Talking About Suicide

Talking with Tom Kelly

 

In this era of creative business titles, there’s something pretty cool about being the manager for recovery and resiliency. That would be Tom Kelly, whose life reflects his work. He’s been through a period of homelessness, the questionable interstate shipping of mental patients known as “Greyhound therapy” and more than one suicide attempt. Now he works for a major mental health provider as one of its peers.

He’s also moved from being scared of mentioning his attempts _ what if he was the only person with the experience? _ to being absolutely open. And after he tells his story, he often finds people who reply, “Me too.”

Here, Tom talks about his transformation, his work and the question of whether peers one day will run the mental health organizations that now offer them welcome. He thinks that it will take a lot to overcome entrenched perceptions.

“In my opinion, the professionals that work in the field only see people when they are doing poorly and in need of attention, help etc.,” he says. “They do not see people when they are doing well! When they see people such as myself, they say, ‘But you’re different!’ I am no different than the person who walks in off the street today … ’cause I was that person 20 years ago!”

We spoke by Gchat:

 Tom:  hi
 me:  aha!
 Tom:  Finally
 me:  sweet. thanks for being available!

Tom:  no problem my pleasure

 me:  ok then. is it all right to use your name?
 Tom:  Yes
 me:  great
 Tom:  First and last if you wish
me:  very nice. OK, then, and we’re off …

my first question is always to please introduce yourself. who are you?

Tom:  Well my name is Tom Kelly and I work in the greater Phoenix area for a managed behavioral healthcare company.

I am their Manager for Recovery and Resiliency.  In that role it is my job to help get the voice of individuals receiving services and family members to the table.  As a person with bipolar disorder with psychotic features and as a person who has attempted suicide on more than one occasion (three serious attempts) I am able to use my lived experience to help others understand what it is like for individuals such as myself.  I am able to help coach, mentor, train and educate not only staff members but also community stakeholders and individuals receiving services and show them that recovery is real and possible for everyone … no matter where we came from.

Anything else?
me:  how did you decide to talk openly about your own experience?

 Tom:  I decided to speak openly about my experience after a series of different events that have happened throughout my life!  It was a process.  I remember having challenges with mental health issues going back to kindergarten … throughout elementary school and high school and college I suffered from depression and the resulting desire to end my life.  After going through several hospitalizations and spending some time living on the streets I ended up in Arizona where I started getting the proper treatment. I was misdiagnosed with depression at that point but I knew there were other things.  When I started to understand the swings of bipolar disorder and get the proper diagnosis and treatment my life started improving.

Tom:  When I started getting that proper treatment and my life started taking a turn for the better I thought that it was my turn to share my story to help others who may have gone through what I went through.  I didn’t disclose everything at first – it was some of the things that happened to me! I would talk about the mental health challenges but not the suicide attempts.  It was not until I met others who shared a similar experience with suicidal ideation or attempts that I was able to say … Me Too. I guess there was hesitancy because of what people would think of me if I told them I had attempted to end my life.  I’ve come to the point where I am not ashamed of anything that happened so if I can share and help one person than I’ve helped one person!

me:  Where did you bump into others who talked about their experience?

 Tom:  When I first got introduced into the Arizona behavioral health system I started going to a support group for people with depression and bipolar disorder.  I was referred to the group from I was referred to the group from my hospital social worker at Good Samaritan Hospital.  I thought I was alone, I thought that no one went through the things that I went through … but in that group I found some shared and similar experiences.  From there I started advocating in the system and would meet others throughout the state.  Eventually I began meeting people from all over the country.  It’s interesting in that I can talk to a group of individuals wherever they may be and usually without hesitation there are always one or two people who open up and share their experience.  I wish I had bumped into these people decades ago as opposed to years ago!

 me:  How to make it easier for everyone to find each other, by the way? Any ideas?
(And why has it been challenging to find them?)

Tom:  Let me tackle the “why has it been challenging to find them” first!  Stigma, discrimination and prejudice!!  People who have attempted suicide have shared with me that they were ashamed, that they felt guilty, and that they became disconnected from themselves and others!  I can understand why some choose not to talk about their experience.  I was ashamed and couldn’t even tell my family what I had tried in the past because of the “perceived” belief on how they would treat me – so I just kept it bottled up!  I think we could make it easier for people to find one another by sharing resources and information throughout the “health community”!  Primary Care Physicians should have information about mental health and suicide in their waiting rooms.  They have information about high blood pressure, heart disease and how to get better sleep.  If they had information about suicide, suicidal ideation and behavioral health issues perhaps that would help people find a connection to a professional who could connect them to the community.  Education is also important – we need to start education individuals in kindergarten!

 me:  Did you ever tell your family, eventually? And how was the response?

 Tom:  I was in a hospital in Iowa and transferred to a hospital in Canada (where I grew up) – my doctor thought being around my family would help in my recovery! My sister flew down to Iowa and we drove back to Canada.  I shared with my sister and that was well received.  I have a great baby sister!!  When I got into the Canadian hospital I was able to tell my parents about what had happened and my second suicide attempt (but no one knows about the first or third).  They response was supportive from my perspective – I still have one sister that doesn’t quite understand what I go through – but my family is understanding!

me:  What’s your advice on how to tell family members about an attempt, or about thoughts of suicide? And what’s your advice on how they should respond?

(This being a big concern out there.)

Tom:  I wish I had an answer to that question as it is a big concern!  I guess I would take a matter of fact approach and describe the signs and symptoms of what it going on in a person’s life!  Paint a picture to help the family understand and empathize what their family member may have been going through.  After painting that picture by trying to educate the family about the signs and symptoms of depression, bipolar, etc … and explaining that some people with mental health challenges sometimes attempt (and share
those statistics) …I would suggest that they disclose their attempt.  If family members could understand the underlying issues going on in a person’s life perhaps they could understand the attempt.  I can not imagine what it was like for my mother to hear that her only son tried to kill himself.  My mother could not imagine what it was like for her only son to want to end his life!  By understanding the diseases, illnesses, disorders – whatever it is we want to call them, perhaps family members could understand why someone would attempt to end their life!  How should they respond – truthfully, honestly, and openly!

 me:  I want to go back to something you mentioned, about living for a while on the streets. Can you talk a bit about how you got there and how you got away from that … or at least how you got away?

 Tom:  I was married for about six years and after my divorce I became seriously depressed and decided to end my life!  I ended up at a hotel and took an overdose – about thirty or forty pills – can’t remember what they were and I started to become sick and I wanted to die – I didn’t want to be sick (weird I know) so I called 911.  I ended up at a private psychiatric hospital.  After a few weeks of care I was transferred to the State Hospital where I spent about 18 months.  After my release from the State Hospital my home was the streets of Waterloo, IA. They basically dropped me off on the streets with no plan of action – except the address for a homeless shelter and the name of a behavioral health outpatient clinic.  Well there was no room at the shelter and I spent the next few months on the streets of Cedar Falls/Waterloo Iowa.  I ended up back at the State Hospital and once again after another year or more at the State Hospital I was offered “Greyhound” therapy.   I was given a bus ticket to Florida – I had secured a place to live with my father at his trailer in Fort Lauderdale.  I was given the name of an outpatient clinic but
didn’t follow up. Eventually I left the trailer and spent a few months on the streets of Florida!  I ended up in Arizona in August 1998.  It was here in Arizona that I finally got introduced into the public mental health system.  The public mental health system gave me the support I needed to get back onto my feet.  They helped with vocational rehabilitation, medication, therapy and most important ‘housing’!! I ended up on the streets because I didn’t have any hope, I ended up on the streets because I didn’t care … well the AZ public mental health system offered me that hope and caring at a time when I had none!

 me:  And how did you move from being helped to helping?

Tom:  When I was introduced into the Arizona mental health system I thought I was the only person who went through what I went through.  When I found out there were others I started to socialize with them and attend a few support groups!  The one I mentioned earlier!!  From that I learned about the Arizona Behavioral Health System and a friend mentioned a County Advisory Council.  I didn’t know anything about advocating or speaking on my behalf let alone the behalf of another but there was a person that my friend thought I should meet.  That is the only reason I went to that meeting.  From that meeting someone heard me share a little about my story and said they wanted me to talk to some case managers. After sharing my story with those case managers in the system on thing led to another to another. I met people who were interested in helping me (because I started to want to help myself) and from there ended up doing some contract training for the local managed care company.  I say that I am blessed for what I have gone through (the good, the bad and the ugly) because I would not be where I am unless I went through what I went through.  I’m helping or attempting to help others today because I want to give back to a system that saved my life.  I want to give back to those who helped me get to where I am today!  In all honesty though – giving back is selfish for me –  for when I give back and help others I get the opportunity to let others know that there is hope … the more hope I can give … the more hope I get back in return!

 me:  Do you think the approach in Arizona is pretty representative of the approach in all areas of the country? I suppose this is a way of backing into the question of what changes are still needed to the system at large …

Tom:  I have had the opportunity to do some work around the country and I do not believe that the Arizona approach is representative in all areas of the country.  I was discharged to homelessness in two other States (Florida and Iowa) – I was given transitional living services when I was discharged from my only hospitalization in Arizona back in 1998.  The behavioral health systems throughout the country state that recovery and peer support are some of their overarching principles … Arizona followed Georgia into the peer support world within a few months!  I think some states are strong on peer support – many need help.  In my experience where there is strong peer support, the behavioral health system is a little stronger too!  Maricopa County through Magellan Health Services offers support groups for people who have attempted suicide that are peer-run and peer-led.  There are only a handful of support groups for people who have attempted suicide across the country … there needs to be groups such as this throughout the country.  Funding is a big challenge within the behavioral health world as many programs and states are underfunded.  I think funding would help improve the system at large – I think helping develop programs and including those individuals who go through what they go through need to be part of that program development!

 me:  You mentioned “Greyhound therapy,” and that reminds me of a story about a similar case that made the news earlier this month. Any idea how widespread that practice is? And surely it’s illegal, or at least unethical?

Tom:  Getting a bus ticket from one part of the country to another is cost shifting.  But other states offer that same service!  I do not know how widespread that practice is but to me it’s unethical.  In retrospect when I was given a bus ticket from Iowa to Florida, I did have an appointment with a counselor at an agency in Florida.  I didn’t know where they were, didn’t care, didn’t really plan on meeting anyone because of the ‘mental’ state I was in but the hospital did their ‘due diligence’.  If something happened they could have said “Well we gave Mr. Kelly the name and address of the Henderson Mental Health Clinic and he had an appointment!!”

 me:  Still, it’s amazing that people are just put on a bus. Have you seen any programs that do a really good job of addressing not only mental health but the underlying economic issues?

Tom:  There is one agency in Maricopa County that really focuses on employment for the people they serve.  Throughout the country the average rate of employment for people with serious mental illness is around 10%. This one agency in Maricopa County has an employment rate of 26% for people with serious mental illness.  Help put a job into someone’s weekly list of things to do and not only does it help the individual financially it helps the system because the individual becomes a tax payer and gives back to the community!!  The programs that focus on Housing First and Employment First are those that are doing a really good job of addressing the mental health and helping to improve the underlying economic issues!!

me:  This may be an ambitious thought, but how long will it take to move from peers being part of the system to peers running, or helping to run, the system? And how long will it take for many in the system to be comfortable saying openly that they’re peers as well?

Tom:  What is the saying about a cold day in …

Tom:  There are a handful of agencies across the country that have “peers” on their executive teams.  I was in such a position for a few years with another managed behavioral health agency.  There are many agencies that are non-profit agencies which are governed by Boards of Directors.  Many of those agencies have peers that serve as Board Members. I think that the peer voice is at the table to a better extent today than it was in 10 years ago!  I think that because of the belief that peers can recover and do in fact have knowledge, skill and abilities to move forward in the employment area many of them choose to stay within the behavioral health world. There are two National Managed Behavioral Healthcare Organizations that have peers who are serving at the Executive Team Level …

Tom:  I think the other question about how comfortable people are in disclosing their lived experience is a challenge!  I see more and more when I present that someone will come to me after the presentation and open up and say “Me Too” … when I ask them if others know about their lived experience they say “I can never tell people that I’m a peer – what would they think?” … there is still a lot of stigma, prejudice and discrimination going on … one day my friend … one day!!!

me:  I’m always curious about the more striking or surprising questions and responses people get when they talk openly about this. Does anything stick with you?

 Tom:  Please elaborate a little not sure what you are looking for ….

me:  You’re open about your experience. What are some of the more surprising questions or responses you’ve had about it?

Tom:  I guess I share so much about my experience and I am an open book that I don’t get too many surprising questions.  The responses I get, to be honest, are things people don’t say or ask!  Here I am, an open book willing to let them ask me
any question they want and … nothing!

I will have to think more about this particular question … I think I can find something that is surprising … just cant think about it now
 me:  What would you love to be asked? I don’t mind being guided along here!

Tom:  Once again … I don’t really know!

Tom:  Discrimination and prejudice seem to be more prominent within the behavioral health world and suicide prevention world than in the general community … How do we really get to the heart of the matter when it comes to understanding the damage that fear, ignorance and malice does in the work we do!

Tom:  I think it’s important for people to share their experiences and not feel ashamed to tell their stories.  Every civil rights movement started with a few people who had the courage to move forward … we need to develop courage and character and support folks for sharing their stories!

 me:  Why in the world would discrimination, etc., be stronger within the very field that talks about breaking down stigma?

Tom:  That’s the million dollar question!  In my opinion the professionals that work in the field only see people when they are doing poorly and in need of attention, help etc.  They do not see people when they are doing well!  When they see people such as myself; they say – but your different!  I am no different than the person who walks in off the street today … cause I was that person 20 years ago!!  When they don’t see that recovery is real and that recovery is possible they use “dark humor” and other defense mechanisms to protect themselves from “those people”.  It is funny that there is more stigma in the very field that is trying to eradicate it!!

me:  Interesting that you mention humor … Is there any way to talk about this issue openly with humor, dark or otherwise? I’ve seen a few interesting projects, like cartoons or documentaries …

Tom:  I think that the program coming out of Vancouver, British Columbia – Stand Up for Mental Health – is an interesting program.  David Granirer who is a therapist and has some stand-up comic experience travels around the continent and trains people with serious mental illness to deliver stand-up routines.  Victoria Maxwell does a one woman show about the ups and downs of bipolar disorder at different conferences around the world (I think she has three different shows).  I heard of another gal that does a one person stage presentation on the lived experience of bipolar too … but I forget her name!

Tom:  With the proper funding and support I think developing an Improvisational Comedy Troupe would be a good idea.  That way they could react to what the audience was giving them to work with!!

me:  Those people are good to know! I’ve spoken with David before … And here’s a change of subject. Let me know if you’d rather not go here, but why does it seem like the topic of assisted suicide is completely separate from the usual mental health world?

Tom:  A topic for another discussion for sure!!  Perhaps it should be called Assisted Death …

 me:  And for that matter, there doesn’t seem to be a lot of philosophical conversations in this field …

Tom:  I think the topic of assisted suicide is separate because the person has to go through lots of different things in their decision and are they not being challenged by whatever challenges those who do die by suicide without the assistance!

Tom:  I don’t really have a stance on anything in life … I really try to be a non-judgmental person … if push comes to shove … I would support someone asking me to pull the plug if it were in their living will!!  How about you?

 me:  I think I agree. It was startling to watch my father pass away and have no inrush of nurses because he had a DNR order, but he had declared his wishes and had been very open about his long fight, in his case with cancer. I just think there’s a lot of ground for very good discussions out there.

Anyway … here comes another change of topic:
 Tom:  Sure but you only have me for another 10 minutes …

 me:  Got it. Two more questions, then. This is question I often ask, because it was something that certainly stopped me from a more serious attempt: What if suicide prevention messaging emphasized the idea that no method is foolproof? That you can wake up in far worse shape? I think many people think, “Maybe this will work” and take huge risks in their attempts …

Tom:  I believe I have seen some messaging in that people could wake up and be in far worse shape.  To me it’s kind of interesting, I didn’t think of that at all when I was in a position where I wanted to die!  I didn’t want to jump because I was afraid of heights – not because I didn’t think it was NOT going to kill me.  I know people (two friends of mine today as a matter of fact) that survived bullet shots to their head – so that was out of the question.  With me it was always medication overdose.  I just wanted to end the pain, go to sleep and die in my sleep.  I’ve heard people have ended up in worse shape from all three of those different types of attempts!  I’m blessed and lucky after putting more than 150 pills into my system that I made it out of the coma relatively mentally healthy with no brain damage (that I know of LOL).  Those that think “Maybe this will work” are at a place where they need connection to something, someone in my humble opinion.  Perhaps the messaging would touch them – in my personal situation – I would not have thought anything about messaging around that thought!!

me:  Good points, and I’m scared of heights myself! OK, I like to end with this question: Since this experience most likely doesn’t define you, at least completely, who else are you?

Tom:  I am intuitive, perceptive, fun-loving person that enjoys helping others!  I’m a friend, brother, son, athlete, dancer and all-around nice guy!!!  Do you know anyone looking for someone like me … I’m single too!!

 me:  Ha! Let’s see what happens when that’s posted for the world to see!
Thank you so much for taking the time to do this!
Tom:  Hmmm maybe I’ll need to edit that last comment!