Please Don’t Thank Me

I hear it all the time.  “Paul, that’s great work you are doing.  Keep it up!  We need you!”

If you work in suicide prevention, you hear it, too.

I think we hear it because people don’t see a role for themselves in preventing the next suicide. They might want to help, but no one has asked them.  Job descriptions are few. The word suicide has an “ick” factor, so perhaps the taboo alone chills the heart.

But when I hear “thank you” from a psychiatrist, or social worker, or psychologist, or priest, or rabbi, or school health professional, or physician (as I did just the other day), I am reminded that flattery can be a dodge, as in, “You fight the battle, I’ll cheer you on.”

Most of us working in suicide prevention did not choose this career path; it chose us.

We lost someone that mattered to us and asked, “Why?”

When convincing answers did not emerge, agony-driven curiosity pushed us into this strange territory — an alien landscape without a trustworthy map.

Doing this work is not for the faint hearted.  Fighting Ebola is hard; fighting suicide is harder. Both take a kind personal courage, and while the former takes hundreds of lives over months, suicide worldwide takes thousands of lives every day.

If doing this work required no more courage than, say, repainting your kitchen, everyone would do it.

But they don’t. Perhaps because the work is hard and it takes guts.

Consider Marny Lombard, editor of this blog.  She lost her only son to suicide just two years ago.  A gifted college student suffering from depression when he died, he unmoored her from life’s most basic joys.  She will never see him married or hold a grandchild in her arms.  In a blink of time, all her futures were destroyed.

Except one.

Fighting suicide.

This job.

This unpaid job.

This job of trying to prevent the next suicide.

Marny does this work with passion and great intelligence.  She said to me after I offered her work for zero pay to edit this blog, “I’m grateful to have a chance to do anything.”

Now she is doing tons.  Asking questions, driving agenda’s, writing, organizing communities, and influencing decision makers.  She knows, better than most, that things don’t just happen, they are made to happen.

But why is the price of the ticket to join in the labor force so high?  Why must we lose something as precious as a life in order to pitch in and make a difference?

To create an enlightened, loving, humane, and compassionate world where everyone understands that psychological pain is as real as physical pain, we will need every single Marny we can find.

If few, we will fail; if many, we will win.

We don’t need more experts; we need more voices.

Like yours.

And like the person’s voice I hope you will forward this blog post to.

True, more and more people are stepping up and stepping into the front lines to fight for suicide prevention.

Policies are being written, new laws written, and real paying jobs are being created. Public expectations are rising and, yes, federal, state, and local leadership is emerging.

But not enough.  Not nearly enough.

Twenty years ago a leader in the suicide prevention field accused me of trying to make preventing suicide popular.  You know, as in, “Everyone is doing it!”  At first I thought I’d been slandered; now I realize the observation was high praise.
Until preventing suicide is popular, the politicians who influence policy will not know which way the parade is going so that they can – as a political best practice – scurry around to the head of it and shout, “Follow me!”

Last year Governor Pat Brown of California used his veto pen to kill a life-saving mandatory training bill for mental health professionals to learn to do a better job in preventing their patients from killing themselves.

He vetoed the bill not because he believes 4,000 Californians dead by suicide this year is a good idea, but because a bunch of professional membership organizations lobbied him to let them do their own thing.

I can only interpret this executive action to mean that the public’s health is less important than the narrow interests of mental health professionals who choose to believe they already know it all.  They don’t, and I have the data to prove it.

A few years our group collected pre-training survey data asking more than 4,000 practicing mental health professions across America – including hundreds from California – the following question: Do you feel that you have received sufficient training in suicide risk assessment and risk reduction/intervention?

Of the four thousand plus responses, almost exactly 50% said “yes” and 50% said “no.”  Fully 20% of those surveyed had already lost at least one active patient to suicide over the course of their career. Some had lost two or three or more.

I don’t know about you, but I would not go to a dentist who drilled the right tooth half the time.  Nor would I take a suicidal love one to just any old therapist if half of them admit to being poorly trained.

One training deficit proof is found in the results of a national knowledge exam on suicide prevention our team has administered to more than 10,000 active clinicians of every kind and stripe across America.  Using a 70% correct cutoff on a 25-item exam, the fail rate – except for psychiatrists – averages 90% across all major mental health professions.

If preventing suicide was actually popular in California, and the public knew the truth about how rampant ignorance is among those who allege to know how to prevent suicide, Governor Moonbeam would not have peed down both legs and caved to the interests of the few.

The risk of leaving the battle to prevent suicide to Marny and John and Sabrina and me, and a few thousand health workers and a handful of experts scattered around the world, is that you don’t take down a huge, frightening, cultural elephant like suicidal self-directed violence with a company-sized outfit armed with pee shooters.

This fight isn’t about us; it’s about you.  And we don’t want you to have to buy a ticket to join us.

I am reminded that after his arrest for failing to pay a poll tax — which he believed supported an “immoral” Mexican-American war — Henry David Thoreau was jailed.

His friend Ralph Waldo Emerson came to see him, and asked through the bars, “What are you doing in there?”

Thoreau retorted, “What are you doing out there?”

Here is my Haiku to end this blog:

Do not thank me for the work I do

Step up

And do the work I do

                                                            Dr. Paul

4 thoughts on “Please Don’t Thank Me”

  1. Paul,
    What can I say, man? None of us wanted to become a ‘subject matter expert.’ Love your last line and what you do. I thank you…and I’m with you shoulder to shoulder on the front line. We will gladly make room for others.

  2. Thanks Paul, every chance we can get to open up the dialogue in this country to get folks on-board. Here in Anchorage the politicians keep talking about lowering the homicide rate, and I counter with what about lowering the suicide rate, and I am told it is not problem. Then I tell them that suicides in Anchorage occur 4-5 times more than homicides, a sobering number, which usually leaves people speechless. Thanks again for your encouragement.

  3. The easiest recruit to the cause is the one already impacted by a loss. A good question of anyone standing on the sidelines is, “Take a minute. Have you every lost someone you knew of a first name basis to suicide?” If the person is over 40, the answer is almost always yes.

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