Suicide has been of heartbreaking prominence in the recent news cycle. But of course it's a perennial issue, and one fraught with misconception, pain, and anxiety on the part of many Christians and their leaders.
I caught up with expert Karen Mason, Associate Professor of Counseling and Psychology at Gordon-Conwell Theological Seminary and author of Preventing Suicide: A Handbook for Pastors, Chaplains and Pastoral Counselors to ask a few key questions for how Christian leaders can practically—and skillfully—respond to the special needs surrounding suicide.
What are the biggest misconceptions surrounding suicide in church culture?
Well, one misconception is that real Christians don't become suicidal. Of course only God knows if a person is a Christian, but I've worked with a number of suicidal people who cope with their suicidal thinking with the help of their Christian faith.
Many prominent Christians have written about their suicidal thinking—like John Donne, the 17th century Anglican priest, Dr. Kathryn Greene-McCreight, Episcopal priest and theologian, Rev. Dr. Jim Stout, Presbyterian minister, and Dr. Rev. Edward John Carnell past president of Fuller Theological Seminary. The biographers of William Cowper, 18th century hymnodist, have written about his suicidality. Dr. Francis Schaeffer's son has written about his father's suicidal thinking.
There are other misconceptions too—such as "Prayer is all a Christian needs for healing." God is the healer of all our diseases (Ps 103:3), so Christians ought to ask God for healing. However, healing often also requires the use of treatment. For example, when Paul recommends that Timothy use a little wine because of his frequent illnesses (1 Tim 5:23), he didn't recommend prayer alone. Preventing Suicide challenges many other myths too—such as suicidal people are "just trying to get attention," or that there's nothing we can do to prevent suicide or that talking about suicide will plant the idea in a person's mind.
In your mind, what is essential basic preparation related to suicide for pastors and other leaders to experience?
Suicidal people come to clergy and other leaders for help. Pastors perform funerals following a suicide death, and minister to suicide survivors (the people who have lost someone to suicide). Therefore, clergy need to be prepared to recognize people who are suicidal and need to have ideas for how to intervene in these situations. In addition, clergy need to have some preparation for conducting funerals following a suicide and ideas for how to avoid suicide contagion while ministering to a suffering community.
Clergy have also told me and other researchers that they would prefer to have developed a theology of suicide before someone comes to their office and asks them if suicide damns a person to hell.
Other than your new book, what resources are must-haves?
The reason I wrote Preventing Suicide is that I don't know of a resource that addresses the gamut of suicide prevention issues that clergy will face. However, there are many other resources that I think are must-haves.
- Training to recognize suicidality. Several options exist, including LivingWorks (https://www.livingworks.net/), the QPR Institute (http://www.qprinstitute.com/) or the Connect Program (http://www.theconnectprogram.org/).
- The National Suicide Prevention Lifeline—a free, 24-hour confidential hotline available to anyone in suicidal crisis or emotional distress including veterans and Spanish speakers (1-800-273-TALK).
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Some excellent books on suicide including:
- Kay Redfield Jamison's Night Falls Fast: Understanding suicide (New York, NY: Vingage, 1999)
- Thomas Joiner's Why People Die by Suicide (Cambridge, MA: Harvard University Press, 2005).
- Lloyd and Gwen Carr's Fierce Goodbye: Living In the Shadow of Suicide (Harrisonburg, VA: Herald Press, 2004)
- Dave Biebel and Suzanne Foster's Finding Your Way After the Suicide of Someone You Love (Grand Rapids, MI: Zondervan, 2005)
- Al Hsu's Grieving a Suicide: a Loved One's Search for Comfort, Answers & Hope (Downer's Grove, IL: InterVarsity Press, 2002)
- Kathryn Green-McCreight's Darkness Is My Only Companion: a Christian Response to Mental Illness (Grand Rapids, MI: Brazos Press, 2006).
So often, it seems like suicide or attempted suicide "comes out of the blue." What can leaders do in a congregation to proactively prevent suicide?
Think about suicide prevention as standing by a stream to prevent drowning. One type of suicide prevention is pulling people out of the stream; another type is going upstream and building a fence to prevent people falling into the stream. Upstream, there are many things leaders can do that build in place protections against suicide—like giving people reasons for living, and guidance about how to build lives worth living, teaching people how to manage suffering using their faith practices, offering people a community to which to belong and contribute, and providing people with moral objections to suicide. Preventing Suicide makes the point that pastoral caregivers like pastors, chaplains and pastoral counselors are uniquely positioned to build these protections into people's lives.
Further along the stream, leaders must recognize people who are in the stream. People in the stream are often people with a mental health problem like borderline personality disorder, anorexia, major depression, bipolar, schizophrenia, or a substance abuse disorder, to name a few. But only a few of these people fall into the stream. People at greatest risk are those who have already attempted suicide. These people are about forty times more likely to die by suicide. However, the best way to determine if someone is in the stream is to look for warning signs and ask them directly if they are in the stream.
One prominent warning sign is talking about suicide. In one study, about three-fourths of people talked to someone else about their suicidal thinking before killing themselves. Taking all talk of suicide seriously (no matter how many times the person may have threatened suicide) is very important. It's important to educate yourself about other warning signs which you can find on a few key websites:
- National Suicide Prevention Lifeline (suicidepreventionlifeline.org)
- Suicide Prevention Resource Center (sprc.org)
- American Foundation for Suicide Prevention (afsp.org)
- American Association of Suicidology (suicidology.org).
And it's important to say—there is no substitute for training to recognize suicidality. This training will also help you ask a person directly about suicidal thinking.
For the youth pastors out there—are there any different considerations when dealing with a suicidal youth versus an adult?
Though young children take their lives, suicidal behaviors begin to emerge for many people in adolescence in startling numbers. In 2010, suicide was the third leading cause of death among 10 to 24-year-olds, and the second leading cause of death among 25 to 34-year-olds. Upstream, helping adolescents develop reasons to live is important. One approach is through a Hope Kit, which can be a shoebox or a memo in a phone that reminds the person of their reasons to live, like wanting to go to college or get married. It's important also to help youth avoid alcohol and drugs—about half of youth suicide involves alcohol intoxication.
It's also important to help them have stable relationships. Problems with parents play an important role in suicidal behavior in younger adolescents, and romantic difficulties are often key among older adolescents. Downstream, one of the most important considerations is not to keep suicidality a secret—even if the youth asks you to. Suicide is a life and death issue, and life-and-death issues supersede any promises to confidentiality.
Following a suicide, it's important to prevent suicide contagion, which occurs most often among vulnerable people, like adolescents and young adults, who gather in small, intense social networks, or others who may be already inclined toward suicide or are suggestible. Preventing contagion depends on how suicide is talked about. Preventing Suicide provides a number of recommendations for how to talk about suicide including not describing location or method and monitoring vulnerable people closely following a suicide.
How can the church offer hope and healing to those affected by suicide or attempted suicide?
Upstream, religion can protect against suicide: using faith practices like prayer and reading scripture to cope, having moral objections to suicide, having reasons to live, belonging to a faith community, and having a place to contribute in a meaningful way. In my mind, these protective factors offer great hope and healing.
Downstream, we in the community of faith offer prayer to the Great Physician for healing for our suicidal brothers and sisters. We stand firm with them because their hope is eroded, and we claim for them our faithful certainty in the God who is present, loving and sovereign. We lament the brokenness of this world, and wait for God to redeem all suffering and create a new heaven and earth.
In the meantime, we help people get treatment. Following a suicide, we offer a non-judgmental ministry of presence. We allow lament, "Why, God?" We offer practical help like meals or visits or babysitting for the long haul. Whatever a community of faith does following other deaths, they ought to do following a suicide. And in that way, we take a hopeful step in preventing suicide by recognizing it and talking about it.
Paul J. Pastor is associate editor of Leadership Journal and PARSE.
