The Experience of Living and Crisis Centers
--
By Bart Andrews, Ph.D.
Let’s be clear about one thing: when I first came forward and publicly disclosed my suicide attempt history, I HAD NO IDEA WHAT I WAS DOING.
I told my boss; I told my coworkers; I stood in front of rooms filled with strangers and non-strangers and told my story. But, after a bit of this, I said to myself, “Now what?”
Just like the end of the movie The Graduate, I was like Ben and Elaine in the back of the bus where the elation of finally doing something turned into awkward uncertainty.
Above: Bart Andrews presents his Ignite talk on learning from lived experience and the path forward.
Where do we go from here?
How do crisis centers use lived experience, whether it is from their own staff/volunteers/leaders, the people we serve or members of the community at large?
We spend a lot of time talking about the power of lived experience of suicide loss and suicide attempt survivors, but I am not always sure we know how to use or measure the impact of that power. I think it is vital that lived experience become more than something we talk about; lived experience must be something that we DO. This is it why it is good to know amazing suicidologists like Dese’Rae L. Stage, the creator of Live Through This.
“The intention of Live Through This is to show that everyone is susceptible to depression and suicidal thoughts by sharing portraits and stories of real attempt survivors — people who look just like you.”
This quote from the Live Through This website really hit home for me. At the heart of the prejudice and discrimination that people at risk of suicide face is this sense that suicide only happens to “those” people, that it could not happen to me and to mine. We all readily accept that cancer, heart attacks, or car accidents can happen to us or the people we love; we have a much harder time recognizing that suicide can and does happen TO ANYONE, including to us and the people we love. This bias is not overt and purposeful, it is implicit and subtle and weaved into our culture, our belief system and our values. Implicit bias is the invisible thread that guides us at all times, yet we are unaware when we are being pulled by these threads.
This got me thinking about the concept of cultural competence relating to lived experience of suicide. We spend so much time talking about diversity and inclusion around race, sexual orientation and gender identity but we rarely talk about the cultural competence of working with persons with lived experience of suicide. I realized that Behavioral Health Response (BHR) needed a training that helped our clinicians recognize that we are unconsciously incompetent about the culture of being a person with lived experience of suicide. What is it like to be a person with lived experience of suicide? Where could BHR staff learn more about what it’s like being a person who survived a suicide attempt without having to listen to my story again and again and again? And, finally, wouldn’t it be great if there was a place where people who needed to learn more about what this experience is like? Then it hit me — the Live Through This website was the perfect resource. I reached out to Dese’Rae and asked her if we could use the website as a tool in teaching BHR staff about lived experience. Thankfully, Des said yes and provided input on how we could go about doing this.
I brought the idea to BHR’s ZeroSuicide committee and we started working on a structure and a plan to have our entire clinical staff take this training (we call it a training, but it is really more of a facilitated experience.) Two of our committee members, both our Account Manager and HR Manager, asked why only clinical staff should get this training and advocated that ALL staff should get this training. They were right — goodness, they were so right. Everyone on the committee practiced with the structure and we learned some things right off the bat. First, while the stories are amazing, they can be long and emotionally exhausting to read. We cut the number of stories we asked new staff to read down from four to two. We originally talked about assigning specific stories but the group wisdom to let participants choose their own stories prevailed. We also recognized that staff needed ample time to read the stories, but that debriefing and facilitation needed to occur as quickly as possible afterward. We also recognized that staff that did not do the pre-reading needed to be excused from the facilitation group. We were finally ready to really test the training and made a decision to assign the training to the entire management team. We devoted an hour of our monthly management meeting to the activity. We created the instructions, pulled together a worksheet and emailed the entire management team. It was time to try this out and see how it worked.
“What is it like to be a person with lived experience of suicide?”
I will admit to being anxious about this. I did not know what to expect or how this would work. Would folks appreciate the stories? Would they be willing to talk about the stories and share the feelings involved? Would it lead to people sharing their own stories of lived experience? BHR’s CEO, Pat Coleman, was a part of the exercise. How would this go with the CEO present? Yes, I was nervous.
Here is what happened: the hour long discussion turned into 90 minutes and could have easily gone on for two hours. Everyone spoke and had something to share. It was eye opening and life-affirming. Learning directly from people with lived experience, via the website, created good tension and learning. In the helping profession, we like to think of ourselves as the good guys, as the helpers . . . but we have to face hard facts. Many times, not all the time, but many times, persons fighting suicide have very bad experiences with crisis lines, with police, with hospitals, with therapists or even with their friends and families. We need to be aware of these experiences. It was eye opening to the clinicians to hear from survivors about those things that helped and hurt. It was educational for the non-clinicians to hear about both the good and bad about how our health care system responds to people fighting suicide. It completely reinforced the need for all persons involved in suicide prevention to have a much better understanding of what the EXPERIENCE of being at risk of suicide is like.
The Lived Experience exercise is now mandatory training for all staff members at BHR. It has been fully integrated into our training program and our culture. It has led to staff being able to not only understand more about what we are fighting but who we are fighting it with. It has led staff to talk more openly about their own experiences and how that plays a role in their lives and work. In the end, we all have the experience of living. We have all had rough times. We may not all have had a suicide crisis, but we all now have a greater humility about the pain others have been through, their courage and their willingness to teach us to be better at what we do. That is the true experience of living.
Dr. Bart Andrews is the VP of Clinical Practice and Evaluation at Behavioral Health Response. He his an ardent suicide prevention advocate and suicide attempt survivor. Bart co-hosts #SPSM Chat, an expert-to-expert web-series about the intersection of social media, technology, and suicide prevention.
If you’re involved with a crisis center and interested in joining the Lifeline, a network of over 150 crisis centers around the country, please email lifelineinfo@mhaofnyc.org.
If you or someone you know is struggling with depression or thoughts of suicide, reach out. The Lifeline is available 24/7 at 1–800–273-TALK (8255).
