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Barbershop: Rising U.S. Suicide Rates

Jun 9, 2018
Originally published on June 10, 2018 2:13 pm
Copyright 2018 NPR. To see more, visit http://www.npr.org/.

MICHEL MARTIN, HOST:

Now it's time for the Barbershop - that's where we talk to interesting people about what's in the news and what's on their minds. And I'm just going to say it upfront - what's on our minds today is a really tough subject. It's the kind of thing where you're worried that even talking about it is something that's going to cause pain for more people.

You might have figured out by now that we're talking about suicide. The noted fashion designer Kate Spade took her own life at the beginning of the week. We learned yesterday that the chef, author and TV host Anthony Bourdain had done the same. And, in the middle of all of that, the Centers for Disease Control published a new report calling attention to suicide as a serious public health issue, noting that suicide rates have risen steadily in nearly every state from 1999 to 2016 - some 25 percent in that time period.

But we are journalists here. We're in the business of trying to talk in a sensible way about issues that concern the public, and something that's caused the death of some 45,000 people in the U.S. in 2016 - one of only three causes of death that is increasing - well, we think that's something we need to talk about. And, what's more, two of us in this conversation have experienced this personally. So we're going to do our best with this, and if it's more than you can handle right now, please come back in a few minutes.

With that being said, we have with us Roxanne Roberts, reporter at The Washington Post. Her father took his own life in May of 1976 when he was 46 years old. She's here with us in our studios in Washington, D.C. Roxanne, thanks so much for being here, and thanks for being here with me and keeping me company on this because many people know that my brother took his life in May of 2010. So thanks for coming.

ROXANNE ROBERTS: You're welcome.

MARTIN: And joining us from the studios of Emory University is Dr. Nadine Kaslow. She is at the Emory School of Medicine. She's also the former president of the American Psychological Association. She sees patients, and she's done research into suicide for more than 20 years.

Dr. Kaslow, thank you so much for being with us as well.

NADINE KASLOW: I appreciate your inviting me.

MARTIN: Roxanne, you wrote about your father's suicide in The Washington Post 20 years ago, and it was reposted this week. It's a harrowing story, and I'm not going to go into all of the details. But there's so many things to talk about with this. What are some of the things that you think are most important to bring up about that experience in your life?

ROBERTS: I originally wrote the piece because I thought that suicide had been either made too clinical in terms of statistics or romanticized in terms of pity for the person that died. And I thought, even though that is entirely understandable, my experience, my family's experience was so shattering that I wanted to remind people what the effect of suicide was. It's different than a natural death. There's so much more guilt and grief and finger-pointing and second-guessing. And I wanted to help other survivors articulate that.

MARTIN: Dr. Kaslow, I'm going to go to you on this. The latest research - I mean, the CDC released this report detailing this rise in suicide rates around the country. Do we have any idea of why this is?

KASLOW: Well, we certainly don't know for sure why this is, but I think people have talked about the fact that there are lots of economic challenges that people face. I also think things have become less personal. Our communities have become less tight-knit, and it's much more individualized and much less focused on our communities and our neighborhoods and reaching out to each other.

MARTIN: And what about the whole question of, you know, children versus adults - like, why different groups seem to be responding in different ways to this? I mean, I know there was a big concern that these two high-profile deaths this week of Kate Spade and Anthony Bourdain further kind of elevates this issue in a way that the visibility of this is also triggering, you know, for some people. Do you have that concern?

KASLOW: So I do, on the one hand, have the concern that, for a subgroup of people, this may indeed be triggering. The research is actually mixed about whether or not that's the case, although there was some evidence after Robin Williams took his own life that there was indeed an increase. So, for some people, this may make it easier for them to die by suicide.

On the other hand, I think for a large majority of people, opening up this conversation will be incredibly helpful and make them feel less alone and more likely that they can get help - where they can turn to those they're worried about and secure help for them.

MARTIN: Roxanne, I wanted to, again, just sort of open it up to you. You mentioned that, you know, your phone - people are calling you now when your piece has just reposted again. It was first published in 1996, in the 20th anniversary of your father's death. At the time, you had an enormous response, and you're having an enormous response again. What are some of the things that people are saying to you?

ROBERTS: Well, it articulates what a lot of people are feeling but haven't been able to express to their loved ones. I think there's so much private agony about suicide that it's really hard to talk about. Everybody wants to know why. Why did this happen? How did it happen? How did we miss the clues? How could it - how could you have not known? And good friends can't say that to somebody. And so there's an isolation that comes from the family.

And then there's a lot of internal blame between family. You know, this happened to - for me, it was a parent. If I were a parent, I honestly don't know how I'd get out of bed if that happened to my child. I think it's so overwhelming because you think it's your job to protect your loved ones, and if you can't, and they make this choice - which is such a shattering choice - it's just devastating to a family.

I said I was permanently changed by it, and that's true - and in some bad ways, in some good ways. But I strongly believe that the more we talk about it, the less likely that people are going to be isolated when they're either dealing with the aftermath of it or even considering it.

MARTIN: Dr. Kaslow, one of the things that Roxanne was saying earlier and she said in her piece is that, you know, suicide seems different than other deaths - like the blame within the family, for example. Something - that there's - sort of there's an ugly tail to it that sometimes happens, or that people feel ashamed to speak about it, or they want to cover it up, or they want to act like it didn't happen. First of all, do you agree that that's true? And secondly, if that is true, why do you think that is?

KASLOW: Yes. I absolutely agree that's true. While death is devastating - especially unexpected death to any family - death by suicide does bring a whole different set of issues. As you mentioned, there's often blame - self-blame, blaming other people. There's often anger at the loved one who killed him or herself. There is often a lot of shame. There's still so much stigma, unfortunately, around mental health problems, around suicide that people feel very isolated and alone. Many times, people won't even say how their loved one died.

In increasing numbers of communities, there are support groups for families who have lost a loved one to suicide. But historically, that hasn't been true. And many communities, unfortunately, still don't have such support groups.

MARTIN: Is - Roxanne, is there something you feel that you know now that you didn't know when this first happened - I mean, now that you've had some time, some distance?

ROBERTS: Well, I mean, the cliche is true. Time does make it better. But I continue to think what a waste it always is. And the tragedy of it is that it's an act that there's no recovery from. You know, I've thought about having conversations with my father. I never got to know him as a grown-up. I never - he never got to grow or mellow or become any of those things that might have made him a fuller, happier person. He never got to know his grandson. And that, to me, is just such a tragedy. I still get choked up, and it's four decades later.

And I didn't have this in the story, but it's an analogy I've thought about a lot. I grew up in Minnesota, and there's always this apocryphal story about people being lost in this snowstorm, and it's so thick with snow that they can't see in front of them. So, at some point, they just get tired, and they give up, and they lay down in the snow, and they die. And then they always find the body about, you know, about 100 yards from a farmhouse.

And I always think if people could understand that if they just go on a little further, there's warmth, there's help, there are people who desperately want them to be alive. And if they can just try to find the help - I never have ever faulted anyone from having depression. I just always wanted them to make the choice to get help.

MARTIN: I remember at my brother's funeral, it was packed. You know, my brother was a firefighter. And he'd lost a number of friends on 9/11. I know he felt survivor's guilt about that. There were so many - there were a bunch of things.

But I remember thinking, I wish he'd been here to hear this - you know, about all the people he sent birthday cards to who never forgot it and all the people that he - like, I remember one of the firefighters in his house said that when he realized that he was studying for a degree, he made a - he - my brother organized, like, a study carrel in the firehouse so that he could have a quiet place to study and not disturb the other firefighters trying to sleep.

And I thought, you know, I had never heard any of these stories, and I thought, what if he could have been here to see this? Wouldn't he have understood how much we miss him?

ROBERTS: Can I say that I think people are so complicated, and they - when you're depressed particularly, I think you see things in black and white. But we all have good things and bad things. We all have strengths and weaknesses. We all screw up. And the people that love you love you anyway. And I think it's hard for a depressed person to really understand how fully they're loved and how - to what lengths the people that love them will go to help them. I think they just want to escape.

MARTIN: Doctor...

KASLOW: Yeah. I could not agree with that more. When people are depressed, when people feel hopeless and helpless, when - after a relationship ends or a job is lost, people just unfortunately sometimes feel so isolated and alone and hopeless and like they don't want to burden other people and like they don't fit in that they can't take those extra hundred steps to that farmhouse. And that's what's really so sad to me.

MARTIN: So what would make it better? You know, what would make a difference? And, Roxanne, obviously, I'm going to give the doctor the last word. But do you have thoughts...

ROBERTS: I do.

MARTIN: ...About what would make a difference?

ROBERTS: One of the things that would make a difference - besides simply talking about it, which I think is healthy - is having a lot more compassion for survivors. For every person that dies, there are a dozen people around that loved that person that are completely thrown by the fact that this has happened to them. And it's very hard for them to talk about it. So what I would urge anybody who knows someone who's lost somebody by suicide is to give that person the room and the love and lack of judgment to talk about it because I think that's critical to healing.

MARTIN: Doctor, we've had all kinds of epidemics in this country that we've managed to address and somehow not this one. So what would make a difference?

KASLOW: So I absolutely agree with Roxanne that compassion matters so much, and I'd like to offer both of you my compassion for the losses you've experienced. And I appreciate your courage.

I think there are a number of things we can do. I think we need more accessible and affordable mental health services. There are lots of people either whose mental health problems are not diagnosed or who have them but can't get the care they need. We also need more social services when people are really struggling financially. I think it would help if we start teaching coping skills to children in school so that when they face stress in their lives - which we all encounter - that they have more strategies that they can use to help them manage through difficult times.

And finally, and maybe most importantly, I think all of us need to do a better job connecting to each other - reaching out to our friends, our colleagues, our neighbors - and not just reaching out once but continuing to reach out to each other. I think we all need to be part of the solution to this problem. There's been a lot of attention now to hotlines, and I think that there are hotlines - national hotlines, and there are often hotlines in your own community. I think if you're feeling suicidal, there's some apps out there that can be extremely helpful. People can go to their primary care providers, their clergy, certainly reaching out to friends.

And please reach out to mental health professionals when you really are struggling - that there is help, there are evidence-based psychotherapies can really make a difference and help you feel better about yourself and your life. And, for some people struggling with mental health problems, medication may also be helpful.

MARTIN: That's Dr. Nadine Kaslow of Emory University's School of Medicine. She's also the former president of the American Psychological Association.

Dr. Kaslow, thanks so much for joining us.

KASLOW: Thank you so much.

MARTIN: Roxanne Roberts is with us. She's a reporter for The Washington Post. She wrote about her father's suicide in 1996, and that piece that she just re-published is getting a lot of attention today, and we urge you to read it. And, for me, I'm hopeful that I was able to get through this conversation (laughter). I made it.

Thank you both so much for speaking to us.

KASLOW: Thank you.

ROBERTS: Thank you. Transcript provided by NPR, Copyright NPR.