When I sat down to watch Oprah Winfrey’s interview with Meghan Markle on Sunday night, I didn’t know what to expect. As a psychiatrist dedicated to reducing the loss of life through suicide, I homed in on the aspect of the interview in which she discussed the depth of her suffering.
Meghan Markle is one of many celebrities to speak about their experience with suicidal crisis. Those disclosures provide opportunities to increase the public’s understanding of mental health and to deepen compassion for what others may be going through. They challenge our culturally normed assumptions: false beliefs – such as the idea that beauty, wealth, and success protect people from mental health struggles. We would do well to trust that the dichotomy between external appearances and internal experiences is always at play, and we never know what someone is going through. Human beings are both enormously resilient and vulnerable.
Suicide, while complex, is a health issue. Therefore, it is important that we all do our part in approaching mental health and suicide risk in a similar manner to other health issues.
We all have a dynamic and continuous interplay going on between life circumstances and our internal biological, genetic, and psychological makeup. The more honest and the more we learn about our own vulnerabilities and strengths, the more proactive we can be in protecting and optimizing our mental health. All individuals should be able to receive support and access to care to have their mental health needs addressed.
It’s important to note that distress leads many people to instinctually withdraw, just at a time when receiving support is even more important. In addition, cultures that traditionally emphasize self-sufficiency or stoicism may unintentionally create additional barriers to reaching out for help. Therefore, many people who experience suicidal thoughts do not disclose them to anyone. If someone does mention they are struggling, you can thank them for opening up and let them know you want to support them, and that you are there to help them find the help they need.
This is what we should tell our patients: If someone you know is struggling and might be thinking about suicide, assume you are the only one who will reach out. Having an honest conversation with the person will let them know that you care. Take the person seriously and speak up if you’re concerned about them. Ask directly if they are thinking about suicide. Help the person by connecting them with a mental health professional. If you aren’t sure if their safety is imminently at risk, connect with crisis resources and services immediately. Realize that most people who are suicidal are ambivalent about taking their life and really just want relief to their pain: Part of them wants to live and part of them wants to die.
by helping them secure firearms, medications, and any other potentially lethal means.Suicidal thoughts cut across all demographic groups, occupations, and socioeconomic strata. By understanding that life presents intense challenges for all of us and that suicidal thoughts are an indication of suffering warranting professional evaluation and intervention, we can approach the next person who discloses suicidal thoughts with compassion and action. To learn more, go to afsp.org.
Dr. Moutier is chief medical officer of the American Foundation for Suicide Prevention. She reported no disclosures.