Paul Szmal: Good morning, it's 8-16, it's FLX Morning, it's our monthly visit with Family Counseling Service of the Finger Lakes, FCFSL.org, Jen Cox with us, part of the Therapeutic Team. Good morning.
Jen Cox: Good morning, I'm happy to be here.
Paul Szmal: We're glad to have you. September is Suicide Prevention Month. How much do we know and how much are we learning about what causes people to take that step? Most everybody probably thinks about it at some point, what causes someone to take that final step?
Jen Cox: Well, you actually just touched on one of the things that we're learning more about as time goes on. The fact that suicidal ideation is actually a pretty common human experience and understanding that and destigmatizing that, helping people recognize that that's not inherently an outlandish thing to experience, is one of the first steps that we take towards suicide prevention, helping people realize that it's more common than they think, also helps people realize that it's survivable and it's something that can be worked through. We're also learning a lot more about aspects that contribute to suicide that go beyond mental health symptoms, because when people think about suicide, and for good reason, we usually think about mental health preventives first. And obviously, as a therapist, I'm going to say counseling is a good support, but we're learning about more contributing factors that extend beyond the therapy session.
For example, we had a huge rise, unfortunately, in suicide statistics within the years of the pandemic, huge rise between 2020 and 2022. That is evidence of what research has been telling us for some decades now, that factors like isolation, economic instability, and uncertainty are all contributing factors, and that's part of why it's such a common human experience.
Paul Szmal: So during the pandemic, a lot of people had that lack of human contact. Do we find, in general, people who are more isolated are more prone to suicide?
Jen Cox: Isolation is a huge factor. Other factors that the CDC has found includes, again, that financial insecurity, which was a huge thing in the pandemic, because even if you didn't lose your job, there was uncertainty about certain companies being able to survive, or at least your pay was cut. Stable housing, we're going through a housing crisis for a lot of people right now. Rent is more expensive, finding access to homes that are for sale is getting harder to do. And then that isolation was more than just people being stuck at home. There was also a culture of isolation for a while, where it was hard to reach out to people because people's opinions were so divisive about what was going on. It was hard to connect even over the phone or on the online without feeling like you were going to walk into an argument with people, and that led to some emotional isolation on top of the physical isolation.
Paul Szmal: When I think of suicide, I can't help thinking about it among young people. Here in the Finger Lakes, we've had high-profile cases in recent years. Is it life is getting harder, or are we not teaching our kids the proper coping skills, or some of both?
Jen Cox: I think the first thing we have to acknowledge is that it's actually across all ages. From ages 10 to about 64, suicide was one of the top nine leading causes between 2020 and 2022. Now, it is one of the top two leading causes for ages 10 through 14, and about 25 to about mid-30s. So it is a little bit more prevalent in younger people, but even in middle adulthood. And while I'm obviously always going to encourage us to keep strengthening that emotional well-being in our young people, keep teaching them those regulation skills and those coping skills, I think we also need to acknowledge during the pandemic, our school kids were hit the hardest. They lost their peer connection. They lost their ability to go to school. And a lot of us are still recovering from that. A lot of school districts are still recovering from that. And returning to school was actually very difficult because some school districts weren't sure how to pick up on the education gap that happened during those years. And that's led to a lot of conflict where students who know that they're intelligent and capable are still struggling to pick up where they had left off. But it is an all-ages thing. Again, it's a human experience across the lifespan.
Paul Szmal: Let's talk about social media and electronics and cyberbullying. I mean, it's been a long time since I was in school, but the tools available to the bully have exploded. And I mean, some of this, it gets very vicious.
Jen Cox: It can, it absolutely can. So when you are talking with your adolescent about their online activities, and I absolutely encourage parents to not necessarily hover over their shoulder every time they're on a device. I know that's not realistic, but have open conversations about what their experiences online are like, what kinds of messages they're getting online. On top of cyberbullying, your adolescent is also more likely now more than ever to encounter things like hate groups, who instead of encouraging people to find positives or to develop coping skills or to come together in togetherness to work through our problems, they sow feelings of anger and hatred and self-loathing and instability and isolation, because keeping your teenager angry at themselves or at marginalized groups then makes them vulnerable to targets of people who want to sell them a solution or want to continue to make them have extreme radicalized beliefs. So having that open conversation and nonjudgmental conversation about their online experiences and how it connects with your family's values is very important to do.
Paul Szmal: It seems to me as well, across all ages, that we have no time to decompress anymore. With communication the way it is, work expects you to be on all the time and people are waking up in the middle of the night and checking messages and email. It seems to me like we need time to just be off-grid and just mentally recharge.
Jen Cox: I could not agree with you more, and the CDC could not agree with you more. Some of the things that actively contribute to suicide prevention is having a healthy organizational policy and culture. The CDC is actively telling us that if your workplace does not respect your work-life balance, that contributes to suicidality. So yes, work-life balance is essential to your well-being and health. Having that ability to turn off your phone, to tune out whatever your responsibilities are in the workplace so that you can take time for you and for your family, that is essential.
Paul Szmal: What are some of the things you do in Family Counseling Service of the Finger Lakes to try to help?
Jen Cox: Well, I know everybody thinks about our therapeutic services, and as a therapist, obviously that's something that I'm very proud of that we do provide, but our reach does go beyond that. For example, we have our LGBT plus advocacy program that contributes to a sense of belonging and connection for our LGBTQ members of the community. We have our DV advocacy program that is helping people in some of the most dangerous situations they can imagine find safety and find a way forward for their families. We have opportunities like this where we connect with you in the community to try and destigmatize some of those really difficult conversations about mental health. We talked about the CDC. Also, NAMI, the National Alliance on Mental Illness, has a good resource set for Suicide Prevention Month at nami.org. You'll find that link.
Paul Szmal: What do we do if we suspect someone in our lives is seriously suicidal? What do we say, and more importantly, what don't we say?
Jen Cox: That is a very tricky question because a lot of it is going to be listening to your gut judgment in the moment, listening to what relationship you have with that person, because I would tell you to approach it differently if it was a friend versus a coworker, for example. The most important thing is to establish immediate safety, figure out if this is somebody who's acting or talking like something drastic is going to happen the minute they leave the room, or if you have a little bit more breathing time to understand what's going on. The next thing you're going to do is remind yourself to not be judgmental. Our gut instinct when somebody tells us that they want to not be here anymore is to start defending that they should be here, start saying that whatever you're going through, it can't be that bad. We'll figure it out together. But if the person you're talking to has already reached this point where they are openly acknowledging with you out loud that this is what they're thinking of, then whatever they are experiencing does not look like it has a light at the end of the tunnel for them, and you trying to force them to see that before you've given them that breathing space to keep opening up with you is going to make them feel like they're burdening you and they're going to close down.
So as difficult as it is, you have to sit and acknowledge with them for a moment that right now in that second, this experience for them is real, and this is what feels like their option right now. And as you breathe together, start trying to find what we call the turning point, something that might make it worth for them to try one more day or to try working for safety. The more you know about a person, the easier it is to try and connect with this. But it could be a loved one that they need to take care of. It could be something that needs to happen tomorrow. If it's something like, well, you always talked about publishing a book that could take years, focus on something that is here today that provides meaning and that their absence would impact, don't guilt them into it. Don't be like, if you leave, it's going to make everyone sad because they already feel guilty. They've already thought about that. But ask them, would it be worth it for you to have one more day with this person you care about or to have another opportunity with this thing that you're working on right now? And then ask, what do we need to do together to help you be safe today? One day at a time.
Paul Szmal: All right. That's fantastic. ESFL.org is the website for Family Counseling Services. The Finger Lakes September is Suicide Prevention Month. Jen, thanks for what you do, and thanks for sharing this information today. It's very important.
Jen Cox: Absolutely. Thank you for having us.
