Services being called on me is currently writing publicly about the loss of her husband to suicide. She is telling the world that ultimately, it is a suicidal person’s responsibility to save themselves and that “personal accountability” is paramount for preventing suicide. She is a mental healthcare professional. She is also my sister-in-law. She caused tremendous harm to me and my family and is now causing further damage to anyone who is suicidal that might come across her writing. This is because what she is saying about her husband’s death is that it could have been prevented if only he had tried harder. Not only is this victim-blaming, but by leveraging her position as a mental health professional, she is perpetuating what has been dubbed “suicidism.”

A unique art of a woman that thinking about saving life.

Alexandre Baril coined the term “suicidism” to describe the unique discrimination and marginalization suicidal people face. Suicidism intersects with ableism and sanism in important ways, insofar as most suicidal people are deemed “mentally unwell,” despite research indicating that while mental illness is a major risk factor, other precipitating causes, such as Adverse Childhood Experiences, psychological abuse, and marginalization play equally important roles. Suicidal persons are often criminalized as well. Saying someone “committed” suicide, for example, implies they perpetrated a crime, but against whom? Thieves victimize others but those who die by suicide are victims, not criminals. Thus, suicidologists have argued this terminology should not be used.

Another important movement in suicide research is “postvention.” Rather than focusing on prevention strategies, many of which Baril rightly notes are suicidist, we need to pay more attention to how we frame suicide after it’s happened. Postmortem speculations about what led a person to suicide tend to pathologize victims. The person was “out of their mind” or must have been mentally unwell to do such a thing. As many advocates have argued, this is harmful, because it assumes no person could rationally contemplate dying: no “sane” person chooses to die, their “mental illness” did that to them. These sorts of statements subtly imply a suicidal person is a patient rather than an agent, and thus is incapable of authorship over their actions.

But perhaps the most harmful ‘help’ offered is insisting that suicidal people reach out and “save themselves” without also recognizing how unsafe it can be to do so. Often, when people reach out — by calling a hotline or confiding in someone — they are punished.

Suicidologists have warned against the commonly touted ‘solutions’, such as the 988 hotline, and have noted the likelihood of police intervention when contacting these services.

Imagine calling a hotline hoping it would save your life, only to find yourself involuntarily hospitalized and drugged. Or worse, the police show up, and if you happen to be in crisis while also not being white, your chances of being shot dead are alarmingly high. For those who are hospitalized against their consent, their chances of dying by suicide after being released actually increase. In short, many intervention strategies are violence disguised as help.

The irony in my case is that I did reach out. I blogged and shared that blog with a close-knit group of supposedly trustworthy family and friends. During my pregnancy, I knew I would need significant support to remain mentally healthy, so I proactively put those supports in place. I was doing everything right, according to my sister-in-law’s recent recommendations, namely, “recognizing my vulnerabilities” and holding myself accountable for my well-being. I told the truth: that I wanted to die. Rather than reach back toward me to help, she set off a chain of events that resulted in CPS knocking on my door. My family was terrorized by this for nearly two months until it was finally settled that I posed no risk to my child. To this day, I have panic attacks and nightmares, and when the doorbell rings, I often shriek in fear or drop my coffee all over the floor. This is textbook post-traumatic stress.

My suicidality did not begin with my first pregnancy. I can remember planning to kill myself at age 16 and taking active steps to do so. I’ve also struggled with anorexia most of my life, which I later learned is the most lethal mental illness. Nevertheless, I’ve always managed to find coping mechanisms that keep me alive and in a mostly healthy relationship with food. I do triathlons and open water marathons and generally focus on goals I can see myself fulfilling in the future. But it’s not an exaggeration to say that most of my life is spent finding ways not to think about killing myself.

This battle with suicidality reared its ugly head after the birth of my first child. The birth was incredibly long and traumatic, 60 hours in total, and ended in an emergency C-section, which I had desperately tried to avoid. I knew being sliced open would only exacerbate my body issues. Then there was the sleep deprivation. Three days of labor that resulted in a thankfully incredibly healthy new baby boy, did not result in much-needed sleep, as any new parent will know. A few weeks after his birth, I found myself hallucinating, having intrusive thoughts, and cutting myself. Even when I had a chance to sleep, I didn’t. I would sit in the dark in the living room alone, while my baby slept in the bedroom with my partner. I would sit there with a drink in hand, rocking back and forth, trying everything I could to shake it: the thought that I would be better off dead.

One night like this, I penned a letter to my child and began making my plans. My partner found me early the next morning at my computer, with blood on my arm from a deep wound I’d inflicted. He encouraged me very strongly to go see someone. Suffice it to say, I’m a hard sell when it comes to entrusting my mental well-being with mental health professionals.

Mostly, it’s the lack of scientific rigor in psychology that makes me skeptical, but this is not the essay for that discussion. There are plenty of books and articles out there that delve into all that. I’ve always been ambivalent about assuming any labels, primarily because I’ve received so many. Depending on the doctor, it can range from OCD, to generalized anxiety disorder, to bipolar, and I have even been diagnosed by one therapist as autistic. A psychologist once told me to pick a diagnosis so she could properly code for insurance. In short, I have a healthy dose of skepticism regarding the mental healthcare profession.

Nevertheless, I begrudgingly went to see a psychiatrist and even more begrudgingly took the meds she prescribed. Immediately, I was able to sleep. My hypervigilance abated. With help, I eventually weaned myself off the SSRI I was taking, and looking back, I am glad I did. Research consistently links SSRIs with all sorts of complications, not least of which is a risk for suicide. I say all this with the very important caveat: if these drugs help you, by all means, take them. I did. I am pretty sure I would not have survived without them. There is no one-size-fits-all model for mental health and there certainly is not a consensus about the effectiveness of most psychotropic drugs.

So there I was, feeling like myself again, looking at my beautiful child. I had just successfully taken a trip with him to a friend’s wedding. My partner and I were amazed to find that our nine-week-old slept through the night for the first time, in a hotel, seven hours from our home. We didn’t question it. We slept. Glorious, back-to-back hours of sleep. We danced at the reception. The pictures are some of my favorite images of our family. Our son was dressed in a little conductor outfit since the wedding was in an old train station. We were all so happy. Life finally seemed like it was worth living again.

I was reminiscing about this great weekend while nursing him upstairs in the bedroom and that’s when I heard the doorbell ring. A few minutes later, my partner was in the doorway telling me I had to get down there. What followed was a nightmare that I am forced to relive whenever it chooses to push itself to the forefront of my thoughts.

If CPS has never invaded your life, you are fortunate. Apparently all suicidal people are doing illegal drugs, because I was forced to pee in a cup, in my own bathroom, in front of the caseworkers. They told me they had 45 days to substantiate or drop the charges against me. After they riffled through my belongings and demanded to see how much milk I had pumped for my baby, I asked them who called. They told me that information is confidential, but they said it was because of a blog. I knew someone very close to me had filed the report.

As expected, the allegations were unsubstantiated. But DCFS took the full 45 days to officially close the case, even though all they had to do was call my psychiatrist and it would have been settled. I was at a conference two days before their deadline, chairing a session, and my phone was buzzing incessantly. I had to leave the room to take the call because I knew it was them. They were trying to get a hold of my psychiatrist, on a Friday afternoon, and wanted me to help. I was flabbergasted. “So you are telling me you are just now trying to interview her?” I asked, exasperatedly.

We requested a copy of the report once the case was closed and we were appalled by the sheer incompetence of the Arkansas DCFS. The colleagues I had suggested as references were all listed on the report as having been interviewed. Their responses sounded bizarre to me, so I called each of them and found out that they were never actually interviewed. The report also listed an interview with someone else, a person neither my partner nor I knew, and she claimed she was worried about her “friend’s” blog. It turns out she was a social worker employed in the same office as my partner’s sister. This is how we found out that my sister-in-law had a hand in causing the terror of CPS invading our lives.

There isn’t really a word to convey how angry we were. I made vague comments on social media about being betrayed by family and how enraged I was, but never mentioned anyone by name. I needed an outlet for my feelings. Rather than try to understand this, my partner’s family began a smear campaign against me. His mom jumped in to tell me I was unfairly judging their “loving” family. This is the same woman who, weeks prior, had written an angry post directed at whoever did this: “Just let me get my hands on you. Nothing meaner than an angry grandma. You had no grounds or sensibility. Shame on you — hope it comes right back at you!” When she found out it was her daughter, however, I became the enemy. She even had the gall to tell me that “CPS only investigates the most serious cases,” which is patently false — CPS investigates every call they receive — but also, this contradicted her earlier claim that there were no grounds for the call in the first place. I could write a novella about the gaslighting and moving of goalposts that transpired in an attempt to frame me as the unhinged bitch who deserved what happened to her, but there is no point. I will forever be the scapegoat in the story they tell themselves in an attempt to avoid the truth. But I know truth. And I have receipts.

Today, I realize my anger was a perfectly normal reaction to completely abnormal and abusive treatment, but back then, I saw my partner suffering, and it broke my heart. His sister did apologize, but her story about how my blog landed in the hands of that social worker never sat well with us, and today, seeing what she writes, her apology seems as hollow as the platitudes she invokes. Nevertheless, I genuinely wanted to allow my children to have relationships with aunts and uncles and cousins. I am an adoptee, and the product of a closed adoption, so I was involuntarily estranged from my own genetic family for most of my life. It is not a situation I would inflict on anyone, unless it was the only way to ensure their safety. Thus, I tried to bury it, for my partner and my children. But dust swept under a rug doesn’t magically disappear. It’s just hidden temporarily.

It’s now been eight months since my sister-in-law’s husband died by suicide. When I learned it happened, my heart broke, for her, for her kids, but most of all, for him. A fellow suicidal person who did not survive. It is a tragedy and I would like to think it was preventable, but I cannot say this with confidence. I know that when I was at the height of my postpartum crisis, I was not delusional or irrational. Hopeless, yes, but my mind was clear and I had a well-reasoned path to end my pain. I did not want to be rescued or saved. I wanted to stop hurting. I have no idea what my brother-in-law was feeling in those moments, days, or weeks leading up to his death. But I know he died alone, with no one holding his hand, with no proper goodbyes, and likely believing his family would be better off without him.

My sister-in-law states that if her husband had taken early steps to prevent his own spiraling into despair, then maybe he would never have reached such a helpless state. This is victim-blaming. For one, he was on medication, so he was trying to do something about his mental health, but also, it’s not entirely clear that depression is what caused this. Their marriage was acrimonious, and by her own admission, they were headed for divorce. I don’t want to speculate beyond what I know to be true, but it’s not wild conjecture to assume that there were discussions of custody and other anxiety-inducing and depressing conversations. To say it was “his” depression that caused this overlooks the material conditions that might have contributed to his desire to die.

I also cannot help but think about how he knew what happened to me when I reached out. He saw what his wife, a clinical psychologist, did when I told the truth about wanting to die.

It’s not unreasonable to think he might not have felt safe reaching out. Nevertheless, she touts her credentials in the wake of his death, stating false or outdated claims, such as that “the majority of people who die by suicide never ever communicate their intentions.” In reality, many suicidal people communicate their intent before dying, with some studies suggesting as many as 68% of victims do so. Moreover, we have to consider that communicating intent can take many forms, and hence, many researchers note that there are likely far more cries for help than their studies indicate. Regardless, this misinformation she is sharing, coupled with her insistence that there is no way she could have seen this coming, is troubling, and frankly, harmful.

Causing harm and refusing to be held accountable for it seems to be a theme in my partner’s immediate family. When I was at my lowest, not one of them checked in on me to see if I was managing okay. Knowing I had tried to kill myself, none of them said “I’m so glad you are still here, because you matter.”

It’s easy to tell a dead person they mattered. Humans are great at writing eulogies. But we are shit at making people feel like they matter while they are alive. I’m not saying I think my brother-in-law was made to feel like he didn’t matter, but to leave that unexplored as a possibility is to do a disservice to him as a human being. He deserved to be heard. He still does.

To publicly proclaim that suicidal persons are responsible for their own rescue is to completely disregard what real despair feels like. Perhaps this is why, as Baril and others argue, it’s time we stop centering non-suicidal persons in discussions of suicidality. If you have never known what it’s like to want to die and to actively seek that out in earnest, then maybe you don’t have much insight into what a person in that state ought to be doing.

Maybe, if folks quit talking about experiences they have never lived, others who are actually living those things would have space to share their stories, without shame, and without the interventions of policing systems. Perhaps, ironically, lives could be saved if we started truly hearing the ones who say they don’t want to be saved.

I didn’t want to be saved. I believed it was better to save my family from me. Whenever I’ve struggled with thoughts of ending my life, the ideas running through my mind are not “help!” or “I wish someone would save me from myself!” It’s mostly relief, knowing that if I go, my children will not have to suffer because of my incompetence as a mom. Where on earth would I get that idea, you ask? It didn’t just spring forth from a deep well within me, I assure you. The world is fucking rough, and it’s especially rough on new moms, as I began this essay discussing.

Today, as I write, it is hard to imagine looking at my children and thinking they’d be better off without me, but I vividly remember having those feelings in the moment. And guess what? Struggling with thoughts of suicide doesn’t make you selfish, or delusional, or a bad parent.

Ironically, the last lines of the letter I wrote to my son seven years ago read: “I love you so much and want nothing but your happiness. Finally, I found a reason to be unselfish. Thank you for that. I love you, my little Bigfoot. Be kind. Be thoughtful. Be happy.”

I am not sorry I blogged about being suicidal. I am sorry that those who should have supported me most chose instead to turn their backs on me and allow me and my family to suffer even more at the hands of the family-policing industrial complex. I am sorry they continue to perpetuate suicidist marginalization by speaking for a victim of suicide without his consent and by washing over the damage they have done and continue to do.

Suicidal people exist, and yet we do not. This is because, in the minds of non-suicidal people, we are either dead, or we are one of them. Suicide has either claimed us, or we are “cured,” the thought of dying never again entering our mad minds. But we are here. We live in underground networks of secrecy, because we don’t want to be found out, lest we be subjected to suicidist violence. However, we must be heard. It is time to stop rendering living suicidal people voiceless, and to center them in discussions of what it’s like to experience suicidality. Proximity to it does not count, either. Much like adoption, unless you are adopted, you simply do not understand what it’s like to be adopted. Suicide rates have not declined over the last decade. In fact, they are on the rise among various demographics. All the different approaches to prevention, from the biological and social models, to the social justice approach, suffer from a common problem: silencing suicidal people. Thus, suicidism prevails. Suicide prevention regimes are steeped in it because people who have no lived experience with suicidality talk over those of us who do.

I hope, for my brother-in-law’s sake, and for all others out there, both living and deceased, who have experienced suicidality, that the mic gets passed one day soon. You deserve to speak. But more importantly, you deserve to be listened to with care.

*** Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own. ***

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