Culture of Caring

A Positive Approach to Suicide Prevention

Suicide is a growing problem in the US and around the world. Experts share prevention methods, researchers learn more about the causes, survivors teach others what they have learned, but it is not enough. It’s time to be innovative and resist doing the same things over and over just because that’s the way we’ve always done them.

Jackie Simmons has created a more positive approach to suicide prevention for youth. She sees herself as an advocate for living. Instead of intervening when a young person may be in crisis, the idea is to start a conversation with the question, “Why not?” It’s about re-wiring the brain to focus on reasons for staying alive before a crisis ever occurs. Jackie calls it the path to perpetual optimism.

In today’s world, youth suicide is increasing in spite of prevention efforts in schools and communities, research and advocacy by prevention organizations, increased public awareness, and a wide variety of training opportunities available to the public. It’s still hard to talk openly about suicide.

Suicide’s stigmas

Jackie believes three main concerns prevent conversations about suicide.

  1. The number one reason people don’t talk about their struggles with suicidal thinking has to do with other people’s opinions, judgments, and expectations.
  1. The second reason people don’t talk about it is because they don’t want to be referred to a mental health professional.
  1. The third reason people don’t want to disclose their true feelings is that they’re afraid of being a burden to others. They don’t want other people to worry about them. It is an act of selflessness when people take their own lives because they believe they’re relieving the family of a hardship.

In every group of teens, at least one is struggling to stay alive. What if we could break the silence and give everyone permission to “have the talk”?

Why Not?

Jackie created a “Why Not?” workbook for teens and young adults based on one simple question. It can help change our thinking about why suicide might seem like the best idea at the time, or why it’s not.

“Why not commit suicide today?” The idea is to list all the answers you can think of. Then revisit your responses. Repeat the exercise for 30 days. Share the list with family and friends and get everybody in on the activity. When asking others to listen, teens say they need help practicing their lists. Ultimately, most people will have a list of reasons why they want to stay alive to fall back anytime they need a reminder.  

If someone can’t list any positive reasons “Why not?”, a safety message is included in the workbook.

If your list, or someone else’s list, is completely empty, immediately call the Suicide Prevention Hotline: 1-800-273-8255. Offer to hold their hand as they call or ask someone to hold yours.

Calls can be made anonymously. It’s often easier to talk with a stranger than to share with someone who knows the possible players in our pain.

The Why Not Workbook is free. Anyone can download a copy and learn more about the strategy.

Re-wire the brain

When we are concerned that a friend or loved one is struggling with suicidal thoughts, current best practice tells us to ask them directly if they are thinking of suicide. The “Why Not” approach is very different.

Instead of saying, “I think you’re at risk. We need to talk,” another starting place might be to rephrase and say, “Why Not? Why is suicide not the best idea?” Teens who are following the “Why Not” approach spend time practicing scripts – the list of reasons why it’s not a good day to die. The more time they spend thinking about “Why Not”, the less time they have to dwell on their troubles.

The script is precise. Participants must promise they will read the script, use the guide, and they will not wing it. It is written in specific, neutral language for a reason.

Simply put, it changes thinking about suicide as a concept to reflecting on whether they have a personal connection to someone who’s tried or died in the community. Then they consider whether they ever thought of leaving that way. The list of “Why Nots” redirects their thinking to reasons for staying.

It is totally based on each individual’s story, the one thing the subconscious mind cannot argue with. The brain is building a neural network labeled “reasons for staying.” This new network, built on reasons for staying, now becomes a barrier to thoughts of leaving.

It works. Even if a person is good at masking that they’re suffering from depression and struggling to stay on the planet and people around them don’t know they’re struggling to survive. But that doesn’t matter. It doesn’t even matter if they lie because their subconscious mind is still hearing them list the reasons for staying and building a file folder labeled “Reasons for Staying”.

How does this work?

Jackie explains how she dug into the complicated concepts of the reticular activating system, neural networks, and the prefrontal cortex to determine why the teen brain struggles with suicide more than would be expected. It’s because they don’t have a pause button, or the benefit of perspective, since that part of the brain is missing or not fully developed yet.

By teaching kids to use the “Why Not” list, we no longer have to directly ask them if they are thinking about suicide. We’re teaching young people how to take suicide out of the shadows and shine a light on it. This becomes a stigma-free solution to a problem.

Learn more about Jackie Simmon’s approach to suicide prevention

Read the “Why Not” Workbook.

Learn about the Teenage Suicide Prevention Society.

See Jackie’s TED talk .

Sign up to participate in Talks that Save Lives.

Visit “Teaspoons,” aka the Teen Suicide Prevention Society (“TSPS”)

A Culture of Caring: A Suicide Prevention Guide for Schools (K-12) was created as a resource for educators who want to know how to get started and what steps to take to create a suicide prevention plan that will work for their schools and districts. It is written from my perspective as a school principal and survivor of suicide loss, not an expert in psychology or counseling. I hope that any teacher, school counselor, psychologist, principal, or district administrator can pick up this book, flip to a chapter, and easily find helpful answers to the questions they are likely to have about what schools can do to prevent suicide.

Theodora Schiro