Support for NPR and the following message come from the William and Flora Hewlett Foundation. Investing in creative thinkers and problem solvers who help people, communities, and the planet flourish. More information is available at Hewlett.org. You're listening to Shortwave from NPR. Hey, Shortwavers. Emily Kwong here, and today we are talking about how to help someone you love who is in a suicidal crisis. With the NPR health correspondent who covers mental health, Retu Chatterjee. Hey, Retu. Hi, Emily. Last time we talked about this, we focused on how to help those who are at risk. You offered a lot of practical advice, how to develop a safety plan, how to identify the warning signs. It was a really rich, thorough conversation we had. That's right. And today we're adding yet another layer to that topic. I'm ready. And that is, what is needed emotionally from someone who is caring for a person in suicidal crisis? So today we're focusing on the caregivers. That's right. Caregivers like Joe Lambert in London. So I've been an unpaid, full-time unpaid carer for loved ones in a suicidal crisis, continuously for the last eight years. And actually, both my loved ones have survived and are thriving now. And so eight years ago, Joe first learned that someone she loves was feeling suicidal. And as she started to learn how to care for them, she made a promise to the universe. If I survive this, I will do something to change this so that people are not powerless watching a loved one suffer like this. So a couple of years ago, Joe used her experiences to write a poem. It's about what someone in suicidal crisis needs to get through that crisis safely. And it's a message she wished everyone could hear in order to support a loved one who's struggling. Almost like what she wishes every caregiver knew. Exactly. Exactly. Actually, almost every person because, you know, everyone has someone who may be struggling, whether it's a suicidal crisis or not. And Joe called this poem, Hold the Hope. Will you hold the hope for me? I feel I've lost my way. I need you to be strong for me and help me find the strength to stay. And around the same time, she began working with a group of people who had also been touched by suicide through a loved one or they themselves lived with suicidality. And the group wanted to use their collective experiences to make a short educational film about preventing suicide. The film, also titled Hold the Hope, uses this poem as narration. And then this year, Joe took it to the next level by turning that poem into a song. Will you hold the hope for me? Today on the show, how suicide survivors and caregivers are turning their experiences into art and reimagining what suicide prevention work sounds like. You're listening to Shortwave, the science podcast from NPR. Retoo, my mom is a suicide attempt survivor. We're so fortunate she's with us now. I love her so much. And when I heard this piece, it made me wish I had a song like this in my life when I was going through this at 21, the experience of almost losing her because it was such an isolating time. And I just didn't know what to say to my mom and I didn't know how to help. Yeah, Emily, I totally understand that. And it's what I've heard from so many people who've cared for a loved one who's suicidal. Most people in your situation feel like that. And it's how Joe Lambert felt when she first found out that one of her loved ones was suicidal. I felt out of my depth powerless, completely illiquid to help my loved one. And she says she felt terrified about losing her loved one. I was so panicked by the grief I might experience if my loved one died, that it prevented me from giving my loved one what they needed. But, you know, eventually by trial and error, Joe did figure out how best to care for her loved one during suicidal crises. And a big lesson for her was that she had to put her own feelings aside during these moments and focus on the person in front of her. As soon as I detached myself from the outcome and made this about the person in the crisis fully, that was when I got the hang of it. Because then it's not about my fear or what might happen, it's about what they need right now. Yeah, it requires a lot of focus, but you have to center the person in despair. And it sounds like that philosophy was really carried over into how Joe approached this film project. Can you say more about that? Oh, for sure. And you hear it in the poem, right? And the song, which was sung by a group of volunteers, mostly students, mental health care providers at UK's National Health Service, Mental Health Trust and some who are suicide survivors. This is the voices of those who regularly return to active suicidality and are surviving it because of the compassion of others. Can you be strong enough? Stay by my side for long enough? Will you keep trying till you've done enough so I abandon what I've planned? What would you say are the most important lessons the song has to teach? So line after line, the song stresses the importance of emotional safety for the person in crisis. Keep safe this place for me. Hold my gaze. Don't look away. Meet my hurt. Head on. Don't leap back in alarm. Stay focused. Steady. Calm. And this message is conveyed by various voices in the spoken word section of the song. I need you to hold on for me in brace my human friend. I love how these are all active verbs, you know, observe, share, help me because it is an active choice to be there for someone going through this. Like an image that really helped me in supporting my mom. It was a screenshot in my phone was if a person is sitting at the bottom of a hole and you can't just shout down into the hole, we'll climb out of the hole. In fact, what you have to do is have the courage to go down into the hole and sit with them to accompany them in that moment. And that's when change can really happen. That's a beautiful image, Emily. And yeah, you're right. Now, I will note that the song acknowledges that the most important part for the person in crisis is knowing that their loved one tried their best. What's compelling about this music to me is it embodies how I wish my mom was treated before and after her attempt. But it's so often this compassion is not shown to people who have suicidal thoughts. And people can respond in ways that are very counterproductive. Yes. And, you know, Joe told me, for example, that sometimes the thoughts that her loved ones were having about dying weren't taken seriously, even by well-meaning healthcare providers. You can imagine the invalidation of knowing this is going to happen, shouting for help, not being taken seriously. Now, that's an example of an under-response, right? Now, what can also happen is an exaggerated response when someone discloses that they're suicidal, which is also harmful. So here's psychologist Ursula Whiteside, who runs a suicide prevention nonprofit called Now Matters Now in Washington state. There's an over-response in that person is then directed to the emergency room where they may stay for, you know, 12, 24, three days while they're being assessed and ultimately sent home. And in both situations, people learn, why would I ever share that again? That was so unhelpful. Yeah, we talked about this a few years ago that most people naturally want to call 911 in an emergency situation. But that is not always the best approach when someone is in a suicidal crisis. Absolutely. Because ERs, you know, weren't set up to address mental health crises, because they're intensely busy, chaotic places that just make a person already in despair, more stressed out. So if you're a caregiver and, you know, you don't know what to say or do when a loved one discloses that they're feeling suicidal, a better number to call is 988, the Suicide Prevention Lifeline, because their trained counselors can help coach you as to how to respond to your loved one. And they will probably echo what Ursula says. We give the advice first and foremost, when you're sitting with somebody who's struggling with suicidal thoughts is to not panic, like at a bare minimum. And then secondarily, to be present with that person, like to be in in the room with them as much as possible, to be like a real human with them. Now Ursula says she also tells people to validate the feelings of the person in crisis, because they want to feel heard and understood. What does this kind of validation sound like? I'll let Ursula give some examples. When they say the horrible things about how they want to die, instead of, you know, disagreeing with them or it's reflecting back like you're in so much pain right now. This feels excruciating. Of course, your brain is trying to find ways to escape. I'm so glad you're still talking with me. I'm so glad you're here. I know you're in pain right now, and I love you and I care about you. And I'm right here. These are beautiful things, and they are so validating of that person's reality. Right. Now, the other part of this has to do with the stigma around suicide, which according to Joe stems from the fact that people feeling suicidal are often looked upon as weak. But her song calls for others to see the strength in someone feeling suicidal by understanding what they've been through. And that's the absolute kernel of this project, which is the upending of the stigma. Can you turn stigma on its head and see my staying power instead? How is this song being received by people in her field? So the song is the latest iteration of what she's trying to do. But the film and the poem that came before are being used by the UK's National Health Service Mental Health Trust in southwest London in their suicide prevention and awareness trainings. And by the way, Joe herself works for the UK's National Health Service Mental Health Trust, coordinating these kinds of trainings. And I spoke with her boss, Justine Trippier, who's a psychiatric nurse. And she says using the film has made the sessions more engaging. It feels like people are more open to share, to discuss, and to really pull out what the difficulties are for them. So sometimes this is a person who has a loved one who's suicidal that they're trying to support. And at other times it may be a new health care worker. And they had the first suicide and how they emotionally can manage that. Their goal ultimately is to use the song to help make suicide prevention everyone's business. And research shows, by the way, that when we share experiences of those who live with suicidality, it increases the likelihood that others in crisis will seek help, that they too will have a sense of hope. Here's Ursula again. When I was listening to this, I kept coming back to the fact that there are so many times that people survive. And what we only count is when they die. And Emily, as data shows that for every person who dies by suicide, more than 300 feel suicidal or live with suicidality, but don't die. And Ursula says Joe's song is a much needed reminder that with the right help, people can and do choose life despite having persistent thoughts of death. Ritu Chatterjee, thank you so truly so much for bringing this song, this message, this care onto Shortwave. Always a pleasure, Emily. If you would like to listen to the full song or read the lyrics, check out the link in our episode notes. Give that conversation with Ritu and I from 2021 a listen. We've linked it too. And if you or someone you know is in crisis, call or text the suicide and crisis lifeline at 988. Will you acknowledge what it takes to keep on living when you feel you're going to break? Can you turn stick? This episode was produced by Burley McCoy. It was edited by Rebecca Ramirez and fact-checked by Tyler Jones. Kwayce Lee was the audio engineer. I'm Emily Kwong. Thank you for listening to Shortwave from NPR.