June 23, 2022
The NAN Project Celebrates Pride Month 2022

          June is celebrated as LGBTQ Pride month across the world. In recognition of LGBTQ Pride month The Nan Project would like to highlight five mental health resources that LGBTQ youth can access year round. Throughout the article, we will be mentioning “drop-in centers,” which are places for people to hang out, connect with others in a variety of groups, and access resources such as healthcare supplies and food.

Drop-in Centers

          One center LGBTQ youth can go to is BAGLY in Boston, MA. BAGLY (The Boston Alliance of Gay, Lesbian, Bisexual and Transgender Youth) is a drop-in center that is a part of the AGLY Network, which has locations across Massachusetts that offer resources and programs for LGBTQ youth. BAGLY specifically offers group therapy, a narrative art therapy group where youth create art based on therapeutic prompts, and free 101 therapy sessions affectionately called “Tea Time.” Therapy services are free and open to LGBTQ youth under the age of 25. You also do not need to have proof of identification or health insurance to receive these services. BAGLY also offers a variety of non-therapeutic social groups and programming as well as HIV/STI testing for LGBTQ youth under the age of 22. 

          Another drop-in center LGBTQ youth can go to is Boston GLASS (Gay & Lesbian Adolescent Social Services). Boston GLASS caters to LGBTQ people of color ages 13-29 and offers HIV/STI testing, PrEP access, as well as sexual wellness counselling. Additionally there is virtual or in-person therapy, in-home family therapy, and therapeutic monitoring offered. Similar to BAGLY, youth do not need insurance to receive services as all GLASS services are free. Youth can also attend a variety of social groups and events hosted by GLASS that cater to different interests and needs of the LGBTQ youth community. 

Other Community Resources

          One resource that serves both youth and their loved ones or caretakers is Greater Boston PFLAG (Parents, Families, and Friends of Lesbians and Gays), where folks receive support and education around their/their child’s sexuality or gender identity. These support groups are run by parents of LGBTQ youth or adults and take place across Massachusetts. They also have a helpline people can call for resources and to have their questions answered if they cannot attend an in-person support group.

The Sidney Borum Jr. Health Center

          A favorite for healthcare across the local LGBTQ community, The Sidney Borum Jr Center in Boston provides mental health counseling, support groups for transgender youth and adults, substance abuse treatment, STD testing and treatment, and medical care. The Sidney Borum Jr Center takes most insurances.

          Finally, a virtual resource LGBTQ youth can access across the country is The Trevor Project, which has a helpline folks can call for support, as well as a text line and an online chat room they can use if they aren’t able to make a phone call. The chat room has a private feature that enables the user to close the tab with three taps of the “esc” button if they cannot show their family their computer screen for safety reasons. The Trevor Project also has online chat rooms that LGBTQ youth can use to connect with each other.

         These are not the only services available to LGBTQ youth in Massachusetts. There are a lot of organizations able and ready to serve the extensive and varying needs of LGBTQ youth, and we encourage you to reach out for either yourself or someone you know if you need it. 

Links to These Resources

BAGLY

https://www.bagly.org/  

(617) 227-4313

 

Boston GLASS

https://jri.org/services/health-and-housing/health/boston-glass

(857) 399-1920

 

Greater Boston PFLAG 

https://gbpflag.org/

(781) 891-5966

 

Sidney Borum Jr Health Center

https://fenwayhealth.org/info/locations/the-borum/ 

(617) 457-8140  

 

The Trevor Project

https://www.thetrevorproject.org/

(866) 488-7386 

December 22, 2020
Presentations to Medford Senior Class

Each of our partner schools is using a unique blend of in-person and remote learning this year,  which means all of our presentations have been adjusted to their scheduless to best accommodate our student audience.

This December, we had the opportunity to completely reorganize our typical presentations while working with the senior class of Medford High School. Our capable team ran three activities for students simultaneously, rotating students each week for a total of nine sessions.
In all, we reached over 250 students! 

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The Presentations: 

Screening of 13 Reasons Why We Need to Talk About Suicide:
Executive Director Jake Cavanaugh and Senior Peer Mentor Andrew Christopher screened vignettes from our 13 Reasons Why We Need to Talk About Suicide series. These videos dramatize some of our core curriculum, and offer some engaging visuals that our remote learners definitely appreciated! The Depression and Anxiety vignettes show a fictional, but honest, portrayal of young people experiencing these mental health challenges, and describe how common symptoms may look or feel for students. These videos are a great jumping off point to discuss some of the signs and symptoms of anxiety and depression, in a slightly different way than our Comeback Stories.  Jake and Andrew also lead a discussion around our Coping Strategies video, where some of our own TNP Peer Mentors describe their self-care techniques!

Creating a Self Care Toolbox: Peer Coordinators Elli Peltola and Shilpa Thirukkovalur lead students in an interactive, hands on activity focused on creating a Self Care Toolbox. The activity taught students about different types of self-care, such as physical self care, or spiritual self care that, together, create a well rounded set of skills that can be used across different scenarios – like a toolbox! Shilpa and Elli reported a lot of great interaction in the chat with students, discussing different self-care activities they are doing during the pandemic as well as how their self-care has changed.

Does your Self Care Toolbox include emotional self care?

Stress relief was a popular topic, and students recommended going on walks and spending quality time with their dogs, cats, and other furry friends. Sounds like a good idea to us!

To check out the activity Elli and Shilpa used, check out Virtual Hangout #10 in our Lesson Plans for educators!

Peer Mentor Presentations:
Clinical Director Donna Kausek and Peer Coordinator Lizzie MacLellan lead our Peer Mentor Presentations to students, using two breakout rooms to create smaller, more personal groups. Peer Mentors shared their updated Covid Comeback Stories, which focus on the strategies and supports they’ve found most helpful in managing their mental health this year. Students were so appreciative of these stories, and asked some thoughtful questions about the challenges our Peer Mentors discussed. Medford was the first student audience for some of our newest training graduates,  but you wouldn’t known that from how skillfully they handled the  fast-paced Q&A!

That’s four Nan Project presentations running all at once! This strategy was unique, but it allowed us to keep each presentation group small and interactive as our in-person programming. Most students made use of the chat feature to share their reactions and questions, and we were so impressed by their curiosity and insight. Though these students have had a strange senior year, we’re hopeful that this knowledgeable bunch will continue their conversations about mental health through the rest of the school year.

Our Peer Mentors once again rose to the challenge presented by remote learning, as they have all year! We’re excited to return in 2021, and to work with underclassmen in the future! 

The NAN Project’s End of Year Recap

End of Year Recap

The NAN Project team has been super busy this school year with our Peer Mentor presentations, professional development trainings, and parent presentations. Since the beginning of this school year, we have presented for 16 schools to over 1,350 students and 770 caregivers, parents, and community stakeholders. That’s a total of 2,120 folks! While most of our presentations were to high school students, we really expanded our audience this year with a successful rollout to middle schoolers and parents. We recently finished up a round of presentations at Beverly Middle School and their students were so excited to talk with us. They asked our Peer Mentors questions about their stories and shared their own experiences and coping strategies. The conversations were enriching for both the students and our team. Check out what Beverly’s teachers had to say about us: 

“Speakers were fantastic, love the new addition of the self-care kahoot, great education around strategies to help.”

“I thought it was great. Super well organized.  I loved that you had 3 speakers and I think it was 3 others as well [to answer students’ questions]. It felt like you set it up for safe conversation. The speakers chimed in when students were more quiet making it conversational. “

What Does a Typical Middle School Presentation Look Like?

Three of our Peers present their COVID Comeback stories,which talk about how their mental health has been affected during the Pandemic and what strategies they are using to take care of themselves. Between each Comeback Story, we have a discussion with the students about warning signs they noticed in the story, the importance of reaching out to a trusted adult, and different self-care activities they could try. Every class has a guidance counselor come in to talk about their role and the mental health resources available in the school, so students know they have a trusted adult available if they need to talk.  We’ve added a self-care Kahoot, which is a virtual trivia game , to engage students and make presentations more interactive. 

Parent Presentations

We’ve also had big turnouts and lots of positive feedback about our parent presentations! Because we are doing everything virtually this year, our trainings have become a lot more accessible for busy parents. Schools have told us that parents they haven’t had any contact with all year have come to our events. One of our popular trainings is called Building Resilient Families, where our knowledgeable trainers go over different strategies to help families adapt to challenging situations and bounce back. We also provide many resources including hotlines and websites with mental health information. Since parents and families are a really important source of support to young adults, we are so happy that we’ve been able to connect with them more in the past few months.

We look forward to continuing our work in the New Year. We hope everyone has a healthy and safe holiday season!

November 9, 2020
My Anxiety and Self Image Got Weird in Quarantine

By Sarah Dickie

When I was first laid off from my receptionist job in March due to COVID-19 (with the promise of unemployment insurance), I was relieved. 

I have social anxiety. I’ve struggled in environments my peers find ordinary – restaurants, waiting rooms, birthday parties, or really anyplace with unfamiliar people. My heart would beat faster in line at Starbucks as I rehearsed my order in my head. I would worry excessively about what others thought of me, especially those I was just meeting. I would examine what I say, how I sound, how I hold my body. I would decide it was all wrong; that nobody liked me, or could like me. I’ve struggled with disordered eating, partially due to poor body image. At the intersection of these anxieties, I found myself practicing obsessive grooming; always seeking reflective surfaces, or avoiding them; refusing to take pictures, or eat in front of others. 

In this stage of my life these behaviors manifest much less often, and I can cope with them when they do – though sometimes I still struggle.  

If you think this sounds exhausting, you’d be right. Given the shame-spiral I have historically been prone to in the company of others, it may come as no surprise that I’m quite introverted. (Is it a feature of the anxiety, or a true personality trait?) I spend plenty of joyful time with friends and loved ones, but at the end of the day, I recharge best in the company of myself. I had dreamt of shutting myself in, opting out of being perceived, only to venture out for food – and suddenly, when the lockdown began in March, to live like this was public safety. It was recommended. I breathed a sigh of relief – I could take off my carefully curated, public-facing mask for a while. 

There was dissonance between the apocalyptic scene around me – desolate parking lots, entire strips of shops closed and darkened in broad daylight, shelves upon shelves emptied of toilet paper and disinfectants – and the relief I felt, privately, it seemed. I saw time stretch in front of me:  day after day to do whatever, whenever, an indefinite vacation from the comfort of home, with no one to bother me and no one to judge me. I indulged in anti-productivity: I watched TV, I played video games; I danced around in my sleepwear. Sometimes I just did nothing. I got weird; I spoke out loud to myself, and made unintelligible noises just to hear them. I stayed up into the night and slept far into the day. I took my time eating breakfast. I smiled at myself in the mirror. I liked being alone – I liked me, if I wasn’t worried that others might not. I ignored calls and texts from friends and loved ones – social connection was no responsibility of mine anymore.

Summer came, though I never really felt it. My comfort in quarantine morphed into a maladaptive super-isolation, dissonant now with images online of folks flooding beaches and restaurants. Nothing tethered me to the passage of time. By August, I was outright avoiding speaking with family and friends. Conversation seemed too exhausting. I sent so many I miss you! texts, and ignored the responses. I couldn’t make sense of this myself, so I’m sure friends couldn’t either. I dreaded answering a how are you? – I didn’t know. I hardly felt present in my body long enough to assess that. I wasn’t moving much – maybe from my desk to the kitchen to the couch – so my own body felt foreign to me; it felt heavy. I was dissociating frequently. I scrolled endlessly through social media, absorbing bad news and others’ anxieties; engaging with others only superficially through “likes”, but never in real conversation. A voice in my head thought I might be struggling now, and it might be time to reach out for support – but I didn’t feel real, and I couldn’t imagine that other people were, either, if I couldn’t see them. I had unlearned object permanence. I had become so forgetful – what day was it? Had I eaten? 

I showered only to replace old sweatpants with clean ones. I didn’t bother with my hair, or with makeup. I didn’t care how I looked. The NAN Project teaches middle and high school students that similar changes in hygiene habits can indicate poor mental health. Pre-pandemic, I was someone who found joy in fashion and hair; someone who was known in my social circles for my style – but in COVID-era isolation, I gave up on these things. Was it still a bad sign if my life was so different now? Was my obsession with appearance better than not caring at all? If I had nowhere to be, no one to see, did I still have to make the effort, or else have it mean something? It didn’t make me feel better not to get dressed.

In October, I asked myself another tough question: how did my body image change when no one was around to see me? How did my opinion of myself change when I was alone?

Now, in November, my pandemic unemployment assistance has long run out, and I am preparing to return to full-time, on-site work. I am afraid. All the anxieties I’ve worked so hard to quiet have reared their heads again. Will I do a good job? Will I make a fool of myself? Will people like me? I will make use of coping strategies I’ve learned and practiced pre-pandemic: grounding exercises, journaling, art as self-expression, seeking love and reassurance. There are some things, though, I cannot as easily cope with, like the fear that re-entering the public sphere will render me vulnerable to contracting COVID-19. How much of my fear of others is warranted now, to keep me safe? How much of it must I challenge in order to grow?    

There is no right way to respond to this health crisis. (Except for wearing your mask and engaging cautiously with others in person, if at all – please continue to do these things.) No matter how you feel, you are not alone; no matter how strange your emotional responses, or the ways you’ve found to adapt, you are not alone. If you are overwhelmed by loneliness, or by fear, if you feel you are moving backwards (and then forwards, and then backwards) in your recovery journey, if you have asked yourself some heavy, existential questions – me too. Keep in touch with the people who lift you up and calm you down. Remember to remain present and take care of yourself in any way you know how. I am trying to remember, too.

October 29, 2020
A Night for NAN 2020

Due to the Covid-19 Pandemic, The Nan Project will not be holding our annual fundraising event, A Night for Nan. However, we know the need for suicide prevention and mental health education is more important than ever.

The Nan Project team prepared this video to thank you for your ongoing support, and show you how we’ve adapted our programming to reach students, educators and parents in this challenging year.


Until we can be back in schools again, The Nan Project will continue its work through every possible platform.

We hope you will consider donating to The Nan Project in support of our work, and we look forward to seeing you next year.

October 27, 2020
Grief Ripples Out, But So Does Hope

Trigger warning:  this post discusses a suicide attempt. 


In September of 2000, 19-year-old Kevin Hines attempted to take his life by jumping off the Golden Gate Bridge in San Francisco, California. He had been struggling with paranoia, hallucinations, and depression, he had been diagnosed with Bipolar disorder, and he had been convinced that he was a burden to all those who loved him. He saw only one way to escape his pain.  

Still, just as he launched himself into free fall, Kevin felt instant regret. 

 God, please save me, he thought. I don’t want to die. I made a mistake. 

Statistics show that one person goes to the Golden Gate Bridge to attempt suicide every 7 to 10 days, with over 98% of these attempts being fatal. The bridge has been nicknamed “the suicide magnet of the world.” It is estimated that only 26 people have survived the jump, one being Kevin Hines. Most will say they felt the same regret as Kevin – they didn’t really want to die.

    For twenty years since that day, Kevin has dedicated his life to using his story to inspire hope in others struggling with mental health challenges. Suicide: The Ripple Effect offers a glimpse into Kevin’s life before and after his jump, chronicling his world-renowned career in advocacy and motivational speaking, and his personal journey through mental health and healing.  

On the day of his suicide attempt, Kevin’s father came to see him in the hospital. Through heavy sobs, they immediately apologized to one another. Kevin recalls the conversation for Marcus Butler, a retired US Coast Guard officer who came to his rescue that day, as the two float under the Golden Gate bridge in a small motorized boat. 

    “Both of our immediate reactions for what I did there,” Kevin laments, looking up at the bridge, “Was guilt.”  

    Guilt, followed by rage and fear. Later, Kevin recalls how much rage his suicide attempt had sparked in the people he loved; he recalls the pain and the grief all around him. He once asked his father, years after the jump, if he still feared Kevin’s death by suicide. His response? Every time the phone rings. 

    “My actions did that,” Kevin laments. He imagines his father’s intense anxiety as he feels his cell phone buzz in his pocket.

It’s true that Kevin’s suicide attempt brought much grief into the lives of his loved ones. It’s true, too, that his survival, and his willingness to share his story, has inspired so much progress in mental health advocacy and in the lives of countless struggling people.

Among the many dedicated advocacy workers Kevin meets throughout the film is one crisis line counselor in Georgia, who happens to be a big fan. He had heard Kevin tell his story at a pivotal moment in his life.

“You saved my life, man,” he says earnestly. The two share a long, warm embrace. 

Kevin has also inspired Christy Frecceri, a trauma nurse, to speak at conventions around the country about Golden Gate Bridge jumpers. She tended to Kevin in the hospital following his suicide attempt. She was shocked to read Kevin’s chart and discover what had happened to him. 

“I hadn’t ever thought of such a thing in my career,” she says to Kevin, remembering that fateful day that changed both of their lives. She hopes to use Kevin’s story to educate other nurses about caring for a patient who has experienced physical and mental trauma. 

    “They call that the Ripple Effect,” Kevin says, smiling down at Frecceri’s presentation notes. 

Likewise, Kevin’s father Patrick Hines became involved with the Bridge Rail Foundation, a non profit organization dedicated to erecting a suicide deterrent barrier along the Golden Gate Bridge. It is personal for many participants, having lost a child, a spouse, or a friend to suicide by bridge-jumping. 

“They’re not going there to die in front of a beautiful bridge,” says Kevin of the bridge-jumpers, “They’re going because of a four-foot rail; because it’s easy.”

Most large buildings and high public attractions have suicide barriers – the Eiffel Tower does, as well as the Empire State Building – but the initial proposal to install such a structure at the Golden Gate Bridge was met with criticism. Patrick Hines says the main reason was preserving the bridge’s beauty. Still, according to the Bridge Rail Foundation’s blog, suicide deterrent structures will soon be installed at the Golden Gate Bridge.

     Experts interviewed throughout The Ripple Effect emphasize that restricting access to physical means is just one piece of the prevention puzzle. We also need to change how we talk about suicide, and how we support one another in our journeys to mental wellness.

David Covington, President of American Association of Suicidology, criticizes our culture for waiting until we lose a struggling individual to suicide to talk about it. 

“I think we have many, many more examples of people who’ve found a way to survive, to cope, to find supports, and in some cases even thrive,” says Covington, “But we’re not telling those stories.” He expresses his admiration for Kevin, who has used his survival story to touch other struggling individuals, and give them the hope to choose living. “I think there’s a huge opportunity as we talk about stories of survival to support people who are out there who are in pain,” Covington says.  

    Kevin Hines knows that hope is not an action plan, but it is a necessary starting point. 

    “If you can give a hopeless person hope, they can turn a corner,” he says.  Now Kevin is equipped with the emotional tools and the loving support he needs to manage his symptoms, though his Bipolar disorder has not gone away.  He is seen throughout the film sharing embraces with his wife, father, and friends. 

“He actually goes through something — whether it’s mania, or depression, or paranoia, or suicidal ideation — something, every day there’s something,” Kevin’s wife, Margaret Hines, says of his life now. “But because he is taking care of his wellness, he manages it so well. He has a support system — me, our friends, our family — and he knows that he’s always in a safe place.” A mobile phone video plays of Kevin, formally dressed, dancing in the aisle of a pharmacy. 

Though Suicide: The Ripple Effect engages with some heavy subjects, it is not a somber film. Kevin Hines teaches us that some good can come out of the trauma and tragedy of suicide. We feel the “ripple” of suicide for better and for worse: a whole community grieves one fatal attempt, but one recovery can inspire hope in so many struggling people. The Ripple Effect is an earnest, tender, enlightening watch — and Kevin hopes that it’s the beginning of a movement. 

“No matter the pain you’re going through today, or the people you love are going through today, they can have a better tomorrow,” says Kevin. 

To learn more about suicide prevention worldwide, visit the Ripple Effect web page here

Rent The Ripple Effect on iTunes or Amazon. See Kevin tell his story for Buzzfeed here

October 7, 2020
You Are Not Alone: What Local Experts Want You To Know About Suicide

Last Friday, The NAN Project Peer Coordinators Lizzie MacLellan and Shilpa Thirukkovalur sat down to speak virtually with Mayor of Cambridge Sumbul Siddiqui and psychiatrist Dr. Camilo Acuna from the Cambridge Health Alliance about suicide prevention, mental health, and COVID-19. Broadcast live on several social media channels, this conversation with local experts was meant to destigmatize mental illness and recognize the role each individual can play in preventing the suicide of a young person as part of the city of Cambridge’s Suicide Prevention Month efforts. 

Mayor Siddiqui explains that the importance of this conversation is even more critical now: as we enter the seventh month of the COVID-19 pandemic, many of us are experiencing heightened anxiety and worsening depression due to social isolation, financial instability, and health concerns. Some of us may be experiencing these symptoms for the first time in our lives. The Center for Disease Control recently reported that a quarter of young adults ages 18 to 24 have seriously considered suicide during this pandemic. 

When asked to weigh in on the impact of COVID-19 on young folks’ mental health, Lizzie refers to what we call “risk factors,” attributes or traits that make a person more likely to consider suicide. Lizzie explains that certain risk factors have been heightened by the pandemic, such as loneliness, aimlessness, and instability — especially for high school students, who are missing out on certain rites of passage and other coming-of-age experiences, now that many schools have gone remote. Lizzie also explains that the behavior of a person at risk might look different in COVID-times. The NAN Project teaches students to look out for a friend who is isolating from others. While we are all isolating for our physical safety, this might instead look like not showing up for virtual hangouts, not answering phone calls or texts, or an uncharacteristic absence from social media. 

Senior Peer Coordinator Lizzie MacLellan, live from home last Friday.

Lizzie advises viewers to look out for drastic changes in mood, behavior, or appearance, and to reach out right away to a person displaying these warning signs of suicide.

“Ask the question,” Lizzie insists, and what she means is it is vitally importantto ask a young person directly if they are thinking about suicide if you notice some of the warning signs. Most untrained individuals are hesitant to mention suicide to a young person in their life, for fear of putting the idea in the person’s head. The NAN Project teaches students that asking about suicide will instead give the struggling person an opportunity to open up about what they are feeling, which is the first step to getting support. The next step, Lizzie advises, is to take that information to a trusted adult. 

    On identifying a trusted adult, Shilpa says this is simply someone who makes the young person feel heard, validated, and safe. For Shilpa, this adult was her father. In a case where a young person feels uncomfortable to bring up a mental health concern with a parent, Shilpa suggests approaching a teacher, a coach, or the school guidance counselor.  

Peer Coordinator Shilpa Thirukkovalur offers her insights.

    Therapy is something this trusted adult might suggest. Dr. Acuna discusses the myriad of telehealth options available during the COVID-19 pandemic. He says he is surprised how many young people have found this mode of therapy helpful — maybe because it is less intimidating for a youth to try therapy from the comfort of their bedroom, rather than in the unfamiliar environment of the therapist’s office. Of course he notes that teletherapy comes with its own accessibility issues, such as young folks not having access to a stable internet connection or a private place to talk. 

Mayor Siddiqui asks her guests to suggest how LGBT youth and youths of color might go about finding a therapist who fits their needs. Shilpa says that while there aren’t enough therapists of marginalized groups, it is important for young people to find a therapist who respects their identity and their culture. 

“It’s not something you should compromise when looking for care,” Shilpa says. “Many therapists are still learning, and are willing to educate themselves – as long as the respect is there.” 

“It’s something the field still needs to work on,” Dr. Acuna agrees. “There’s a long legacy of racism, of misogyny, of homophobia and transphobia in the medical system, and mental health Is certainly not an exception, unfortunately.” Dr. Acuna advises young people to feel empowered to change providers until they find someone who makes them feel safe. 

Given the undeniable importance of mental healthcare, the speakers emphasize that you don’t have to be a mental health professional to support someone at risk for suicide. 

“Suicide prevention is something we can all do – you don’t have to have all the answers,” Lizzie says. A young person supporting their friend can make a call for them to a suicide hotline or a mental health professional, walk with them down to the school’s guidance office, or simply be with them while they make their own plan to reach out to an adult. Further, we can all educate ourselves about the signs and symptoms of a mental health concern, as well as work to become more comfortable discussing mental health. 

Lizzie uses the example of someone with a broken arm: people would show sympathy, help them carry their bags, ask how they’re doing or what they need — without judgement. 

“Mental health and suicide don’t have to be different,” she says.

Mayor Siddiqui and her guest speakers leave viewers with an important message: if you are struggling, you are not alone, you are cared for, and help is available. 


The full video is available to watch here.

September 29, 2020
ED-SAFE: A Study in Suicide Intervention

Original study by Edwin Boudreaux, Carlos A. Camargo, Ivan Miller, & “the ED-SAFE investigators.”


As we continue to learn from home during this strange fall semester, The NAN Project brings to you a quick bit of suicide prevention science. 

The ED-SAFE study, published in 2018 by the Massachusetts Department of Mental Health, echoes some truths about suicide prevention that The NAN Project brings to high school classrooms: 1) the first step in suicide prevention is detecting risk; 2) persistence is the key to supporting a person at risk; and, 3) intervention led by the person at risk is most successful. 

ED-SAFE began in 2009 in response to a critical need for a suicide risk screener for patients in emergency departments. Suicide is the tenth leading cause of death in the United States, with one million people per year attempting suicide. Many individuals at risk for suicide are seen in emergency departments (“EDs”) for unrelated concerns. The ED-SAFE team argues that these are underutilized opportunities for suicide risk screening, and that to prevent suicide, ED-based screening and intervention for suicide risk must be developed. ED-SAFE aimed to test an intervention in which emergency departments screen for suicide risk using a standardized test, and initiate follow-up telephone contact with individuals who screened positive. 

1,376 adult ED patients were enrolled in this three-phase study, the third of which produced the most enlightening results. Phase three had testing sites implement a three-component intervention for patients who tested positive for suicide risk: first, a second screening to determine the level of risk; next, a personalized safety plan, with a guide to local outpatient mental health resources; and lastly, a series of phone calls to the patient by trained mental health advisors for a full year following the initial ED visit. 

It should be noted that treatment was not assigned to the patients (beyond check-in calls), nor were they pressured to comply with a treatment they had no part in developing – it was the patients’ decision to reach out for help using the provided resources. We know that it empowers the struggling person to lead their intervention, and that they are more likely to stick with a treatment they initiated. 

Results of ED-SAFE’s phase 3 showed that universal suicide risk screening within emergency departments almost doubled suicide risk detection. We know that identifying a person at risk for suicide is the first step in preventing suicide. The NAN Project teaches “signs of suicide” in our classroom presentations and professional development workshops, enabling young people and the adults in their lives to recognize these signs in their loved ones. ED-SAFE also found that the multifaceted, long-term suicide prevention invervention tested in phase 3 reduced suicidal behavior in patients by thirty percent. Persistence is key when supporting someone struggling with thoughts of suicide: this communicates to them that we care. The NAN Project highlights this in our QPR suicide prevention training, in which we encourage participants to ask a struggling person “the question” – namely, are they thinking of suicide – and to be sure that they follow up later on. 

The results of ED-SAFE demonstrate that a multi-component, persistent, patient-led suicide intervention is most successful. The research team predicts that their efforts will inform and accelerate the adoption of best practices for suicide prevention across diverse health settings, which would save countless patient lives.

The official Psychiatry Issue Brief on The ED-SAFE study can be found here.

As we work to become better supports to ourselves and the people in our lives, let us keep these findings in mind. And remember that there is help, and there is hope! 

September 18, 2020
The Weight of Gold: Athletes and Mental Illness

The NAN project knows that in a society where depression and suicide are still heavily stigmatized, fostering honest discussion about mental health can literally save a life. When our Peer Mentors open up about their journey back from a dark place, we send the message that no one who struggles is alone, and that recovery is possible.

These are sentiments of HBO’s new documentary The Weight of Gold, a must-watch for sports fans and mental health advocates alike. The film investigates the connection between elite athleticism and psychological struggle, drawing on the experience of several Olympic competitors. There is an assumption that their global fame and incredible skill mean that these superstar athletes are confident, fulfilled, and happy — Michael Phelps, the most decorated Olympian of all time and the film’s narrator, says this is part of what makes mental illness so difficult for his peers to talk about. The hour-long feature invites us to consider how Olympians are uniquely at risk for suicide, and how we can do better by them and those close to us who may be struggling.

Michael Phelps in The Weight of Gold

The athletes featured in HBO’s film all agreed that training for the Olympics requires a powerful, sometimes toxic hyper-focus on sport. 

“I didn’t develop outside interests,” recalls Jeremy Bloom, two-time Olympian and world-champion American skier. “I had a singular focus on my sport.” 

“I thought of myself as just a swimmer, not a human being,” Phelps adds. He had no confidence in himself outside of his sport.

The athletes agreed that when it came to training, all other things were secondary: hobbies, education, and even relationships. We know that lacking a support system is a major risk factor when an individual is considering taking their life.  

Adding to this harmful emotional environment is the incredible criticism Olympic athletes face, from the media, from fans, and from themselves. 

“I was driven by [thinking I was] inadequate,” Bloom remembers. “Every day, I wasn’t good enough.”

Lolo Jones, an American track and field athlete, can relate. The moment she hit a hurdle at her first Olympic competition was immortalized on global television and haunted her for years. 

“I had no one to help me through that,” she laments. 

Lolo Jones at the 2008 Summer Olympics

There is an immense pressure for Olympic athletes not only to perform physically, but to appear in control of their emotions. Sasha Cohen, the 2006 Olympic figure skating silver medalist, recounts how she fell twice in the first thirty seconds of her performance. It was difficult for her to hold herself together, but she felt it was her responsibility.

“You need to show the world that you are strong,” Cohen explains. “And so if you were to say, like, oh, I have mental issues, like, that just cracks the facade of trying to show the world that you’re impervious.” 

We know that too many struggling individuals are feigning wellness to preserve their careers, their relationships, their image – surely there is even more pressure to do so when one is broadcast live to every corner of the world.

If the heat of the Olympic spotlight was not enough to test one’s emotional regulation, a new challenge looms when athletes return home. 

“After every Olympics, win or lose, I’ve felt a dramatic emptiness,” three-time Olympic gold medalist Shaun White explains. “Just because your whole world is built around this one day… after the Olympics, there’s this incredible crash.” After competing, White reckoned with near-unbearable feelings of isolation and aimlessness. 

Shaun White at the 2010 Winter Olympics

Many athletes struggle so intensely with post-Olympic depression that they turn to reckless and self-destructive behavior, and some consider taking their lives. Phelps recalls thinking there was only one way to ease his pain after his second DUI arrest in 2014. He didn’t realize at the time that he wasn’t the only retired Olympian who considered suicide.

Jeremy Bloom recalls the time Jeret “Speedy” Peterson confided in him that most days he did not want to be alive.  

“I thought of Speedy as someone who is so happy and so successful,” Bloom said. 

Jeret “Speedy” Peterson at the 2010 Winter Olympics

Peterson ended his life in 2011. He is far from the only Olympian to complete suicide – Phelps calls it an “epidemic.”

One might ask why these struggling athletes did not seek help. Phelps attributes this partially to the Olympians’ conviction that they can make themselves unbeatable if they just work at it. The stigma that prevents so many struggling individuals from admitting to their pain also weighs heavily on superstars like Phelps and his peers.

Though such an immensely important issue calls for more than a single hour-long feature, The Weight of Gold is an honest, tender, informative step in the right direction. The conversation is not over: Phelps urges the Olympic institution to take action; he encourages athletes to speak up and seek help; and he teaches viewers that anyone, no matter how talented, famous, or wealthy, can struggle with their mental health. 

“It’s as much a part of my life as being a husband or a father,” Phelps says of his healing.  

If record gold-medal-winning Olympian Michael Phelps can recognize his depression and embrace professional help, let us all feel empowered to seek what we need to heal, too.

September 9, 2020
A Different Kind of Summer with The NAN Project

While COVID may have slowed down many industries and left folks physically isolated, The NAN Project and our Peer Mentors kept hard at work and socially connected all summer! One of our major initiatives during the typically slower, sunny months of school vacation was our 2020 Senior Peer Mentor Training! The goal of these 8 weeks of workshops was to support our Peer Mentors, while also keeping them active and engaged, and prepping them for what was sure to be a very different school year ahead. It was also an opportunity to provide educational development to our incredible young adults by bringing in an array of outstanding guest speakers that helped us all build skills for use both at work and in our everyday lives. We invited a different guest speaker to each Wednesday of our two month training to talk about different topics related to mental health, social justice, emotional intelligence and much more!

Image may contain: 3 people, text that says 'What can you you do to soothe exiles? snuggle dogo stuffed animals! call a parent differentparts ofme name them Peltola Greta reading self help books KaylaScott'
Greta during our IFST Zoom training

Two of the outstanding presenters were current and former NAN Project staff – Rachely and Greta! Both covered different therapeutic methods that our Peers might find helpful in their recovery, and can also teach others about. Rachely introduced us to Wellness Recovery Action Plans (WRAP), and covered how to identify stressors, create a wellness toolbox, and develop a daily plan to maintain strong mental health. Greta educated us about Internal Family Systems Therapy (IFST), a type of therapy that looks at ourselves as different parts, and focuses on healing the wounded parts as a part of recovery. Learning about IFST helped our Peers think about their own recovery in different ways. 

We also invited Jon Mattelman to present about anxiety, specifically, what it can look like in middle and high schoolers and how to support them if they are struggling. This was valuable because we work with young adults and knowing more about how they can experience anxiety will help us get them to the support they need. 

Image may contain: text that says 'What Can Do? Censusi due mid -Aug., then they to visit households that didn't complete it. Encourage friends/f family do these activities also. They make difference! census facts 2020 Census data will help inform how billions of dollars are distributed to states and communities every year for the next 10 years. REGISTER. SHOW UP. VOTE. C2OSU'

Additionally, we had speakers talk about topics that were relevant to the pandemic and current events. We had Hannah, a grad student from Salem Statem, present a workshop titled “Beyond the Rectangle,” which covered what Peers can do to feel alive and happy during a virtual presentation (skills just about everybody can use these days). Thinking about self-care activities that they can do before, during, and after a virtual presentation will help our Peers approach their work in a way that feels rewarding and prioritizes their mental health. We also had Maryanne, a longtime friend from the Department of Mental Health’s YouForward in Lawrence, present a social justice training with the help of our Senior Peer Coordinator, Lizzie, and our Peer Coordinator, Shilpa. They spoke about how COVID-19 affects Black people disproportionately in what is called the Double Pandemic, what systemic racism is, and how to be a better ally to people of color. We had a really engaging group discussion with our Peers and they had many personal experiences to share.

In light of this pandemic, the importance of developing emotional intelligence and strength is important now more than ever. We brought in inspirational speaker Kurt Faustin to introduce us to the concept of emotional intelligence through a training titled “Learning the Ingredients to Become a Better You”. This covered the importance of how developing a supportive community and helpful coping skills can affect our lives positively and help us develop emotional intelligence. Our Peers really enjoyed Kurt’s enthusiasm and we look forward to having him back!

Another important piece of the training was our weekly small group work, where we created projects for Suicide Prevention Week. Each of the four groups did a wonderful job producing very unique ways of promoting mental health education and suicide prevention. Our first group focused on the importance of a trusted adult, and our Peer Mentor, Margaret, created a story about how a trusted adult impacted her life. Group two decided to examine how mental health is portrayed in the media and we will be posting their reviews on our social media in the coming week. Group Hope! created inspirational social media posts and a personal story about mental health and recovery, and our fourth group made beautiful artwork to raise awareness for suicide prevention. We are so grateful to our Peer Mentors for all of their creativity, hard work, and commitment. Make sure to keep a lookout on our social media over the next week so you can see all of their amazing content!

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