To the Doctors and Nurses of Washington State,
Two years ago, Washington State passed legislation requiring mental health professionals to have training in suicide assessment and treatment. Spurred by the death of her husband, University of Washington Professor Jennifer Stuber partnered with Senator Tina Orwall to push for The Matt Adler Suicide Assessment, Management & Treatment Act, and in doing so started a conversation about something that has been taboo: mental illness and suicide.
This month, Representative Orwall, Professor Stuber, and other leaders in the field are taking it a step further, proposing that this mandatory training be extended to primary care physicians and nurses. I had the privilege to be present at one of the planning meetings in which the logistics of this bill were debated, and while much of the discussion was hopeful, I was crushed to hear the stance of leaders representing doctors and nurses. Both opposed mandatory training, stating competing training demands as the reason.
Perhaps you aren’t aware that the majority of those who die by suicide have had contact with their primary care physician within the last month. I state this not as blame, but rather as the very stark reason why training in this area is so vital.
We require training in HIV and CPR for medical professionals because it is a simple way of saving lives. Suicide training is not any different. And 6 hours every 8 years seems a small thing to ask when seen through this vein of preventing deaths.
I can’t think of any other condition where asking a question in a non-judgmental, compassionate way has the potential to be the treatment itself. I don’t pretend that the cure for major depression, anxiety, or any of the other host of mental illnesses that can contribute to suicidal ideation is as simple as one conversation. However, knowing someone cares enough to ask, feeling heard and not alone-these are essential elements that can nudge a person who is contemplating ending their life in another direction. Thus, empirically based trainings that discuss the role of the clinician’s own awareness of their thoughts and biases around suicidal ideation are key.
I know this not because I am a mental health professional, but because I have experienced suicidal ideation. I know what it is to feel utterly alone and entirely hopeless. I know the shame and fear that comes with suicidal thoughts, and how difficult it can be to talk about them because of stigma and judgment. And I know how important it can be for someone to ask the question “Are you having thoughts of suicide?” and for them to respond to the answer in a measured, caring way. I also know the damage that can be caused by a response that is fear-based or critical. Training makes a difference-a difference that can save a life.
So to sit in that meeting and hear that doctors and nurses don’t think this issue is important enough is heart breaking, because for me, I hear that my life is expendable. Those 6 hours mean life or death to me, and for the 57.7 million other Americans who live with mental disorders. Why are we so afraid to treat emotional suffering as we would physical pain? Why should one be more “real” than the other? Doctors and nurses go into their fields for various reasons, but I believe at the core it is because they care about helping people. So I ask, please don’t push suicide and mental health back under the rug, where they have been for far too long. Because the bottom line is people are dying from something that is preventable, and there are ways we can work together to change that.