My mother always said, “Bad news comes in threes.” That concept, along with many of her other superstitions, never made much sense to me.

In truth, the bad news never stops. She knew that. I suppose that organizing bad news into groups of three offered hope that the suffering might soon end—at least until the next set of three bad things came round.

This week we’ve had bad news in waves, with three particular pieces distinctly linked to suicide. On Tuesday, there was fashion designer, Kate Spade. Yesterday, there was the release of a new CDC report on Suicide. And then this morning there was Anthony Bourdain.

When people like Kate Spade and Anthony Bourdain die by suicide, it’s hard not to be mystified. By all measures, both Spade and Bourdain were highly successful. They were passionate and fully alive. The dynamics that may have led them to choose death are opaque. We can’t see these dynamics. They’re not obvious.

Another thing that’s not easily seen or especially obvious is the fact that, along with Spade and Bourdain, 865 other Americans will die by suicide this week. Let that number sink in. Many of these other American suicides will be military veterans. These 865 Americans may choose suicide for reasons similar or different than Spade and Bourdain. We can’t know the deeply personal reasons why individuals choose suicide.

In honor of my mother’s desire to manage bad news in groups of three, I’ve got some other threes to share:

Three Things to Remember About Suicide

1. As Spade and Bourdain’s deaths illustrate, suicide is unpredictable. Many respected suicidologists have thrown suicide risk factors and warning signs into the trash bin. Because we may not know if someone is suicidal, our best strategy is to treat everyone with kindness, compassion, and respect. This approach is all about connecting with others in ways that are meaningful and authentic. Then, from the context of your interpersonal connection, if you suspect or intuit that suicide is possible, ask directly in a way that normalizes suicidal thinking. You might ask something like, “It’s not unusual for people to think about suicide. Has that been true for you?”
2. As the CDC report highlights, a person’s mental health may or may not be linked to suicide. In the CDC’s analysis, about 54% of suicides were not associated with a known mental disorder or pre-suicide warning signs. This implies that thinking about suicide or acting on suicidal impulses may be something that arises from challenging life stresses or circumstances. This information also means that you shouldn’t blame yourself for suicide deaths. We imagine suicide to be a terrible tragedy for the person who dies, but it’s also a palpable tragedy for many survivors. Of course, if you knew a person who died by suicide you deeply wish you could have known the right thing to say or do to save that person’s life. But the reality is, suicide is unpredictable, and so you and I shouldn’t beat ourselves up over not being able to effectively intervene. If you feel guilty after a suicide, talk about your feelings with someone you trust. Although it’s natural to blame yourself, there’s no point in being alone with your guilt, so please reach out for support for yourself.
3. The deaths of Spade and Bourdain bring suicide to the front and center of our national consciousness. Although it’s good to shine a light on suicide, the deaths of Spade and Bourdain overshadow the 865 other Americans who have or will die by suicide this week. Many of these Americans will not have sought help. The irony of not seeking help is that there are several excellent talk-therapies that specifically target suicide risk. These therapies can be highly effective. Hotlines are a fine first step and medications might help, but the interpersonal connection that comes with evidence-based talk therapies, is profoundly important to positive outcomes. Effective help is available. Let’s bring the evidence-based talk therapies front and center in our national consciousness also.

Three Evidence-Based Therapies

Here are links to the three top evidence-based therapies for suicide.

Dialectical Behavior Therapy (DBT): https://www.amazon.com/DBT%C2%AE-Skills-Training-Manual-Second/dp/1462516998/ref=sr_1_1?s=books&ie=UTF8&qid=1528498109&sr=1-1&keywords=linehan+suicide

Collaborative Assessment and Management of Suicide (CAMS): https://www.amazon.com/Managing-Suicidal-Risk-Second-Collaborative/dp/146252690X/ref=sr_1_1?s=books&ie=UTF8&qid=1528498077&sr=1-1&keywords=jobes

Cognitive Therapy for Suicide: https://www.amazon.com/Cognitive-Therapy-Suicidal-Patients-Applications/dp/1433804077/ref=sr_1_4?s=books&ie=UTF8&qid=1528497986&sr=1-4&keywords=cognitive+therapy+suicide

Three More Resources

The CDC Report, although depressing, includes excellent information. You can read it here: https://www.cdc.gov/mmwr/volumes/67/wr/mm6722a1.htm?s_cid=mm6722a1_w  You can also listen to or read an NPR interview with the report’s lead author, Deborah Stone, here: https://www.npr.org/sections/health-shots/2018/06/07/617897261/cdc-u-s-suicide-rates-have-climbed-dramatically

A while back I wrote an Op-Ed piece for the Missoulian newspaper. This Op-Ed emphasized core factors or dimensions that often drive suicidal behavior. Reading the article can give you a better understanding of suicide dynamics and could help you help others, but in no way will it make you capable of successfully preventing suicide amongst all of your family and friends. This article is available through the Missoulian: https://missoulian.com/news/opinion/columnists/suicide-prevention-ignore-the-math/article_ce3c7f1e-ab86-587e-9505-310cc00b3355.html

In January I had a suicide assessment and intervention article published in the Journal of Health Service Psychology. This article is a good resource for professionals who work with suicidal clients. It’s an easy read and might also be of interest to non-professionals seeking to understand more about how professionals work with suicidal people. Conversations About Suicide by JSF 2018

I wish you all a weekend of connection and healing.