Covering Suicide and Mental Illness is a three-day seminar for journalists sponsored by The Poynter Institute, The McCormick Specialized Reporting Institute and the Action Alliance for Suicide Prevention. Here are my thoughts on issues covered during today’s session. #suicidereporting
What the DSM is to mental health, the AP Stylebook is to journalism. The Stylebook is our Bible. It not only tells us where and when to put our commas, it provides journalists with a uniform set of rules for grammar, principals and practices.
The Associated Press first published the Stylebook in 1953 and updates it every year. On March 7, 2013 – three months after the Sandy Hook school shooting – the AP added an entry on mental illness to the Stylebook. Below is an excerpt from the guidelines, the new industry standard:
mental illness Do not describe an individual as mentally ill unless it is clearly pertinent to a story and the diagnosis is properly sourced.
When used, identify the source for the diagnosis. Seek firsthand knowledge; ask how the source knows. Don’t rely on hearsay or speculate on a diagnosis. Specify the time frame for the diagnosis and ask about treatment. A person’s condition can change over time, so a diagnosis of mental illness might not apply anymore. Avoid anonymous sources. On-the-record sources can be family members, mental health professionals, medical authorities, law enforcement officials and court records. Be sure they have accurate information to make the diagnosis. Provide examples of symptoms.
Mental illness is a general condition. Specific disorders are types of mental illness and should be used whenever possible: He was diagnosed with schizophrenia, according to court documents. She was diagnosed with anorexia, according to her parents. He was treated for depression.
Do not use derogatory terms, such as insane, crazy/crazed, nuts or deranged, unless they are part of a quotation that is essential to the story.
Do not assume that mental illness is a factor in a violent crime, and verify statements to that effect. A past history of mental illness is not necessarily a reliable indicator. Studies have shown that the vast majority of people with mental illness are not violent, and experts say most people who are violent do not suffer from mental illness.
Avoid unsubstantiated statements by witnesses or first responders attributing violence to mental illness. A first responder often is quoted as saying, without direct knowledge, that a crime was committed by a person with a “history of mental illness.” Such comments should always be attributed to someone who has knowledge of the person’s history and can authoritatively speak to its relevance to the incident.
Avoid descriptions that connote pity, such as afflicted with, suffers from or victim of. Rather, he has obsessive-compulsive disorder.
I am on a plane, flying to Washington, DC. For the next three days I will be immersed in suicide – specifically, how the media covers suicide and mental health.
The seminar is being sponsored by The Poynter Institute, the McCormick Specialized Reporting Institute and the Action Alliance for Suicide Prevention. As a journalist, this is a topic that is especially dear to me: I know people who have killed themselves, I’ve attempted twice and in the newsroom, suicide is a touchy editorial issue.
I sit near the police scanner. Every day there are numerous suicide calls. They are automated. A Siri-esque woman with a choppy monotone announces the call: “Rescue 2, attempted suicide, 1234 Main Street.”
We only write about suicides if the suicide is a public spectacle – someone jumping off an overpass and closing the interstate, causing a massive traffic jam – or if there is a suicide cluster – a group of teens kill themselves by allowing a train to run over them or the victim was famous, such as Robin Williams.
There are countless suicides and attempted suicides that you never hear about. Are they news? Should they be news? We write about teenagers who kill themselves in drunken driving accidents but we don’t write about a teenager who kills herself.
Why? Are we contributing to the stigma that plagues mental illness by not doing so? I believe, unwittingly we are. Allegedly we do this to protect grieving loved ones. More often you hear, “it just isn’t news.”
But is it?
As a journalist, this is a unique opportunity for me. With deadlines constantly over our head, we rarely get a chance to sit down, think, breathe and exchange ideas about how the media covers suicide and mental health. These decisions are usually made with haste and are forgotten by the next news cycle.
I will be tweeting and blogging for the next few days and would love to get your take on this issue. Our hashtag is #suicidereporting
Last week I celebrated 16 years of sobriety. Let me say that again because I can’t believe it: Last week I celebrated 16 years of sobriety.
The first 8 years of my sobriety were filled with mayhem: divorce, single-working motherhood, death of my parents, death of my dog and a deep-dark depression that led to a diagnosis that – along with my higher power – has kept me sober.
For me, the obsession to drink was gone by the time I put down the bottle. I was blessed. I have watched many, many alcoholics and addicts struggle with that agonizing obsession in early sobriety. Their desperation and self-loathing is visceral. My heart breaks for them.
I gave little thought to picking up a drink until I fell down into my black hole. My depression – and my seeming inability to fix myself – was so exasperating that I thought about picking up a drink. Nothing else seemed to work. Why not turn to the go-to remedy I used for decades: a bottle of chardonnay, a Corona with lime or a half-dozen glasses of Long Island iced tea?
Why not self-medicate my depression with alcohol? I asked myself that question and then got my ass to a meeting.
The answer to that question is simple: Alcohol is a depressant. The very thing I had been using for years to make me feel better had made me feel worse. I was blind to that fact until the brain chemistry was explained to me.
I can’t recall the details but simply put, alcohol would briefly alter the chemistry in my brain and make me feel better. But when the euphoria wore off, the hormones and receptors in my brain would not function as they should and I would plunge even deeper into my depression.
I had one of those cloud-parting epiphanies and my life made sense to me. I had been self-medicating with drugs alcohol since I was a teenager and I progressively got sicker and sicker. I accepted my diagnosis for depression and decided to get on with treating …
Last week a federal appeals court ruled that the Second Amendment trumps the First.
The case involved a Florida pediatrician who routinely asks the families of his patients if their are guns in their homes. He also asks if they use car seats, smoke or have a pool in the backyard. Dr. Tommy Schechtman does this as part of his message to keep kids safe in the home.
Then, in 2011, the Florida legislature – with the blessing of the NRA – decided that doctors inquiring about access to guns is not appropriate and passed a law restricting conversations between doctors and their patients about their access to guns. Schechtman sued, arguing that the law violated his First Amendment right to free speech.
The case made its way to the 11th Circuit Court of Appeals in Atlanta. Last week the appeals court upheld the Docs vs Glocks law and ruled that it “simply acknowledges that the practice of good medicine does not require interrogation about irrelevant, private matters.”
Because Schechtman is a pediatrician – also the president-elect of the Florida chapter of the American Academy of Pediatrics – debate has focused on preventing children from being injured or killed by a gun.
What has been overlooked in the debate is suicide and a doctor’s ability to ask of suicidal patient if they have access to a gun. Why is this important? Because about half the people who kill themselves do so with a gun.
Will a doctor asking a suicidal patient about access to a gun prevent a suicide? I don’t know. It might. What I do know is a doctor has as much right to “interrogate” a patient about access to guns as texting while driving.
In my last major depression my nurse practitioner suspected I was a candidate for suicide. In college I had two prior attempts. She asked whether I had thought about suicide. Then she asked if I thought about how I would do it.
For me – as with most women who commit suicide – the answer was pills. She then asked if I had the pills or considered how I …
The last thing an alcoholic wants, besides a hangover, is to be reminded that she has a “drinking problem.”
I know. Back in my drinking days I would avoid conversations about last night’s festivities – especially if I had been in a blackout most of the night. Which is why I think this will work: Txt message from the ER cuts binge drinking.
Young adults who screened positive for a history of hazardous or binge drinking reduced their binge drinking by more than 50 percent after receiving mobile phone text messages following a visit to the emergency department, according to a study published online in Annals of Emergency Medicine.
Researchers enrolled 765 young adult emergency patients with a history of hazardous drinking in the study. Hazardous drinking is defined as five or more drinks per day for men and four or more drinks per day for women.
For 12 weeks, one-third received text messages prompting them to respond to drinking-related queries and received text messages in return offering feedback on their answers. The feedback was tailored to strengthen their low-risk drinking plan or goal or to promote reflection on either their drinking plan or their decision not to set a low-risk goal.
One-third received only text message queries about their drinking and one-third received no text messages.
This month Florida became the first state to offer a Medicaid health plan designed for people with serious mental illnesses, such as schizophrenia, major depression and bipolar disorders.
This is remarkable because Florida is not known for its progressive and humane treatment of people with serious mental illnesses. In fact, Florida is the state that last year executed John Ferguson, a 65-year-old man with schizophrenia who believed that he was the immortal prince of God and was being executed because he could “control the sun.”
Ferguson’s attorneys unsuccessfully argued that he lacked a “rational understanding” of his execution, which violated the eighth amendment to the U.S. constitution. Did that stop Florida? Hell no. Florida is also ranked 49th of the fifty states in per capital funding for mental health.
So, what should we make of the news reported by Kaiser Health News that Connecticut-based Magellan Complete Care wants to coordinate physical and mental health care for Florida residents on Medicaid? Should we believe that the skies parted and Florida policymakers realized that the brain is connected to the rest of the body and that it only makes sense to provided coordinated care?
I don’t wear a watch. I have watches, very nice watches, in fact. I don’t even know where they are – probably in a drawer somewhere.
I don’t wear a watch because I have a thing with time. I learned early on in my recovery from alcoholism and depression that “time” was a problem for me. A very big problem.
I didn’t realize my “time” problem until a friend in recovery asked me one day, “What time is it?” I looked at my watch and told him the time. Then he asked again, “what time is it?” And I looked at my watch again and told him the time.
“No,” he said. “What TIME is it?”
I looked at him like he was crazy and said, “I don’t know. You tell me, what time is it?”
“Now,” he said. I had a D’oh Homer Simpson moment and then understood what he was trying to tell me. I was not in the present. “That’s why I don’t wear a watch,” he said.
I went to visit my daughter this weekend. She lives about 2-1/5 hours away. Half way there I realized I had forgotten my medications.
I take three medications, two antidepressants and mood-stabilizer. I have been taking them for 7 years. Every day. Morning. Night. I don’t mess around and skip a day here or there. I take them without fail.
I did the math in my head. I took my last dose at 7 am Friday. I was not planning on getting home until at least 7 pm on Sunday. That would be 60 hours without my medications. Once I forgot to order a three-month supply of one of my antidepressants and ran out for about three days so I knew what it felt like to skip a few days without one of the medications.
I had never gone as long as 60 hours without all three. I knew I would feel some kind of withdrawal. I just didn’t know what to expect.
Apparently, there is a correct way to swing a sledge hammer and an incorrect way.
I was doing it incorrectly, although it still felt pretty good. Luckily, Tommy, one of the coaches at my CrossFit gym, witnesses this old lady swinging a sledge hammer the wrong way and – without a snicker – taught me the correct way to swing a sledge hammer.
For a long time I didn’t know how much anger I was carrying around. Invisible baggage accumulated over decades. Then, a major depression right-sized me and I asked for help. I learned anger was a part of my depression, even though I felt numb. I would not be well until I learned to deal with my anger.
Women don’t get many chances to express their anger. Unlike men, who grow up playing sports like football, hockey and rugby, we don’t have many sanctioned activities that allow us to release our anger. Sure, we can get gnarly on the tennis court or golf course, swinging away at the balls.
But other than that, what do we have? Bridge? Book club? Scrap booking?
About 8 years ago, during my last major depression, I was told that depression was anger turned inward and that if I did not get rid of my anger, I would not get better.
This baffled me because at the time I felt nothing but hopelessness. I had emotionally flatlined. I didn’t feel angry. I felt exhausted. However, the people who told me this – my psych nurse and therapist – knew what they were talking about. They had spent decades treating people with depression. If they said I would not get well until I got rid of my anger, then I would get rid of my anger.
My therapist gave me a whiffle bat and wanted me to beat a pillow. Really? A whiffle bat? A pillow? I figured that if the amount of anger in me was enough to reduce me to a listless, despondent lump of flesh, a whiffle bat was not going to do the trick.
I put on my steel-toed work boots, found a metal baseball bat in the shed and drove to a junkyard. I asked the guys if I could have a few minutes alone with one of their vehicles. They raised their eyebrows and took me to a green truck. They left me alone.