An Interview with NASW MN & ND’s Anna Ehl & Nat Vue

September is Suicide Awareness Month and we’ve all seen the posts:

Check on your friends.

It’s OK to ask for help.

Dial 988.

We all know what we’re supposed to do when someone is struggling. But what happens when we do the right things—we check on our people, we reach out for help—and it doesn’t work?

“It was 7:30am when I got the call from a friend that she wasn’t going to make it on her own, I was alone with my 2-year-old and I felt like time was stopping.”

Anna Ehl, Communications & Membership Coordinator for NASW-MN & ND almost lost a friend to suicide in 2019.

“At the time I was living in rural northern Michigan—the upper peninsula—where the healthcare system is so remote it’s not even considered rural health; it’s ‘frontier’ healthcare. We sat in the emergency room all day, we called the hotlines. There wasn’t a bed available anywhere within a 4 hour drive. They sent me home with her and told me not to leave her alone.”

The standard advice—reach out if you’re struggling—falls apart in huge sections of our country where help just isn’t available at a scale that matches need. So how do we support our friends, families, and clients in places where the standard of care might not be available?

“Every time I see those ‘just dial 988’ posts, part of me wants to scream a little” Anna said. “I am so eternally grateful that those interventions exist but I wish more people knew just how fragile the safety net supporting our society’s mental health is, and how many gaping holes there are in it depending on where you live and what your health insurance looks like.”

For those supporting friends, family, and clients in remote locations, support may not be as simple as ‘dial 988’ or ‘go to the emergency room’. Finding ways to build alternate care networks—having people locally in the lives of those struggling who can provide support when formal structures aren’t available, or being prepared to help those struggling travel to get the care they need can make all the difference. Knowing to check what supports are actually available rather than just telling someone to ‘reach out’ can be a game changer for those struggling in remote places.

Sometimes we can access all the right interventions, and it still isn’t enough.

“It was confusing for me, I’m a social worker, I know what I’m supposed to say or not say, I have the education and awareness. I was there to support her, she got help, she went to therapy, she got medication, she was trying to help herself, and she still died.”

Nat Vue, Program and Events Coordinator for NASW-MN & ND, remembers with love her younger sister, lost to suicide in 2022.

“Mainou had this obnoxious laugh. The way we grew up, we didn’t talk about our emotions. We didn’t get that from our parents or do that with each other. My sister was the only one who would say ‘I love you’ to me.”

What happens when all the interventions just aren’t enough to save someone? Awareness isn’t just about prevention, it’s also about finding the right ways to support those who are left behind when prevention fails.

“People get uncomfortable talking about death in general, and suicide is such a taboo topic that people have different opinions on, so that makes it more difficult. Then people are worried about saying the wrong thing or making us sad. People don’t know what to say. For me, I realized I’m just worried about people forgetting her, like she never existed.”

Often when people don’t know what to say, they say nothing at all, leaving those who have lost someone to suicide feeling like the whole world is afraid to speak their name. When we lose someone to suicide, there is an increased risk of developing complicated grief compared to other kinds of loss. The feelings of shame, guilt, anger, confusion and rejection combined with societal stigma can leave those left behind by suicide afraid to discuss their loss. This stigma and silence are an impediment to healing.[1]

“In the Hmong community the older generation doesn’t understand mental health, there are not words to properly explain it to them.” Nat said, “ There’s some embarrassment around it. Something we did differently is when she passed, we talked openly about it. At her funeral we invited a social worker to come and talk about mental health to build some awareness in our community. I’m really proud that is something we did, I’m proud my parents weren’t ashamed or embarrassed to talk about it and were willing to talk about her mental health struggles openly and that we lost her to those struggles. “

We know that sharing about suicide loss, and receiving individual and community support after loss can serve as protective factors against complicated grief.[2] Many of us find ourselves supporting family, friends, and clients who have lost someone to suicide. Many of us have lost someone ourselves. Receiving support in talking openly about both the grief and the person lost can make a huge difference in healing. Suicide awareness doesn’t end in October, nor does it end when a life is lost. When you or someone you care for experiences a loss to suicide, we encourage you to make room for yourself to grieve, make time to share your own memories, make space to remember the whole person.

If you’ve lost someone to suicide and you want to share your story, the American Foundation for Suicide Prevention would love to hear from you.

Learn more about the complexities of suicide bereavement here: https://behavioralhealthnews.org/the-ripple-effect-impact-of-suicide-on-family-and-friends/

[1] https://pmc.ncbi.nlm.nih.gov/articles/PMC3384446/
 

[2] https://pmc.ncbi.nlm.nih.gov/articles/PMC7190787/