The significance of one death by suicide

At about this time last year, I clicked "Publish" and put out into the world an incredibly personal piece of writing. I struggled for months to decide whether or not I should publicly claim an identity as someone bereaved by suicide. I decided that taking the risk was better than sitting with what had become a sort of secret, and published a blog post about my father, who died by suicide when I was a child.

I worried about so many things as I wrote and published that post: That my father's memory would be reduced, that he would become a statistic, not a person. That I would get weird, unwanted and unwarranted attention focused on my identity as a survivor rather than my professional accomplishments and skills as a preventionist. That I would have put out something that I couldn't take back.

What happened was remarkably different. I was immediately supported by colleagues and friends both virtually through comments and in person. I came to appreciate, by hearing this feedback from others, that I'm someone who can hold in balance a personal and emotional connection to the issue that I've made my occupation. Most importantly in my mind, I confronted the shame that I'd held on to for over 20 years.

I'd underestimated everyone's ability to hold two seemingly contradictory things that I had trouble holding - that someone can be a person and a statistic. It meant something for me to identify as a survivor, because it made my father's death count in a new way. It made me count among the hundreds of thousands of people bereaved by suicide. It allowed my father's death to be counted as what it was - the end to years of unbearable emotional pain and a courageous struggle with a mental illness, bipolar disorder.

I'd also failed to imagine how greatly I might honor my father by writing about his death. Now, I get to talk about him more than I did before, because people ask and want to know. I've been asked so many good questions about him that gave me the chance to remember him, but also to extend his memory to others.

Through answering some of these questions, I was given the opportunity to realize, and articulate, that my father worked very hard to live. He fell in love, married, and had three children. He had lifelong friends and made a valuable contribution to the world through his career. He lived with mental illness in a way that I think many people, including myself, often do not picture.

Critical to his story, though, is that he died because of his illness. I think some people believe that people who die by suicide are weak, failures at life. Suicide deaths are so often seen as selfish, and because the act of suicide is self-inflicted, the person who dies is blamed for his death. Thinking that way leaves out that mental illness is influenced by multiple factors, biological and environmental, just like physical illness. I wouldn't blame someone who died after years of having cancer, especially if they were able to get treatment and the treatment couldn't fight the disease.

Someone asked me last year if there was anything we in the suicide prevention field could have done differently to prevent my father's death. As public health professionals, we don't spend a lot of time thinking about how to prevent individual deaths, so it meant a lot to me to be asked that question.

I said that I think my father was sick at the wrong time. His sister, my aunt for whom I'm named, died of breast cancer in the late 1970s. The treatments available for young women with aggressive forms of breast cancer were extremely limited at that time. My aunt died because of her illness, not because she was a weak person.

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Throughout my father's adult life, when he was struggling with and being treated for bipolar disorder, the treatments available were also extremely limited. My father engaged with treatment the best he could, but I know that he also didn't always take medications he was prescribed, and it's pretty clear to me now that he was released from hospitalizations without adequate safety plans.

Not all suicides are connected to mental illness, but my father's was. While there truly is never a good time to have a mental illness, now is such a better time. We have better, more expansive and scientific, ways of thinking about mental illness than ever before. We have different types of treatment, give people with mental illness more choices, and know more about suicide prevention. We train mental health professionals specifically to recognize and respond to signs of suicide. We have national organizations devoted to determining best practices in mental health promotion and suicide prevention, so that mental health and public health professionals are supported in doing quality work. We're talking about mental health and mental illness, suicide and suicide prevention, in ways that we just weren't 20 years ago.

I'm proud that I'm able to be a part of the field at this time, that I can honor my father's memory through my work, and that I've integrated this loss into the way I think about my life, and I'm grateful to the community created through this blog for providing support and inspiration.

Copyright 2010 Elana Premack Sandler, All Rights Reserved