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Rob: Hi, I'm Rob Stewart and I'm so glad that you are with us right now.

We are talking about a topic that is incredibly important right now as it is always, but particularly with the circumstances that we all are facing today.

The number of people who are suffering from depression, from mental illness, and tragically, thoughts of suicide have dramatically increased in the past year.

And today I want to bring on someone who is a very wise and sage person when it comes to talking about issues that can save people's lives.

Dr. Rick Grant-Coons joins us now on Rob at Home.

Rick, it is so great to see you.

Rick: Good to see you too, Rob, thank you for having me.

Rob: First, I want to talk to you about what you are seeing in your practice, in your psychology practice.

Tell me about what you're seeing with your patients and are we seeing locally what we're hearing nationally from the CDC and from the NIH about mental health?

Rick: Very much.

What I'm seeing the most is fatigue.

It's been a very long year.

Um, the... the required amount of coping that, uh, works, uh, under these circumstances is more than I know I've personally ever experienced.

And I know that people I'm talking to it's... it's a very different world, uh, that we're in and dealing with it, getting through it, uh, is... is, uh, it... it's, uh, it requires a creativity and endurance that... that we've never experienced before.

So, I know a lot of my conversations is... is working with people, trying to figure this out together, not really having answers to provide, um, like on some other topics that I might have more experience in.

But when it comes to just getting through this past year, we're all working together to try to find the best way through.

Rob: You have some phenomenal direct, which I have to say surprised me when I heard it.

And I loved that because you have a very direct way that you want people to talk to someone who they may feel is thinking about suicide, contemplating it, ideations, uh, versus really... really planning it.

How should someone deal directly with someone who is struggling?

And if that person that is struggling is you, hear this, okay?

Alright, so go.

Rick: Yeah, absolutely.

The most helpful thing you can possibly do is ask, is just ask the question.

uh, the- what contributed-— Rob: Directly?

Rick: Directly, uh, clearly, um, are you thinking of suicide?

Um, are you thinking of killing yourself?

Um, because-— Rob: That direct?

Rick: That direct.

Absolutely, that direct because what that communicates is I can handle the answer.

I can handle this topic, um, cause often suicide, mental health, but suicide in particular is a scary topic to discuss.

And often people want to avoid the topic and hope that it will go away, or it won'’t become a problem, but really that fuels the fire and the more we minimize or avoid or discount someone's struggle, uh, the worse it gets.

And just by asking the question directly, um, can provide someone with great relief just knowing that someone is seeing them, someone is checking in, someone's concerned.

And with the desire to die and thoughts of suicide often that's, uh... uh, perpetuated by thoughts of being alone, um, being a burden, um, feeling that... that they're... they're better off or their family and friends will be better off with them.

And so, to have someone that, uh, is in their life that says, "“Hey, I'm concerned.

And you know, I really want to know what you're going through.

"” Um, gives them an opportunity to open up and discuss something that's really difficult to discuss.

And oftentimes they want to keep it secret because of how people often respond to someone talking about death or suicide.

And so they don't feel safe to open up to anyone really.

And so, to have at least one person in their life that says, "“Hey, I want to know these things.

I...

I can...

I can...

I can sit with this.

I can be here with you and... and talk about this with you.

"” Is some of the most effective ways of supporting someone than, you know, than, uh, compared to what else is out there, and anyone can do that.

That's the thing is, that when it comes to other levels of support, yes that can include therapists and counselors and people that have experience working with, um, suicide and suicide loss and suicide attempts, but often the... the... the... the most helpful thing, and the thing that everyone can do is really just check- in, ask the question, and go from there.

Rob: Can we just act this out between the two of us, because immediately I feel like if I'm going to ask someone this question... Rick: Yes.

Rob: I'm scared I'm going to plant the seed, but you have a great talking point for that.

Rick: Yup.

Yup.

That is a common concern, is that, uh, by asking the question or even saying the word that someone may start to think about it, um, and therefore, just by asking, you're putting someone had more danger when in reality, that's just not the case.

Uh, we are often, uh, not going to give someone the idea of suicide if they haven't thought about it already, you know... For example, like if... if I were to ask, like, "“Are you thinking of suicide?

"” Someone's not going to respond with "“Well, no, but now that you've mentioned it now... now maybe I'm going to consider it.

"” Uh, in reality, what the response typically is and what I'’ve experienced is relief and that, um... um, the fact that I went there allows them to, uh... uh, in that moment, hopefully feel a lot safer that they can now reveal that information knowing they're talking to someone who knows how to respond with empathy, with respect.

Um, and... and that in and of itself, even if you don't know how to fix their problems, even if you don't know what to say or do when it comes to what is causing the stress in their life, that's leading to thoughts of suicide.

Um, just by sitting there and saying, "“I don't know what to say, but I'm so glad you told me.

"” is really most of the work that, uh, is helpful when it comes to asking the question.

Rob: I wanted to also say, I...

I heard you say one time, you're not that powerful.

Rick: Mhm.

Rob: You're not going- by asking someone you're not going to plant the seed that's going to cause it, we don't have that much power.

Rick: Right.

Right.

Yeah, absolutely.

That's um...

Someone, you know, someone really considering suicide as a way to get out of their pain, um, that's something that's been typically present in their life for... for quite a bit.

It's not something typically someone gets to, um, uh, you know, impulsively... uh, that it's something that they've considered, they've thought about.

And so, um, as a... as a concerned friend or family member, by asking the question, it's not going to bring them from not thinking of suicide at all, to now all of a sudden going, "“Wow, now that you've asked the question and the thoughts in my mind, now it is something I'm really considering.

"” Um, it's... it's just not something that we can make people do.

Really.

Rob: What about, um, someone saying, "“Are you thinking about hurting yourself?

"” Rick: Great question.

Rob: Or are you... Do I- or here's another one, "“Do I need to be worried about you?

"” Rick: Exactly, exactly.

That- the way those questions can be problematic is that you won't necessarily get the answer that you're really looking for.

You know, for example, if you say something like, "“Are you thinking of hurting yourself?

"” Well, that answer could be yes, if it's self-harm behaviors, but self-harm behaviors are not necessarily suicide.

Self-harm... self-harm behaviors can be more of a coping mechanism to relieve some pain.

So, you're hearing yes, but they're not really thinking about suicide.

Whereas, um, the answer could also be no to that question, but what they're saying is that they're not gonna feel hurt, they're not going to feel pain.

They're gonna... they're going to die by suicide or attempt suicide in a way that's not painful, like an overdose, for example.

And so, it's not- you're not guaranteed to get the answer that you're really looking for.

Um, and it also is communicating, um, a hesitancy about the topic and also communicating that the answer I really want is no, right?

Like, if I'm- Rob: Yeah.

Rick: Saying something like, you know, um, "“Are you thinking of... of doing anything?

"” Or, you know, "“I'm concerned about you.

"” Um, uh, you know, um, "“Are you thinking of harming yourself?

"” Then that person is picking up that, okay, you know, this... this person doesn't want to say- want to hear me say yes, because then they might panic.

They might not know what to do.

So, I'm just going to say no to relieve them so that they can hear the answer that they want to hear.

And we can get out of this conversation.

Rob: We see, um, and I...

I love that discussion with you, Rick, because as I'm talking about it with you, I understand the importance of a direct question.

Rick: Mhm.

Rob: Um, and while it may seem direct, it needs to be... Rick: Yeah.

Rob: Um, because we are searching for direction-— Rick: Yeah.

Rob: When it comes to... to where that's going to go.

We have seen, um, all across the board depression and suicide affecting people throughout the past year.

Um, I did read a study and I'm curious about your thoughts on this, that one in four young adults, um-—and this was from the CDC since coronavirus, since the outbreak-—have struggled with severe depression, um, one in four.

And first of all, your thoughts on that.

Rick: Um, it's... it's a sad truth that, uh, when it comes to 15 to 24-year-olds, suicide is the second leading cause of death in this country.

And that was before the pandemic.

And so, it's already been a very difficult challenge when it comes to figuring out, um, what's causing that, how to help those, uh, that are- those young people that are struggling with thoughts of suicide since it already was at an unacceptable level, um, before the pandemic.

And then now with, um, uh, not being able to see friends or go to school and being home all the time.

And with... with... with living with family that is, you know... anybody growing up will have their challenges and challenges growing up, uh, you know, with... with typical family, uh, issues.

However, when you can't leave and you're there 24 hours a day, seven days a week, and everyone could be working from home and going to school, and you just don't have that space or those breaks that allow you to, uh, get your other needs met and other relationships that you can enjoy.

Um, it just makes the... the days even tougher to endure and day after day after day, month after month of this, uh, for all families and especially for young people, um, have just exacerbated the challenge more than it's ever been.

Rob: And it's still even with all age groups, if I'm not mistaken, is a leading cause of death.

Rick: Yeah.

Rob: Um, we- you mentioned with families, or being isolated with your family or from your family, um, in this time when so many people are divided, um, and it's deeper this time, it feels, um, with that division with... with families, um, because they have been driven apart... Rick: Mhm.

Rob: With politics... Rick: Mhm.

Rob: Um, being at center stage.

Rick: Yeah.

Rob: And then you see these people who are... are struggling just constantly, um, at odds with each other about the political stage and underneath that we're missing the emotional stage, which is just horrifying.

Rick: Mhm.

Rob: What are your thoughts?

Rick: It, I think, really demonstrates what happens to us all when there's such a lack of empathy.

Um, I think that's a lot of what we're seeing when it comes to the conflict and the hostility, um, with... with the... the division that we're experiencing is... is an inability to really slow down and just walk in someone else's shoes for a little bit.

Even if you don't agree with them or understand them that that's okay.

Um, there's just so much, uh, that is helped by taking some time just to, um, uh... experience the world through someone else's eyes.

Um, it gives you perspective, it gives you some patience, it gives you less judgment, um, and allows us to... to try to probably, what I would believe, is it would allow us to work toward common goals much more effectively.

Um, if we could stop seeing each other as... as the other, as someone that, um, is the enemy and instead look at each other as... as fellow humans that are trying to survive the best they can and that, uh, we all know pain.

Um, we all know connection or disconnection.

Um, there's so many fundamental human, uh, um, qualities and experiences that we all share.

That if we can at least start from there, um, and... and understand and... and connect with people on those levels, then perhaps from there we can build, uh, with, you know, build on that, uh... with some of the more challenging issues.

Um, that, you know, we'll never agree on everything, but at least we can move forward and figure out a way for all of us to find a way to enjoy our lives and... and create the lives that we want without trying to make other... other people's lives harder.

Rob: It'’s so interesting to hear you talk about that.

Um, it's almost like the perfect storm-— Rick: Mhm.

Rob: During this past year.

Rick: Yeah.

Rob: You know, we have all seen so much focus on who we like... Rick: Mhm.

Rob: Who we are for... Rick: Yeah.

Rob: Instead of how we like and how we are for each other and how we love, instead of who we love.

And this... this focus to how really needs to, in my opinion, just reemerge because it has ripple effects that are deadly.

I recently got a call from somebody out of state, um, who said, "“I just have nowhere...

I don't have anywhere to go.

I have no... no.. .no one to help.

I have no, uh, I can't get an appointment at a doctor's office or a therapist.

And I have nowhere to go.

"” And I said, "“Well, you have somewhere, you called me.

"” And it's a starting point.

Pick up the phone and call somebody anywhere.

Anywhere.

Um, I also want to talk about, uh, the Suicide Survivors Support Group.

Rick: Yeah, yeah.

Rob: Take that.

Rick: This is a really special group that I've been a part of for quite some time when working at the Suicide Prevention Center at Didi Hirsch in Los Angeles.

They weren't developing before I got there, they began developing a support group for suicide attempt survivors.

Um, there had been plenty and there still are plenty of support groups for loss survivors and very much needed and very helpful.

So, if anyone has lost someone to suicide, they're, uh, typically in- not too far away, especially now with everything being online, you can, uh, really, uh, access support groups that are... that are specific for loss survivors and are so helpful in connecting with others that have gone through something similar and moving through that grief process.

Um, now when I first started there though, uh, support groups for attempt survivors really did not exist.

I mean, on a national level, they just did not exist.

And I think, um, from the research that had been done at the time, and what we continue to learn was the stigma around mental health, the stigma around suicide, but also the stigma around surviving a suicide attempt was just, um, affecting the available resources that were out there.

Just people, even in the mental health and suicide prevention community, um, were hesitant to, um, uh, look at creating these resources.

And a lot of it had to do with just fear, just fear, um, and... and working with those that have not only survived a suicide attempt, but may be on the, you know, on the verge of thinking about it again, since a high-risk factor for a suicide attempt is having survived a previous one or knowing someone that died by suicide or attempted.

So, we're w- the... the-— working with this population can bring up a lot of anxiety for even, you know, seasoned mental health professionals.

So Didi Hirsch took the reins and, um, started creating the support group.

Um, and over the years, developing this group that was an eight-week group, um, structured so that it had some curriculum.

And if anything, the most important thing it did was provide connection.

And that's what I experienced a lot running these groups was seeing people that had all had a history of surviving, a suicide attempt, at least one, some people multiple attempts.

And for the first time being in a room where they felt seen and heard and not judged, and they could relate with everyone else in the room and that safety that... that brought and that connection that brought and how healing that... that was, uh, to find that space.

And then the rest of the group, uh, weeks, uh, including, uh, discussions around suicide, safety planning, uh, creating hope and resilience, and really setting someone up to move beyond, uh, just... just trying to cope, just trying to survive, but... but really start to create a life where they can experience themselves thriving in it.

And that's what I got to witness, which was so fulfilling, is seeing someone really at... at the end of their rope, really, really struggling to find a reason to... to stay around and to stay alive.

And through this community that was being developed from the support groups, um, finding that... that, uh, reason finding that clarity of... of- and that purpose of why they're here and why they want to be here.

So, the group has been really helpful.

It's now been evaluated and there's been studies done on it to show its effectiveness.

We've now...

I'm still a part of, uh, working with the Suicide Prevention Center, training other facilitators, therapists to run these groups all over the country.

We've been all over from Georgia and Canada and Montana and, you know, wherever anyone would have us, we would go and do this two-day training so that other people could start, uh, running this group.

And now we have groups all over the country that are happening and we're about to roll out all throughout California, an online version since all of this had been done in person up until the pandemic.

And so now we're going to roll out an online version where we're going to work throughout California.

And then when we see how that works, we'’re, uh, the next step is to do it in Florida so that we can have, uh, a different area and see what their results are from doing the groups in Florida.

And then hopefully after that, with... with the success we're hoping to have rolling out these groups, then we can take it nationwide.

Rob: That's fantastic.

Rick: Mhm.

Rob: I love that.

That's really good, Rick.

Rick: Mhm.

Rob: And I...

I just, I love that when you said someone finally feels seen.

Rick: Yeah.

Rob: Um, you mentioned stigma-— Rick: Yeah.

Rob: In that last discussion, and what I have learned is that stigma equals silencing someone that then leads to hearing from that issue 10 times louder.

Rick: Yeah.

Rob: So, when you stigmatize you temporarily silence.

Rick: Yeah.

Rob: But whatever you're silencing will be heard a zillion times louder... Rick: Yeah.

Rob: Because you can't silence someone's pain forever.

Rick: Yeah.

Yeah.

And at a certain point, whether we want... want it to, or not, it will explode forward.

And, uh, w- those are the very things we're trying to avoid, the repercussions of that, those are the things that nobody wants.

And so, if we can, uh, minimize the stigma and... and really the way to achieve that is to have the conversation and to de -stigmatize the conversation, uh, so that it's not silenced and it's not building up, uh, with pain and pressure, but that it can be dealt with at more manageable levels so that it never gets to that crisis level.

But it gets to a more manageable level, um, which, is the goal really in suicide prevention work, is not necessarily eradicating all thoughts of suicide, but allowing someone the... the capability of coping and managing thoughts of suicide so that they feel safe and they feel, uh... uh, capable of taking care of themselves no matter what they may think on some days that may- we have tough days, you know.

That life can get tough sometimes and... and that's to be expected.

And so, um, we just need the abilities to know that even when we're feeling really down and in pain and we want to give up, that we've learned some ways to endure that, um, rise out of it and be even stronger moving forward.

Rob: Final words of wisdom, anything you want to share.

Rick: Um...

I...

I think...

Rob: Or that you feel must be shared.

Rick: Right.

Right.

You know, I think the... the biggest takeaway from our talk today and what I really want people to know is that suicide is an issue and is... and is...

The issue that it is today because of our avoidance of it.

Uh, with the 10th leading cause of death in this country, it would make sense that it's something we would really want to address and talk about, especially for our young people who are much higher risk, uh, for... for attempting suicide.

And so, not- to not be afraid, um, that we can start having this conversation in ways that are safe, that are helpful.

Um, and that if we just kind of open up to it, we are going to save a lot of lives, um, just by being willing to have a conversation about something that can be tough to talk about.

Rob: That's exactly why I wanted to have you on today.

Rick, thank you so much.

Rick: Absolutely.

Rob: I appreciate your wisdom, um, and your sage advice.

Dr. Rick Grant-Coons in Sacramento.

Thank you for sharing your wisdom and... and your hope.

Rick: Thank you so much.

Thank you for having me, Rob.

Rob: Absolutely.

This has been Rob at Home and we will see you next week right here.

Same time, same location.

♪♪ Annc: Murphy Austin Adams Schoenfeld, LLP, focusing on business law and commercial litigation is proud to support Rob on the Road Region Rising.

More information available at murphyaustin.com.