Cindy Lopez: Please be advised that today’s episode discusses suicide and suicidal ideation. If you are having thoughts of suicide, feeling suicidal, or have concerns that someone you know may be at risk of suicide, please contact the National Suicide Prevention Lifeline at 988 or text HOME, HOME, to 741741 to reach a crisis counselor. And remember, you are not alone.
Welcome. My name is Cindy Lopez, the host of this CHC podcast, Voices of Compassion. We hope you find a little courage, feel connected and experience compassion every time you listen.
Today’s episode is focused on teen suicide. It’s a topic that’s hard to discuss. It’s one of the most challenging topics we face as a community, and yet it’s crucial. We address it head on. Listen to this conversation with Stanford’s, Dr. Shashank Joshi, and CHC’s, Jennifer Leydecker, as we talk about youth suicide and explore comprehensive prevention strategies that work at the community level. Our conversation includes an examination of what makes teens vulnerable today, including the complex role of social media and digital environments in both creating risk and offering protection. We explore how factors like LGBTQ+ identity, bullying, academic pressure, and family dynamics intersect with suicide risk, particularly here in the Silicon Valley and the San Francisco Bay area, where we’ve experienced the profound loss of teens to suicide. So rather than shy away from this difficult reality, we address it directly to strengthen our prevention efforts.
Shashank V. Joshi, MD: Well, it’s great to be with you, Cindy and Jenn. My name is Shashank Joshi, and I’m a professor at Stanford. I work in psychiatry and pediatrics. I am a child and adolescent psychiatrist by training, but I also trained in pediatrics. We have a saying child psychiatry is family psychiatry. So, we always think about families and communities whenever we do this work with young people. At Stanford I do several things, I run a training program for residents interested in training in this way. They become pediatrics trained first, and then they become general and child and adolescent psychiatrists over a five year program. I work in the community in suicide prevention and school mental health, and I direct that program for Lucille Packard Children’s Hospital, and at Stanford University I have a role in the Vice Provost’s office as the Senior Associate Vice Provost for Academic Wellbeing. So, that’s more of a health promotion role, but I get to work with faculty and staff and students in that role.
Cindy Lopez: Wow. Thank you. We’re so happy to have you and your experience and expertise with us today. How about you, Jenn?
Jennifer Leydecker, LMFT: So, my name’s Jenn Leydecker. I’m the Rise Intensive Outpatient Program clinical manager at CHC. I have been at CHC now for almost nine years and was part of the team that originally developed the RISE Intensive Outpatient Program to work with our most at risk youth in terms of suicide. And so, I work with families coming to us post-crisis and after hospitalization, or really needing that higher level of care, and have had the pleasure to work with Shashank in that venture in the community supporting those really at-risk youth in the schools as well. And then also get to train some of his fellows sometimes when they come over to us as part of the training program that’s embedded in RISE for multiple levels of clinicians to be able to work with high risk youth, to really be able to get that knowledge out into the community as well.
Shashank V. Joshi, MD: And we feel so fortunate for that partnership because getting trained in dialectical behavior therapy is a crucial skill, I think for any clinician, especially any mental health clinician, but in particular for trainees. And I think what CHC has done so well is model the interdisciplinary approach. And, all of our trainees spend a lot of time with families and most of our trainees are not parents themselves yet. So, seeing how that is modeled, seeing how the clinicians hold space for parents and also how parents learn from one another is really crucial I think for the training of any mental health professional.
Cindy Lopez: Thanks so much. We’re excited that you’re both here. To our listeners, we hope you walk away with some insights and ideas about how you can help and how you can support teens through this process as well as we think about mental health. So today, we’re talking more about teen suicide. And it’s a hard topic, but it’s so important to address. So, at a high level, Shashank, maybe you can tell us what the data tells us.
Shashank V. Joshi, MD: Well, the data are a bit sobering I will say that. In any given year, somewhere between 16 and 20% of our teenagers and young adults, so between 15 to 24, they will have seriously considered suicide to deal with their problems. Somewhere between 6 and 8% make a suicide attempt and 2 to 3% land in our emergency rooms or make up an attempt that’s serious enough to require medical attention.
What’s interesting is during the pandemic, the suicide attempt numbers did not appear to go up, but the anxiety and depression numbers did go up. And what we’ve seen since that time in the last five years is in certain sections of the population, suicide attempts increasing for different reasons, and one of them has to do with how we talk about the connection to mental health, mental health distress, mental illness, and the connection to suicide, and help seeking, how we deal with stigma. I think the more that we discuss suicide in a responsible way, in a proactive way and in a way that the state of California has recognized needs to start early and often in the context of mental health. Mental health is part of overall health and talking about it in schools, which is why we have the people suicide prevention bill that requires that each of the 58 counties public schools are having suicide prevention policies and administrative regulations. All of our students have the 988 number on the back of their ID badges now, on the ID cards – and so these are on a high level.
On a population level, we need to be able to acknowledge that suicide, it’s been in the top three preventable causes of death for a number of years. It is the number one preventable cause of death among Asian diaspora youth, and in the Bay Area, we have a very high number of Asian families who are immigrants, children who are immigrants. Nationally about 25% of our young people are immigrants or children of immigrants. In the Bay Area, that’s more like 30 to 50%, in some areas even higher. We have a number of families who are Latinx and from other parts of the world. So, when they come to this country knowing that yes, we do discuss mental health, we teach about it in schools, it’s a very important part of what young people need to learn. That can be a new experience for families who may not be familiar with that. So at a high level, I do think it’s very important. And the data show that if you can get education out there responsibly early and often, you can make a difference in the trajectory of young people.
Cindy Lopez: A couple things from what you just said, just stand out me. One is the data that you started with, that’s sobering. And also the fact that you said it’s preventable. So, that’s hopeful, right. So, before we jump into like what can we do and our community and such, let’s talk for a minute about some of the things that can contribute to teens being more vulnerable. You alluded to that Shashank in some of your last remarks, but Jenn, did you want to add to that?
Jennifer Leydecker, LMFT: Yeah, I think one of the pieces when you kind of zoom in a little bit further with the data that we found is that members of the LGBTQ+ community, both as adults and youth, but specifically the teens that we’re talking about, twice the rate of really strong thoughts of acting on their suicidal urges.Their rate of making attempts is higher than their cisgender peers, specifically and the kind of national average. And then, the space too that we find, I think especially in the Bay Area is when that identity overlaps with one of their other identities in terms of their family of origin, their religion, their culture, all of those pieces really sometimes increase their risk for mental health struggles and for suicide. And so, keeping that in our minds as we’re talking through the overall piece of suicide prevention and really what can be done for some of those specific populations.
I think the other factor that has come into play more recently and we are seeing an increase in distress and suicidal behaviors in the LGBTQ+ community and given the political components of things at the moment and laws being passed and things like that that really discriminate against the LGBTQ+ community and specifically the trans population. And so we are seeing that higher level of distress in our youth as they come into program. We’re serving more teens from that community and really finding that they need much more support in the context of their day-to-day space.
Cindy Lopez: I’m hearing too, both of you say like, Shashank, you mentioned in your remarks, that your cultural background plays a part in this, and that’s what you also said, Jenn, too, like the intersection of those things with the LGBTQ community, that all plays together.
Shashank V. Joshi, MD: Yeah. I would say one of the things we’ve learned is culture is everywhere. Jenn talked about intersectionality, people having different identities that intersect with one another. We know when we talk about culture, and we teach several courses focusing on culture and mental health, you know, it was Eric Erickson whose books we’ve read over many, many years -who was a psychoanalyst – he was also a developmental theorist and he studied Native American populations. He was very attuned to the idea that how young people identify culturally is very important. Every young person has a culture. It may start with their race. It doesn’t end there. So, we want to be very attuned to how a young person identifies in particular, if their mom is from one part of the world, their dad’s from another part of the world. How do they self-identify? What are the values and beliefs and customs and practices that they take from one parent or another, from their heritage culture and blend them with the culture they’re growing up with here? We know that stigma does not discriminate based on whether you’re an immigrant or not. We know stigma runs rampant throughout our population and that’s why Jenn and I when we do these parent meetings or work in schools, when the parent says, “Well, what can I do? This auditorium holds a thousand people. There’s only 500 of us. What about the other parents?” And we say, well, if you learn something or thought something was interesting, talk about it. Go home tonight and share something interesting. Talk about it at work tomorrow. Call your sister, text your brother with something interesting or a resource that we highlighted. That’s how we defeat stigma, one conversation at a time across cultures.
Cindy Lopez: I appreciate you saying that because it makes me want to go call my sister later, but in addition to that, and it’s probably on people’s minds, on our listeners minds, thinking about media and the role that social media and different digital environments play in teen mental health. Can you comment on that?
Jennifer Leydecker, LMFT: Yeah, I think there’s pros and cons and we talk about this often. So, I have an almost 13-year-old and then 7-year-old twin boys. They are growing up in the digital age, a very different experience than me as a Gen X – millennial mix, and so that is how they build connection. During the time of the pandemic, with COVID restrictions that’s how our teens connected with their peers. That’s how they maintain friendships, and that’s expanded in a lot of ways their access to people with similar interests, people that are able to really fill their cup in terms of relationships outside of school. I think the tricky part that we sometimes find is the algorithms are not always mental health friendly in terms of really moving them in the direction of connecting with more positive aspects. And so, a lot of the times, as a clinician working with adolescents, we’ll look at their social media because we’re looking at like what are they following on TikTok, what are their algorithm, what is coming up for them because that can really sometimes contribute to the level of distress that they’re experiencing or even increase their feelings of isolation. So, it’s like the other side of the coin in terms of social media, I think one of the things that we’ve talked about in the world of mental health is catching up in terms of the access through technology for mental health supports and that kind of really reaching out, creating things that are easily accessible. We refer out to the Trevor Project for a crisis line all the time, and you can go online and chat with them. You can call them by phone or you can text them. Increasing that accessibility, I think is really important.
I think sometimes the other side to that is we are all attached to our devices and so even I know as a parent, the idea of like not bringing my phone to the dinner table and modeling that space. Just having screens in front of us and there’s research that demonstrates it does increase youth anxiety, that higher levels of screen time can actually create higher instances of anxiety. It also then creates interference in terms of some of their other day-to-day things that they’re trying to do. We talk a lot in DBT about mindfulness practices and being one-mindful and being effective in the moment. And we are not good multitaskers (even though we really think we are) and so that space of trying to do homework, we’re also texting your friends and listening to music. We’re pulling our brains in different directions and it usually it doesn’t end in the way that we’re wanting it to in terms of getting things done and being present. And so, it also sometimes contributes to like decreased satisfaction in their kind of quality of life is the other thing that we hear from our teens. As a parent, it’s really hard to also balance that space around access to social media and things like that. From the clinician side of things, it’s a tricky piece to navigate because of the social pressure and so I think that is a big piece.
Cindy Lopez: Yeah, it is important. And because it’s here to stay, right.
Shashank V. Joshi, MD: Yeah, we get some good advice from our students at Stanford about how they manage their media, you know, to get away from just doom scrolling when they’re by themselves. They have figured out simple ways to just hack their feeds in the algorithms. So, they make sure to go to things that are uplifting and positive. And so that then gets selected as well. And also the idea that we have a lot of time with our devices in our hands, but trying not to start your day and end your day with looking at email or ending with your device. I mean, if you’re going to listen to music or some nature sounds to go to bed, that’s one thing. But to get the eyes off the screen, you know, at least an hour before you go to bed so you can have this kind of routine and at the same time in the morning to not start with a screen as the first thing you check. I mean, these are great pieces of wisdom from our teens and young adults who have found this to be a useful strategy.
Cindy Lopez: Yeah. And great for all of us to think, yes, I have really tried to not pick up my phone first thing in the morning, doesn’t always work – but, yeah, it’s so important. It just changes my day too, if I can do it.
But, as I think about our community here in the Silicon Valley, San Francisco Bay area, we have listeners from all over, but a lot from Bay Area and California. We have experienced loss of teens by suicide, and as I said when we started, it’s difficult to even say that, but we need to talk about it so we can continue working on prevention. So, as you think about effective teen suicide prevention at the community level, like what does that look like, Shashank, do you have thoughts about that?
Shashank V. Joshi, MD: Well, I think it starts at the home and it starts in schools. We’ve talked a lot about home, having conversations about mental health from an early age. What does it mean to be well? You know, when you’re a kindergartner or a first grader, you may not be using the same words, but you want to be thinking about the things that you do that you enjoy and when you are noticing that your friends are not as happy or seem distressed about something or upset about something, how does that teacher cultivate a classroom environment where a friend as young as kindergarten or first grade can go to their teacher and say, I’m worried about my friend, right. What does that look like?In some school districts, there are intentional messaging strategies and lesson planning that can happen as part of community rollout strategy called developmental assets. Developmental assets are the assets we need to thrive as young people. The Search Institute has defined 40 developmental assets and they are things that you might imagine to be true, like, having mentors, adults in my community care about kids having positive activities, having a neighborhood where you feel safe, where you’ve got people you can go to. The data is very compelling on trusted adults outside the home. Of course, it’s ideal to have one or two in the home, ideally, but outside the home, if you have one trusted adult that’s really good, if you have two, that’s extraordinary. And we hope our young people have more than that, but sometimes they have those trusted adults in schools, in school settings or in the community. And so, I do think, you know, with the work that I do in schools, they do play a big part in this. Our children have to be mentally healthy enough to learn. I mentioned earlier on this podcast that we think about it in that way.
The superintendent may say, “Doc, this all makes a lot of sense, but I’m not running a community mental health center here.” And, you know, we can agree on that. At the same time, they are in charge of this community of individuals where 18 to 20% have thought about taking their own lives as teenagers. And so how do we have these discussions about mental health as a part of overall health? Having our students healthy enough to learn means they can connect with each other. They can connect with a teacher or other trusted adult. And that, if they’re worried about a friend and they talk to a counselor or a teacher about their friend, they’re worried about they’re not getting them in trouble. They’re getting them out of trouble. So, how do we intentionally message about that. It’s okay to not be okay. It’s part of everyday life. We work through things. What’s your story? The school newspapers that have done that really well, the high school papers in the area, they will have columns either bi-weekly or monthly, where different constituencies from the principal to different school staff members and of course the students themselves will share a story and they’ll talk about a time they struggled and what helped them get through it. And so these are part of best practices to intentionally message. So, you’re not caught flatfooted when there’s a tragedy because you’re in a community that values the input of students and where the students know that adults care about them – not just when they’re in crisis, when there’s a loss, but also at other times, you know, during the academic year.
And schools are of course part of a larger community. So, in our community of Palo Alto, we have this organization, Project Safety Net, which came together in 2009 when we started experiencing what’s known as a cluster, suicide cluster – and that’s a number of losses that you have in a defined period of time, in a defined area. It may or may not be by the same method, but it’s more than you would predict given the size of a population. And so Project Safety Net came together really as a city and schools convening as the co-leads, bringing the healthcare agencies, places like Children’s Health Council and Lucille Packard Children’s Hospital, and the other health clinics like, Palo Alto Medical Foundation and Kaiser, but also faith-based organizations and the YMCA and a number of other places where young people are, youth community service. I mean, there are so many, but also bringing in police and other civic agencies. So, you need this sort of coalition that can work together and do what’s called asset mapping, where we can figure out, okay, who’s working in what spaces as the youth serving agencies, and then have a coordinating body. And that’s what Project Safety Net has been about and that’s a really important part of the work.
And secondly, to bring together, in particular those who might be in say the healthcare agencies and schools together. So, we formed this group called the HEARD Alliance. And HEARD is an acronym for Health Alliance in response to adolescent depression and related conditions. And, we came together around the same time as Project Safety Net, 2009, and it was a collaboration among mental health clinicians, primary care clinicians, and school staff and school leaders to convene the best practices together to figure out, well, what is the role of schools? What is the role of primary care? What’s the role of parents and peers in order to really understand what’s going on here and how do we turn a tragedy where we implement postvention, all the things that happen after a death by suicide, and how do we link that to prevention? And that’s very important. All the steps we take after a loss is not only to support the community in the immediate aftermath, but also to prevent the next one.
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Cindy Lopez: I appreciate the fact that you’ve brought up Project Safety Net and HEARD Alliance and so many others. That’s part of how communities come together to support their youth is those organizations talking to each other and collaborating and collectively making a difference – and saying where are the gaps and how can we address those gaps?And that’s been an important part of the work in the community, schools, and more.
Shashank V. Joshi, MD: Well, and Children’s Health Council has done a wonderful job of convening not only the public school, but also the private school leaders. And between the leadership council, between the convenings that have been happening for a number of years through Dr. Ramsey Khasho and other folks who are really leading the way, we do benefit from a lot of collaboration across the communities here in particular – in the north part of Santa Clara County and the southern part of San Mateo County. So Palo Alto, Menlo Park to our north, Mountain View, Los Altos, even down to Los Gatos. But these two counties in particular have been affected since 2009. And so, the silver lining here is there’s plenty of work to do and the agencies play very well together in the sandbox. There’s a lot of collective learning to be had through these experiences.
Cindy Lopez: So, Jenn, let’s talk about schools for a minute and how schools can help balance that academic pressure with mental health support.
Jennifer Leydecker, LMFT: Some of the ways that Shanshank has mentioned bringing different programs into the schools. One of the pieces that I think comes up often when we talk with teens is knowing that there is a wellness center at a lot of our schools in the community. Reaching out in some ways and also like the stigma that looms over teens that are reaching out for support and I think creating that space. I know when I worked in San Mateo County, they were doing mental health first aid as part of their county initiative for schools and for providers and for community based organizations in San Mateo County. I think pieces like that of finding ways even within the classroom to integrate more language around emotional experiences.
There’s also from the DBT perspective, there is DBT steps, which is school-based DBT that’s developed for middle school and high school and there’s expansion into universities and college age students. And that space of just creating that similar curriculum or space within the time that provides the teens that emotional intelligence that we do see a lot of our teens in the Bay Area struggle with because they really are driven and they really want to be successful. And sometimes that gets lost in that space of figuring out how to also bring in their emotional side.
And we know that adolescents by nature developmentally are emotional beings and so having that acknowledged, I think, more often–because then they’re talking in small ways about feeling sad versus feeling depressed to the point that it’s impacting, or I’m a little worried about this, instead of, I am so anxious about this test that I can’t go to school today and how to navigate interpersonal relationships in person. I think one of the things that is really difficult, and my sister’s an educator, I hear from her quite often, the lag in learning that we’re seeing just in general coming out of the pandemic. We also see that in their emotional intelligence coming up at the same time. And so, really creating a holistic experience for the teen. And it doesn’t always have to be a separate space. It can really be integrated into the social studies curriculum in terms of how you look at things or even in some of the humanities. But that space of navigating the human side of the teens and then also sharing with parents about how to have those conversations. I think one of the things that we have a really close relationship with PAUSD and talking with their counseling staff and their wellness team, they are delivering a lot of services on site and that speaks to the needs that we see in our community and feeling like I think we all do in the communities that we want to do so much more. And so, how do we lean into that and support on both sides where we’re, and I know we do some of this, going out and providing community ed to our parents about how to navigate mental health in the context of our high performing youth or even within the different populations that we see in the community – and how the culture of the Bay Area sometimes contributes to the idea of mental health and suicide being a quiet topic as opposed to being really direct and talking about it openly,which I think a lot of us, especially in DBT because we tend to be a little bit more direct about things and very specific. But that space of naming it is important in the context of one-on-one interactions with students, and as adults I know we hear from a lot of parents in terms of “if I talk to them about feeling suicidal, doesn’t that mean that I’m going to make them suicidal” or like they weren’t thinking about it until I kind of dropped it into their space.
And I think if we talk about just mental health in general, more often for the parents, that will also become a much more comfortable topic to bring up in terms of asking them directly and finding ways to have more conversations at home after they listen to the podcast, but really increasing kind of the EQ of everybody in the community. And I think the schools, because they spend such a significant amount of time there, and it’s that living experiment of day-to-day life that they get to try out things and learn things from one another. And I think also in terms of finding the things that bring them together that are similar and building that community as opposed to feeling so separated sometimes in the context of their day-to-day.
Shashank V. Joshi, MD: And I am so glad you brought up dialectical behavior therapy, DBT, which you do every day, Jenn, as part of your work that you convene with the Intensive Outpatient Program. You mentioned the manuals that have been developed, STEPS-A skills training for emotional problem solving for adolescent environments. So, training teachers in high school and middle school to learn first and then disseminate the four core skills of DBT: emotion regulation, mindfulness, distress tolerance, interpersonal effectiveness. What are the steps to get there? And you may have heard there’s going to be a STEPS-E coming out for elementary school. We’ve adapted it for university environments and partnership with University of Washington folks. And, we have found that training the resident assistants, the RAs in the dorms, and the RFs and RDs who supervise them, is a very efficient way to impart this kind of skills training in real time for the near peer leaders, which are the RAs. And so the students in their charge can actually learn the skills in real time. So the RAs come in for training and then they go and they have these interactions with their students, and then we have office hours with them over the course of the year. And we learn a lot about what’s helpful in those domains.
But we find that those coping skills are crucial. So, having a space just to be and just to listen is important for peers, but for the youth serving adults, learning first and then being able to teach the coping skills that DBT highlights, especially adapted for teens, I think is what really makes a difference. And in peer programs that have shown to have evidence, they work in school settings for suicide prevention, like sources of strength and youth aware of mental health to name two. Teaching and modeling and practicing those skills about how to get help for a friend, how to intervene, how to get a grownup involved, how to get a teacher involved. It comes with practice, so being able to do those role plays. Then the peer leaders get that confidence. The friends of the peer leaders get that confidence, and the more we can talk about it, the less stigma becomes a barrier to being able to get help for yourself or for a friend.
Cindy Lopez: For our listeners, a lot of mention of dialectical behavioral therapy, DBT. If you’re interested, we have a couple of podcast episodes on the topic. You can find more, Jenn has even done a couple, communicating with your teens. All of that you’ll find in our podcast episodes from the past. So, feel free to look those up as well.
You mentioned peer support, what about mental health and healthcare systems? And where are kids getting support? Where can families get support? What would that look like?
Jennifer Leydecker, LMFT: One of the pieces in that space of overlapping between schools, and community-based support related to mental health, that kind of pipeline and referral source within the different agencies and specifically to Palo Alto and CHC, working with the school district. We also work really closely with a number of private and other districts in the community, where we’re collaborating with them and supporting their staff and also really trying to figure out how to best support their specific group of families.
I think the other space–and we do this quite often–is the healthcare system. And so referring to various medical providers for additional support, but there’s also feedback or kind of loop where we’re getting referrals from pediatricians. I know that at LPCH and Stanford, there’s a big movement around assessing for mental health and distress and suicide risk at their medical appointments. And so things start there in terms of those touch points. We see a lot of our teens who are seeing the pediatrician and they sit and have a conversation for 30 minutes about where things are struggling, where the things that are showing up. They also sometimes feel much more comfortable from their medical provider versus talking with a therapist. I think because of that continued stigma in different ways around accessing mental health support versus talking with your pediatrician, who may have also known you for years. I know a lot of the different providers in the community are also cross-trained in that space of being able to have really important conversations with their adolescents. And even there are some that specialize in working with that age group, which I think can be really helpful in that understanding.
Cindy Lopez: I am wondering about the access, you talk about access to mental health and it can happen through primary care clinician, school. There are additional organizations, I know that Shashank is associated – affiliated with some of those.
Shashank V. Joshi, MD: Thank you, Cindy. I want to highlight a couple. So, in California we have really the privilege of bringing in through my colleague, Dr. Steve Adelsheim and Ms. Vicki Harrison at the Center for Youth Mental Health and Wellbeing, the Integrated Youth Mental Health Center, the drop in model that was first developed in Australia. It’s called Headspace there. They have 200 plus centers there, not the same as Headspace, the app. And that is a great app by the way. But the Headspace, youth mental health drop-in centers are now a model that’s been replicated throughout the world and in the US we’re starting in California and the centers are called allcove. And if you look up allcove, all lowercase, it’s a youth driven, youth led, youth designed model. There are clinicians who are overseeing the support and the day-to-day activities, but if you walk into an allcove center. The lowercase, a-l-l-c-o-v-e, that name comes from young people. It’s allcove. It’s for all of us. So ages 12 to 25 in California, young person can walk into an allcove center, most of which are open, 10:00 am to 7:00 pm, some even on the weekends, and you can just go hang out, you can do your homework there. They have different activities, and they have counselors available. They have primary care available. If you are food insecure or housing insecure, if you need job training, the idea behind the integrated center is that you can walk into an allcove center and get your needs addressed by a young person. So there’ll be a teen or a young adult who is there to greet you, to guide you about whatever it is that you need. So, I want to highlight that allcove, allcove, a cove where we can all hang out and for all of us. From ages 12 to 25.
There are some other great resources. We mentioned CHC has a very robust website with a number of resources for parenting as well as for young people. We mentioned the heardalliance.org website that is a site I’m a part of that is currently live and it’s been around for the last 10 plus years, but the end of September as part of suicide prevention month, we’re going to be launching a newly refreshed version that’s been enhanced in many ways and easier to use. We also have resources there for media outlets, around accessing quickly and easily best practices in covering suicides, for example, covering suicides safely. Another really great online support resource is the Soluna app. If you’re in the state of California, you can connect to a wellbeing coach through Soluna. Wellbeing coaches are really unique, and I think a very important part and really the future of what we do for upstream crisis prevention. We’re doing quite a bit of that on the Stanford campus. So, these are all wellbeing coaches. They’re trained by the International Coaching Federation, so they have do several hundred hours of training and then they are available and through this app, you can connect with a wellbeing coach. And these folks are there for the everyday issues. You don’t have to be in a crisis to be able to access a wellbeing coach.
But there are a number of crisis resources that I know you’ll also highlight in the show notes here. And of course, the one that we all talk about is 988. That’s really if you’re having an emergency or if you’re a friend and you’re concerned about someone else, you can call that number, you can text that number, that also connects through the crisis text line now. You can still use the text any word to 988 if you want to do that, but the National Lifeline is trying to make it very straightforward and simple to be able to get access to an urgent resource when you need it.
Cindy Lopez: So, Shashank and Jenn, we’re so grateful for your time today, for your expertise, for your experience in sharing that with us and our listeners. And I think you’ve given our listeners a lot to think about, a lot of resources that they can go to. I’m wondering as we wrap up this episode, what do you really want our listeners to hear from you today?
Shashank V. Joshi, MD: I would say, a very important take home message is talking about mental health is really important, thinking about mental health in the context of overall health. So, it does not become stigmatized. And that is how we defeat stigma one conversation at a time. We know that talking about suicide does not introduce the idea of suicide to a young person. There’s been a lot of research looking at that. We can talk about and teach about suicide prevention safely that does not mean we sensationalize in the paper or on social media. There are guidelines for that. And, if you go to the Center for Youth Mental Health and Wellbeing, there’s a number of resources there for how to message safely. There’s a group out of Australia called Chat Safe. If you search, #ChatSafe, you’ll see the guidelines there for young people to be able to communicate safely about mental health and suicide. On social channels, that is really the gold standard using the chat safe guidelines. Goodformedia.org, a site convened by young people for young people about how to safely communicate online about mental health issues and also manage your media and that’s why it is called goodformedia.org. So, I know a number of these are already on the CHC online website, but you’ll have them there. But I think, reach out for help. Help is out there. As community members, our job is simply we need to listen more than we talk to our young people when we are youth serving adults, when we are parents. But we also need to talk about this, talk about mental health. Talk about suicide prevention. If you’re worried about someone, reach out. The resources are out there. Help is out there.
Cindy Lopez: Thank you. Jenn, what would you like our listeners to really hear from you today?
Jennifer Leydecker, LMFT: I feel like I say this at the end of each of our podcasts especially, I think as parents, a lot of times we don’t want our kids to struggle. We really want them to be successful. And so in that space of really wanting to support them and not have them kind of fumble in the ways that it can sometimes naturally happen as they’re moving through the developmental process. When your teen comes and tells you that they’re struggling with something, take a breath, pause, listen to what they’re saying. And pick one thing that you can understand and share that back as opposed to going into problem solving mode. And as a parent, my almost 13-year-old daughter would tell you, I sometimes get really into problem solving mode. And so that space of really just hearing them, I think is the biggest from that parenting perspective. And listening to what they’re saying and sitting with it. Noticing and kind of on the other side of that, what comes up for you as a parent as part of that and talking with other people about that. Giving yourself that support too. I think a lot of the things that we hear in addition to our teens feeling isolated, our parents feel isolated in terms of being able to know where to access support. And so in kind of the way that Shashank started and like talk to everybody about the podcast, after you listen. I think also talking and maybe spending some time reflecting on what came up. What was your response to when we talk about suicide, what is your response to that? Because that also gives you important information for if you hear your teen talk about it, even an offhanded comment, which we still want you to flag as that’s relevant. Dig a little bit deeper later, but that space of being prepared for that hard conversation because I think sometimes we go into problem solving or self-preservation as parents, where we miss the opportunities to connect with our teen especially, and really hear them in the moments that they’re asking for support and then not feel as isolated ourselves as parents too.
Cindy Lopez: Thank you so much. To our listeners, thank you for joining us. If you are listening and you’re thinking, I need more help, and my child is in a space where I need to figure it out, give us a call, look us up, chconline.org. You can reach our care team by emailing [email protected], and you can also call 650-688-3625 to reach our care team. So, thank you everyone for being with us today, and I want to go back to what Shashank said at the beginning and what Jenn just reiterated. If you found this interesting, talk about it, talk about what resonated with you, and as Shashank said, that’s how we defeat stigma, one conversation at a time. So, thank you.
Shashank V. Joshi, MD: Thank you, Cindy.
Jennifer Leydecker, LMFT: Thank you, Cindy.
Shashank V. Joshi, MD: Thank you Jenn. Great to see you again.
Jennifer Leydecker, LMFT: Yeah, you too, Shashank. Thank you so much.
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