Editor’s note: This column focuses on suicide, self-harm and other topics related to psychiatric distress. If you or a loved one is in crisis, call 988. Additional resources are available here.
In my house growing up, suicidality hung in the closet like a cloak waiting to envelop any one of us at any time.
My first recollection of not wanting to be alive anymore came at the age of 4. This was two years after my parents lost a baby at 38 weeks to a congenital heart anomaly. My mother said over and over again that I was the reason she stayed alive and how she survived the grief of that event.
Growing up, that sounded romantic, like it was out of a tragic love story. Love won, right? Later I realized she had been experiencing suicidality in the midst of her grief.
My first suicide attempt was at 8 years old. At 10, I remember kneeling next to my father on the hallway floor as he cried out, wanting to die.
This was before suicide prevention hotlines existed. We didn’t have crisis response teams besides police and firefighters. There were no crisis stabilization centers.
One night when I was 13, my mother and I clung to each other in terror as my father left the house in distress. We had previously treated suicidal thoughts like the elephant in the room, but that night we both acknowledged we would be lucky if he came back alive.
Two years later, he didn’t make it home. He died in a fiery crash on a country road, killing himself and one other driver.
We had not been able to keep my father alive; we didn’t have access to the resources, cognitive tools and emotional skills we needed to help him. My mother and I continued to cling to one another. It was just the two of us left.
Without realizing it, I learned cognitive skills that can be lifesaving in suicide prevention efforts. Acceptance and Commitment Therapy uses a skill called behavior activation, where one makes a plan on a daily or weekly basis to choose activities that are meaningful, purposeful and enjoyable. I found meaning and purpose in dance and choir. Looking forward to Saturday morning rehearsals helped me through the grief.
In the excitement of growing up and becoming independent, I thought I could be free from the painful parts of my childhood. But that cloak in the closet followed me to college, then to graduate school and into parenthood.
During my children’s baby years, my mother had a stroke. Being uninsured at the time meant she went bankrupt. Her retirement savings went to medical bills. She was desperate to give up and begged me to let her die.
I did not know how to help her, so I went back to what I knew. I begged her to stay alive for me the way she did after my brother died. Later I would learn about mental health first aid, a public health training that teaches people how to recognize and respond to mental health concerns in their loved ones and community members. The goal is to connect people who are struggling with care that will help them recover and heal. I wish more than anything that my mother could have accessed mental health care at that time so she could have recovered mentally and emotionally.
While listening to Seattle’s NPR station one day, I learned about adverse childhood experiences (ACEs), which are a variety of potentially traumatic experiences that occur in childhood. I began to have language for what I experienced and I learned the physiological response to chronic traumatic events leads to lifelong effects on health, opportunity and well-being. About 64% of adults have experienced one ACE, and 17% have experienced four or more types of ACEs, the Centers for Disease Control and Prevention reports.
When I learned each of my children had also experienced passive thoughts of suicide, I realized we had to be more proactive in getting resources and support to break this intergenerational pattern. I was not about to let them inherit the cloak that hung in my parents’ closet and then in my own.
This led to a summer of dialectical behavioral therapy (DBT) for each member of my family. DBT teaches skills to work through distressing thoughts and experiences, and it’s considered the gold standard for addressing self-injury and suicidal threats or attempts. People experiencing depression, post-traumatic stress disorder, eating disorders and substance abuse disorders are able to benefit from it, as my family can attest.
My oldest qualified for residential treatment for depression and anxiety. My middle child participated in a community intensive outpatient program. The therapists for my spouse and our youngest child incorporated DBT skills into their therapy sessions. I participated in a virtual intensive outpatient program. This was all thanks to good insurance.
Finally, we were able to learn skills that could help us navigate life’s distressing events. We also learned how to navigate the levels of care available to our community: residential treatment, partial hospitalization, intensive outpatient and regular visits to mental health providers in the community. This knowledge was lifesaving for most — but not all — of us.
Though my mother was now insured, thanks to Medicare, the company providing her Medicare Advantage plan denied her access to the mental health care she needed, so she was unable to benefit from the level of care that was appropriate for her. In the middle of DBT summer, my mom died by suicide.
DBT skills became more necessary than ever before as we all struggled to bear her loss. Instead of the cloaks in the closet smothering us as they had long threatened to do, each of us now had a lifeline to cling to.
In Washington state, more than 1,000 residents die by suicide every year, and adults who are 75 and older have the highest rates of suicide. Suicide is also the No. 2 cause of death for young people between the ages of 10 and 24 years; 20% of tenth grade students in Washington have seriously considered suicide, according to the Harborview Injury Prevention and Research Center and the University of Washington.
The trauma and grief of losing my mother led my family to become more aware of community resources for mental health. In my role as a council member for the city of Bothell, I was able to support the expansion of crisis response services, opening a crisis stabilization center serving North King County, and using American Rescue Plan Act funds for mental health services for residents lacking access.
With the implementation of the 988 suicide prevention hotline, North King County cities achieved something special. Community members in five cities now have access to the complete crisis continuum of care: someone to call, someone to respond, somewhere to go and someone to follow up. What was needed in my childhood was now a reality for my children.
Insurance plans still differ on how much mental health coverage they will provide, leaving many people like my mother in crisis without adequate follow-up care. This leads to increased strain on our public safety systems and contributes to less safety and well-being in our communities.
I lost both of my parents to their mental health crises, but I am beyond grateful that my children are benefiting from improved service delivery and less stigmatization of mental health. Appropriate care and treatment can interrupt the generational transmission of trauma and emotional dysregulation.
More than anything, I want to live in a world where emotional regulation skills are taught to every person. Where mental health therapy is easy to afford and access, people who are struggling can get the levels of care they need to pull through and survive their challenges, and every friend and family member knows how to help their loved one navigate the mental health care services landscape. We would save lives. And our society will be safer and more resilient as a result.
Jenne Alderks is a parent to three teenagers and was elected to serve on Bothell’s City Council in 2021.