Hello and welcome to your South Florida.

I'm Arlene Bornstein.

September is suicide prevention awareness month, and today we'll look at the risk factors and warning signs of suicide and what to do in a mental health crisis.

Considered a national public health crisis, suicide is a leading cause of death in the U.S., affecting people of all ages with far reaching impacts.

And while suicide or even suicidal thoughts can happen to anyone, there are some negative factors that can play a role in a mental health crisis, including discrimination, economic hardship, and barriers to mental health care access.

Joining me now to share more on how to talk about suicide and ways we can all help prevent it, is Alan Mednick, and you are a suicide prevention manager with the southeast for Livingworks education.

How are you?

I'm doing well.

Thank you so much for doing this.

You are brave.

And you have your own personal story, but you're here to talk more about what you're doing with this organization.

Tell us more about that.

Yeah.

First of all, I want to mention suicide is a tough subject.

And, you know, although it is a tough subject, suicide is preventable and there's hope.

And through livingworks, what we do is we try to provide the hope to do it and what we how we do that is through teaching people how to identify if somebody is in crisis to the point where we take them to, uh, you know, recognizing that they want help and reaching out to help, to reach them, to connect to somebody to get that help.

So that's one avenue we do it through, and there's another avenue where we take it to what we call a turning point.

And that turning point basically brings out the life in someone and says, I want to live.

And at that point we help them develop a plan.

So that's what we do.

And we do this through trainings.

Livingworks is the global leader in suicide prevention trainings.

I've been around for 40 years doing that, and that's basically how we do it through the trainings.

(Arlene) Well, it's a tough topic to talk about, especially if you are the one, you know, perhaps hiding these feelings.

And this could be anyone from your family or even a coworker.

And I can imagine if you know your coworker is going through something tough, or maybe you just notice they're acting different, maybe more reserved.

I mean, how do you open up this conversation at work?

(Alan) Yeah, that's actually a really good question.

The first thing we want to do is we want to be able to identify what we call invitations.

Invitations are what you see, hear, sense and learn in somebody that says, I need help.

I'm in crisis.

People, you know have the will to live and that will usually speaks is how does it speak to you?

So, you know, what do you see in somebody?

Are they giving things away?

Are they saying things I don't want to live anymore?

It doesn't matter.

There's a lot of different avenues that people go into to tell you that they're in crisis.

A lot of people don't see those.

And that's where the issue comes.

And that's why these trainings are so important.

(Arlene) They are.

And there's higher risk groups.

But anyone can really be going through this tough time.

You see, you know, higher risk groups with LGBTQ youth.

But that doesn't mean that someone else, you know may not be suffering as well.

Talk to us a little bit more about that.

What are maybe some risk factors or things to look out for.

(Alan) You know, it's pretty interesting because in the training we actually go through this and we talk about what events, what groups, what things do you learn about somebody that could say that they're in crisis?

And obviously we know veterans, we know LGBTQ, um, we know, like, you know, American Indians, you know, things like this.

The Native Americans, things like this are people that have a higher risk.

But what I want to say is, like, my parents had diabetes, my father had diabetes.

I go to the doctor to get checked out for diabetes.

Okay.

Obviously I have a higher risk for it.

But if nobody in my family had diabetes, should I just ignore it and say I'll be fine, I'll never have diabetes.

It's the same thing here.

We don't want to miss the signs of somebody.

If we're saying that somebody is not in this group or somebody's not in these events that have happened to them, that they're going to be fine, that there's no cause we're going to miss the signs, and that's what we don't want to do.

(Arlene) And that segways into myths about suicide.

Tell us a little bit more about that.

(Alan)So one of the myths that we talk about when we we identify that somebody is in crisis, we want to ask them straight forward.

You know, sometimes when people are going through losing a job, financial troubles, maybe other things that they're thinking about suicide.

Are you thinking about suicide?

People feel that if I say that word suicide and you're not suicidal, then it's going to give you the thought of it.

It doesn't.

We know that research shows that that's one of the big myths.

And it's really important to say that word.

It connects with the people.

Um, the other myth is that you have to be a mental health counselor.

And again, we actually I actually tell people during the trainings that you got to take that mental health counselor off because we don't have time to analyze somebody.

We don't have time to go through all these steps.

That's for afterwards, after they realize that they want to live.

Right now, we just got to get you to what we call stay safe for now.

And that's where we want to get at this right moment.

Right now, when somebody is in crisis, crisis, we want them to be safe for right now.

(Arlene)And how do the symptoms or risk factors or things to look out for present different in adults, teens, children.

(Alan) So you know that's a real interesting question because what I usually tell people is any change in anybody antibody is a sign if you have somebody that changes.

For instance, I mean, you would obviously think that somebody is outgoing, very, you know, happy go lucky calls everybody and all of a sudden they're isolated.

That's a sign, right?

Right.

But what if somebody is really reclusive and doesn't really talk to a lot of people and is shy?

But now all of a sudden they're going out there and they're talking to everybody, right?

Can that be a sign?

Yeah.

Any kind of changes that go on in anybody but with kids you see a little bit more, it's a little bit tougher because obviously they're going to school.

If you have grades that are declining usually they're an A student.

Now they're getting D's and F's.

They're not doing their homework.

Things like that could be signs.

Typically we say if it's two weeks or longer.

If it lasts for two weeks longer, that's where the signs come in.

But we don't want to ignore anything either.

And it's really important.

The other thing I just want to bring up with kids and it happened with me, with my son, my son struggle.

He has anxiety and depression and we saw him sleeping more.

Hey, he's a teenager.

He's going through those, those times.

And that's what you kind of miss, too.

Um, it actually took three of his friends at one point to let us know that he was really struggling.

And because of those friends, we were able to bring him to help and get him into a facility.

Um, and they basically saved his life.

(Arlene) What a blessing.

And, you know, the impact of approaching someone who loves that person.

In that case, how is it that you suggest to people to intervene or to help or get involved?

What is the right way to approach this conversation with someone who might be at risk?

(Alan) One of the things I always tell people is to be honest with somebody.

Never lie.

Never tell them that you could do something when you can't do it, and approach them in a direct way.

Again, if you know the person, ask them straight out, I know you.

I've seen these things changes in you.

Sometimes when people are going through that, they're thinking about suicide and ask them directly.

A lot of times what we want to do is we want to use our gut feelings.

We want if they, you know, if they tell us that nothing's wrong, use that gut feeling and you know, you know what and press them on it.

It's okay.

But just be honest with the person and direct with the person.

(Arlene)How would you do it with let's just say an adult.

And then how would you do that with a child or a teenager again?

(Alan) So it's done the same exact way.

You want to tell them the reason why you see these things going on.

You just don't want to come out and say, hey, what's going on with you?

You know, you got to have a back backing behind it to understand, they understand why you're asking them the question.

And it's just not something that you're saying out there.

Um, I also just want to mention, too, is that there are times when you might not be able to help that person because you're not in a good place, or you might be too close or emotional with the person, and that's okay.

But you don't want to leave that person just there and say, okay, I'm not in a good place, I'm going to walk away.

You want to be able to connect them to somebody that can could help them also at that point.

Right?

Um.

(Arlene) Yeah.

No, that makes perfect sense.

You're identifying someone maybe because you're also going through some things, and that's a tough thing.

There are resources out there.

But first, you know, is that a reason why you might not want to help that person personally?

Is there any other factor you know, into, you know, maybe referring someone to someone else.

Or there's.

(Alan)A lot of different reasons why you would do it for me.

Again, I'll go to my son.

I'm too emotionally close with him.

I did lose my daughter to suicide.

And because of that, I'm a little bit more sensitive of talking to him.

My wife's the strong one in the family, so that's good.

But when I recognize that something might be going on with him, I will talk to him.

I'll say something.

But then I have to get somebody to help me intervene with him.

(Arlene) What are the best resources for a mental health crisis?

Someone you know you want to help them or someone calling for their own help?

Yeah, there's a lot of good resources out there.

You could start off with 908 and 211.

The crisis unit there, the crisis hotline, um, again, 988 is a perfect resource to use.

There's other resources to go to.

Also, the mobile crisis unit is a phenomenal one.

There's one in each county in Florida.

The other thing is Nami and Afsp, the American Foundation for Suicide Prevention.

You go to their websites and they have some phenomenal resources there, too.

(Arlene)That's wonderful, and thank you for sharing your personal story and such valuable information that will save lives at the end of the day.

(Alan) Thank you.

(Arlene) Absolutely.

Thank you Alan.

After spending years battling anxiety and depression, Palm Beach County resident Caidin Smith was losing hope and dealt with multiple instances of suicidal ideation and hospitalizations while coming to terms with his gender identity.

The turning point for Caidin came when he was finally able to live as his true self, and now he's helping others with their mental well-being.

Here's Caidins' story.

(Caidin)I experienced anxiety from the time I can remember growing up in school, socializing, a lot of anxiety around my classmates, other people.

It just proceeded to get worse as I got older.

Going to college, it got more intense and that's when it started to impact my mood.

I was diagnosed with major depression in college and started experiencing intense suicidal ideation, and that continued for about 15 years.

I had been on medication, doing therapy.

I did ect.

I did TMS, um and nothing was really relieving the depression.

The ideation was mostly like I can't see myself Existing in this world any longer with the way that I'm feeling right now and it.

It led to thinking of certain plans.

It led to, you know, really considering ending my life as an option.

I was always able to express when my thoughts got to that point, which is what kept me safe.

I always reached out for help when I had those kinds of thoughts, and there were many times where I did need to go to the hospital, where I did need to be stabilized.

Try different medications, or just have some time somewhere where I could be safe.

When my therapist brought up that this could be me struggling with my gender identity, that was something that I experienced from when I was very young.

I just didn't have the words for it.

I didn't have the vocabulary.

There was no representation of trans masculine individuals that I could look to to say, wow, I resonate with you.

It took a therapist explaining what gender dysphoria was and what being trans meant for me to understand that that's what was going on with me.

It was partly a relief and partly like, oh my God, how am I going to do this?

How am I going to exist in this world that is so binary structured?

How can I exist in this world as somebody who doesn't fit those binary boxes that led to major depressive episodes, just that in of itself.

I had mixed emotions regarding my my gender identity and what that meant for me.

But once I was able to meet other people going through similar things who, you know, identified, similar to me that gave me hope.

I actually went to the Philadelphia Trans Health Conference and that was my first time, really like getting exposure to all kinds of people across the gender spectrum and seeing them thriving, happy, you know, just living their lives authentically that that saved my life.

I got to a point where I felt like I could do more to give back because I, I started feeling better.

I felt like what I had been through, I went through it for a reason, almost.

That's what helped me was, was other people being visible and outspoken about what they had been through.

It gave me the hope to be able to keep going.

I have a private practice called Authentic Presence Counseling.

I utilize telehealth across the state of Florida.

I'm able to be my authentic self and also help other people understand their own authenticity.

And it's really powerful.

And it's it's helped me to kind of come to terms with what I've been through a lot of times with LGBTQ plus individuals, there's a lot of anxiety, a lot of depression, a lot of negative views of themselves because of what they've heard living in in our current society.

All the messages that we get growing up and throughout our lives every day, even especially in Florida like that, it's not okay to be who you are or, you know, not having that acceptance that is is needed by each human being, that connection with others that is meaningful and genuine.

A lot of my clients struggle because people very close to them have not accepted who they are.

It plays a major role in people's mental health.

That lack of acceptance, the ability to relate to other people and provide that the space that people need, the the validation of their feelings and their experiences.

It helps me to feel more confident in myself, which is something that I grew up lacking.

The constant negative self judgments and critical self-talk really kept me down for a long time, and changing that to be more affirming and understanding and just taking care of myself really went a long way.

And it's something that I have to practice every day.

It's not something that just comes naturally.

I. I make it a point to get to the gym in the morning before I do anything.

Getting involved in in local community events.

I was part of the national Gay Flag Football League for for many years.

That gave me a sense of of joy.

It was something that I was told I couldn't do for so many years.

Being assigned female at birth, you know, you can't play football.

That's for boys.

One of the things that I was concerned with that my family was concerned with was through the transition process.

Um, how how was I going to find love in that?

It's been challenging.

Um, you know, dating, um, being a gay trans guy, it was a change because prior to that, I, I was seen as a straight female.

So not only was my gender identity a shift, but I was also now part of the gay community for the first time.

I am beyond grateful that I was able to find my now fiance.

That we found each other.

Being with him has unlocked like a sense of joy and love that I've never experienced in my life.

I can't, I can't even put it into words, these feelings, because I never thought that it was possible for me to feel this way.

Existing with depression and anxiety for so many years.

It's hard to believe that that I could I could feel this good.

But since meeting him, my my whole world has changed for the better.

I am so grateful to have him in my life and I, I now, you know, look forward to each and every day.

I am excited for the rest of my life.

Like for the first time, which is is a huge shift going from, you know, not really caring if, you know, I woke up the next morning to now planning a wedding and a future.

It's it's a huge shift and I am so grateful.

(Arlene)The aftermath of a suicide can be an overwhelming and traumatic experience for those left behind.

That's where the loss team comes in.

It stands for local Outreach to Suicide Survivors, and is made up of trained volunteers who have also lost loved ones to suicide.

Providing emotional support and resources to help survivors cope and begin to heal.

Earlier, we spoke with Loss team director and suicide survivor Phil Balone to learn more about their work, his lived experience with suicide, and the healing power of art.

MHA of Southeast Florida, has been in Broward County since 1957, and we are primarily a referral agency for mental health programs.

And we also offer the Broward connections.

Org linked on our website, which provides lots of resources for mental health and community services in the county.

And we also have the Nine Muses Art center, which is a drop in center.

Anyone 18 and over is welcome to come and take some classes in art, music, creative writing, you know, lots of different creative outlet classes, and they also run support groups.

And the only requirement is that you have a mental health diagnosis.

MHA is also an agency that emphasizes peer support.

It was a natural fit for the loss team to be housed with Mental Health America of Southeast Florida.

And that perspective, the loss team, which stands for local outreach to suicide survivors, more particularly loss survivors those who've lost someone to suicide, is based on a national model and MHA of Southeast Florida saw the value and the need of that in the community and worked with the Broward County Suicide Prevention Coalition to bring the loss team to Broward County.

We are the only active and funded loss team in the state of Florida.

Studies have shown that before a loss, teams are implemented in the community.

It could take about four and a half years for our family to reach out for help because of so much stigma involved with the suicide death.

Our goal is to reduce that to an immediate response as possible.

And studies show that that time gap has actually reduced from four and a half years to about 43 days in areas where there is a loss team.

It was important for the Broward loss team, all their staff and all their volunteers, to have a lived experience with suicide loss.

All the staff on the loss team and volunteers have lost a loved one to suicide.

We work in partnership with law enforcement.

In certain cases, they'll call us out and we'll arrive at the scene, usually with two survivors, and we'll get some information if we can, before we get out to the scene to understand the family makeup or who is left behind.

With the method of death was.

And then we'll do our best to curate a match of at least one person on the team to have had at least as the closest experience as possible to relate to that family or loved one left behind because of the death being so stigmatized and sudden and violent and traumatic.

A lot of what our role is, is to appear on scene or get there as soon as possible, and just by saying I too lost a loved one to suicide helps to break down that stigma.

And you see that.

You see it in the in the families and those left behind.

When you approach them and just utter those words, it gives permission to that person to talk about suicide, to talk about their loved one.

And we all know that we're very vulnerable in that point in time.

It’s not just talking about the suicide death, but then suicide prevention measures, because we are a postvention program, which means our goal is to instill hope and and prevent further suicides after suicide.

About two thirds of survivors of suicide loss will idiot suicide or or attempt or exhibit suicide behaviors.

It's such a complicated loss.

Daily functioning decreases.

You know, folks might have trouble going back to work or back to school.

And, you know, it could just create a whole domino effect in the aftermath.

We really want to be there to help shine a little bit of light on the path that those who left behind don't even foresee a path, don't even know a path exists.

We’re there just to help shine a little bit of that light, help them get on that path of recovery and healing.

I lost my spouse, Nicole, to suicide on Christmas Eve 2019, and I found her so as anyone can possibly imagine.

It's such an unfathomable experience.

You struggle with the whys.

You're always faced with the whys and these whys.

You're probably never going to have an answer to the why, it's like having a puzzle and never having all the pieces to complete the puzzle.

Suicide loss.

Survivors also struggle with the coulda, woulda, shoulda's, and you're constantly replaying your last conversation.

And those those those last moments with your loved one over and over again.

And your mind is going to play tricks on you.

You know, things like having an argument or noticing maybe that they weren't eating or sleeping just become, well, they we've had an argument before.

They weren't maybe eating another time before.

They didn't kill themselves then.

It’s trying to work through all of that.

And having the power of the peer support really is important because you could talk about these things with others.

And but what I found as a suicide loss survivor in the work that I do, Speaking with others who have gone through a similar experience makes all the difference in the world.

Nicole and I had both decided to change careers shortly before she died, so she went back to school for nursing, and I was contemplating going back to school for a mental health counseling in a particular art therapy, which kind of brought together some of my other careers that I've had as an adult.

Um, so when I found Nicole, it was confirmation that I was going to then turn my pain into purpose and fully commit to going back to school to become a mental health counselor and art therapist.

I find art therapy so powerful because, you know, you might have heard terms like, you know, a picture is worth a thousand words or words cannot describe.

And that's where art comes in for me.

It's another language to use.

It's another language to express emotions, to work through emotions.

It's also an opportunity to bring form to the pain or to the anguish where otherwise words can't really do.

Bringing that form so that you could see it, address it, befriend it, work with it, and move forward with it.

I'm honored and privileged that Mental Health America of Southeast Florida will be exhibiting my artwork in October, and it's going to tell the story of my journey of finding Nicole, the grief work that I had done after losing her, and then leading up to also some of the post-traumatic growth that I've experienced.

It's a heart, clearly.

I had mentioned that Nicole was going to nursing school, she had all these study guides posted on the wall about, you know, anatomical hearts and things like that.

I was inspired by not just the physical aspect of the heart, but again, the symbolic aspect.

And the heart is a symbol too, for forgiveness.

One day I had found a big box of Nicole's nail polish, and I knew I didn't want to just get rid of it, so I added her nail polish to the paint.

So now I've memorialized her in the art to carry her forward with me forever.

What I've learned in my studies through Postvention work is those that show the most post-traumatic growth have four areas kind of really illuminated in their life.

One is family.

You know, family is important.

Having family, whether it's biological family or, you know, your friends as family.

However, family is not enough.

Also having a faith practice and sort of a spiritual component to your life, having a curiosity and an intention to seek joy in life and then also helping others.

I believe that my work as a mental health counselor and art therapist, and helping others really is what helps me in my healing journey, and it helps me honor Nicole's life and continue with her legacy.

(Arlene) If you or someone you know is experiencing suicidal thoughts or a mental health crisis, please call or text the National Suicide and Crisis Lifeline at 988.

Or call or text your local crisis hotline at 211.

These services are free and confidential.

I'm Arlene Bornstein.

Thanks for watching.