Speaking of Suicide

Content Warning: This episode discusses suicide. 

According to the CDC, suicide is the second-leading cause of death for teens and young adults, and LGBTQ+ youth are more than four times as likely to attempt suicide than their peers. Additionally, there’s often an increase in suicidality and mental health crises around the holiday season, especially in the days that directly follow the holiday itself. This week’s In the Den episode is a conversation between Sara and special guests Beth Markley and Elizabeth Kingsley about suicide prevention strategies. They discuss practical suggestions of how to help suicidal loved ones and provide tools for talking about mental health and suicide more openly and directly.

Special Guest: Beth Markley

Beth is the Executive Director of NAMI Idaho. NAMI is the National Alliance on Mental Illness. Beth has been in the nonprofit world for more than 25 years. She is a feature article writer and content developer and has been a regular contributor for several local publications. She has served as an adjunct professor at Boise State University for a course on nonprofit management and is active in her community serving on a number of Boards.

Special Guest: Elizabeth Kingsley

Elizabeth has transitioned from being an ultra Trad wife, stay-at-home and scrupulously religious mother to being a happily divorced, self-expressed, open-hearted single mom. She loves life now with her passel of queer children. They have taught her how to fully accept and love herself as she easily accepts her children.

Links from the Show: 

• The National Alliance on Mental Illness (NAMI): https://www.nami.org/ 
• Resources for family members and caregivers: https://www.nami.org/your-journey/family-members-and-caregivers/ 
• NAMI Publications and handbooks: https://24-7.master-print.com/NAMI/UserJCatalog.aspx?category=1 
• The 988 Lifeline website:  https://988lifeline.org/ 
• QPR Suicide Prevention Training: https://www.mamadragons.org/suicide-prevention-training 
• Join Mama Dragons today: www.mamadragons.org 

In the Den is made possible by generous donors like you. Help us continue to deliver quality content by becoming a donor today at mamadragons.org. 

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Transcript

SARA: Hi, everyone. Welcome to In The Den with Mama Dragons, a podcast and community to support, educate and empower parents on the journey of raising happy and healthy LGBTQ+ humans. I am your new host, Sara LaWall. I am a Mama Dragon myself and an advocate for our queer community and I’m so honored and excited to join this amazing podcast team and to learn and grow with all of you. Thanks for joining us. We’re so glad you’re here.

This episode discusses suicide and for some of you who have some lived experience with that reality, this may be too much for you. So please take care of yourself. And if you or someone you know is having thoughts of self-harm or a mental health crisis, please seek help and support. Here in the US, anyone can call or text 988 24/7 to talk to someone ready to help. You are not alone.

Suicide is the second-leading cause of death for teens and young adults according to the CDC, with 22% of high school students reported having seriously considered suicide in the past year. And we know that LGBTQ+ youth are more than four times as likely to attempt suicide than their peers.

The Trevor Project’s recent survey on the mental health of LGBTQ+ young people found that 41% of LGBTQ+ youth seriously considered attempting suicide in the past year. And young people who are transgender, nonbinary, and/or people of color reported even higher rates than their peers.

These are astonishing statistics and especially concerning for those of us parents of LGBTQ+ youth and young adults. Many in our Mama Dragons community have lived the difficult and devastating reality of suicide in their own families. And still, suicide and mental health carry such a big stigma that when we do find ourselves in the middle of it, we don’t talk about it. It can feel lonely and isolating and so overwhelming. And if we’ve been part of conservative religious tradition, there can be a lot of communal and religious shame that comes when someone dies by suicide. And then those of us on the outside of the immediate impact often don’t know how to talk about it with our friends or family who are dealing with suicide directly.

So today’s episode is such an important conversation. And I’m here with two wonderful guests who are going to help us talk about it and lift some of that stigma, help answer practical questions about what to do when suicide impacts one of our children or beloveds and give all of us some tools to talk about mental health and suicide more openly and more directly. Today we're talking with Beth Markley and Elizabeth Kingsley.

Beth is the Executive Director of NAMI Idaho. NAMI is the National Alliance on Mental Illness. Beth has been in the nonprofit world for over 25 years. She is a feature article writer and content developer and has been a regular contributor to several local publications. She has served as an adjunct professor at Boise State University for a course on nonprofit management and is active in the community serving on a number of Boards. Welcome, Beth. We’re so glad to have you.

BETH: Thank you so much. It’s great to be here.

SARA: And Elizabeth Kingsley is a transformed ultra–Trad wife, having transitioned from that world as a stay- at-home and scrupulously-religious mother to being a happily divorced, self-expressed, open-hearted single mom. She loves life with her passel of queer children. They have taught her how to fully accept and love herself as she easily accepts her children. Elizabeth, so good to have you back on the podcast. Welcome.

ELIZABETH: Thank you so much. It’s good to be here.

SARA: This is a really tough topic, both of you. And so I’m really grateful for your time on this. and I’d love to start by hearing a little bit about why this issue is so important to you? Beth, can we start with you?

BETH: My background is in nonprofits. And actually, the first time I’d heard about NAMI was when I applied for this job. And it was really disconcerting to me that the organization had, at the time, such a low profile in Idaho because as a mom who had been seeking mental health resources for a loved one, I had struggled. And I’d found a few national resources and I thought to myself, “Well, I could’ve really used a NAMI.” I can still use a NAMI. And I’ve had concerns about a loved one with suicidal ideation and wondered all sorts of things about how I could support that person, what I might’ve done to contribute to the situation. And my normal courses of support were just not helpful. As any parent, I think in this situation will tell you, people have all kinds of advice about stuff that they know nothing. And parenting is one of those situations and things will be thrown about that are just unhelpful and sometimes just really hurtful: things like tough love, and setting boundaries, and not being a codependent with no real information. So it’s a very, very stigmatizing and lonely place to be. And data is out there that shows us that that kind of loneliness is in itself detrimental to our physical and mental health. And so I’d felt the impacts of that and just wanted to make sure that I was doing what I could to make sure that other people in the same situation were not experiencing what I had. And we have a long way to go. But it feels better doing something than not.

SARA: Thanks. I appreciate that. Thanks for the reminder about how that loneliness and isolation can be a contributing factor to mental health crises and suicidal ideation. Elizabeth, how about you? What is your story? Why is this issue so important to you?

ELIZABETH: I am a mom of five kids. Now several of them are adults. When my second child was 15, they attempted suicide. And, for me, it was devastating. And what I mean specifically is that my identity was crushed. So a lot of the pillars of my identity, who I am as a mother, actually that was the biggest, most painful one because it was like I had already been divorced and it was like the last big one. I’m okay not knowing who I am in a lot of areas. But I know who I am as a mom. I was always a big reader on parenting and considered myself this top-notch mother. And for my child to attempt suicide just meant that I wasn’t able to keep them safe, which was like my one thing. In my mind, that was my one job on earth. And so it massively changed everything about the trajectory of my life. And I can talk more later, I guess, about my actual experience of it. I’m trying to put into words why that is now such a passionate concern of mine, but I don’t know if it’s already obvious. You know how sometimes we say things without directly saying them and they’re obvious. But all of that led to, I needed to know more, I needed to know how to deal with life if my one job isn’t to keep my kid safe. So, I guess, what I learned out of that was that I don’t have the option to guarantee my children’s safety which was something I was living with the illusion that I could before. And having that illusion destroyed required me to reorient to life and to my children and to my relationship and my identity as being a mother. And one of things that came out of that is a very personal and passionate concern about, especially, LGBTQ+ teens and suicide.

SARA: Great. Thank you. Thanks for sharing that personal story. And I hope you will continue to share what feels comfortable for you as we go along in our conversation today because I think hearing those stories is so important for us to know that there are other people out there who have lived through similar experiences. It makes us feel less alone. The same is true for parenting queer kids, to connect with other parents who are living through the same experience just makes you feel a little bit more supported in what can feel like a really challenging space in the world. One of the reasons we’re having this conversation right now is because there’s often an increase in suicidality and mental health crises during the holiday season, particularly days after actual holidays. When we’ve had lots of gatherings, difficult family dynamics often are at play. And accompanied by inappropriate questions and microaggressions especially for our queer kids and beloveds. And, also, just lots of peopling and lots of stimulation that can really easily push folks into increased depression and anxiety.

But then also, we’re living in this really unprecedented moment right now in the aftermath of this election when we’re already hearing families and youth talk about a rise in fear and a rise in anxiety and really deep impacts on queer youth and family and friends. And so I think this is a really important time for us to be talking about this and talking about how we can help one another through times of crises, how we talk about, how we understand it and identify it. So thank you for being here. Thank you for being part of this conversation.

In light of all of that, I want to ask you about how we know what to look for. What might be some signs as parents in our own household that we should watch out for to determine whether or not our child might be having some suicidal thoughts or be in some kind of mental health crisis? Elizabeth, let’s start with you.

ELIZABETH: I would love to speak to that. I do want to say, before my child attempted suicide, they’d been in therapy for years. We talked about mental health. It was not a stigmatized subject in my home which I thought was this big protective thing that would mean that my kids would always be safe. And I guess I want to point that out because there’s so much shame if you feel like you’ve covered all your bases. In fact, I felt anger because it was like what more supports could I possibly give this child? And the answer’s probably nothing, as in we didn’t do something wrong because our child goes into crisis and wants to unalive themselves. But I would say looking back, I’ve learned, is that I have to soften the question. So I have other kids who’ve experienced mental health at this point. And plus with the one child who was in the crisis, with them, I just every day would ask, “Is it okay if I ask how you’re doing?” And then once I get permission I would say, “On a scale of one to ten – or one to five depending on how I was feeling – tell me about your – like you can say, what are your suicidal thoughts at? Have you had one in the last 24 hours, one in the last week, five in the last 24 hours?” And I’d repeat this. I’d try to do it every morning because then it’s like normal. It doesn’t feel like, “What, now you’re worried about me? Now I have to be defensive.” It’s like, “Oh, this is just what we do. We do this now.” So my next youngest also has been through some mental illness struggles and so with that child, he’s more defensive. He doesn’t want to be considered broken or suicidal. And so what I’ll say to him is, I’ll soften the question. So, for example, “Do you feel like it would be a relief if you could never wake up again?” That’s a softer question than, “Are you thinking about ending your own life?” Right? And if there’s any sense of that being too, “Oh no. I’m fine.” If I get the “Oh, no. I’m fine,” response then I’ll soften it even more and be like, “Okay. So tell me about your feelings?” Especially if it’s obvious they’re depressed. “Tell me about your feelings of depression?” Or “Are you feeling numb lately?” That’s an even softer version because that comes first for my kids – well one of them. He goes numb and he says, “I feel like a shell of a person.” That’s what proceeds his acting out with self-harm versus my other child; it was more like anxiety and overwhelm would precede it.

SARA: I really appreciate your offering some really practical language for us to use. But what I’m also hearing in your story is that it’s varied.

ELIZABETH: Yes.

SARA: And it’s about learning how your child responds and who they are.

ELIZABETH: Yes.

SARA: Beth, I’m curious if you have some tips to add to that because I’m sure this is something that NAMI really hones in on in terms of what are the warning signs and how do we talk about it?

BETH: Well, first of all, I want to address something that’s a myth. You’re not going to plant the idea of suicide in a person’s head. And so asking the question outright is something that is probably not going to offend somebody. If you say, “Are you having thoughts of suicide?” Or “I have noticed a change in your behavior. You’re isolating more. You seem to be using substances that you know are harmful, or you’re angry more often, or you’re avoiding us. I’m worried about your mental health. Are you having thoughts of suicide?” It was like when my kids were little and they would drive up to [indiscernible] and my husband would say, “Don’t ask them if they’re getting car sick because you’ll make them think about that.” That’s not going to happen. Same thing with thoughts of suicide. You can talk to your older children. And also forewarned is forearmed. If you feel like you have a situation where there might be a mental health crisis, NAMI has a How To Respond To a Mental Health Crisis book in English and Spanish on our website. You just google that and you can find it. And it’s a 36 or 38 page booklet. And it’s not something you want to read when you’re in a mental health crisis, right? If you are seeing signs. If you’ve been through a mental health journey with your child and it also is something that everybody’s journey looks a little bit different. You can educate yourself in advance. You can take a 90 minute QPR – which is Question, Persuade, and Refer course – or something more along the lines of ASSIST which is a prevention course. And it could be a couple of days. But know the signs and also recognize that you know your child. And you know your loved one. And when those red flags come up, you can ask the question. And it’s just, frame it in terms of, “I’ve noticed. I’m not trying to be insulting or belittling or imply anything in particular. I just want to keep you safe and I want you to know that you are welcome to share these with me in a nonjudgmental fashion.” And another thing that I think could be really important, when I talk about that isolation being really, really detrimental in the life of a parent. Find support groups of people who have lived experience because everybody’s journey is a little bit different. And so you’re not going to find publications that speak to exactly what you’re going through. But you can start to puzzle pieces together and find resources based on what other people have experienced that might work for you. And it also just feels a little bit better to know – Elizabeth was talking a little bit about feeling like this was a reflection on her parenting – and that is a universal experience. And we, as a society, are very judgmental of parents who are in a position. And the fact is – I learned this in therapy – you have a child and they might have a big target on their back or a little target on their back, right? And a big target, and you launch those parenting arrows and you hit the target every time. A little target, you launch the parenting arrows – and it’s a very violent metaphor, I know – but then you just can’t hit that target because it’s so tiny. And it’s not that your aim is any different. It’s that some children are going to seem to float through life a lot easier than others within reason. The type of parenting doesn’t necessarily make as big a difference. I know that the tendency is to look back and say, “What did I do wrong?” And to analyze every single point in that life. And my husband has, with our own situation, has a recurring dream where he came across the point at which we made a decision and going this way would ensure our son would have a reasonably safe and secure life. And going this way got us to where we are today. And he says he wakes up every time that happens just before he discovers what exactly that point is. That’s not helpful. You didn’t cause this by being a caring parent. And getting support from people with lived experience can help you realize that and remain strong for the other stuff that you have to do on behalf of your child.

SARA: Thank you. You said so many really helpful things there. I want to make sure that we let our listeners know, we’ll link to the NAMI guide that you referenced right there. And also, you reference QPR. And I want to just remind our community that Mama Dragons offers a QPR course on our website. It’s a Gatekeeper Suicide Prevention training. And QPR stands for Question, Persuade, and Refer are the three simple steps that anyone can learn to help save a life from suicide. So that’s a really great course and we’ll link to that as well. 

You both have said some really great things about questions to ask, how to be direct. It’s okay to be direct. And then how to modulate when the directness maybe doesn’t get you where you need to go. And I want to just clarify a few little things about the warning signs. Elizabeth, I heard you talk a little bit about numbness. I heard talk about isolating or noticing unusual behaviors, substance use for example, things that are outside the norm that you’ve seen. So what might be some other behavior warning signs or things that we might listen for that might help remind us, “I should start asking some questions?”

ELIZABETH: I first want to say, I could not second and support what Beth said more strongly about asking directly. Even though I talked a lot about asking less and less directly, that’s because one of my kids gets defensive. But it’s so important to start off with that direct, “Are you having thoughts of suicide?” And also, I want to second what you just said about QPR being worth it. I did the Mama Dragons QPR, after the fact of course, and subsequent children facing suicide, it’s made a huge difference. So I just want to say without it and with it, wow, so worth the 90 minutes. As far as warning signs, I want to speak to this practically. But all of my kids are different. So here’s some practical examples, okay. And I knew one person in my life who had a child who had attempted and that was a lifeline to me because I did feel completely alone. And what they went through wasn’t what I went through and it was still so helpful to know another parent. Anyone can contact me, by the way, personally. I’m in Mama Dragons, you can private message me on Facebook, anyways, if you need to know someone who’s had the experience. So with my first child, they had put themselves – meaning we talked about it and I let them decide – into a high school where you can get a lot of college credit before graduating. Like years of college credit before graduating. And I was concerned about this because this child has had a mental health journey. And I was like, “This is not a good idea, but I will let you choose. And then if it gets overwhelming, we can always go to a different high school, right?” And so warning signs, honestly, it was tricky because a lot of action toward self-harm and suicide happens in a very non-premeditated window by far. But this child started planning weeks ahead. They were kind of getting ready in case “I need a quick exit.” I didn’t know about any of this. So that’s why I’m looking in my brain for warning signs and I’m like, “Well, they were a little bit more withdrawn than normal.” But it wouldn’t have been something that was out of the normal for their up and down journey.

SARA: I really appreciate you saying that. I remember when my kiddo shared their own struggles with suicidal ideation, a year or so after the fact. And I was kind of shocked and deeply sad that I had missed something critical. I mean, I did that game of going back and trying to figure out what I had missed, how could I have missed that, just the fear that that could have progressed to an attempt was terrifying to me. And also just to name and recognize that sometimes those signs can be really hidden and we don’t see them.

ELIZABETH: Right. I mean, this kid was planning, didn’t want anyone to know. They were intentionally not exhibiting their angst because they wanted it to be secret. They wanted to take care of it, in like quick fell swoop thing. In fact, the only thing that preceded the attempt was, that night I was going out for a walk and it was a Wednesday with a group of other single adults that I’d never met because I was like, “I’m going to escape the house because my other kids are going to be with their dad. So I’m going to go for this walk two blocks from my house.” And there was something they would’ve normally done that night that they’re like, “I’m just going to stay home.” And I was like, “Oh, that’s a little weird. Okay, cool. I’ll be back in an hour.” And then the devastation of the shock and everything after. 

Let’s talk about my other kid. So my second child with mental health journey, he was like, “I need to go to the mental hospital.” Like out of nowhere. A normal performing child, good grades, decent social life, I mean they had a therapist. We went to therapy about twice a month, okay. So it wasn’t like we shouldn’t have had some kind of warning. Of course, the therapist wasn’t warning me. This child was probably 14 at the time. And they’re like, “I need to go to a mental hospital.” And I’m like, “Really?” I mean, as a parent you’re just like, I don’t know. That’s really extreme right? If you either have insurance or you don’t, it’s like a crazy journey where nobody wants to pay for them to be in the hospital. Nobody wants them to be in the hospital unnecessarily. But with him, he’s like, “Yeah. I wrote this letter to prove it.” And so I’m literally calling my sister who miraculously is a psychiatric nurse practitioner. And I’m like, “Really? Should I?” And she’s like, “You know what, you can’t always tell by affect – especially this child who identifies with the autism spectrum we’ll say – you can’t always tell with affect what’s really going on.” And this would’ve been a case where I would’ve said, “Are you having suicidal thoughts?” and he would’ve said, “Yes.” But he didn’t look like he was. He wasn’t acting like he was.

SARA: Sure.

ELIZABETH: And so we did go to the ER and they evaluated him and said, “Yes. He’s basically intending on self-harm. So it is appropriate to place him in the mental hospital.” So that you get these extreme differences, okay. And as far as warning signs go, it could be anything. And I love what Beth said earlier about you know your loved one which doesn’t necessarily mean you’re going to see them or you should see them, right? We shame ourselves like that dream you shared is so relatable. And the misery of waking up before you find out the moment.

BETH: I know. I was like, “What was it? What did we do?”

ELIZABETH: That would be the worst part for me. But I had to give that up because to have to come to grasp the reality that I can’t actually keep my kids safe was so devastating. But helpful, because now I can relate to them without me being in crisis all the time. For me, if I can keep them safe and I’m not, that’s not okay. My life stops. Action stops. And so I had to get to that place of “I can’t keep them safe and then mourn and grieve and literally be devastated to slowly grasp onto the reality, okay then what can I do?” Do you know what I mean?

BETH: That’s where the time of year ties in so concretely. And I’d say the vast majority of us who want to be deliberate parents and loving parents and who come at it with intention and compassion, we also have very little compassion for ourselves. We have an idea of what the perfect Christmas looks like – or whatever holidays you celebrate – and to be smacked in the face with not only the fact that your life is not matching what social media is showing you, but also you have someone who you love who’s in dire straights, is a double-whammy. And then also having people weigh-in on your situation who don’t get it is very, very tough on parents. And sometimes reading the warning signs as a parent of any child can be kind of scary because sometimes the typical warning signs look like the typical teen signs: Risk taking behavior, isolation, oppositional behavior. The difference is big swings. And I wouldn’t say absolutely because like Elizabeth had two very different experiences with her two kiddos. It depends on the kid. But just reading the warning signs and then freaking out over the possibility that, “Oh my gosh. My kid has been isolating.” I will say, don’t ever minimalize when someone talks to you about this person had suicidal ideation or was having suicidal thoughts. Because I hear people say things like, “Well, it wasn’t a serious attempt.” Or “It was a cry for attention.” Every time somebody tells you that they’re feeling things are that dire, you can’t do anything but believe them and respond accordingly. Take them to an emergency room. There are resources in Boise for teens you can go to without an emergency room referral. I know that Cottonwood Creek Behavioral Health is one of them. Respond seriously when that specific thing comes up. And I will tell you when my 15 year old came to me and said, “I need some help. I have really serious anxiety.” My first response was, “Well, you need to get out more. You need to have better sleep hygiene. You need to pay attention to all of these things.”

SARA: We all have anxiety.

BETH: Right. “You just need to shake that off. You have to grow up and get over it and push through and all these other things.” And that ended up not being the right response. It took a little bit more prodding for me to be like, “Oh, this is very, very serious.” And then it got much more serious after that before it got better. But pay attention. If you’re seeing the warning signs like an increase in impulsive behaviors, sleep disruption is a big warning sign, but then teenagers have a hard time sleeping sometimes. And so it’s just a change in habits, a change in how they’re taking care of themselves, their general appearance, talking in kind of a fatalistic manner. “Well, it’s not going to matter anymore anyway after so-and-so.”

ELIZABETH: I hear the fatalistic talk with my older child. They had been saying, repeating out loud memes for years that were really, really dark. Like, “I’m fine. I lied. I’m dying inside.” That’s what they would say. “Oh, I’m fine. I lied. I’m dying inside.” Like it was this joke. But there was a lot of dark jokes. But I mean, not like more, but I hear what you’re saying, fatalistic speaking is actually an indicator of where someone’s at mentally, I think.

BETH: But if you know your child, it’s about, are you seeing a change or are they saying it directly. I also don’t want somebody to be listening to this who has experienced either the loss of a child or a family member who has either try to die by suicide or otherwise harm themselves to hear this and think, “Oh, I missed.” I don’t want them to have that dream because sometimes the overwhelming pressure in society is to stay the course, don’t speak about it, don’t plant the idea in someone’s head. And it doesn’t benefit anybody to beat ourselves up.

SARA: Let’s keep going on this thread for a moment. I’m thinking about we’re engaged in a conversation with our child or a loved one and trying to ascertain what level of risk are they at. But I understand that one really helpful question to ask after you’ve asked the direct question of, “Are you having thoughts about ending your life or taking your own life?” Is to follow up with, “Do you have a plan?”

ELIZABETH: Yes.

SARA: And see where that yields. And then that might give information. And I do want to talk about the next steps of what do we do when we understand that it is immediate and there is a plan. But before that, there can be this in-between moment when someone is in a deep mental health crisis, skyrocketing depression or anxiety and just kind of spiraling, but can’t articulate that, while they’ve had thoughts of suicide, they don’t have a plan. How can we help them create a safety plan in that moment of crisis? I understand there’s some really great tools out there that we can use to walk someone through, “Okay, when it gets too much, who are three people you’re going to call? Let’s identify them. Write them down. Put them on a piece of paper and tack them to your wall or your fridge or your door, or wherever you’ll see them.” So that kind of really literal safety plan. Beth, can you talk about that? Do you have some resources for that?

BETH: Well, first of all, if you are working with a care provider for your child, talk to the care provider about working with that. And all of those components are part of that safety plan. Who are your three resources you’re going to call, what are the signs that will spur some sort of action, and what do we know about behaviors that are going to make things worse for our mental health. If they are working with a provider and I think if they indicate that they have suicidal ideation or they have thoughts of self-harm, you should be working with a provider. And that provider should be able to help you.

SARA: When you say provider, do you mean therapist, counselor, doctor, any of the above?

BETH: Any of the above. And that was a stumbling block for me because when I wanted to get my child help, do we see an LCSW? Do we see a psychiatrist? If you talk to your general practitioner, they can make a referral that will generally help and there might be a need for a medication provider and there might be a need for a talk therapist. And just work through, if you have a general practitioner, then they can make that referral and get you the support that you need. It can be tricky. In Idaho, every county in Idaho is a mental health shortage area, federally designated mental health shortage. We don’t have enough providers. So be patient. And also recognize that the first provider you find may not be the ideal for your child. And that is frustrating too. Adolescents have such a sense of everything in the moment and everything has to be fixed right now. But it takes time. And I’ll tell you also, just some stats about mental illness, 50% of symptoms are going to be present by age 14. So people who have mental illness, 50% will have symptoms by age 14. 75% by age 24. So a lot of times, mental illness shows up in this adolescent period. It is really not uncommon. And at the same time, the average length of time before somebody starts to seek treatment is 11 years. That’s average. So for many people, by the time they actually start to look for treatment, they have suffered for half their life. They’ve suffered for half their life or more and you know from experience or, at least Elizabeth and I do, that people around them are suffering too because it hurts to see someone you love hurt. Possibly by the time they actually seek treatment as adults, they’ve alienated everybody in their lives. People are just like, “I wash my hands of you because you’re so difficult.” So if you are lucky enough to have a kiddo say, “I need help.” Pay attention to that. 

Back to the safety plan, work with a professional in your child’s life. Or you can just google, “Mental Health Safety Plan”. What’s important, I think, is getting buy-in from the person in question. If they don’t agree to this, if you insist on being one of their top three, but they don’t feel comfortable telling you some really tough stuff, then let that go. Let other people be; ask if they have a favorite aunt or uncle or an older sibling. Make sure that those people know they’re on the safety list. If grandma’s on the safety list and grandma gets a phone call from your kiddo who says, “I need help.” She should be willing to drop everything and make sure that they get help, and take it seriously. And so have those conversations with people in that safety plan. And these need to be people who, if they’re getting a text from your loved one on Christmas day or New Years Eve, they’re dropping everything and making sure that this person gets help. And that’s hard to hear for mothers that it might not be us.

SARA: Oh, it’s so hard. I personally have found it very hard. I know how deep the impulse is to want to imagine or want to be the parent that your child can turn to for anything, for any reason, that you’ve parented them in a way that they know that. And while that might in fact be true, it’s really hard sometimes to turn to a parent. We have this conversation in my house a lot and I know how hard it is for me to be able to be like, “It doesn’t have to be me.”

BETH: I mean, embrace the notion of impermanence. Everybody goes through the situation where they’re closer to one member of their family than they are to another. And that’s okay. I’m not going to be the most popular parent of the two of us 100% of the time. And as long as they have someone, that’s okay.

SARA: And I want to mention it again – I mentioned it at the top of the show – but here in the US we’re really lucky right now we have this national crisis lifeline 9-8-8 that anyone can call or text any time of day, 24 hours a day, 7 days a week. And what I really appreciate about the lifeline is it is for anything. So I try to reiterate to the people in my world that you don’t have to be thinking about suicide in order to call. You can just be having a hard time. You can just want to reach out because you’re struggling and you don’t know who to talk to or you don’t feel comfortable talking to me, your mother. And I’ve heard some beautiful stories of folks who have called to asked for advice about what do to about a friend or a loved one, like feeling really concerned, kids coming home, I heard a mom tell this beautiful story of her daughter came home and was deeply concerned about a friend who was expressing suicidal thoughts and they called 9-8-8 together. And the counselor at the other end of the phone was able to offer them some really good tips and tools about how to talk with a friend and proceed from there. And so I just want, sometimes we think about that we have to be suicidal and you have to be the one in crisis in order to call. But really, it’s open to anyone for any crisis at any time for any reason.

BETH: Absolutely. And also, that’s important because the word isn’t penetrating some sections of our society. I understand that whenever I do a presentation, I ask who’s heard of 9-8-8. And I tend to get like 50% of the people in the room raising their hands. And so 50% of the people, and actually studies show it’s more like 70% do not understand what 9-8-8 is. So telling that, saying that over and over again is super important. And you actually don’t have to be the person who’s looking for support. You can call on behalf of somebody else.

SARA: Wow. I’m not surprised, but also what an important reminder that all of us can be doing a public service by talking about 9-8-8 to everyone in our lives. And to the people, loved ones who might be on the safety plan for our child, telling the loved one, “Hey. If the kid calls you, here’s where you can go. Here’s what you can do. Here’s where you can call.” 

I want to shift now to the more practical information and tools for when we are in that high-crisis moment of suicidal thoughts and a plan. Like, we’ve asked the right questions, we’ve heard the answers, and now we understand it’s serious and we need to take action. What do we do first? Where do we go?

ELIZABETH: I’d say, if you’re in a high-crisis situation and you’re not sure that you need to go to the ER or call 9-1-1, calling 9-8-8 is great. They can help you decide. I have a family member who is a nurse practitioner so I’ve called them actually every time anything’s happened because I trust them and I know them really well. But if I didn’t, 9-8-8 would be a great place to call and be like, “I’m sitting here with my child and this is happening and we’re trying to decide do we go to the ER or not?” So if there’s not a hesitation, if you’re not sure but you have insurance, just go. Here’s one thing it tells your child: they matter. You’re taking this seriously and you’re totally committed to them getting the help they need. If it’s accessible for you to go to the ER and you’re not, “I’m not sure but I definitely don’t feel like we definitely don’t need to go,” just go. You can sit there with them, be there for them, and/or – depending on what your child needs, right – but even the waiting room time that you’re going to have is time where you showed up for your kid, whether or not they ever recognize that because I’ve had to give up my attachment to that. But I know I was willing to be there for my kid. So if you’re not sure and/or have serious concerns about going to the ER, call 9-8-8. And somebody very well trained will help you out. That’s what I would say. Also, my kids, all of my children – the ones who haven’t gotten to a crisis yet, that are just having a mental health journey – they’ve all used hotlines or warmlines. So 9-8-8, they’ve used and it has made a difference when they did. So that really does help kids because it’s simple and when they can’t think straight – i.e., when they’re in crisis and there’s no blood going to their frontal lobe of their brain – they can go, “Oh yeah. 9-8-8“. So I strongly recommend that.

BETH: And they might have a kiddo who is reluctant to go to the Emergency Room. They might be able to deploy a mobile crisis unit. And those folks are really good at talking through these crisis situations with your loved ones.

SARA: Oh, that’s very helpful. That’s great.

ELIZABETH: Yeah. We’ve actually utilized that too at my house and that was great. I agree completely.

SARA: Excellent. So I want to talk for a minute about in-patient care. This is the piece that I don’t think gets talked about very often. And I’m sure, because there is the shame and stigma around sending your child to in-patient care skyrockets when that happens. And all of those feelings I know parents who have confessed to me feelings of being a total failure by having to send their kid to in-patient care. So, Beth, can you talk to us a little bit about what is in-patient care and where does it come in? What does it provide? Where is it good in the crisis moment? And what do we need to know as parents about in-patient care?

BETH: Well, first of all, a lot of times in-patient care, if it’s necessary, is going to be recommended by your provider or through an emergency room referral. But it doesn’t have to be. If you have experience with in-patient care and you might talk to your provider about when to just go check in. And it’s when serious intervention is needed. A child is experiencing serious self-harm ideation, suicidal ideation, or is in psychosis. It can be overnight. It can be a week to ten days depending upon the severity of the issue. And this is not some space that I’m super well-versed on. But we do have several different resources. And, again, your care provider can help with making that determination, a referral through an emergency room, that process through 9-8-8. And honestly, when we had the experience of in-patient care the first time was involuntary and it was just such a relief to know that our loved one was in safe hands and starting on that process of healing. And then we graduated from there to a residential, it was actually out of state because Idaho doesn’t have longer-term residential treatment care. And then from there to a partial hospitalization which meant they had some freedom to leave in the evenings and so forth. And then an intensive out-patient. And this is going to be really confusing, again working with your care provider to assess what the safest path for your loved one is ,is super important. And asking questions. And I’ll also say, advocating on behalf of your loved one of any age is super important. We have a situation where we don’t have enough care providers for people of any age. and so keeping track of what medications they use, what their therapy treatment is, what they’re safety plan is. This is not a situation where somebody needs to just learn how to manage things on their own. And it doesn’t matter if they’re a child, minor child, or an adult. These situations require a lot of family support. Having a medical power of attorney is really important. Making sure that if they have a child who is no longer a minor and maybe even guardianship for the more serious mental illnesses. So there’s a lot of conversation around those different glossaries of terms. But your care provider can help and also there are times when your child might ask for that kind of intervention like yours did, Elizabeth.

SARA: Yeah. Elizabeth, you’ve had this experience. Do you want to share some personal insights?

ELIZABETH: Yes. I feel very cognizant of the fact that everyone’s experience on this matter is going to be extremely personal. And I would love to share because I’ve had two different kids, each in two different in-patient settings. And what that means is they stay there in the facility and the parents may or may not be allowed to visit. Some of it was during COVID.

SARA: I want to pause right there because I know parents have expressed this and I think it’s really important. If you’ve never experienced in-patient care as the parent putting a child in in-patient care, there is very restricted visitation and contact. And I know that can feel like a surprise for some parents.

ELIZABETH: I’m just going to speak to a mom, but this equally applies to a loving father. So let’s say a mom feels like a total failure because their kid is being sent to in-patient care, okay. This is so relatable. In fact, I think for me this was what was so isolating because I felt like, A, I can’t tell anyone in my family. They won’t understand. They might now have an idea of my child that is totally unhelpful. But my point I really want to make is, when you feel like a total failure, it’s critical that you get your own support. If you have a therapist, hallelujah. If you have access to a therapist that you haven’t tried, go for it. Talk to someone who has lived through this, whether that’s the intake person, maybe they’ve had a child or maybe you know of someone in your religion congregation who has had – anyone that you have even a modicum of trust for, or reach out to me – someone you know who’s lived through it to say, “Am I going to be okay? I don’t feel like I’m going to be okay.” And this is why I’m emphasizing that so dramatically, is because I stopped functioning. I barely got out of bed in the morning. I barely got to work. I had to get my own support because it was all about me inside of me. Meanwhile, I’m still committed to providing for my kid. And the kid got better a lot faster than me because they had all the supports, right? Two months in, my kid was better than they’ve ever been mentally, right? And I was not wanting to get out of bed. I was like, “I have to feed my kids.” And when that’s done, I found a really mundane video game that kept me out of the gutter. And that was my crutch and it was a very healthy crutch relative to what I could’ve used, right?

SARA: Yes.

ELIZABETH: So get your own support. Feeling like a total failure is real. Why? Because you have failed at what you thought you could do. You have failed and I failed completely. And that took two years before I was functioning mostly like myself. And I was going to therapy. I was reading books. I was desperate because I was like, “I don’t know why I can’t move on. I want to live my life again. But I don’t want to live my life anymore.” So it’s like this, if you feel like a total failure, it means your body is telling you: you need more support.

BETH: Yeah.

ELIZABETH: You need someone who’s able to say to you it’s okay to love yourself because whatever in reality has allowed this to happen, we’ve been trained that it shouldn’t have happened because of us. And that’s crazy. That’s not real. But we’ve got to have someone in our life to say that, that what’s making you crazy isn’t real.

SARA: Thank you for your honesty and thank you for the vulnerable honesty and clarity about how long it took you. That really resonated with me, that it is not the kind of thing that is just, “Boop, your child’s home. Everythings fine again, and you’re fine again and it’s all good.” Those feelings can really tear you up inside for a long time. It takes a lot of effort.

BETH: I found that there was this really harmful narrative that I had that I had to let go of. And that was I have never failed at anything that I’ve earnestly tried to do. And then here I’m face-to-face with a failure – and I use air quotes around “a failure” because it’s a child who needs help – and I am now a trained family support group facilitator and all of the families who come are families that tend to be in a position of crisis where somebody is experiencing homelessness or suicidal thoughts or hospitalization or something really, really dire. We’re conditioned as parents to say, “Oh. Here are the risk factors, adverse childhood experiences, improper role modeling, people in their life using drugs or self harming or making bad decisions or whatever.” Those are the predominant reasons why kids can end up having mental health issues. And so then when we are faced with something like this as parents, that’s when we start spinning on that cycle of “What did I do? What did I do? What did I do?”

ELIZABETH: Amen.

BETH: And it’s compounded by stigma and your friends who don’t know what they're talking about. And then suddenly you’re in the holidays and you can’t put this on a Christmas card and you’re getting all these pictures of people who have loving families and everybody’s happy and you just feel more and more miserable about it. And it’s important to recognize people tell us that participating in a support group for themselves, even though they weren’t the person experiencing suicidal ideation, it was life-saving. I never in my life had suicidal ideation until I had a child who was miserable and I couldn’t do anything about it. It is very real, the impacts to your mental health and physical health. And there’s data behind it that shows when you feel lonely and isolated and hopeless, it’s more detrimental than a sedentary lifestyle or smoking. And data is behind it. So it’s literally life-saving to you as a parent to get your own help.

ELIZABETH: Amen.

SARA: Yes. Thank you. Thank you, really both of you, for underscoring that so clearly and so importantly. You’re talking about how we see all the contributing factors to mental health challenges and adversity in life. And so then when your own child doesn’t measure up to that level of adversity, it feels very disconcerting but also just wanting to name, for our community in particular, that our queer youth could have had the best possible home lives, but our culture is pretty awful right now. And that undercurrent of marginalization and targeting and potential violence and all that rhetoric – I hear from my own kids and I hear from my own queer beloveds – it takes a toll on a person.

ELIZABETH: For me, it’s even more helpful to consider that there doesn’t have to be anything at blame. They could just be having their own internal struggle. And it’s definitely not about us. But we don’t even have to make it about the culture or the community. We all suffer. And some of us suffer in a way that they’re not able to regulate it as well. Whatever’s going on with them, it feels like not being alive would be a relief. And that’s a brain trip, right?

BETH: Like what’s traumatizing to one person just rolls off somebody else’s back. I didn’t mean to interrupt you, Elizabeth.

ELIZABETH: No. You’re good. Is it okay if I go back to speaking about in-patient experience, though?

SARA: Sure.

ELIZABETH: So once you have your own help as a parent, and someone has validated that it’s okay that you’re upset, devastated, or angry. Now, they’re in in-patient. One of my kids was trans and one was orientation-questioning at the time when they went to in-patient where they stay for seven to ten days, on average in my experience. It could be less, right? I’ve had the experience where they refuse to use their chosen name and pronouns after I had called and advocated for my kid. I’ve had the experience where they were completely supported and that their autonomy was respected as a 16-year-old. So all it is is to de-escalate their immediate crisis. And some are better than others. So, I guess, as far as, if you have a choice of facilities, talk to anyone you can including the social worker at the hospital who’s going to interview your child to decide, do they need to go to inpatient or not.

SARA: That’s great. I hear preparation and research are our friends and worth doing.

BETH: I want to put in just a notion there and Elizabeth was talking about her experience and also the importance of networking and getting feedback and multiple sources of information. One of the things that makes mental health issues different from other medical issues is the treatment plan is sometimes woefully lacking in being straightforward. You break your arm, you go get x-rays, you get a cast, you might need surgery, you might need physical therapy. It is very hard to intuit the notion right at first that there’s not a single path that works for everybody or at least works for 70, 80, 90% of the population. And so it’s hard when people say, “I need answers.” We’re like step A, B, C, D. It doesn’t work like that. I might step A, B, go back to step A, skip over to step C, move over to Step A.2, for everybody. And it’s just not an easy path. And so it can be quite disconcerting to hear that if you haven’t had that experience. Buckle in for the long haul. This is not an easy journey and it’s not straightforward. Get feedback from other people. Get support for yourself. It’s a marathon, not a sprint. And subscribe to that notion – and I think it’s a Buddhist notion – of impermanence because it might be okay and just relish that and be grateful for it. And you might be back in the thick of things tomorrow. And that doesn’t mean that you failed again, it just means that’s the nature of the situation that you’re dealing with. And thank God for your kiddo that you can be there as part of their support system because a lot of people don’t have that.

SARA: Thank you. I want to finish out our conversation and our time together today talking about how we support our friends and family who are facing these situations. Elizabeth, you talked a lot about “Get support, find support–”

ELIZABETH: For you.

SARA: For yourself. But I’m thinking about my own friends and connections and family members and part of a church community. I hear this conversation a lot. One of the things that we do really well is caring for people typically when they’re facing some physical crisis, they’re hospitalized, they’re having surgery, they’re having a baby. And we do meal trains and we check on them. But then I’ve heard folks share that when they are in a mental health crisis, it’s like silence. Nobody’s doing that. Nobody’s bringing the casseroles to you when your kid is in in-patient care. So I want to just name that because I want to just name that it’s okay to reach out for that. And when we know, bringing the casserole can be a really tangible, beautiful thing that we can do for someone who’s in crisis. But one of the questions is, how do we do that? How do we reach out? And how long do we keep that going?

ELIZABETH: For me, I would say be honest with the people that you can trust to be adults. So I had a teacher reach out to me after my child went into in-patient and they’re like, “Is there anything I can do for you?” And I said, “You know what? I could really use some frozen meals.” It was so beautiful. I still find it moving. They put together, I want to say, like two paper grocery bags of meal kits. That were like, here’s instructions. Here’s what you do. It’s going to take you 5 minutes and 30 minutes it’ll be hot out of the oven and taste awesome. It was so thoughtful. But I just knew that they actually wanted to know. What I found was helpful was to give up all of my expectations of myself, i.e. to cook.

SARA: You also get to experience the care of someone else. So whether or not you could actually do that for yourself or not, what you don’t get in those moments then is recognizing there is a community of care who wants to support you.

BETH: I say this all the time, there’s no meal train for a mental health crisis. And the fact is that with the numbers of people experiencing their own mental health issues or that of a loved one, the numbers are pretty high, more than one in four. And I talked about the statistics about it impacting children. So if you have a child with a mental health crisis, you’re dealing with a whole bunch of significant stuff too. And sometimes you only have the energy to just make it through the work day and then you’re going home and you are not making dinner, you’re not cleaning your house, you just cannot keep up with life and you’re just reserving all your energy for the stuff that you have to. And sometimes that’s not even enough. If you work in a group of any size, there is somebody right now who is coming to work blurry-eyed because they spend the night in the emergency room with a suicidal child or they’re worried about somebody who didn’t come home last night, they might be in psychosis. Or they’re worried about somebody with a substance-use issue. It is happening. So be open and be empathetic and compassionate. If you’re in a manager position, we have a whole series on stigma-free workplace, how to talk about mental illness, how to pay attention to language, and also pay attention to how you role-model your own mental health care if you’re the boss. Take the time that you need to take care of your families, to manage good self-care practices, and exhibit those for others. So if you, as a leader, exhibit healthy workplace coping skills, then people will feel safer. A huge chunk of the population says it’s important to take care of our mental health, and also I fear job loss and judgment in the workplace if I advocate for myself. So, Elizabeth, your standing up for yourself was huge. Most people will not do that at this point. And we might not have the policy decision, but we as individuals, we can change our language, we can change our approach, and we can change the amount of compassion that we have for people who are in that situation.

SARA: That’s awesome, Beth. That is a beautiful message that we can change the conversation. We can support people in these situations whether we’re directly related or we’re their manager. So when your young person or your family member has been through in-patient care and they’re coming home, or they stay home and don’t go to in-patient care but their risk is high and you’ve assessed that, how do you prepare for that? What are the steps that you need to take in your own home to make your own home as safe as possible? And rarely do we think about this as parents and then it just becomes sort of starkly evident. I had one mom just ask, “How do I hide all the sharps? How do I lock them all up?” So let’s talk about that. Elizabeth, you shared early on that you’ve been down this road. So what did you do? Give us some tips about how we can start to think about our homes when our beloveds are coming home from in-patient care or at high risk?

ELIZABETH: There will be some variation because kids that make a certain kind of plan – for example, my kid’s first attempt was an injection of a regular household chemical, not something particularly dangerous – and so for me, I needed to lock up a lot of things, the laundry detergent, any toxic shampoo, everything, okay. So let’s talk about sharps because that is really common, self-harm post-crisis, I’m asking my kid every day, “Tell me how many suicidal thoughts are you having on a scale of 1 to 10 in the last 24 hours?” And then I’m like, “Have you had any thoughts of self-harm? If you did, what would you use?” And once you have a good rapport and trust with your child, they will tell you, “I was thinking about using those scissors.” Okay. Great. “Do you mind if I lock these up?” “Yes.” And then we lock up all the scissors in the house. And by lock up, what I mean is, I bought the first locking thing I could find which was a fishing tackle, large ammo box or small fishing tackle box that had a lock with a key. And I just put that key on my key ring. There was no other keys. No one else could find the key to that. If there are extra keys, I tend to lock them inside the box just because I don’t have another safe place that I know my kids won’t find it. It started with that. So if you don't have to lock up a ton, definitely lock up all medication even if you think it’s safe. Tylenol and Ibuprofen are not safe at high doses and it’s easy to get a high dose. All medications, a little box like that will work. Kitchen knives and scissors and X-Acto knives if you have artists. My house is nothing but artists – not me but my children – Lots of art supplies. I’ve had to put away thumb tacks. When you find out that something is a favorite trigger or favorite self-harm implement, you can put that away. What I did eventually have to do because I had to lock up a lot of things, I got a tool box from Harbor Freight that has – and it’s not a key, key – it has a key. It's a big metal cabinet and they have a bunch of sizes which I loved. And that went in my personal office. So, again, this is just an idea. This is not what you should do. But if you need ideas, it was wonderful. It’s this tall, metal cabinet that locks with an unusual key. I put that key on my keychain and I had to keep my keychain on a lanyard at one point because I had a kid trying to break into it. So I sleep and they would come take my keys out of my nightstand. So a lanyard can help. I’m just saying that for practical tips.

SARA: These are the exact practical tips that we need because then also when we are facing that crisis, our brains aren’t working to think about all of these things.

ELIZABETH: And even at one point, I had one kid who wanted to break into my room. And so I put a keyed lock on my bedroom – Now that one I made a bunch of keys for because it was really important that I don’t get locked out of my bedroom, right? – but I put a keyed lock on my bedroom door so I knew for sure there was not going to be an opening of that door while I was sleeping. I’m a single mom. I don’t have a partner. It could be different if you have another parent in the house. I have not ever since the first crisis, I’ve never had another parent in the house. Personally that’s my preference, but you know, to each his own. Anyways, but keyed locks are your friend if you need them. But a locking metal cabinet will keep my kids out. A locking bedroom door, it’s super easy to push that open just to break the doorframe a little. That’s super easy. But if I’m sleeping and they break into my room, I’m going to hear it, right? That was my goal. The locking cabinet, I had a kid try everything to break into that when I wasn’t there, and it held fine. So that’s fabulous. I just want to say this one thing, a huge percentage – I don’t know off the top of my head – I want to say 50% of children who end up dying by suicide with a firearm, the parents knew it was securely locked. So you need to think. If you think you’re hiding your key somewhere safe, they might not be safe. For me, I took all of my firearms and they got stored in my sister’s attic. So I didn’t even put those in my locked cabinet because the risk was too high for me. And my kids never, there was no indicator that they would’ve used a firearm. For me, that was just my, as a mom, I’m not going to have a firearm that my kids can get a hold of.

SARA: But statistics really tell us that accessible or unsecured firearms are some of the highest rate of death among young people.

ELIZABETH: It’s in Utah specifically, a huge number of death by suicide with a firearm happens to parents who have securely locked it up. They know it’s locked securely and they’re wrong. So that, for me, was enough to be like, I don’t need to have one in my home. I’m not saying you shouldn’t, right? No judgement on people that work that out. But that is a fact in Utah.

SARA: Thank you for, it didn’t occur to me, what you helped me to understand is to keep asking the questions about plans and methods and what our child is thinking that that can help point us in the right direction as to what kinds of security precautions and safety precautions we need to take first. I was overwhelmed to listen, but also appreciate having to hear that you had to lock up shampoo, that you had to lock up every potential chemical liquid at some point. That may or may not be something that we are thinking about unless we’re asking those questions.

ELIZABETH: Right. And a lot of parents won’t need to lock up their laundry detergent, okay, because that can be overwhelming. But if you’re willing to hear whatever your kid is dealing with, and once they’re not in crisis and you’re doing that every-day check in, even if they’re really struggling, it can be helpful to find out exactly what is a trigger for them. What would it help me to take out of your room? That’s been a thing. And I’ve had my kitchen knives locked up for about four years. So after we wash them, they go in my nightstand and at night, I put them in the locked cabinet, right? So when I have to cut vegetables, I have to get out the key . And that’s okay. That’s what we had to do. That’s what I could do. There’s so little that I can do in this area that, for me, it’s whatever I can do, I want to do.

SARA: That’s really helpful. Beth, did you want to add anything about how we think about safety precautions in our own homes?

BETH: So much of what Elizabeth has said has been an education for me as well. And I think as parents, we educate ourselves in terms of what’s necessary. And I’ve not been in this particular place before. So I’d say, talk with your provider about what the needs are for your loved one specifically. And also embrace that notion of impermanence. You might be in a position at some point where this is not a concern anymore. But it doesn’t mean that you don’t check in. And be ready and vigilant. And education is your best friend. Education and then prepare for a lifelong journey in advocacy. I find it really empowering to share what you’ve learned with other families who are going through this.

SARA: Absolutely. That’s what we’re doing right now. Elizabeth, I have one more question that occurred to me as you were talking and sharing a little bit about your own kids and scenario, and your child trying to break into the locked box. At what point, when we’re home, I know that it may feel really terrifying to ever leave the house again or ever leave your child or young adult alone again. Can you talk to us a little bit about that and at what point do you have to finally be able or willing to just go about life and leave the house and go to the grocery store or go to work, whatever it is that you have to do, knowing that your child is home alone, knowing that this very thing might happen, that they might attempt to break into the lock-box.

ELIZABETH: I want to share an experience that relates to this as I answer your question. As soon as my child went in-patient, which was right after their first attempt. We went to the ER and we waited for a bed because the suicide was so premeditated that the social worker was pretty emphatic that we have to do in-patient. This isn’t your typical attempt. I was immediately thrust into this world called, “I don’t know what the Hell I’m doing.” I thought I was doing a lot of really great things. And this outcome is not okay with me. Right? Just a child attempting. And I was so cognizant of the fact that I could’ve been shopping for a coffin. I was so cognizant of the fact that I got lucky. And so I was like, “I don’t know what I’m doing but it has to be something different.” To me, it was about dealing with reality. And when I say reality, what I mean is simply what is so outside of what I think of it. And in this case, I don’t get to keep my kid safe even if I’m with them 24/7, they will find a way if they want to.

SARA: You’ve really shared in your story that struggle to really come to terms with what you have control over and what you don’t.

ELIZABETH: Exactly. And it is the worst news of my entire life, right? This is not good news. This is bad news. But if we keep trying to do what we can’t control, we are going to make ourselves more sick and potentially harm our kids further, potentially. If we keep pretending that we can force the situation to go the right way – meaning they stay safe – that’s the only right way.

SARA: But the right way is, part of it is trying to get ourselves out of the self-talk that the right way is that I have to protect, protect, protect, every second, every minute, every day, hyper-vigilance all the time, and that is an impossible way to live.

ELIZABETH: It’s hard to speak about this for me because it’s so painful at the beginning. When I had to face the fact that I cannot make sure that my kid stays alive, that’s not okay. That was my own personal Hell. And that is why, after two years, I was like 70% recovered. It’s so hard. I have to reorient myself to an unacceptable reality. That’s so hard.

SARA: So that understanding that at some point, the acute moment is gone, you’re living life but the risk-factors are there. You know they’re there. You’re talking about them. But you have to live life. You have to do the things. And you have to, at some point, you have to decide, I need to leave this house, I need to walk out the door, and I can do all the things. I can do the check in. I can feel good about where they are and I still don’t have control over what choices they make when I leave.

ELIZABETH: Right. And if you don’t embrace that, here’s what it could look like, I am going to make sure this doesn’t happen again at all costs. Meaning, I’m going to make sure you are supervised 24/7 when I can’t be there, my sister will be there. We’re going to put a bed alarm. You can do the things. And I could force it. And I could force my kid to live to 18. And then, what do they have to live with? No experience dealing with the uncertainty,. Not that I’m saying introduce the uncertainty. What I’m saying is, if you make yourself and them crazy by forcing them to be safe, you are reducing their ability – in my opinion. This is where I’m not certified or anything – but in my opinion, my kid would be a lot worse off if we had done that. And I would definitely be, like neurotic, off the chains.

SARA: Oh, for sure.

ELIZABETH: The happy ending isn’t that my kid’s still alive. My kid’s still alive and they self-harm occasionally. Also, self-harm can be a release, not necessarily relate to suicide. It can be an unhealthy coping mechanism employed instead of going down that road. But the happy news is they love me. To clarify what I mean is, our relationship is great. They feel supported as an adult. I feel like I can live okay regardless of what they choose. Meanwhile, I can treasure who they are and what I value that I’m able to share with them, which is kind of discovering who they are, they’re unfolding, and what they’re learning in life. Me just knowing them is this huge gift to me.

SARA: They’ve learned that they can be who they are with all of the challenges and that they will be loved and supported regardless.

ELIZABETH: Right. It might’ve ended with them un-alive-ing themselves, too.

SARA: It might.

ELIZABETH: Here’s what I want to say about that because that is a fact, that is probably best if we don’t ignore. I have four other children. Three of the four have come out on the spectrum of LGBTQ and all of them are self-expressed unlike this child that got to crisis by hiding everything. One of them has gone back and forth, literally, “I’m gay, I’m straight, I’m gay, I don’t know what I am, I’m straight.” It’s like, cool. And they know that’s okay. It’s okay inside of them. They’re not ashamed. That’s huge. That wasn’t going to happen. The way I parented, the way I related to my kids was very unhealthy in the sense that it didn’t honor who they were. It didn’t honor who I was either. I’ve learned to love and accept myself. Now I just love and accept my kids. So it all makes sense now. I’m okay. You’re okay. We’re all our own kind of freaky. So we all became better humans. And, yes, my child has chosen to continue to live and now they’re 19. But I know I might not have them for five more years. So every time that we get, we get. And every benefit I give them, I give them. And every support, and that usually looks like honesty, i.e. saying the things they don’t want to hear. Like, “Hey. You know I love you and that’s a really dangerous amount of alcohol for your roommate to have in here. I’m scared.” Stuff like that that they don’t want to hear.

SARA: That’s helpful.

ELIZABETH: Okay. Good. I would never go back and choose neurotic forcing you to live.

SARA: I want to pause here and just clarify for folks for a moment. My question was about the living, that they’re honoring that there is a time immediately after someone comes home or is in the high-risk moment when some more vigilance is really important and is part of the progression.

ELIZABETH: Yes.

SARA: But then there is the time when we start, then that starts to wane and now life has to continue and adjustments need to be made and trying to figure out how to navigate that path can be really complicated. How not to live the life that is hyper-vigilance and over-protectiveness all the time, never ending.

BETH: If I might, this kind of crosses over with dealing with a family member with a substance-use disorder. And mothers, primarily, can make themselves really sick by trying to control those things that are outside of their control. And when I learned that the definition, somebody said, “Don’t be codependent. Don’t be codependent. I’m like, “It’s not like I give him substances that will hurt him right? Codependency, the definition, is caring about something more than the person cares about it. So caring about their well being more than they do. That is codependency. Now, outside of a crisis, outside of that time when they’re in the acute phase and when they first come home and you have to be hyper-vigilant, you should really focus on prioritizing the things that are within your control. It is not in your control whether your child is happy. It’s just not. So you can spend a lot of energy and get nowhere with that priority because it’s not in your control. So look at those things that are, list out your top priorities and say “Is this, A, achievable, B, important to me, and C, anywhere in the realms of in my control?” And if it’s not ranking high on each of those things and you can take it and give each a score of 1 to 10. And then times those numbers across. And if something is scoring 10, 10 ,10, what’s ten, times ten, times ten. It’s going to be a lot more than something like, healthy happy children which might be we don’t know if it's achievable. It’s a priority for sure. But is it in our control? That’s a one. So that’s going to rank a lot lower. So focus on those things in your control and then you’ll have a lot easier time with the codependency issues. But we also need to be aware that these coping mechanisms have been bred into us or as conditioned into us as mothers or as parents. I relentlessly was checking Infinite Campus. Is my kid tardy? And as things were deteriorating for him, he was increasingly tardy. He was increasingly not turning in assignments. He was off campus. He was gas-lighting me about whether his teachers were actually recording the right information. And I think I lost a job because of that at one point because I just couldn’t focus. And then I got our cell-phone company to put some parental measures in place. And there’s no bottom to that list of things that you think are within your control. And it’s a myth. And the only thing that’s going to help a person pull themselves out is intrinsic motivation. You cannot give someone motivation to move beyond their substance issues, beyond their suicidal ideation. You can make sure they understand the supports. And you can be there. And you can also keep them out of immediate danger. But beyond that, it’s just crazy making for everybody.

SARA: I really appreciate the extra time from both of you and the sharing of your personal stories. It means so very much to us. I know that this conversation will make a difference to many people. So Thank you so much.

ELIZABETH: Thank you so much.

BETH: Thank you for the opportunity.

SARA: You’re welcome. Thanks so much for joining us here In the Den. Did you know that Mama Dragons also offers an eLearning program called Parachute? Through this interactive learning platform where you can learn more about how to affirm, support, and celebrate the LGBTQ+ people in your life. Learn more at mamadragons.org/parachute. Or find the link in the episode show notes under links.

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