So thank you for sticking with us or joining us midway. I think this has been
a really wonderful morning and now early afternoon hearing from a variety of
really interesting and smart and decent people talking about their lived
experience and their clinical work and their research their policy level work
there is a place for each of you in there in multiple places for you I hope
you're also taking away that even at our somewhat removed policy level there is a
sense of urgency we have a sense of urgency about this from APA and from all
of you who work on these issues so please let that be one of the messages
you take back and so now I want to invite on stage our final speaker dr.
Sean Joe and we're trying to practice what we preach in terms of
Intercollegiate ease so Sean is one of our social work colleagues and a
professor of social development at Washington University in st. Louis Sean
is nationally recognized for his work on suicidal behavior among black Americans
and I'm eager to hear his message about the role of community but not just out
in the community but in again our own community of psychologists and other
professionals so please welcome Sean
good afternoon good afternoon thank you very much I appreciate that what a
powerful discussion we'll be having today a discussion about suicide
prevention which means we're talking about hope before I go into my segment
of this wonderful session I need a little bit of help I want to call on you
because I know right now I have a very difficult task my job is to close that
means I'm standing between you and lunch so in order to do that I want to make
sure we get the message across and the message we're trying to get across is
that suicide prevention is possible so in order to do that I'm going to call on
I'm going to invocate and call upon a famous Chicagoan and try not to exhibit
any implicit ideological political bias I want you to do something that you've
all heard before is suicide preventable yes we can one more time
it's suicide preventable so I'm going to keep saying that because this is the
message of today I remember when I began my work in suicide I was looking at
homicide my question at that point in time is why are young black men dying
then an article came out but from a psychiatrist named David Schaffer in
about 1991 and David said in his article I mean he pointed out very clearly that
the suicide rates among black teens was rising now first I had to take that in I
had to contrast that with what I know about black America how I was raised in
the black church and what it says to me at that point in time was that's
probably not true because from my understanding suicide is primarily a
white thing blacks do not engage in suicidal behavior
I mean blacks had endured centuries of slavery and brutality in the United
States so what would now make them suus when they were not suicidal before so I
had to really spend some time with it and the more I got involved in asking
questions I had a wonderful advisor named market Kaplan and Mark says well I
want you to help us answer the questions so that's how I got involved with this
so suicide as you heard claimed the lives of well over 40,000 Americans now
an average when I began in network it was about 30,000 and that was a high
number we thought it would never go over that so now is about 40,000 Americans on
average so among black Americans of their 40,000 roughly about 3,000 are
black Americans in the United States and I make the point about black Americans
because I want you to understand that black Americans including includes many
different ethnic groups not just African Americans and there's a distinction that
must be made so in the work that we've been doing we realized that not only we
come to a point in American history and which we have rates of suicide that we
have not seen since World War two that's impacting men blacks Latinos Native
Americans Asians basically we're saying that suicide impacts us all regardless
of your skin color and regardless of the ethnicity and most troubling to me right
now is that we're seeing higher rates of suicides among young black children our
white children rates higher than black children rates raise your hands if you
believe that or the race of suicide among children white higher than the
rates of suicide among children black interesting I would have thought the
opposite what we know right now thanks to some good work by Jeff Bridges and
others is that the suicide rates among black children under 12 are higher than
the suicide rates among white children under 12
our question often when I'm doing this work is why what would make a child age
12 and under come to the realization that the rest of their life is not worth
living these are the questions we ask and as scientists and as clinicians we
have to find an answer so can we prevent suicide however we need the really good
science what do we know about blacks and suicide well we know a few things we
know that blacks engage in suicidal behavior we know that the risk factors
for suicide among blacks are similar to the risk factor to suicide among whites
we know that at this point psychiatric illness matters we know that social
demographic factors predict who is most at risk we know that among psychiatric
illnesses do not talk to me just about depression my mind turns off because I
said anxiety is one of the strongest predictors of whether or not blacks will
engage in suicidal behavior not to say depression doesn't matter but you cannot
just take a depressive framework you're going to miss all the things that are
important that's related to anxiety and given that black males account for most
of the deaths among the population I don't care what age group it's usually 8
to 1 6 to 1 it's a black male phenomenon my question then is in my workers well
what do black males have to be anxious about in American society I think I
could come up with a few things right so we must pay attention to that
overall so the summary around black Americans is that suicide is primarily a
male thing it impacts the younger generation in fact when I really think
about it I remember Charles Prudhomme psychologists Howard University in 1938
Charles made the prophetic statement that as generations of blacks exist in
the United States over next hundred years more and more of them
will have rates of suicide similar to whites and that's what we're seeing
right now that was in 1938 by psychologists and we're seeing that and
we're living that experience right now with the higher rates of suicide among
black children suicide among black Americans and almost all Americans as
you know involves what guns guns are the primary methods among black Americans
that guns are the primary methods in the United States so we must take that into
account younger age groups males firearms and firearms matter why do they
matter you just can't look at the psychosocial of the cognitive condition
access to lethal means when in leith when in crisis results in higher rates
of suicide if it was any other method you have a one to five percent lethality
chance when it is a gun it's a 90 percent lethality chance that that
person will end up dead so the means does matter so but as I'm doing this
work we always ask the question why do people die by suicide so the work must
take a theoretical basis you can no longer do this work a theoretically you
have strong literature that begins us a strong foundation to think about how we
look at this suicide is a goal-directed behavior to address unbearable pain it's
critical that we think about it in that way because then we have a lot of
evidence about how to address behavior so we must begin to think about that we
know that hopelessness plays a significant role not all depressed or
anxious people were going to be suicidal but when you start mixing that with a
cocktail of hopelessness and stress you begin to see suicidal thinking an
ideation you begin to exceed the the exhibits of pain
so what without all of that if you throw in then the capability for self harm not
everyone can do that that exacerbate the risk of suicide for all populations self
harm to do harm to oneself it's interesting there was a movie I saw
actually was based out here in Chicago where someone was trying to demonstrate
how hard it is to self harm they stuck their hand out they said it was a love
story so I'm gonna go with that okay they stuck their hand out the gentleman
said I love you she said if you love me then we see and he goes he tries to bite
himself oh and he couldn't bite himself and when he moved his hand away she goes
ah no blood you don't love me the point is self-harm is a very difficult thing
so we must understand that as part of our work so what can we do to prevent
suicide things that emerge from the work looking at black Americans and other
ethnic groups in the United States says that we must understand that clinical
mistrust is something that we must study and understand
so both the researcher and the clinician in the room must focus a little bit on
clinical mistrust it's important that we understand that looking at generational
differences in coping we're in a new era of coping for young black males how
young blacks coped today I believe and I think I have evidence to say it's
different from how older blacks coped with society and life experiences so
these are some of the things that we must consider also we must understand
the role of trauma trauma is very important almost 51 years ago Martin
Luther King spoke to the APA and Martin Luther King spoke to the APA he made
this statement then and he called upon the APA for action one of the things he
called upon the APA for action is to understand the trauma that blacks were
experiencing in America and how important it is for you as social
scientists to make that plain to the world
but also help us to understand how to heal interesting though he also called
upon the APA to say with all the change in progress that the civil rights
movement is bringing about you must study and understand to help whites deal
with that change and when I think about what we're seeing today with the rise of
these deaths of despair among white males when I think back on the horrific
killing the terrorist killing of people in this nation whether is in El Paso and
elsewhere by these white males I must say to you what Martin Luther King
talked about they're struggling to deal with the changes that's happening in
society the rise in diverse populations was one of the reasons one of those
young men went out there and did such horrible things so again that was 51
years ago this September there is work to be done just like there's work to be
done around suicide but we must look at trauma and historical trauma when you're
doing this work it's critical that as clinicians don't be afraid as you heard
our colleague says jump in you have a role to play but you must maintain your
own health I always look at it in terms of food don't blame me okay I have my
own issues okay and I say my metaphor is always Sean don't be a donut don't be
glossy and professional and wonderful on the outside and knowledgeable but empty
on the inside so much so that you have nothing really to give so much so that
you start to have profiles of your those you work with and dehumanize them you
think about them as less and what happens then your job eventually is to
instill hope that things can get better but let me tell you
oh we wonderful Donuts the hopeless cannot teach hope so it's
critical that you replenish who you are your capacity to serve as you're doing
this important work related to suicide prevention you're not going to go to
much longer because again lunch is here so I also want you to know that from the
work that we're doing how people are explaining what happens to them in the
world matters so wonderful things used to come out of will still do don't get
me wrong of psychology that was very important you used to help us understand
how people interpret their world I think the concept was attribution theory or
attributions those things are critically important people are struggling today to
try to figure out how to make their way given the changing environmental context
who you knows matters Kevin always remind me that connection matters he
jumped because he was looking for a connection and the only connection he
found was a sea lion connection matters these are things that you can do I used
to say often a smile is sometimes better than anything else you can prescribe
because people want to connect they want to know they matter and they want to be
able to move forward in their lives so connection matters so what can you do my
word today from Siri was called fascicle and a fascicle is when you divide things
into sections right like a book that is published and is put into sections or
installments and in many ways it reminds me of APA you have 56 different
divisions or something like that wonderful homes for professionals you
are a fascicle and in many ways it's time that you take that collective
knowledge if you didn't hear many of the presenters and put that into a cognitive
genome initiative you have to pull the knowledge together so
we have a much more intricate understanding of the human brain in its
interaction with the world you need that to be done within this body because you
have the capacity at this point to do that we have the social genome we have
the human genome but this cognitive genome is what I believe your best
position to help us build so we could have more predictive models of suicidal
behavior if that happens across the 56 both the clinical and the research must
be in that process so I put that out as an opportunity overall and then finally
suicide prevention doesn't that happen without the capacity to make it happen
so our states must have the capacity to understand who is dying
how and when they're dying taking all this clinical evidence about what works
and getting it out there if you don't have the infrastructure or someone
responsible within your state to do that then you're not going to be able to
systematically impact or act so you must have that capacity in order to do that
that's what we're doing in Missouri because you cannot wish someone would
make the difference we have to organize and have the capacity as a state to make
the difference so let me close this work is not easy we know that but we must be
hopeful and we go with benecrine the most authentic thing about us is that we
have our capacity to create to overcome to endure to love and to be greater than
our suffering so I say to you be greater than your suffering I say to you you
have the opportunity to go forward and advance science and practice every day
you don't know when your the difference during that moment of suicidal crisis
which is usually about 10 minutes and it happens infrequently
when you are the difference between whether or not someone lives or has the
chip or would probably die I'm just saying every small action
matters and with that have a wonderful lunch have a wonderful conference and do
all you can thank you