Earlier this week, the mental health community marked Suicide Prevention Day. This worldwide observance is meant to bring awareness to the phenomenon of suicide and call attention to the resources available to those who are at risk.

I am not a big fan of “awareness days.” Not for cancer, not for drug prevention, and no, not even for suicide. I think they are frequently a way for those who don’t suffer to feel like they’ve addressed an important issue without actually having to do much. Share a hashtag or a hotline, dress in a certain color, wear a ribbon, and your job is done until it’s time to “bring awareness” again next year.

So I struggled through this year’s Suicide Prevention Day in quiet anger, thinking of those who have died and those that continue to struggle with suicidal temptations. Who in our community, our country, our world isn’t aware of suicide? Who isn’t wounded by it? How are we supposed to “prevent” such a many-headed monster? And at which head should we strike? Bullying? Lack of mental healthcare? Addiction? Grief? Pain? Fear? It’s a huge job, and it certainly can’t be accomplished with a Prevention Day or even a Prevention Year.

But.

There is one commonality that I can identify in all the suicidal people with whom I have ever worked (I run a peer support group for people with depression.) It’s the same common thread I find in the families and friends of at-risk individuals, and the same I find in society at large.

Nobody wants to say “suicide.”

Or “killed herself.”

Or even “took his own life.”

In depression sufferers, this behavior seems to be a part of the disease. The illness itself covers you in a cloak of isolation and secrecy, making you smaller and smaller until it threatens to snuff you out completely. At-risk individuals won’t often come right out and tell you they want to kill themselves. But they will say things like “I just want to disappear.” “I can’t take it anymore.” “The pain is too much.” “I’m not worth anything to anyone.” “I wish this was all over.”

For families, friends, and society, the reasons for hedging around the truth are a little murkier. We want to preserve the privacy of our loved ones, to keep them from shame or unwanted attention. But we also instinctively recoil from the idea of suicide. We speak of it in secrets and metaphors and hushed tones because we don’t want to confront the reality and finality of such an act. We don’t want to believe that someone we know is capable of such a scary and painful thing.

There was a little playground rhyme we chanted back when I was a kid:

“Secrets, secrets are no fun.

Secrets, secrets hurt someone.”

This is especially true in the case of suicide. The cycle of hush and secrecy allows illness and pain to fester, prevents the suffering from getting help, and even follows people to the grave, with the living left unable to come clean about what took the life of their loved one.

What’s the antidote?

Honestly, it’s honesty:

Mental health authorities like the Mayo Clinic, the National Alliance on Mental Illness and the National Institute of Mental Health all agree: The best way of combatting suicide is head-on.

From NIMH: “Asking someone about suicide is not harmful. There is a common myth that asking someone about suicide can put the idea into their head. This is not true. Several studies examining this concern have demonstrated that asking people about suicidal thoughts and behavior does not induce or increase such thoughts and experiences. In fact, asking someone directly, “Are you thinking of killing yourself,” can be the best way to identify someone at risk for suicide.”

It is hard to talk plainly about shame and risk, illness and addiction, grief and pain, life and death. Much harder than putting on a ribbon or sharing a hashtag. But if we really want to bring awareness, if we really want to prevent people from taking their own lives, we have to be willing to speak the word “suicide” and share what it really means—more grief, more pain, more illness, more despair.

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