Healing Together

On the morning of Nov. 22, 2008, Dean Hudson, father of Tyler (Survivors prefer to be identified in this way to keep the memories of their loved-ones alive), opened the daily paper to read about a teenager who had broadcast his death online earlier in the week, while viewers encouraged him to do so. To a person unaffected by suicide, the article may have seemed like another melancholy news story, but for a survivor, someone touched by suicide or attempted suicide, the article elicited a wide range of emotions and questions.

"The emotions we experience range from anguish to anger," Hudson said. "Each and every day, we will all struggle with the tragedy that we have experienced."

Knowing that a father like Dean Hudson is looking for answers and attempting to make sense of what happened with his son is a frustrating reality -- one that is more common among sons and fathers than among mothers and daughters. According to the Suicide Prevention Resource Center, males account for 80 percent of suicides in Oklahoma, but of the nearly 3,000 hospitalized suicide attempts in the state in 2006, 60 percent were females.

For survivors around Green Country who dedicate themselves to understanding and preventing suicide, reading the details of another potentially preventable loss was compounded by the lack of attention by local media (both print and television) to an excellent support opportunity: the National Survivors of Suicide Day Conference at Oklahoma State University's Tulsa campus, which was held that same day - Sat., Nov. 22.

Joan Benedict, mother of Chelsea, had notified a local television station earlier in the week about the first ever National Survivors of Suicide Day Conference in Tulsa. The station ran the story of the teenager who had taken his own life earlier in the week the night before the conference but avoided mentioning the event itself. "It was a perfect opportunity. They can show suicide on TV, but can't announce that the next day is the National Survivors of Suicide Day," Benedict said in disbelief.

One of more than 170 conferences held nationwide, the Tulsa conference is held annually on the Saturday before Thanksgiving; nationally, it was in its tenth year. Attendees at the Tulsa conference, which was sponsored by the American Foundation for Suicide Prevention, were at various stages of growth, healing and grief. They began the day by fastening two butterfly nametags to their lapels. The first butterfly was their own way of expressing themselves as individuals. The second, smaller butterfly was color coordinated to the lost loved one (e.g. white for loss of child, gold for loss of parent, orange for loss of sibling, etc.) and attached to the first to acknowledge the enduring connection and to keep the loved ones' names alive. After all, the focus of the day was to celebrate the lives, not the loss.

As one participant gracefully put it, "My brother's life isn't defined by the day he died."

Once participants had registered and introduced themselves, the conference was ready to begin. Two candles placed next to one another were lit. One candle was then blown out to represent the loss. The second candle remained lit throughout the conference to represent the survivors and their passion, strength and lasting love.

As a contributor to the AFSP Web site said, "One learns to live with the loss. There's no closure. I don't want there to be."

Losing a loved one, be it a parent, child, cousin, grandparent or friend, is a traumatic and life-changing event. "There is no manual, no script and no rules to follow in our grief. We have only choice and action. The life we knew is over and we begin a new journey," Hudson said.

Part of the new journey involves courage: the courage to talk; the courage to act; the courage to discuss the all too painful phenomenon of suicide. It's the courage to be strong and, as survivors, do whatever they can "so others won't have to join our tragedy," Hudson added.

It's the courage to dedicate their lives to advancing the mission of the AFSP -- "to understanding and preventing suicide through research and education, and to reaching out to people with mood disorders and those impacted by suicide."

Another survivor working to raise awareness, Billy "Rocky" Dunham, father of Joey, was unable to attend the conference in Tulsa, although he had planned to. From Edmond, Rocky was at home welcoming a grandson into the world. "We've seen life and death this year," Dunham said.

Earlier this year, Dunham walked 102 miles, a 39-hour trip broken up during four days from Edmond to Tulsa. It was his way of raising awareness and honoring his son. The walk gave him "a lot of time to think. I remembered his life; the fun times. I thought of the missed signs of his depression," he said.

Dunham stopped at three churches along the way. He talked to the young people at the First Baptist Church in Wellston and to others as he walked. He made it to Tulsa just in time for Tulsa's "Out of Darkness" Suicide Awareness Walk, an event held annually here and across the country (2009's national walk is planned for June 28-29 in Chicago). "It's something we all have to get through," he said.

Dunham, along with his wife, son and daughter, have relied upon their "faith in Jesus Christ. It's the bond that has held us together," he said.

He was sorry he missed the conference in Tulsa, but the other survivors rejoiced to learn of his new grandson.

Prevention in Our Schools

With the three tragic deaths by suicide at Edison Preparatory School in 2008, the need for nurturing, preventative programs for Tulsa children is a concern for school officials and community members, according to Tenna Whitsel, director of school counseling for Tulsa Public Schools. Experts believe there are precautions that can be taken to identify warning signs that could help at-risk youngsters avoid suicide attempts.

Currently, eight Tulsa public schools (seven high schools and one elementary school) have active SafeTeams designed by the Mental Health Association in Tulsa. One additional Tulsa public high school and middle school will begin the program the 2009-2010 school year, bringing the TPS total to 10, said Chris Siemens, the SafeTeam director at MHAT.

SafeTeam is an early-warning communication system that is used to identify students at risk of posing threats to themselves and to others. The program addresses more issues than just suicide prevention; its collective goal is creating a "culture of safety," said Siemens.

The program was launched after an analysis of children's trauma and their own need for assistance. In 1997, after a cluster of teen suicides at an area school, a Suicide Violence Prevention Committee was organized by MHAT to assess the situation. As a result of the committee deliberation, SafeTeam was proposed and piloted in 2000 at Booker T. Washington and Bixby high schools.

The realization that troubled teenagers often make their plans known to either peers or parents became the core of the program. Communication, trust and confidentiality, coupled with the reality that youth are embedded and entrenched in a culture of violence, is equally important to the program.

Siemens said that students are "the eyes and ears of the school," and they're integral to the success of SafeTeam. Furthermore, she outlined the importance of diversity among the student participants, so that each student remains connected to the web of support. "The mindset is students will talk to students."

The program has four components: coordinator, faculty, students and community. In order to initiate a program in an area school, the school must first contact MHAT. After school administrators meet and exchange information with MHAT, the next step is to identify a coordinator, a school-based, non-disciplinary, counseling professional whose sole responsibility is to be immediately available to students, staff and families for counseling and referral services. Once this position is filled, each school identifies staff members, students and volunteers using their own defined method. Lastly, all participants are trained to recognize behavioral symptoms and meet about once a week during the school year to discuss issues within the school.

The built-in discretion intended for individualized tailoring in schools leads to differences in each SafeTeam, according to Siemens. But, the ideal situation exists in Glenpool, said Siemens, where the public school system embraced the program. Parents, business owners and police are working together to develop activities for building a safe community.

As Whitsel said, "The program can't be mandated. It's a matter of getting the word out. Hopefully, principals will gain interest."

In addition to SafeTeam, MHAT uses Columbia University's TeenScreen, a mental and physical health screen that tests everything from vision to depression, in all Tulsa Public Schools. The goal of TeenScreen Tulsa, the first site to offer these specific preventative measures outside the New York area, is to ensure young people are offered at least one voluntary checkup prior to leaving high school.

Robin Hudson, the mother of Tyler Hudson who died in 2008, said she had never heard of SafeTeam even though the school he attended had been using the program since 2006. Robin said Tyler was absent the day the Columbia TeenScreen test was given, and that the students were only tested that single day during his freshman year. Siemens said TeenScreens are administered based on the school's needs and thus their frequency is varied from one school to the next.

End the Stigma

Risk factors in adolescents are similar to those in adults, according to AFSP. Signs include a history of attempts, depression, and alcohol or drug use. The onset of puberty and the physical and emotional changes that accompany it can add to that feeling of distress. Other issues include: redefined relationships and interactions, independence from parents, the attempt to establish personal and sexual identity, and establishing values and beliefs.

Whitsel reiterated that students struggling with sexual identity perceive that their family is not in support is such a difficult subject. "It's like pouring salt on the wound," she said.

Siemens and Whitsel are looking to expand the program into additional middle and high schools because its acceptance rate has been very high. Results from a 2007 study on the efficacy of the program found that students do tend to talk to other students. "Parents even refer students to the Safe Team Coordinator," added Siemens. Additionally, the program may decrease dropout rates and increase grades, according to the study.

Benedict added, "We can talk to our children about drugs or sex, but we can't talk about depression? There needs to be more awareness in the schools."

The need to lessen the frequency of suicide is not unique to schools; but the statistics show that it affects all parts of society. Twenty percent of us will have a family member who dies by suicide; and 60 percent will know someone who dies from suicide, according to the Centers for Disease Control and Prevention. Nationally, suicide is the fifth-leading cause of death among those 5 to 14 years of age and the third-leading cause of death among those 15 to 24. It's the second-leading cause of death on college campuses in this country, according to the AFSP. And, for every two homicides, there are three people who die by suicide, according to the 2002 National Vital Statistics Reports.

Contributing to suicidal tendencies are depression, bipolar disorder, schizophrenia, post-traumatic stress disorder and other mental illnesses. When coupled with drug use and anxiety, the adverse effects of these diseases are augmented.

While coronary heart disease and cancer are serious conditions in need of individual and national attention, so, too, is depression, the leading cause of suicide, said participants. While many resources exist that address our physical and social well-being, the "hidden epidemic must come to the surface," said David Ellenburg, father of Daniel and conference participant.

"We have to work together to make our state Legislature work for us," he added. The goal of this joint movement is ultimately to end the stigma often attached to mental disorders, thus increasing suicide awareness and prevention, he said.

Learning to Heal

For most, the questions surrounding the loss outweigh the answers. A better understanding of the situation, improved communication and transformative programs may have made a difference, said participants at the conference. "Our choice is to bring hope to others because for those who are no longer here, we will never know," Dean Hudson said.

"It's a mean world," one mother at the conference said. Her son was reminded of that throughout his life; and she feels that this belief contributed to his tragic decision. Ultimately, though, she doesn't know what caused him to take his own life.

For another man, his elderly father's humiliation over losing things dear to him while dealing with new, debilitating health problems eroded his hope. "The pieces fit together. I could see why he did it," he said.

As Dr. Sid Zisook, one of the conference participants, pointed out: "There are no treatments that work unequivocally." Zisook said that there is still a great deal of research to be done in the fields of genetics and psychotherapy and in the testing of various medications.

"Depression waxes and wanes. None of the anti-depressives have shown to be preventative," said Zisook. He added, however, that lithium has proven successful in preventing suicide in patients, but for those who begin and then stop taking lithium, the potential for a suicide attempt the year following termination of the medication greatly increases.

The reasons for suicide are as different as the individuals themselves and their personal experiences, said Zisook. However, he explained, it is "almost universal" that the person suffered from depression. Sometimes there are indicators, but for others, it might be a mystery. Some people leave notes, others do not, he added.

For survivors, the experience typically includes anguish, sadness and a burden. All must heal on their own unset timeline. At least 20 percent of those who lose a loved one to suicide suffer from clinical depression themselves, said Zisook.

Attendees at the November conference spoke of the importance of giving oneself permission to feel the emotions related to the tragedy. We all grieve in our own way. And, no one way is correct, explained one survivor.

One woman advised others to "Set one goal you can accomplish. Maybe the next day can be something more." The reminder that living and enjoying life is in no way a betrayal to your loved one is an important realization, but one that takes time, she added.

"Faith gets me through," Benedict said.

Support, too, is important to these survivors' growth. "Our support group is growing and growing," said Robin Hudson. She said their bi-monthly meetings used to draw only three or four participants, but the most recent 2009 meeting had 13 people. "I'm glad we're there for them," she said.

"Grief is not a stone on your shoulder that one day you can remove. Rather, your shoulders grow stronger," one facilitator explained.

Many survivors at the conference explored the stigma surrounding suicide. One survivor said that the first question from most inquirers is: "Oh, how'd they do it?" Others in attendance said their friends and family members didn't know what to do or say after the tragedy. Still, others often seek the support of perfect strangers because of misplaced guilt, blame and/or religious ostracism.

"This happens all the time, but [society doesn't] talk about it... [Survivors] want to tell our stories," said Robin Hudson. Her goal is to help some other mother not be in this pain. She added that she is not ashamed of her son.

Dealing with those less connected to the suicide can change relationships; the facilitator suggested that teaching your friends how to help is appropriate and, many times, necessary. Most people want to help, but don't know how, added the facilitator.

In addition to the survivors of suicide, there was one survivor of attempted suicide at the conference whose family accompanied her. All of them were seeking a better understanding of the situation. For her, the support of real-life survivors meant she no longer had to pay to have support or pay for a friend. She said it was the reason she came.

As the question-and-answer period concluded, one survivor embraced the young woman. The other survivors had many questions. They explained that "to be here is an accomplishment." She suffers from post-traumatic stress disorder related to rape.

Earlier in the morning, Dean Hudson had explained that "to bring awareness to people going through what we've gone through is the least we can do to help others." A similar role can be filled by those in lonely, dark places and for those looking for answers and understanding of their loss. This is the kind of courage that survivors hope will reduce the number of suicides in this country, by touching one person at a time, be it in an after school program, annual conference, or a one-on-one phone call.

For More Information

Becky Kruse, Joan Benedict, and Dean and Robin Hudson have founded ACT (Adam, Chelsea and Tyler) Now, a Tulsa-based nonprofit Suicide Survivor support team. ACT Now meets on the first and third Thursday of each month at 1870 S. Boulder starting at 6:30pm. Support for yourself, friends, or family is available 24 hours a day at the Mental Health Association in Tulsa (www.mhat.org): 585-1213.

For more information on Suicide Prevention and Awareness visit the following Web sites: Survivors of Suicide (www.survivorsofsuicide.com/), SafeTeam (www.safeteam.org or Chris Siemens at 382-2412), Parents of Suicide and Friends and Family of Suicide (www.pos-ffos.com/), Suicide Prevention Action Network USA (www.spanusa.org), Suicide Prevention Resource Center (www.sprc.org), The American Foundation of Suicide Prevention (www.afsp.org), and the Oklahoma Suicide and Crisis Hotlines (http://suicidehotlines.com/oklahoma.html), and call 1-800-Suicide, if you are in need of assistance.

By the Numbers

Every day, approximately 89 Americans take their own lives and another 1,500 attempt to do so

13.8 million Americans will attempt suicide at one point in their life

It's the 10th-leading cause of death in Oklahoma. The state ranks 11th in the nation for deaths by suicide.

More than 60 percent of people who take their own life suffer from major depression

More than 15 percent of the general population suffers from clinical depression at some point during their life

78 percent of Americans feel that suicide is preventable with research, interventions and services

For each suicide prevented, the U.S. could save an average of $1,182,559 in medical expenses

Sources:

Archive of General Psychiatry

ACT Now

American Foundation for Suicide Prevention

Mental Health Association in Tulsa

Suicide Prevention Action Network, Research!America and PARADE magazine

Suicide Prevention Resource Center