Suicide is, at best, an uncomfortable topic of conversation.

But with the overall rate of suicides rising across the nation, and the recent death of former Enumclaw High School student Kione Gill, members of the Plateau’s mental health community hope to bridge the gaps in knowledge and break through the walls of stigma surrounding suicide through a series of events starting next month.

On Nov. 14, the Rainier Foothills Wellness Foundation and the Enumclaw School District will host a panel of local mental health advocates and professionals to help facilitate “a community conversation” about mental illness and suicide. The event will be held 6 to 8 p.m. in the Enumclaw High School commons.

Among the panelists will be keynote speaker Deborah Binion, executive director of the Jordan Binion Project — a local nonprofit that has brought mental health education curriculum into Washington schools — as well as representatives from NEXUS, Valley Cities and Talk Saves Lives, and chaplain Marcus Kelly.

But while Kione’s death last September lends the upcoming event more urgency, event organizer Amy Trachte, the Rainier Foothills Wellness Foundation’s mental heath coordinator, said the panel will focus on more than just adolescent suicide.

According to the Centers for Disease Control, Washington state saw an 18 percent increase in suicides between 1999 and 2016. The national increase average is more than 25 percent.

In that time frame, the CDC recorded the highest increase in suicide rates, in terms of age, in adults ages 45 to 64 — their suicide rate increased from 13 per 100,000 people in 1999 to 19 per 100,000 people in 2016.

But when groups are broken down by ethnicity, Native Americans had a suicide rate of 21.5 per 100,000 people in 2015, according to the CDC and the National Violent Death Reporting System. Between 2003 and 2014, more than a third of the 1,500 suicides that occurred in the Native community were completed by youths between the ages of 10 and 24 (compared to the 11 percent suicide rate in white populations in the same age range).

The CDC estimated there were nearly 45,000 suicides in 2016, making it the tenth leading cause of death — and close to three times more than the number of homicides — that year.

“It’s a nationwide issue,” said Lynn Allar, vice president of Valley Cities clinical operations, who plans to be a panelist. “It’s a nationwide health crisis.”

MENTAL HEALTH AND STIGMA

With 40 years of working as a mental health professional, and 30 of those years spent in emergency rooms doing suicide risk assessments and other similar work, Allar said the reasons people die by suicide are “as individual as every human being.”

But there are common contributing factors, including poor mental health — if not a diagnosable mental illness — and the stigmas that come with both.

Exactly how strong of a correlation there is between mental health and suicide is still debated in mental health circles.

According to the National Violent Death Reporting System, roughly 11,000 of the more than 20,000 people who died by suicide in 2015 (54 percent) did not have a known mental health condition.

However, other groups like the National Alliance on Mental Illness and the World Health Organization claim mental disorders “are associated with more than 90 percent of all cases of suicide,” with the caveat that other socioeconomic and individual crisis factors can also play a large role.

Even if someone doesn’t have a mental illness, Allar added, if they’re considering suicide, they’re certainly having a mental health crisis that needs to be addressed immediately.

But for a variety of reasons, people in general are unwilling to talk about their mental health or that they’re thinking about ending their life.

“Society labels people, and society shuns people who are different. People get looked at differently, they get treated differently. Suicide, mental health disorders, even physical disorders can be looked at as a weakness. There are many people who won’t even discuss their physical ailments, let alone their mental health problems, because of how they’re going to be looked at,” she said. “It’s a topic that’s got all kinds of cultural, spiritual, time, and money constraints around it.”

Tony Binion, the son of Deborah Binion and a Jordan Binion Project board member, experienced this in the time leading up to when his brother Jordan killed himself in 2011.

Jordan, who was 17 at the time, had severe depression on top of what the family believes were the beginning stages of schizophrenia. But Binion didn’t recognize this until after Jordan died.

“When my brother was going through his mental health crisis and issues, my parents didn’t say anything to anybody. I didn’t even know how much he was struggling with mental health,” Binion said. “Even though my brother and I were best friends… he didn’t want me to know because he thought that I would think less of him.”

Since Jordan’s death, the Binion family has made it their mission to educate people about mental health and suicide. At first, the Jordan Binion Project would push into Washington schools to talk about their experience and encourage teenagers to talk about their mental health with their families, and seek help if they believed they needed it.

But the Jordan Binion Project has gone “gangbusters” since then, Binion said, and “now we are in the beginning stages of going across the nation” to teach school districts a mental health curriculum for their students.

Part of that curriculum is getting people to recognize the stigmas they have toward mental health.

“When we’re dealing with our brain, we just don’t want to look at it as just another functioning part of our body, just like our heart or our liver or our kidney. If our heart fails, we’re OK to take heart medicine. If we have diabetes… we’re OK with taking insulin, and there’s no shame behind that,” Binion said. “But for some reason, when it’s associated with medication and your brain, there’s a lot of shame behind that. That should not be, because it is a medical illness just like heart disease and diabetes.”

The National Institute of Mental Health’s website lists several prominent myths and misconceptions that color people’s idea of mental illness, from that idea mental illness is uncommon (it’s estimated 1 in 5 adults, or nearly 44 million Americans, experience mental illness in any given year), to the image that people with mental illnesses are unstable and violent (it’s estimated that people with mental illnesses are four times more likely to experience violence than the average person).

These stigmas don’t just affect how the general public sees people with a mental illness — they also affect how people with mental illness see themselves.

Matt Adler died by suicide in 2011 after struggling with depression and a severe anxiety disorder. His illnesses caused him to leave his career as a successful international attorney, said Jennifer Stuber, his wife, in a University of Washington magazine article.

While some might call it a mental-health break, the 40-year-old didn’t see it that way, Stuber said. Instead, he felt stigmatized, shamed and discouraged over what he called “a broken brain,” even though his employers were not aware of his struggle, the article continued.

Matt Adler eventually went to see a highly-recommended psychotherapist, but when he told the therapist he was considering suicide, the therapist “refused to treat him further and accused him of having an avoidant personality disorder,” the article reads.

“This person was his last hope,” Stuber said.

Stuber went on to create the nonprofit Forefront Suicide Prevention and lobbied for the Matt Adler Suicide Assessment, Treatment and Management Act, which requires all health professionals to undergo suicide prevention training. This law, which went into effect in 2014, was the first of its kind in the country.

SUICIDE AND STIGMA

The act of suicide comes with its own stigma, which Binion and others push back against.

Readers may notice the repeated use of the phrase “died by suicide” instead of the more common vernacular, “committed suicide,” in this article.

Mike Nelson, superintendent at the Enumclaw School District, explained why he doesn’t use the word “commit” when referring to his brother-in-law, who died by suicide last June.

He came across the new phrase after his family’s tragedy, and found it resonated with him because it put the emphasis on the death of an individual, rather than on the act of suicide, he said.

The word “commit” can also bring up connotations of sin and crime, which some relatives and loved ones of those who die by suicide want to reject.

“Those students did not commit a crime. My son did not commit a crime,” Desiree Woodland wrote on the National Alliance of Mental Health’s blog, referring to two high school students in her area and her son Ryan. “They believed the only way to end the unbearable pain was to end their lives. They died because they didn’t have the words to express the deep psychological/biological turmoil they were experiencing.”

Nelson and Allar also push back against the misconception that talking to someone about suicide will somehow plant the idea in their head. Nelson found this myth debunked over and over in his research about suicide.

“You can’t put suicide thoughts into a child’s head,” Nelson said. “Having the conversation doesn’t put those thoughts in a child’s head. They either have them or not have them.”

This particular misconception can be especially damaging, Allar said, because it could lead to people not willing to ask their loved ones if they’re having suicidal thoughts.

“We’ve learned in mental health settings and hospital settings that asking the questions is really important,” she said, adding that this knowledge doesn’t always trickle down to the general population.

“Part of the reason people are afraid to reach out is they’re afraid of the answer, and they won’t know what to do with it,” Allar continued. “And they’re afraid they might make someone suicidal by mentioning it, or they might offend them, or hurt their feelings.”

This is why many people need continued mental health education, she said.

“And when I say educated, I don’t mean they’ve got to take a whole semester class,” Allar said, “but Mental Health First Aid.”

‘CPR FOR THE BRAIN’

Mental Health First Aid is an eight-hour class billed as “CPR for the brain,” and it aims to “help regular human beings with no training or education in anything having to do with mental health how to recognize a mental health crisis and at least know some initial steps to take when they identify a mental health crisis,” Allar said.

Mental Health First Aid training includes how to effectively recognize and intervene when someone is having a panic attack, suicidal thoughts or behaviors, going through drug and alcohol dependency or withdrawal, acute psychosis, and more.

“The general public has really had very little knowledge, information, and… skills dealing with mental health issues,” Allar said. “[Mental Health First Aid] really was developed to see whether a little education on just the key things could help to get the potential victim of suicide some help. And it’s been very successful.”

The Rainier Foothills Wellness Foundation has sponsored Mental Health First Aid classes in the past, but Plateau residents can find other nearby classes as well.

A youth class in Covington is scheduled with Hahli Rogers and Heidi Hamer on Nov. 10. The free class is located at Maple View Middle School at 18200 SE 240th St. For more information, email hclark@lowercolumbia.edu, hhamer@lowercolumbia.edu, or call 360-442-2338.

One adult and another youth class will be held Jan. 12 and 14, respectively, at Serenity Hope Counseling at 8910 Main St. E, Suite B, Bonney Lake. These classes, hosted by Laura Ingles, cost $50. For more information, email laura.inglis@serenityhope.com or call (253) 951-8624.

FUTURE EVENTS AND OTHER INFORMATION

The Nov. 14 panel is just one of three events planned by the Rainier Foothills Wellness Foundation and the Enumclaw School District.

Trachte said she plans to have the second event in January and the third in March.

Plans are not set in stone, but the later events could potentially include a film about suicide and mental illness or a suicide attempt survivor as a guest speaker.

If you’re having a mental health crisis or are considering suicide, please call the 24/7 National Suicide Prevention Lifeline at 1-800-273-8355.

You can also text the 24/7 Crisis Text Line at 741741 to talk with a trained counselor.