Susan Reff: May is Mental Health Awareness Month. And on today’s podcast we will be talking about all things mental health, including suicide prevention. This episode contains content that may be alarming to some listeners. Please check the show notes for more detailed descriptions and take care of yourself.
Intro: Welcome to the Lady Lawyer League podcast. They are a league of lady lawyers in an all-female law firm in Omaha, Nebraska, called Hightower Reff Law. On this podcast, you’ll hear stories of what it’s like to be a lady lawyer and an entrepreneur. Now it’s time to talk about the law, share real-life stories about representing clients and discuss the current events of the week. It’s the Lady Lawyer League podcast with Susan Reff and Tracy Hightower-Henne.
Susan: We today have two special guests with us, Jen Sparrock and Tia Manning, both with the American Foundation for Suicide Prevention (AFSP).
Tracy: Welcome again. Thank you for coming back to our podcast, and Tia really is an expert now. A punch card is coming.
Tia Manning: I know on Saturday Night Live they get like a jacket if they’ve been there five times. Yeah.
Jen Sparrock: You’re getting close to the jacket worthiness, Tia.
Susan: Tia, you’ve already been on the podcast more times than some people that work here.
Tia: So I definitely need an office.
Susan: You’d need an office. But here’s the catch. If you have an office here, you have to provide some sort of mental health therapy to the people that work here. Like in passing. Like over coffee.
Tia: I think I could do that. Posters in my windows or? Yeah.
Susan: I’m doing a little, little cute catchphrases. I love it. Do you? Do you? So I’m trying to decorate my house and all the decorations things all have cute little phrases on them. Well, can you have, like, 400 phrases all over your house when you walk in? You’re just reading the walls all the time. I’m so sick of this trend. You all are like, whatever. Sometimes when I say this to people, they’re like, so all, like, live, laugh, love. Yeah, eat. It’s like says eat in the kitchen and, like, wash in the bathroom. Like what? What is this crap? When did we become so stupid that we need to have these things on the wall telling me to live, laugh and love? If I didn’t have that on the wall.
Tracy: Well, we are talking about Mental Health Awareness Month. So maybe live laugh love is an okay thing to have on your wall.
Susan: I think though, when you have like 500. Like when you walk into overwhelming. Yeah. When you walk into the store and it’s like that’s all there is to choose from. I agree. That was my rant. Rant over of decorating and funny, ironic quotes.
Tia: I would, I will say that I’ll come to your house because my like, my house is all Marvel.
Susan: So Marvel?
Susan: Oh, like the superheroes.
Tia: Yes, that’s. Yeah. Captain America is life in my house.
Susan: Is he your favorite?
Tia: No.
Susan: Wait. So who is your favorite Marvel character?
Tia: I will. Oh, I like Iron Man because I like the sense of humor and all the things like that. But my partner is Captain America all day.
Susan: So those are the two big, like they’re the two rival Marvels, right? They got in a big fight. They tried to kill each other.
Tia: Oh, Civil War. Yeah, yeah, yeah. I’m impressed that I even knew that.
Tracy: Yeah, I’m impressed that Susan knows this. Oh, I know a lot of. Oh, you have a son.
Susan: No, I like it, too. Oh.
Tracy: Oh, I didn’t know that.
Susan: Marvel movies.
Tracy: Ten years and I didn’t know.
Susan: No, the curtain is lifted. Susan hates quotes, decorating quotes and likes Marvel movies.
Tia: Same.
Susan: Yeah. Okay, cool.
Tracy: All right, so let’s transition. Jen, tell us again who you are. In case the listeners haven’t listened to our first episode with you, which you should go back and listen. But, Jen, tell us who you are.
Jen: Sure. So I’m Jen Sparrock, and my vocation is that I am a licensed, independent clinical social worker, which is a big mouthful of stuff. But I work with individuals who have mental health issues and have done that most of my life in one way or another, whether it’s been in a hospital setting or in community-based work, and really am passionate about working with folks who are experiencing mental health challenges — a lot of us do — and helping people find a space where they can recover and live a life that is meaningful to them. Right now, I am the manager of the Psychiatric Emergency Services at Nebraska Medicine, and we’ve been there for about 18 months, and that’s been a really fun ride to really be able to see us meeting a need that wasn’t there in our community before. And my volunteer time outside of my work life is connecting with people for suicide prevention and providing education and resources for folks.
Tracy: So AFSP is the American Foundation for Suicide Prevention nonprofit, I assume?
Jen: Yes.
Tracy: And so what kind of activities in the community are they doing?
Jen: Yeah. So AFSP is a national organization. We’re the Nebraska chapter. Every state in the United States and Puerto Rico has at least one chapter. Some have several. And really there’s kind of four pillars that AFSP focuses its work on. Programs and education, which is one of the things that I do, which is going out in the community, being at conventions and giving out resources, doing educational talks in schools and community organizations to provide education about suicide and make us more informed as a community about that. We also do a lot of work with research. AFSP is the largest nonprofit that does independent research on suicide and suicide prevention. And then we have our advocacy pillar, which is really about connecting with legislators on a local, state and federal level to put forth some of the initiatives that help affirm suicide prevention and mental health concerns in our country. And then the last one is loss and healing. And that’s the piece for folks who have lost somebody to suicide or for somebody with lived experience, which is somebody who has had their own suicide attempt or have had pervasive suicidal thoughts. So the loss and healing is really designed to help instill hope for people and find a path beyond that loss that they have endured.
Tracy: And Tia,this is your third time now, but tell us who you are. For the listeners that haven’t met you yet.
Tia: So I’m a PM, meaning I am a licensed mental health therapist. My full-time job is I work for Nebraska Coalition to End Sexual and Domestic Violence, and in that is educating folks on how mental health also impacts those survivors that we’re working with harmed by trauma and then also providing education to the community of working with folks that are in our carceral system that have been harmed by sexual violence and then also those that are in our carceral system that have a mental health diagnosis. And so like Jen, right, like I also volunteer with the American Foundation for Suicide Prevention and I’m pretty lucky because Jen and I are actually doing a lot of the same things. So program and education, traveling around and educating a variety of different folks throughout the community of what it looks like to be educated on suicide prevention. And then we also do stuff with like loss and healing and stuff like that where we have the Survivor Day in November where family members from all across the state can come together and share the memory of the person they lost by suicide, while also building those connections and having that community base together.
Tracy: Well, May being Mental Health Awareness Month, we really wanted to talk about suicide prevention as we think about this month and the awareness around mental health. And one of the things that we thought would be really helpful is to talk about some myths about suicide and maybe some of the statistics that we know about Nebraska and suicide in Nebraska, and maybe what people can do to help support someone who is either contemplating suicide or who has attempted suicide and how they can help. So tell us about any of those things, like the myths about suicide. I’m really interested in some of those things that we hear.
Jen: Well, first, you know, I give you guys kudos for having a conversation about suicide because it can be an awkward subject to discuss. And so I think because of that, we don’t talk about it and it makes us uncomfortable. Then it’s hard to keep talking about something. The more we talk about something, the more comfortable we become. And it doesn’t become this thing that’s so far out there that it doesn’t feel like it’s a real thing or it impacts our lives. You know, we know that most people who die by suicide have some type of underlying mental health condition. And whether that was treated or not, you know, a fair number of times it’s not. We know access to mental healthcare is really difficult, not just in Nebraska, but across the country right now. So people don’t always seek that help. When you talk about some of the myths of suicide, one of the big ones that we hear from folks is, well, I don’t really want to ask her if she’s thinking about killing herself, because I don’t want to put an idea in her head. And that’s not true.
Tracy: Yeah.
Jen: If somebody was thinking about suicide, they were already thinking about it before you asking them if they’re thinking about taking their life. You’re not putting an idea in there. In fact, what our research shows is just the opposite. It shows that by you asking that person, there can be a tremendous sense of relief because people hold that inside. They feel like they’re alone. They feel like they don’t matter. They feel like nobody understands what they’re going through. So the fact that you see someone and you say something to that person really can be affirming and that can be a life-saving measure by itself, just that.
Tracy: Yeah.
Tracy: The other thing too, that in chatting before the podcast, is you talked a lot about words matter around suicide and just using different phrases as opposed to saying commit suicide, using die by suicide because of the stigma around suicide.
Jen: Well, if you think about it, what are the things that we commit? Crimes. We commit crimes. And having a mental health condition is not criminal and somebody dying by suicide is not criminal. And so people don’t commit those things. Um, and so changing those words takes some of that power and some of that blame that is connected to the person off the situation. It makes it something that is, invites more of a conversation with that person. So somebody, and for the people around them, there’s a lot of shame that is present when somebody dies by suicide and the families and the loved ones don’t get that same attention. You know, folks that have died by suicide, and I’ve talked to loss survivors, they’ll say that this is the loss that you don’t get the casserole for. And what they mean by that is if somebody dies from cancer or somebody dies from a heart attack, you know, as a community, we generally make our meal train or whatever else. And we’re going to take things over to the family and help them through whatever the struggle may be. And suicide is not something that you get the casserole for. In fact, it’s the secret. And that’s the thing a lot of times the families don’t feel like they can talk about. So I think using different language and different words takes away some of the shame and takes away some of the stigma about it. Another thing that we talk about with words is not using that somebody had a successful attempt or a failed attempt because we don’t want people to be successful in dying by suicide and we don’t want somebody to feel like they’re a failure if they didn’t die because they had an attempt.
Tia: I think that also passes judgment, right? When we use failed or unsuccessful. There’s a sense of judgment there already, with that shame and all the other things that are going on with that person, too. So that’s a great point. Sorry I interrupted you.
Tracy: Well, I’m really happy to know these things because, you know, just educating someone, hey, you just said someone committed suicide. You know, think about saying that a different way. And having them go out and start saying things a different way is really important.
Susan: Yeah, well, and we chatted about this, but I’m not sure if the general people know that as attorneys, especially doing family law and criminal defense and estate planning we have, suicide is talked about quite frequently. You know, people are in stressful situations. They’re not, you know, maybe people aren’t able to manage their mental health as well as they would, we would want for them. And so sometimes in the middle of a case, we will have a suicide attempt or even a death, you know. And so how we can be part of the conversation either before or after so that we’re being a supportive person or saying the right things and getting the message across the best way we want to, to our clients or their family.
Jen: And I think that’s huge. A lot of times, of course, when someone dies by suicide, there is a lot of questions like, “Why did that person do it?” Or, “Oh, it must have been because they were going through a divorce,” or you know, the whys. Because there’s, it feels very helpless to that person and people that are left with the loss. And one of the things that we talk about and we know in our research is that there are risk factors that are attached to people who may be contemplating suicide or taking their life. And there are warning signs, things that we can watch for that are behavior changes. But one event by itself is not generally the thing that is going to lead somebody to make an attempt or to take their life. It is a converging of lots of things. So when you think of like an iceberg and the ocean, the tip of the iceberg is what’s outside of the water. So that might be the stressful event, the losing their job. The child that dies is some kind of an event, life event like that. But under the water is much bigger than the little bit that we see outside of the water. And so those things underneath, whether that’s an underlying mental health condition or it’s somebody who has a family history of suicide or somebody who has a difficulty with substance use or things like that that are all risk factors that contribute then to when that other situation happens and those things converge at the same time, it can really put that person in a vulnerable spot.
Tracy: Well, and yeah, what we see in our office, too, with our clients who are going through difficult situations is it’s a cumulative effect, just like you describe with the iceberg. And what’s under the water. And sometimes I’ll have clients say, “Well, I had to put my mental health treatment on hold because I can’t focus on that and this divorce.” And that’s a really hard thing to say. “No, no, no. I need you to continue that piece and we’ll help you through the divorce piece.” You don’t have to do that alone.
Tia: Right? Yeah, right.
Susan: We talked a little bit, too, about those feelings and that it’s not just one incident for the person around the person who’s struggling, that it’s that we often will blame ourselves. “What? What did I do? What could I have done better?” Was it, if there is something that the other person’s directly involved in, was it that thing? Like if they broke up with them, if they said no to whatever it was that person wanted them, like, did I cause them to attempt suicide or whatever? Like, and hearing you say there’s so many, it’s not just one thing. It’s not like somebody out of the blue is like a bad thing happened. I’m now going to think about suicide. Like you said, it’s this accumulation of many, many events.
Jen: Right. And what we also know with folks who have ended their life or have attempted is there is a tremendous amount of pain that is connected to that person. And that is this emotional pain and this inability to see a way that that pain is ever going to get better. And so, you know, there are times when a person’s judgment related to that becomes really impaired because that we all can get like that, right? Where we have tunnel vision, and we can’t see any way out of a situation. And that feels really hopeless, and it feels really, you’re very helpless and you feel like you have no other choices. And if I cannot bear this pain anymore, if you have your hand on a hot stove, you’re going to lift your hand off that hot stove because you can’t bear that pain for very long. So when we think about folks who are in a suicidal crisis, they’re really in this space where there’s some ambivalence about living and dying. And so we want to focus more on what are the things we can do to help that person feel like there are things that are going to be in their life that will make life not as painful for them and minimize the things that are making life feel so painful to them. And so we really kind of wrestle in that space of the ambivalence, which is why some of the things that we do with suicide prevention and education we talk about means restriction. And what that means is limiting access to the things somebody may use in a suicide attempt. Because we know that time and restricting the means are the biggest indicators that we can save people’s lives. So we know that firearms tend to be the most lethal means that a person would use. And so we have no position on gun control, but we do take a position on keeping firearms safe when they’re in somebody’s home because there is such a high lethality when a firearm is used in a suicide attempt. So keeping those firearms safe is really important.
Tia: I think also, too, another way is we have like medication lock boxes that we advocate for folks to use. And inside those, we also have like packets of things that once a lot of folks keep meds, like if I have that headache one day or whatever it be. But in there we have like this packet you put in your meds with water and it dissolves it. So then that way it’s not even usable at all as another way to discard meds that.
Susan: You can do at home too, as opposed to taking it and dropping it at one of those drop spots.
Tia: Because especially like, I don’t know, like as busy as we are now, it’s usually sometimes one more thing to do. You see it on the news. You can drop your meds off if you have access to that in your house. That’s also another thing that yeah, for safety and access.
Tracy: What’s some of the advocacy work that AFSP has done? I’m really interested in that.
Jen: Well, there’s a big one that’s going to come up this summer, which I think is really cool. And it’s one of those experiences that I, I think we’ve had, that we get to see when you advocate change can happen. And so that’s the implementation of the 988 suicide lifeline number. So right now it’s a 1-877 number that people have to call. And, you know, it has a great, it’s a great service and it really has saved lives, I have no doubt about it. But again, if you’re in a crisis and you’re having an emergency, we call 911 and we all just know that. But if you’re having a mental health crisis and your thoughts are really like focused and narrow, it’s difficult to remember a really long number. So Congress passed last year funding for 988, making that a national number. So in July, every state has to be ready to implement the conversion to the crisis hotline number to be 988. So that is, I think, a really big change for our society because it also is putting that on the same level as a medical emergency, as a mental health emergency. So I think that’s done a lot to also affirm that it is okay to ask for help.
Tia: And on that 988, we’ll, you’ll have access to in Nebraska. What they’re working on is who will be receiving those calls. Right. So it could be a clinician, a peer support specialist. It could be other folks that can relate in that immediate crisis. And not always a response from law enforcement, which at times can be harmful.
Susan: Yeah, yeah. Let’s talk about peer support, because I have heard of peer support in other mental health areas, but not around suicide prevention. So tell us more about that.
Tia: So peer support is something that I am a huge fan of. And essentially what it is, is folks that are living with their own mental diagnosis, mental health diagnosis, and they are in the community whether they’re working at a local hospital. I have folks that I work with that go and do the crisis response team with me or city, excuse me. And so they’re able to be that support to that person that may be in a mental health crisis and also give hope to that person to say, I can relate, I’ve been where you are, but then also family members as well to be able to see another person that may have the same diagnosis, similar diagnosis and yeah, be able to provide support. But I know Jen works with them more, so.
Jen: No, I think that’s exactly right. I think there’s a unique piece that peers have in that they have walked a mile in the shoes with their own journey and they’re living in recovery. And so these are folks who have gone through special training and they are certified and they bring a lot of richness to a workplace benefiting the folks that we’re serving. Right. Because like Tia is saying, providing hope that this can get better when somebody is in a crisis, it feels like it’s never going to get better. And so being able to see that, oh, somebody else has been through this and they also do a tremendous job of helping us as clinicians, know what that experience is like for somebody when they’re in a crisis and what’s helpful and just as important, what’s not helpful.
Tracy: And they’ve gone through some training.
Jen: Right in the state of Nebraska. They have to go through a training course. They have to take an exam and they get certified through the state, just like another clinician would.
Susan: One of the phrases that we’ve heard a lot when we talk about our researching suicide prevention is talk saves lives. Is that simply the idea of talking about it? Talking about suicide and talking about suicide prevention could reach somebody who needs, you know, who needs that help or needs those supports. Or is there more to it?
Tia: No, I think that’s a great point. I think that by talking about it, we’re opening up a conversation that a lot of folks are uncomfortable having. Right. And if we’re not having that conversation, then what? So I think part of it is the first step, in my opinion, is having that conversation, willing to have that talk to save someone’s life. And then from there being very unique of what that looks like in regards to supporting that person from there.
Susan: And can it even be bigger? Can it be general education for everyone? Maybe someone is not thinking about suicide or their mental health is stable, but giving them tools to talk to other people, it’s like a conduit.
Jen: Absolutely. I mean, I think you could look at some of that like we do CPR, like we learn CPR because we never know when something might happen someplace. Right. So there are short courses like that that can be taken for anybody, not meant to be a mental health professional, but just to be able to have a tool to see somebody, to help somebody if you see them in crisis. And so one of our education programs is called Talk Saves Lives. And it really walks through being able to know what the scope of the problem is and understand that it’s not as small as what people think. And to show some of the research, talk about what those risk factors are, what are those warning signs you look for? And then, for goodness sakes, what do we do? Most of us would want to. In fact, research shows most people would want to do something. They just don’t necessarily know what to do. And because it’s oftentimes a scary subject for people, they don’t want to do the wrong thing. Yeah. And so, and the irony of that is by not saying something that actually can be not something that causes somebody to make an attempt, but it doesn’t allow that person to know that you see them and that you are concerned about them, which is really one of the most important things that we can do when we’re concerned about somebody, whether it’s their general mental health or it’s their something, some behavior or something that’s changed that makes you worry for their safety or whether they’re thinking about suicide.
Susan: Now, both Jen and Tia are wearing these amazing t-shirts that say “Hope” across the front. And so explain the t-shirt and the message on your t-shirts.
Jen: Well, I mean, I think the piece really for when we talk about our mission, which is to bring hope and save lives, is that for the person who’s struggling where there’s so much pain and it feels like nobody can see you and nobody is aware of you and that this is never going to get better, then it does and it will. And there are people who see you and there are people who care. I don’t know you and I care about you and I don’t want you to die. And that there’s hope for people who have lost somebody. Most people that work with AFSP are loss survivors, and they say it’s the club none of us ever chose to be in. But they find this ability to develop their resilience and make something out of this loss that they’ve experienced that sort of lives on in the legacy of that person that they’ve lost by never having somebody else go through the experience that they’ve gone through.
Tia: Yeah. And I think AFSP we pride ourselves on, despite everything, wanting to lead with hope. Like that’s just something that we. Yeah.
Tracy: Well, and I think as we wrap up a little bit, some of the takeaways that I hear are checking out AFSP.org’s website. It sounds like September is a big month for the organization and the walk, but also just listening when someone is in that period of crisis and then checking out the 988 that’s coming out in July, which is right around the corner. But is there anything else that you want listeners to know?
Jen: Well, I think one thing I would say is don’t ever assume somebody else is going to bring it up. Yes. So if you are worried about somebody or you’re concerned and you think, “Oh, well, they will say she knows her better,” don’t assume anybody else is going to say it. And even if you’re wrong, there’s no harm in that. Nobody, if I said to you, you know, you see, “You haven’t seemed like yourself lately. I notice you haven’t been going out with us after work anymore. And I just want to let you know I’m here for you if you need something.” Well, even if you weren’t having suicidal thoughts or feeling down, how would that make you feel if I said that?
Susan: It made me feel good.
Jen: Yeah. Like, oh, somebody sees me and somebody cares about …
Susan: Just noticed that I was not my normal self.
Jen: Right. And so, you know, we think about like universal precautions, like, you know, in the healthcare industry, we wear gloves everywhere. We wear masks now all of the time there. And not every person we come into contact has that. But you’re not going to hurt anything by wearing the gloves. And so we can do these kinds of things and say things to people, and it also lets people know that we see them.
Tracy: Yes. Well, thank you both again for this amazing talk and podcast today. So, Tia, I’m sure we will see you again.
Susan: I’ll be prepping your office for you next time.
Tia: I appreciate it.
Jen: And I have to get a sidecar or something.
Susan: Just put a little attachment.
Jen: Yeah, something. Yeah.
Tracy: But thank you so much. Yeah. And this was, I think, a great discussion for Mental Health Awareness Month. So thank you.
Susan: Thank you.
