Alaska has long suffered with high rates of suicide in the past, people were reluctant to discuss it, But talking openly and often can help people who are struggling choose life.

My uncle told me that if I'm going through some stuff and I can't talk to nobody, I can always go out in the tundra and start talking to the tundra or the rocks or anything there.

What are some of the other tools to help people connect and advocate for their own well-being and health?

We'll discuss it right now on Alaska Insight.

Alaska ranks near the top in the nation for suicide rates.

The work to lower the number of Alaskans who take their own lives has been going on for decades in our state and through the years, The research into how to best help people overcome their darkest days and thrive has evolved from a time of silence to the realization that open discussion and reaching out to others helps.

Tonight, we'll discuss how to best support people in crisis.

If you're struggling right now, there is help available.

And our guests this evening will describe how to get that assistance.

To start off the discussion, we'll watch a few minutes from a longer documentary produced by Alaska Public Media for the video series in Alaska, roughly 500 miles southwest of Anchorage, the Yup'ik Village of Toksook Bay faces the Bering Sea on the coast of Nelson Island.

The community has been grappling with grief and a lack of mental health resources for young people after they finish school last spring.

High school juniors and seniors, they're partnered with Lower Kuskokwim School District and the American Foundation for Suicide Prevention.

Alaska Chapter to lead the residents in community wide events focused on hope and healing.

The suicide rate is really high.

The last five friends actually one year after the other.

I was pretty close.

I even think about them in high school.

I even lost my uncle through suicide to this year.

My four cousins died from suicide.

Most are tired of being strong.

Most are tired of carrying everything that happened in the past.

The suicide rates have gone up for those that finally graduated out of high school and have no longer support.

I've been working with the school district for 19 years.

I travel to seven different villages with the villages I have.

I have a little over 658 students.

That's a heavy caseload for me.

I deal with a lot of depression, mental health issues, thoughts of suicide.

I work with kindergarten through 12th grade.

The graduates are able to give me a call, or when I'm in the village, they can come in and stop in and see me.

But most of them after that, they lose the support from the school and they start their own path.

So they're not too sure about talking about their feelings anymore.

Life is just hard.

Sometimes can be struggle as I was, you know, losing all five of my friends.

I lost what I loved to do.

My grieving was really bad.

My mom and my dad noticed how my mood was changing.

I almost took my life, but somebody brought me back.

I was dead for 5 minutes.

I didn't want to die, but I wanted to at the same time.

I couldn't handle all that pain.

But I got help.

I woke up in the hospital.

The staff members were really nice.

Helpful people, caring people.

They kept me company throughout the whole 12 days.

You know, like, therapists are like, daily.

They would, like, check up on you and ask you the same questions.

Yeah, that's what we need to cry out for out here.

Professional therapy.

That's daily for my attempt even happened, I still had PTSD.

I'm still coping with my trauma, too.

Yeah.

I even go out to my friends or one of my family member's house, and I'll talk to them.

I'll cry.

There are extreme situations where they feel what's happened to them.

Is too.

Harsh, too hard to get over, and hear in Toksook Bay, besides the elders and ourselves, they don't find what they need.

They need like they need somebody else, like a professional.

They need that person.

Or they need that group.

Or they need that team.

They need the constant every day therapy that we don't have out here.

The full version of that documentary is available on our website at Alaskapublic.org.

Joining me tonight to discuss how to help ourselves and others when struggling with emotional distress is Dustin Morris.

Dustin is the area director for the Alaska chapter of the American Foundation for Suicide Prevention and Suzanna Marchuk is the executive director of Caroline Crisis Services, a statewide suicide and crisis Helpline.

Welcome, both of you, for being here.

Thank you.

Thanks for having us.

This is such an important discussion.

We didn't see it in the clip that we watched.

But in the full talk to the Tundra video story, we hear someone say talking saves lives.

Not too many years ago, the opposite was believed to be true.

Not talking after someone took their life, hushing it up in the fear that it would lead to others, it was more the norm.

How has the shift in methods believed methods for coping?

How has that changed things and helped?

Does anyone start us off?

Yeah.

So there's there's been lots of studies on how we talk about this and why we should talk about this.

And the science shows that talking about it in a safe manner actually encourages health seeking.

It's when we don't talk about things, when we keep it bottled inside, and when we hold that shame or we carry forward that stigma, that we are doing more harm than good.

It is important to point out that there are safe ways to talk about suicide.

There are conversations that we should be having, and there are conversations that we probably shouldn't be having or details or things that we should not be saying so publicly because they could encourage contagion.

Or they could if somebody is contemplating suicide or having those thoughts.

And now we have detailed means or some story that included harmful details.

Now we've given them ideas.

So there is still some kind of do's and don'ts that can make that difficult.

But it's really important that we do have these conversations and that people are aware that there's information out there to help guide those conversations.

Absolutely.

And as you noted and Suzanne, I want you to weigh in here, too, now.

The way that we talk about death by suicide is very important.

I was just reading recently about not using the word committed as if that's some criminal act that someone has done, that they they took their lives by suicide.

They didn't commit suicide.

Suzanne, what do you have to say about the importance of language here?

Yeah, I would echo what Dustin said that we want to encourage people to have these conversations that I think for a long time we shied away from.

And I would want people's takeaway to be to have the conversation.

And if you're not sure how to have the conversation, then you can tag somebody in.

There are great resources out there that can support you to get the tools to have that conversation.

Or there are resources like Caroline, where we can reach out on your behalf and have that conversation and check in with someone.

There's great resources to provide education around safe messaging for social media, for communities that are not sure how to come together and heal in a way that's safe and therapeutic.

So there's lots of resources out there that I think can provide some some parameters and some guidelines.

Public notice of deaths that are the result of suicide.

There's no public notice.

Should there be?

Is there a way to let people know how large the problem is without causing more harm to families?

I found a young man who had taken his own life a few years ago and one of the wooded areas of Anchorage.

And in talking to a detective later, he expressed frustration that, you know, if the person would have been shot or hit by a car, we would have got an alert about that happening.

But nothing goes out when it's this type of death.

And the detective told me that in that spring, there had been dozens.

And he was frustrated and said if people were more aware, there would be more work to address this.

He said if we'd had that number of homicides, people would be really up in arms.

Is there.

What are your thoughts, both of you, about that?

We don't want to cause more harm to families who are already grieving, but it does seem like if people were more aware, more attention would be paid to this very serious issue.

Sure.

There's certainly ways to go about that.

And more attention does need to be brought up.

This conversation today is a great example of how to have those conversations, how to facilitate that and bring awareness to the public, but also respecting the privacy of an individual, the circumstances.

Suicide is very complex.

There's no one reason that someone takes their own life.

And so to be able to craft that into a story that is meaningful and impactful is extremely challenging.

And you're day to day as a journalist, as a storyteller, I can only imagine how difficult that is already.

And then you add the layers and complexities of a suicide on top of that.

One thing that I think the state and storytellers can can do is continue to tell the story of the state and general as a whole.

The bigger picture, the state of Alaska, our story collectively is really impactful.

We're leading the nation in suicides, but suicides can be prevented and more can be done to make that possible.

Susanna, would you like to add anything there?

I mean, I think the sense that it beautifully echoed a lot of what he said.

And also, you know, one suicide loss is too many.

And so, well, certainly it's helpful for funding and figuring out how to support communities and coming around suicide loss.

I think identifying when a suicide loss has occurred so that we have the opportunity to support anyone who is impacted by that loss is is where we see the real opportunity to affect change and to support those who are grieving and in return, hopefully prevent additional people from ending up in that place where they feel like dying is the only way out.

And Susanna, following up with you, as we know, anyone can suffer at some point in their life from loneliness, depression, anxiety or feelings of despair.

But some people are at much higher risk.

Who in Alaska is at the higher risk?

And what are some of the reasons why?

Like Dustin said, why people die by suicide is such a complex issue.

We know that the research shows that people who are most at risk or those who are experiencing some kind of often diagnosable and treatable mental health condition.

When we add in substance misuse, that certainly can increase risk.

Experiencing loss to suicide can increase risk.

But the beautiful thing about all those people who are at risk risks that healing is possible.

Recovery is possible.

Dustin, you mentioned that 80% of Alaska doesn't meet federal guidelines for mental health services.

What does that mean, especially given that Alaska is near the top in the nation for rates of violence and suicide?

Yeah.

So when just even the example of the documentary film that was just shared at the at the beginning of this, when you look at that community took bay what resources do they have where those resources or resources accessible and it's a social worker that comes as part of the school district for a period of weeks at a time and then is on to the next village and then comes back and then, you know, the nurse resources are in Bethel.

That's a plane flight away that is weather dependent.

And you know, when you're in crisis, you need to get help right away.

And so things like 98 are making that possible.

But 98 alone is not enough for the state of Alaska or really for any group that are at risk.

So we do need more resources, We need more professionals, we need more access to care.

And affordable care is really another barrier that we're facing not only in the state of Alaska, but across the nation.

This is a huge number.

80% is.

Are there avenues of federal money to address this that you're seeing currently?

Yes.

So there are things such as federal grants that that are in place.

Oftentimes, FSP is called to give letter of endorsements that help the state secure those funding, those fundings are then allocated to resources that we already have.

So we need more resources.

We need more or even to to build out the resources that we have now.

And so that grant funding goes to organizations that are facilitating programing or providing direct services.

The Caroline is a great example of an organization that receives state funding and is able to implement that.

And one of the best ways possible by creating access to care.

Tell us about the mental health trust program called Crisis Now and how it's been expanded beyond the road system.

And a quick disclosure here.

Alaska Public Media does get some program grant funds from the Alaska Mental Health Trust.

So let's hear about this.

This new program, this Crisis now program or the expansion of it, I should say.

It's not a new program.

I'll defer to you first, Susanna.

Okay.

So crisis now is actually not a program.

It's a model and it's a model for communities and states to really build a comprehensive crisis response system.

And the goal is to keep people out of those higher levels of care if that's not what's appropriate for them.

And so the model for crisis now is someone to talk to.

And what that means is a robust call center like Caroline.

And then if people need an in-person response, they still need some support beyond what the crisis line can provide.

Then the next step in that continuum is someone to respond.

And someone to respond is a mobile crisis team, a community based team made up of a peer and a mental health professional, a licensed commission to go and respond to the person in crisis.

And then once they're on scene, they can really work with that person to assess can the crisis be resolved and addressed in their home, in their home community, or does this person need, again, higher level care?

And if that's the case, then the next step in that crisis care continuum is somewhere to go, and that is a crisis.

Stabilization center.

And so there are communities across the state that are in different stages of implementation of this crisis.

Now, model, again, with the goal of that, people don't need to be in an E.R., They don't need to be hospitalized.

We can keep them in their whole community.

That's best case scenario.

Often people need some immediate support, and with that support in place, they never escalate to meeting that higher level.

Yeah.

Yeah, certainly the goal is to be able to keep people where they're most comfortable and have the most support.

Susanna, following up with you.

Why is the news service 988 The National line?

It's offering text now rather than just calling.

Why is that so important?

Yeah, so offering a text option creates accessibility to crisis hotlines in a way that we've never really had before.

It creates access for certainly some of our younger folks who prefer to text.

It creates access for people who maybe have privacy concerns.

Maybe they're not in a location where they can have a phone conversation and there might be safety concerns where they can't place that phone call.

It also creates accessibility for people who are deaf or hard of hearing.

So it really just kicks the doors wide open to hopefully make this lifesaving resource accessible to as many people as possible.

Makes sense.

Thank you, Dustin.

You're taking talk to the Tundra, the Alaska Public Media in the Alaska video that we saw a clip from at the start of the program to the state capitol for a screening in March.

What do you hope comes out of showing this documentary to lawmakers?

Yeah, So it's a big deal to take a film like this and present it to our lawmakers.

Oftentimes, lawmakers are kind of hyper focused on what's happening in Juneau and and big things that are making headline news.

And oftentimes that doesn't include many of the things that are going on across our state.

And so to bring awareness, to educate the folks and to showcase a place that many people have never been or understand really brings the significance of the importance of addressing suicide, not just in our urban communities, where many of our elected officials are from, but also in those remote places where the circumstances are quite different and they are not always easily understandable until you've been to a place.

But having a film that really shares that story, the experiences I think, brings awareness that we couldn't do without it.

Yeah, that is a makes a lot of sense.

Does Susanna, turning to you, does 988 offer a variety of languages for the call center?

Are there Alaska native languages and other languages that Alaskans would want to have available?

Yes.

So our call center and all of the call centers that are part of the 988 Suicide Crisis Lifeline network.

So across the country have access to something called language line.

And so we have access to over 200 different languages, interpreters for three different languages.

I would say, in my opinion, Alaska native indigenous languages are underrepresented, but there are a few that are captured within that resource.

Okay.

Talk a little bit about the hesitations that people have about calling in.

And of course, it's always tough to, you know, even admit out loud that you're having trouble and struggling.

It's not easy for anyone, and especially if you're going to make that effort with somebody you've never talked to before.

But what are beyond just having the struggles and the difficulty in calling?

What are some of the other fears that you hear from people about their concern about what might happen if they call a hotline for help?

Yeah.

So in my line of field, especially when 98 first launched and became widely available, one of the pushbacks where people were under the assumption that the calls were being tracked, that if you identified yourself as a member of the Bipoc community or if you identified yourself as queer and any spectrum that someone would come to your door or to your place wherever you were and arrest you or institutionalize you.

And however, that's the furthest from the truth.

These calls are not traced.

More often than not, we don't even have the technology to do that.

They're confidential.

People have to identify themselves and tell people where they're at.

And I believe it's less than 1% of the phone calls even have law enforcement go out to a scene.

So there's lots of barriers there and misunderstandings of what the help lines are there for, what the crisis lines do and how what happens after you in the call, I think are still a lot of the stigmas and misnomers out there that we're trying to address.

Suzanne, I see you nodding your head in agreement there.

Do people fear that they could be you know, you mentioned legal concerns.

Are they also concerned that just expressing that they are feeling vulnerable in at risk?

Do they fear that there could be legal consequences somehow because of that?

Absolutely, yes.

I think of a top concern for a lot of people, and it's a barrier to them.

Then reaching out and accessing care and support.

That statistic that just that's been shared is true.

We dispatch on less than 1% of our calls, and that's only after everything else that we know to do has not been successful in keeping this person safe.

Another misnomer or that we hear a lot of people tend to count themselves out.

They think I'm not in crisis enough.

Or the language used to describe help lines they just don't connect with like, well, I'm not in distress, so this line is not for me.

And if there were one take away, I would want people to know that this line is for them.

This line is for you, this line is for me.

And like you said earlier, I would argue that everyone hurts, everyone needs support.

Everyone is worthy of accessing support.

And so if a person finds themselves in a place where they need someone to talk to about whatever is going on in their world, then Caroline is for them.

I do know what that struggle is like.

When I was a young mother living remotely in a failing relationship, two young children, we had no phone and I saw no way out and thought about taking my own life and obviously chose life for my children and myself.

But I know that a lot of people find themselves in those circumstances.

What would you say to someone who might be watching this and and feeling isolated like that?

Remote.

The radio was my friend.

What would you want to say to them when they're feeling so stuck and hopeless right now?

There's there's certainly a lot to say, but the number one thing that I want people to know is that they are not alone.

Even though it feels that way, your brain is telling you that everything feels very much that and those feelings are valid.

But you're not alone.

Help is available.

That 98 number is accessible wherever you are.

As long as you have connectivity.

And even when that number is not available, you have a community and your community should be there to support you as much as that lifeline is there for you.

And we are all each other's lifeline.

And so that's that's my takeaway.

All right.

Thank you both so much.

This time has gone by so fast.

As you heard this evening, when it becomes more than you feel you can handle on your own.

There are people who care and want to help.

Standing by.

Don't hesitate to reach out to help yourself.

Everyone deserves to live a life that has more joy than pain.

We all need others to help us at times get help when you need it.

That's it for this edition of Alaska Insight.

Visit our website, Alaskapublic.org for breaking news and reports from our partner stations across the state.

While you're there, sign up for our free daily Digest so you won't miss any of Alaska's top stories of the day.

Thanks for joining us this evening.

I'm Laurie Townsend.

Good.

Goodnight