Talking About Suicide

Talking with Steve Harrington

 

Steve Harrington didn’t decide to come out about his depression. The local newspaper did it for him.

“I was living in a small community at the time I went to the psych unit, and it was actually on the front page of the newspaper,” he says. “It was, you know, ‘Local resident Steve Harrington has checked in with major depression to the psych hospital.’ How they found out and why that was a newsworthy subject is beyond my comprehension.”

In his 40s, with a law degree, he found himself diagnosed not only with depression but with schizophrenia. He was told he’d never accomplish anything again. After a few years of sitting at home and crying, he eventually worked his way back into life, started working with policy makers on national mental issues and now leads a peer support association. His psychiatrist once told him, “You’ll never live a normal life.” “And I say thank god, because I live an extraordinary life,” Steve says.

Here, he talks about how to be taken seriously after coming out, the need for more funding for peer-run support services, and the thinking behind his declaration that “Some of the most stigmatizing initiatives I’ve seen are anti-stigma initiatives.”

Who are you? Please introduce yourself.

I’m Steve Harrington. These days, I’m the executive director of the International Association of Peer Supporters. That’s what I do most of my time. I also do a lot of training on recovery issues. Very often it’s for peer supporters, but I also do presentations for physicians, psychiatrists at universities. Oh gosh, I do a lot of keynotes at conferences of all sorts. Let’s see, I’ve been to Europe three times do to those, Australia, so … Oh, academically, if it matters _ I don’t think it matters, but to some it does _ I have a law degree, but I didn’t practice too much law. And I finished a post-doc fellowship last year at Boston University at the Center for Psychiatric Rehabilitation. I did teaching and research there for two years. Gosh, I don’t know, I think that’s probably the most important stuff.

How did you come to be talking to me?

OK, well, basically, I will try to keep it short but relevant. Basically, gosh, how many years ago was it? I don’t know, it seems like a lifetime ago. Like in 1995, due to the loss of a close family friend, I went into a serious major depression and had a lot of psychotic features. I had hallucinations, visual and auditory, and I ended up in a psychiatric unit. And what happened there was, I was in northern Michigan, and it was a psych unit at a hospital. And I was there for about three days, and I wasn’t feeling any better. They were giving me meds, but I was not feeling better. So I decided if I was going to get better, I would have to do it myself.

I had experience before I got sick, I had worked for a consulting firm where I did a lot of strategic planning for large corporations and state governments and that kind of thing. I thought, “Well, my head is sort of an organization. I can do strategic planning of my own.” I went to the nurses’ desk and asked for some chart paper and a marker. Those are the tools of the strategic planner. I shared a room with another person, and I started doing my own strategic planning, what I wanted out of life. I had a mission statement, a vision statement, value statement. I did what is called a SWOT analysis. So I came up with a number of goals, very comprehensive. And what happened was, my goals were like, I wanted to get my house back, since I lost that as part of the illness.

Also at this time, they diagnosed me with not only depression but schizophrenia. In my 40s I was diagnosed with schizophrenia, which was pretty unusual. But I was thinking back to when I was 18, 20 years old and was having hallucinations and thought everybody did. But I learned how to cope with them. And then when I experienced depression, I lost my coping skills, and that’s why the hallucinations became more obvious. Anyways, getting back to my goals, I wanted to get a job again, a car again. I wanted to write another book. I had written a few. I wanted to get another graduate degree, in public administration. And I had those kinds of things. You know, kind of regaining my life back. And I wrote all these things down, filled up my room, and I had papers all over the room, and I ran out of room on the walls, all over my bed, on my roommates’ bed. And the whole time I wasn’t feeling depressed, for the first time in months. These three hours of planning.

And my roommate came in and was a little disturbed. He called my doctor, and he came down, and I said, “This is how I’m going to get better. This is my plan to get better.” He didn’t say a word, just looked around the room and left. He went to the nurses’ station, and a few minutes later they had two, what they call mental health technicians, who ushered me into a stark padded room that was locked and took my clothes. So I ended up in this room, and after it took me about two days to get the attention of a nurse _ they were just giving me meds through a slot in a door _ I asked, “What am I doing here? Just when I was feeling good, why am I in here?” She said, “We saw your papers. You really believe you can do all those things? Get a house, a car, reclaim life?” I said, “Yeah. Of course.” She said, “Well, you’re delusional. And if you believe that, we don’t know what you’ll do.” So I was in the room for my own safety.

So a couple of days after that, I was released. I was talking with my  doctor. He sat me down and said, “Let me tell you what your life is going to be like.” He said, “You’ll never have your own house. You’ll probably end up living in a group home. You’ll never work again, you’ll never write a book again, you’ll never get that degree you wanted.” He said, “You’ll never live a normal life. Face it, you have a mental illness.” He said I’d be in and out of psych units all my  life, two or three times a year, taking meds, having suicide attacks. Anyway, a pretty bleak picture.

So when I was released from the hospital, I had virtually no hope, because I thought this guy knows what he’s talking about, right? He’s a doctor, he deals with these things all the time. I had no hope, and I went back to my parents’ home. And because I had no hope, I created a plan where I would take my own life. It seemed like the only reasonable option. So I wrote a note: Who will take care of my son, raise him, you know, doing the planning for my own demise. And I had half a pill bottle of painkillers, and I took those with beer, and I thought, “Well, that’s gonna do it.” I woke up a day and a half later, and I was still alive. And so, obviously, it was not a successful attempt. After that, you know, the parents saw the note, of course, and they didn’t know how to help me. They made me promise not to try again. My son, who was 16, was pretty upset. I made the promise, but I sat on a sofa every day for five years, sitting and crying. That’s all I did. It was almost 10 percent of my life I spent doing that. Then my parents said, “Gee, things are not getting any better, why don’t you go down to the community mental health center and see if there’s anything they can do?”

So I did. I met a case manager there who gave me an assessment. The second time I met him, he said to do person-centered planning. I said, “What’s that?” He said, “We sit down, you tell me goals, and we work on that as your plan.” I said, “Goals and objectives? I did that once, and I’m really uncomfortable doing it if you’re trying to get me into a padded room.” I explained what had happened, and he was rather angry. At any rate, I ended up meeting other people like me who had had their own challenges, and virtually all had had a suicide attempt. And it started a period of growth. We said, “There’s hope for getting better.” Things just took off from there. Yeah, and I look back now and I proved the psychiatrist wrong, except for two things. One, he said, “You’ll never write a single book again,” and I’ve written three since then. And the other thing was, he said, “You’ll never live a normal life.” And I say thank god, because I live an extraordinary life. So that’s pretty much it in a nutshell.

How did you get into this peer leadership role?

As I moved along in my recovery journey, I realized that, first off, people can get better, and that there’s a lot of misinformation and bad attitudes among traditional mental health providers. It kind of fueled a passion in me to do something about it. I don’t really know, one thing led to another, and the next thing I know, they were bringing me to Washington and other places to help with policy development, workforce development. I got a job as a peer specialist, and I worked for four years as a peer specialist. They hired six of us at the same time, and we were among the first in Michigan. We felt kind of isolated, and we wanted to know what was going on, and we formed this association. We said, “Gee, wouldn’t it be great if we had 50 members and all get together?” And next week, we’re having our seventh annual national peer support conference, with about 300 people. And we’ve got about 2,000 members. So it’s gone well beyond expectations. But I think, you know, what led to leadership positions has just been, you know, when you don’t have any hope and start getting hope and your eyes open up, you get this appreciation for what could be. You learn to look at challenges as opportunities for personal growth. It just seems like people saw that instead of a really negative attitude I once had. It turned into a very positive attitude. So things just kind of fell into my lap to a great extent.

How did you get people to take you seriously?

Well, sometimes they don’t. I guess quite frankly, I hate to say this, because it’s not important to me but is to others: If you have academic credentials. Often they’re surprised that a person with any kind of psychiatric condition can do things, even though history has shown time and again that’s reality. Sometimes, though, they say, “You’re the exception.” And when they say that, I have a long list of other people, some historical, some contemporary, who are doing very well. I say, “I’m not the exception. How long of a list do you want?” Yeah, for the most part, people are open, and there’s nothing more powerful than that one-on-one contact with people.

I’ve noticed there’s still stigma among mental health professionals, even though the field has so many anti-stigma campaigns. How to change this?

Well, it is changing. I’ve talked to a number of people about this, why it’s changing, and they say the peer supporters are entering the mental health workforce, and they see the power of having that shared experience. And even though they may be a psychiatrist or psychologist or a therapist who isn’t ever really going to be a peer supporter, they are becoming more open about it because they see how powerful it is to develop a meaningful relationship, how powerful having that shared experience can be. There’s the notion out there that people in the psychological, Freudian school of thought are not supposed to disclose anything. And a lot of psychologists get trained in that. But others get trained in the humanistic view, where the focus is on relationships. And we have research and such, showing the humanistic view is much more powerful and effective than the psychoanalytic view. So we are seeing that the vast majority of traditional mental health providers and professionals don’t disclose, but we’re getting progress in that area.

How to find them? For someone who might be suicidal and wants to work with someone who understands and won’t panic.

Well, it’s not necessarily the self-disclosure that’s the key, in my view. It’s a having a therapist, a case manager, whoever, with whom you can create a meaningful relationship. A real, true, caring relationship. And that’s not easy at all. I went through a number of therapists before I found people who were really helpful. And a lot of people, especially in the public system, they don’t know they can change their psychiatrist, they can change their therapist, and I encourage people to do that. One of the best ways is word of mouth. If you meet other people who have mental issues, ask them: Who’s good out there, who are you seeing? What are they like? Word of mouth, I’ve found that to be the best.

What should people ask the therapist in the first meeting to gauge their comfort in talking about suicide?

You make clear your expectations. A lot of it is intuitive. Are they making eye contact, are they really listening? The words they’re using, the tone, the body posture can tell a lot. It’s not an easy thing, and sometimes you have to see a therapist three or four times before you know.

What is the least risky way to broach the s-word?

Suicide? Lay it out there. It takes some courage. There’s such stigma associated with it. But just to lay it out there and if the therapist or psychiatrist or psychologist is not comfortable. Just say, “Yeah, I had a suicide attempt,” and just see the reaction. And that will tell you a lot right there. If they’re not comfortable, move on. That person is not for you. I’ve found that being direct and frank is the best way. If they dance around it, it won’t be addressed very quickly, if at all. The suicide attempt, to me personally, was a sign of how hopeless and how much in despair a person can be. And my life since that attempt has changed so much that you start to grow and develop a different attitude about life and challenges. It’s just how powerful hope can be. I don’t know, it’s just my experience, from one extreme to the other. From totally hopeless to filled with hope beyond imagination.

How do you avoid those thoughts coming back? Or do they?

I haven’t had suicidal ideation. I have had instances where I thought, “Gee, maybe I should consider suicide,” but it was a very passing thought. What I do is, I’m able to look at the relationships I’ve got, what’s happy in my life. I thought about that once, and now I understand how life can change so quickly for the better. So it’s more of a personal thing.

Another thing I do is, something that’s a bit of a trigger for me is stress. So every morning, I wake up and do a self-check. I’m still in bed and think, “How am I feeling today? Did I sleep well? What is it in my day that might be stressful? And how am I going to handle that? How to take care of myself?” And self-care, unfortunately, is difficult for us to put a high priority on, that sometimes we feel that if we’re not productive, we feel we don’t deserve to take care of ourselves. Unfortunately, because that’s what so often fuels the hope. Doing things with friends, that kind of thing. So, really paying attention to self-care is really vital.

How did you decide to be so open about your experience, and how have people’s responses changed over the years?

The decision was made for me, actually. I was living in a small community at the time I went to the psych unit, and it was actually on the front page of the newspaper. It was, you know, “Local resident Steve Harrington has checked in with major depression to the psych hospital.” How they found out and why that was a newsworthy subject is beyond my comprehension. But yeah, I guess the other thing is, so much good has come out of that challenge that I want to share it. It’s something that is, a lot of people find it inspirational. They say it’s helped them. Hearing that story. And it’s not just a story about being sick. A big part of the story is getting better, and how wonderful life can be.

Shortly before calling you, I read an article in The Atlantic online by a young anonymous woman who said she was not able to tell her colleagues about her bipolar disorder because of stigma. What would you say to her?

When you self-disclose, there are a lot of considerations. First of all, it’s not for everyone, for a variety of reasons. Maybe there are workplace issues, or others. We still have a lot of stigma out there. A lot of people don’t understand. I don’t fault anybody who chooses not to disclose. It’s a very personal decision. There are risks involved.

How do we eventually erase those risks?

Education. That’s why I do what I do. I stand up in front of 1,000 people and say, “This is where I’ve been. This is my journey. It’s not just me. There are hundreds of thousands just like me. Some are up front, and some aren’t.” It’s all about educating, and the best way is one-on-one, making connections with people. It’s really funny because so many people have _ when you self-disclose, so often you self-disclose to someone with the same or similar experience. But that doesn’t mean there’s no risk in doing that. But when you figure that 20 percent of the population at any time has a mental condition … There’s still an awful lot of fear based on ignorance.

What kind of changes would you like to see?

First, and this could get me in trouble, but that’s OK, I’m frustrated, like the emperor has no clothes. First, we have a lot of peer-run organizations, and if they get any funding, they’re always the last. And if there are any budget cuts, they’re the first to go. Some provide peer support, some provide education to the community, all different kinds of roles. But there’s still that funding prejudice, the economic oppression that continues. And I’d like to see that change. I’d like to see, you know, when funding comes, it goes to for-profit organizations, to hospitals, to universities, to state and local governments. Why not directly to peer organizations? We have bushels of research that says it’s the most cost-effective way to help people. We’re not seeing it because our policies are still oppressive, our funding policies. And related to that, I’d like to see in these anti-stigma and suicide prevention programs, so many of them are not peer-run or have no meaningful peer input. And you know, it’s really odd that that happens. Some of the most stigmatizing initiatives I’ve seen are anti-stigma initiatives. Because they don’t respect peers. They’re supposed to fight stigma but practice it all the time.

For example?

Well, there’s a California university that was funded several hundred thousand dollars for an anti-stigma program, and when doing their presentation at a conference, I asked, “How many peers did you employ?” It’s all run by academicians. “We don’t employ any. They help us with programs and tell stories, but we don’t pay them. We buy them lunch sometimes, reimburse them for travel.” That was like my first time my eyes were opened. Yeah. but there’s a lot of them out there that operate the same way. And maybe that’s why I’m a little sensitive about academic credentials. I’m fortunate because, with the timing of my illness, I was able to obtain academic credentials. But they’re often used as a barrier. And people with psychiatric conditions often don’t have the opportunity. They get sick after high school, or it gets too expensive, or they’re dealing with internal stigma. A lot of these organizations use a lack of credentials as a barrier to keep peers out.

How to change that?

By doing exactly what you’re doing. We have to step up to the plate and take risks and be vocal. And again, it’s not for everybody, but we need more leaders. We have a shortage of leaders. That’s one of the things I’ve been working on. Through your efforts and others, we can change the notion that, you know, you have to have an MSW to have any credibility. Instead, it’s about your life experience.

Finally, who else are you?

I’m so glad you asked that question. What am I? I love to take pictures, landscape and nature photos. I like animals, especially birds. I’m an avid bird watcher, though they actually call us birders. I have a great number of very good friends, and to me that’s really important. Let’s see, I like to write, so, yeah.

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