Suicide Stigma Busting

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Effectiveness of universal school-based mental health awareness programs among youth in the US: a systematic review
What is the stigma behind suicide?
What is Stigma? Why is it a Problem?
StigmaFree Me
StigmaFree Quiz
Why Mental Health Education in Schools is So Important?
‘1 in 5 Minds’ Campaign Urges Sharing Stories to Bust Childhood Mental Health Stigma
“Let's Bust the Stigmas" Surrounding Mental Health
States Begin Requiring Mental Health Education In Schools
Breaking The Silence-A Stigma Busting Curriculum - New Mexico (12 page PDF)
Breaking the stigma around suicide
Preventing Suicide - SAMHSA (230 page {DF)
Toolkit for Mental Health Promotion and Suicide Prevention - (293 pae PDF)

Effectiveness of universal school-based mental health awareness programs among youth in the US: a systematic review



Stigmatizing attitudes toward mental illness and low mental health literacy have been found to be barriers to seeking help for mental health related issues in adolescents. Prior research has found that it is possible to improve these outcomes using school-based mental health interventions. The purpose of this study was to review empirical literature pertaining to universal interventions addressing mental health among students enrolled in US K-12 schools, especially related to health disparities in vulnerable populations.


PsycINFO, Cochrane Library, PUBMED, and reference lists of relevant articles were searched for K-12 school-based mental health awareness interventions in the US. Universal studies that measured knowledge, attitudes, and/or help-seeking pertinent to mental health were included.


A total of 15 studies were selected to be part of the review. There were 7 pretest/posttest case series, 5 non-randomized experimental trial, 1 Solomon 4-groups, and 2 randomized controlled trial designs (RCT). Nine studies measuring knowledge, 8 studies measuring attitudes, and 4 studies measuring help-seeking, indicated statistically significant improvement.


Although results of all studies indicated some level of improvement, more research on implementation of universal school-based mental health awareness programs is needed using RCT study designs, and long-term follow up implementation.

What is the stigma behind suicide?

  • Stigma: "A mark that denotes a shameful quality in the individual so marked" or a quality that is considered to be shameful in a certain individual
  • Social Stigma: "Prejudicial attitudes and discriminating behavior directed towards individuals with mental health problems as a result of the psychiatric label they have been given"
  • Perceived stigma/self stigma: "Internalizing by the mental health sufferer of their perceptions of discrimination"

Source: Psychology Today

Examples of suicide stigmas (all of these are harmful):

  • Asking someone about suicide may plant the idea in their minds
  • Suicidal people are fully intent on dying
  • Everyone who dies by suicide is depressed
  • A sudden improvement in emotional state after a suicide attempt or a depressive period indicates the suicide risk is over

What current factors contribute to stigma?


Family members' relationship to person may affect the extent to which the patient stigma is transferred to family members. In extreme cases, family members may begin to stigmatize the person and behave in a way that leads the patient to believe suicide is the solution for the situation. A study also found that adolescents with mental health problems found stigma directed at them coming from family members. 46% of them described stigmatization in terms of unwanted assumptions.


In the same study mentioned above, 35% of adolescents reported stigma by teachers. These teachers would show "fear, dislike, avoidance, and underestimation of abilities" towards these students.


In the same study mentioned above, 62% of adolescents experienced stigmatization from their peers. This stigmatization leads to friendship losses and social rejection.


The popular press has been criticized for perpetuating stereotypes, especially via film and social media.

Film, television, and music portrayals of suicide perpetuate and glorify stereotypes that may lead to imitation acts. In social media sites such as Tumblr, the exhibition of self-harm, suicide, depression, and self-loathing are placed under the pretext of something that is "beautiful, romantic, or deep."

This glorification of self-pity could lead to the drowning out of stories of those who are clinically depressed versus those who are not. While social media does allow for awareness on the topic and self-identification, misinformation about the mental disorders are prevalent, leading for mental illness diagnoses, such as depression, for normal everyday things.

Why is the suicide stigma so damaging?

  • The stigma does not promote a healthy recovery:
    In a study published in the British Journal of Psychiatry, 83% of participants felt conscious of the stigma associated with mental illness and had difficulty seeking help. Only 54% of participants had discussed their suicidal thoughts with their family, peers, and/or spouses.
  • The stigma negatively affects treatment outcomes:
    The "perceived stigma can affect feelings of shame and can lead to poorer treatment outcomes" (Psychology Today).
  • The stigma negatively affects the perception of self and others:
    Those with depression and schizophrenia were viewed as unpredictable and dangerous, and those people would be less likely to be employed.

What are the different ways to challenge the stigma?

Participate in a campaign that challenges the stigma:

Participate in discussions and events between individuals with and without mental problems. This will help improve attitudes, increase future willingness to help, and promote behaviors associated with anti-stigma engagement.


  • Accept differences
  • Enable people to believe their own experiences, and not rely on stereotypes
  • Medicalizing suicide may be partly useful, but the issue needs to extend beyond disease models
  • Start from what people know, not what you think they know
  • Talking about wanting to die or kill oneself
  • Looking for a way to kill oneself (ex: buying a gun)
  • Talking about feeling hopeless or having no reason to live
  • Talking about feeling trapped or in unbearable pain
  • Talking about being a burden to others
  • Increasing use of alcohol/drugs
  • Acting anxious/agitated; behaving recklessly
  • Sleeping too little or too much
  • Withdrawing or feeling isolated
  • Showing rage or talking about seeking revenge
  • Displaying extreme mood swings

Be Aware of the Warning Signs

The longer the signs last, the more serious they are, and the more they interfere with daily life, the greater chance that professional treatment is needed.

If you are concerned, ask the question.

  • "It sounds like things are really rough right now, and I am concerned about you. Are you thinking about killing yourself?"
  • (or) "Have you ever thought about attempting to kill yourself?"
  • (or) "Do you sometimes feel so bad that you think of suicide??"

If person needs immediate help

  • Do not leave the person alone
  • Call Public Safety 206-296-5911 (24-hours/day) or 9-1-1 or the King County Crisis Clinic at 206-461-3222
  • Remove any drugs, alcohol, firearms, and sharp objects
  • Take the person to a medical/mental health professional
  • Never keep talk about suicide a secret


Crisis Lines and Hotlines

Nearest Emergency Departments

On Campus Resources

  • Counseling and Psychological Services (CAPS) - professional team of licensed clinicians provide confidential individual and group psychotherapy for students and referral services for those requiring specialized or on-going care. These services are provided free of charge to students currently enrolled.
  • Public Safety - offers 24-Hour Emergency Line: (206) 296-5911
  • Campus Ministry - Regardless of one’s faith background, Campus Ministry offers a chance for individual exploration in a one-on-one confidential setting with a Campus Minister experienced in the art of assisting others with personal and spiritual growth.
  • Student Health Center - offers on-campus healthcare.
  • Health and Wellness Crew (HAWC) - is made up of student volunteers who are trained as certified peer health educators. HAWC is here for you as peers to answer questions, offer support, provide resources.


What is Stigma? Why is it a Problem?

Stigma is when someone, or even you yourself, views a person in a negative way just because they have a mental health condition. Some people describe stigma as a feeling of shame or judgement from someone else. Stigma can even come from an internal place, confusing feeling bad with being bad.

Navigating life with a mental health condition can be tough, and the isolation, blame and secrecy that is often encouraged by stigma can create huge challenges to reaching out, getting needed support and living well. Learning how to avoid and address stigma are important for all of us, especially when you realize stigma’s effects:

  • People experiencing mental health conditions often face rejection, bullying and discrimination. This can make their journey to recovery longer and more difficult.
  • Mental health conditions are the leading cause of disability across the United States.
  • Even though most people can be successfully treated, less than half of the adults in the U.S. who need services and treatment get the help they need.
  • The average delay between the onset of symptoms and intervention is 8-10 years.
  • Suicide is the second leading cause of death of youth ages 15-24 and the tenth leading cause of death for all Americans.


StigmaFree Me

The need to eliminate stigma is nothing new. Fifteen years ago, a U.S. Surgeon General’s Report on Mental Health—the first and only one to date—identified stigma as a public health concern that leads peoples to “avoid living, socializing or working with, renting to, or employing" individuals with mental illness. Thanks to stigma, people living with mental health conditions are:

  • Alienated and seen as "others."
  • Perceived as dangerous.
  • Seen as irresponsible or unable to make their own decisions.
  • Less likely to be hired.
  • Less likely to get safe housing.
  • More likely to be criminalized than offered health care services.
  • Afraid of rejection to the point that they don’t always pursue opportunities.

Many people living with mental health conditions don’t feel comfortable talking to their friends and family about what they’re dealing with. Those living with a mental health condition don’t want it any more than a person would want a broken leg. But focused thought and effort can’t make depression go away, just as focusing on healing won’t fix a shattered bone.

Even worse, individuals living with mental illness often internalize the stigma that exists in our culture, damaging hopes for recovery. Some don’t seek treatment from a mental health professional. Their conditions worsen because they aren’t receiving the support and care they need to recover. And too often people take their own lives because they aren’t told by anyone that they’re not alone, they can recover and there is hope.

To change this harmful status quo, NAMI is asking everyone to take our StigmaFree Pledge. Building a movement for change will require commitments from individuals, businesses, organizations, campuses and churches, as well as others.

Once you’ve taken the pledge, consider all the ways you can live StigmaFree in your daily life. Maybe you can begin by being aware of the language you use or by choosing to be open or by deciding to learn more about mental illness.

Every day brings new hope. Every day, we have an opportunity to help create broader understanding of mental health, overcome stereotypes and break down barriers. We can all do a little bit more each day to eliminate stigma and replace it with help and hope.

So, help NAMI spread the word. Take the StigmaFree pledge and encourage your family and friends to do the same. This initiative, this movement is our attempt to reverse the harmful effects of stigma. So, when you hear someone using stigmatizing language, correct them. If you see someone using misleading stereotypes, educate them. And never forget to see people for who they are, not for how they act during their darkest days.

Together, we will turn the tide on stigma by spreading awareness, support and understanding for every person who experiences mental illness. Together, we can make a difference for the better.



StigmaFree Quiz

One in 5 Americans is affected by mental health conditions. Stigma is toxic to their mental health because it creates an environment of shame, fear and silence that prevents many people from seeking help and treatment. The perception of mental illness won’t change unless we act to change it.

Take the StigmaFree quiz to see if you are affected by stigma. Examine the correct answers to learn about the affects of stigma and what you can do to help.

Are You Affected by Stigma?


Breaking the stigma around suicide

September is Suicide Prevention Month, a time to share resources and stories and to break the stigma associated with suicide. Now more than ever, as people's mental health is really being put to the test, we need to talk about this reality.

That’s exactly what Brad Gill is doing, sharing his story to reach others. He lost his father when he was 48 years old. “He was awesome, really focused, kind of intense to be honest, I have to mention that too. But he was really focused, successful, worked a lot. As far as his background from a mental health perspective, everybody thought that he was almost even, like superhuman or Superman. He would always be helping other people.”

Gill said his dad never really showed any signs that something was wrong. “There's some stigma I suppose. There's some assumption that with suicide, it's like, oh, it only affects people of a certain socio-economic status, or maybe people with certain health challenges or whatever it might be. It really doesn't discriminate.”

According to the CDC, suicide is the 10th leading cause of death in the U.S., with a 35 percent rise in the suicide rate from 1999-2018.

Christy Buck, executive director of the Mental Health Foundation of West Michigan, says that simply talking about suicide can be more powerful than people realize. While people may want to avoid the topic, becoming comfortable in having tough conversations with family and friends can save a life. "We have to get to the point where we're actually having good conversations with people, where we're actually asking someone the question, 'Are you thinking about suicide?'” she said. "We know that that is a life-saving question."

As for Gill, he is now on the board of the Mental Health Foundation of West Michigan and attends events like Stomp Out Stigma with his family, sharing his story, all in the hopes it helps someone else feel less alone.

"I think that (Dad) would just be proud of us sort of taking a negative experience and turning it as positive as possible," says Gill. "I’m just thankful that we were able to take what happened and kind of lean into it as much as possible and use it to help so many other people."

If you want to get involved in this year's Stomp out Stigma 5k Walk, it is Thursday, September 10, which is Suicide Prevention Day. The walk will be virtual, but there a lot of different ways you can participate.

Why Mental Health Education in Schools is So Important?

With the prevalence of mental health issues in our society, it’s astounding that we still tend to stigmatize mental illness. Many mental health misconceptions still exist.

Mental health issues often begin during the school-age years. It follows, therefore, that education about mental health should to also start at an early age. Because children spend so much of their daily life at school, mental health education logically should begin in schools.

Some facts about mental illness

Millions of people globally are affected by mental illness. In America, an estimated one in five adults experiences mental illness in a given year, according to the National Alliance on Mental Health.

The Centers for Disease Control and Prevention reports that one in five children in the U.S. currently have, or at some stage have had, a debilitating mental illness. Fifty percent of mental illness begins by the age of 14, according to the American Psychiatric Association.

Depression is on the rise

Mental illness, particularly depression, is predicted to become one of the major health burdens in the future. The World Health Organization (WHO) states that depression is the leading cause of disability worldwide. Over 300 million people of all ages suffer from depression.

As childhood and adolescent mental health disorders are so common, it’s baffling that we are not equipping our children with an understanding of mental health.

Undiagnosed, inadequately treated or untreated mental illness can seriously affect their ability to learn and grow. It can lead to negative coping mechanisms and at worst, may result in suicide.

Opportunities for mental health education in schools

The breaking down of stigma and misconceptions about mental illness has to start in schools. School is where friendships begin. It is where teens hone their sense of self-worth.

It’s also the place where children need to learn that their behavior towards others can cause serious self-worth issues. Many students experience conflicts, bullying and social exclusion at school.

Alex Crotty was only eleven when she started feeling miserable all the time. She felt disconnected from other children and empty. She suffered alone and even switched schools, but that did not help. It was only when she was 14 that she told her mother what was going on.

She was diagnosed with major depression and anxiety and was able to receive treatment. Her story reveals the difficulty young people experience when it comes to speaking out about their depression or anxiety.

Anxiety symptoms in children are often minimized or ignored

In the school environment, children face many challenges. Some are better at managing these than others.

Many children feel anxious, ranging from mild symptoms to more severe forms, such as panic attacks. When these symptoms are ignored, they can lead to depression, lack of performance and increased risk of substance abuse.

Related Content:

The Importance of Teaching Health in High School

We Need a Focus on Mental Health, Not Just Violence, In Schools

The teen suicide epidemic

The Netflix show “13 Reasons Why” is currently in its second season. Teenager Hannah Baker is a victim of gossip, bullying, rape and body shaming. She commits suicide and leaves behind 13 tapes explaining why.

The show has many detractors, including health awareness professionals and parents who believe that it offers very little insight into the psychology of suicide. They believe it highlights just how bad things can get and how cruel teenagers can be and may even contribute to new ways for teens to think about suicide.

All of these criticisms may be fair, but the show has certainly provoked dialogue about the epidemic of teenage suicide, a very real problem. Suicide is the second leading cause of death for people aged 15 to 24 in the U.S. (Editor's Note: In 2017 (latest CDC data) reports that Suicide is the leading cause of death for 15-54 year old Oregonians. See

The influence of social media on mental health

Current research indicates a possible connection between increased social media use and mental health although it’s still unclear exactly how they are connected. What is clear is that young adults are the most active users.

Some studies show that online connections to small groups of people may be beneficial, while other research indicates a connection with anxiety, depression and eating disorders. With no long-term studies having been completed, we are still largely guessing at its influence.

The upside of social media is that teens are hardwired to socialize, and social media makes it easy and immediate. Teens in marginalized groups may find it easier to make friends and find support.

The downside of social media is that those using social media may be faced with many negatives such as toxic comparisons, cyberbullying and less face-to-face interactions. Someone’s reputation can be destroyed in minutes and face the consequences for years.

The importance of early intervention

Family, friends, teachers, and individuals themselves often notice small changes in thinking and behavior before a mental illness appears in the full-blown form. Learning about early warning signs, and taking action can help.

It can reduce the severity of the illness, and it may even be possible to prevent or delay the development of a major mental illness. Some of these signs are apathy, feelings of disconnection, nervousness, unusual behavior, withdrawal, mood changes and a drop in performance.

Mental health awareness in schools

In an article written by Nancy Barile, M.A.Ed. on the importance of mental health awareness in schools, she relates how she noticed some drastic changes in one of her students over a short period of time.

The student no longer did her homework, and she would come to school in the same clothes, although she’d previously been meticulous about her appearance. She was withdrawn and distant when Barile tried to speak to her.

Barile had some training in mental health issues and recognized that the student was in trouble. Social workers on the staff were able to speak to the student and found that she was depressed, suicidal and in need of immediate psychiatric intervention.

She was admitted to the hospital for a short while, given medication and therapy and managed to graduate with her class.

Mental health education should be part of the curriculum

We need to be working towards a school environment where students are able to recognize when they’re dealing with mental health issues and feel they can ask for help.

79% of British parents feel that mental health education should be a part of the curriculum in schools. Across the globe, parents understand the need for mental health education for children. With 50% of mental health conditions developing in children of age 14 or below, the support for the cause is growing rapidly.

Adding mental health education to the curriculum

Open lines of communication between home and school should exist where parents are able to share their concerns about their children and collaborate with teachers to address them.

Just as physical education is part of the curriculum in schools, mental health awareness and education should be too. Our children spend most of their day at school. We need to empower them with knowledge about mental illness.

Related content:

A Back-To-School Checklist for Children with Special Needs

Five Tips for an Effective Health Education Curriculum

Progress is being made

A growing number of schools are beginning to realize the importance of mental health education. They are working to create an environment where mental health issues are recognized and support is offered.

School-employed mental health professionals work with teachers to provide support and with parents to better understand students’ needs and implement appropriate support.

In July 2018, New York became the first state in the U.S. to require mental health education for all students. The School Mental Health program will promote the healthy emotional, social, and behavioral development of all the students.

It will also take into account the general well-being of school staff and families, and collaborate with other student support and services. Mental health needs will be assessed, and access will be provided to mental health services and programs.

What do we know about the effectiveness of these programs?

As reported in US News and World Report, a few small studies have found “that teaching high school students about mental health improved their attitudes toward treatment, increased willingness to seek help from a counselor and boosted their overall mental health literacy.” There is a pressing need for more studies to determine programs’ effectiveness and identify ways to improve them.

Mental health education is not yet mandatory in schools. Until it is, teachers and administrators need to help shine the light on the concept of self-care. And, they need to emphasize the fact that mental health is an integral part of health.

The Bottom Line

A cultural shift in attitudes about mental health needs to start with the young. The only way they’re going to understand more about mental health and stop stigmatizing is if they receive the necessary education.

Schools need to foster an environment in schools where mental health issues can be identified and addressed without being stigmatized. Awareness should be raised about mental health crises, such as self-harm, substance abuse, eating disorders and other negative coping behavior needs to be created.

If everyone in schools is empowered with knowledge, and dialogue is encouraged, students will have the freedom to open up about what they are going through. This will allow them to get the support they need before it’s too late.

Making mental health education a mandatory part of the school curriculum is long overdue.

1 in 5 Minds’ Campaign Urges Sharing Stories to Bust Childhood Mental Health Stigma

“Will they think I’m crazy? Will they think my child is crazy?”

Parents and kids worry what other people will think if they talk about childhood mental health issues. Negative stigma often keeps them from seeking help.

This isn’t news to Michele Brown, vice president of marketing and development at Clarity Children’s Guidance Center in San Antonio, Texas (63.7% Latino). Brown knows the shocking stats all too well:

  • 1 in 5 kids suffer from mental illness.
  • Of those, only 1 in 5 receives treatment.

These stats spurred Clarity’s “1 in 5 Minds” campaign to share stories, counter mental health stigma, and boost support, Brown said.

The Problem of Mental Health Stigma

Stigma is when someone, or even you yourself, views a person in a negative way just because they have a mental health condition, according to the National Alliance on Mental Health (NAMI).

Stigma is especially relevant for Latinos.

Latino youth are far more likely than their peers to have mental health issues, which often go unaddressed and untreated. Immigration, cultural identity, poverty, bullying, and other factors affect these disparities, according to a Salud America! research review.

People who don’t get the mental healthcare they need have higher rates of attempted suicide, dropping out of school, abusing substances, etc.

Michele Brown at Clarity wanted to do something to help.

Clarity Children’s Guidance Center is San Antonio’s only nonprofit treatment center for children ages 3-17 who suffer from serious mental health problems. Clarity’s counselors engage people in community education and school resource fairs.

But families need more than just information, Brown said.

They need tools to help them move past the stigma and know what to do and where to go next. They need to know that they are not alone in this.

“In our society, we have a tendency to judge,” Brown told KENS5 in San Antonio. “Parents are afraid that if their child has behavioral issues or a mental illness that it’s going to reflect on their parenting.”

A Campaign to Support Healthy Minds

The Clarity team started to study different mental health campaigns.

They found a missing link: Promote talking about mental health and connect people to available resources.

That led to the “1 in 5 Minds” campaign.

Launched in 2013, the campaign aims to raise awareness about children’s mental illness. It also seeks to break down stigma and increase access to treatment. The goal is that “no one will be afraid to speak about mental illness” and all children “who need treatment will be able to access it.”

You can find information on mental health. You can download handbooks to help parents navigate their children’s systems of care. You can even get help for children with military deployed parents.

“The reality is we want to catch kids when they first start exhibiting behaviors that parents or caregivers start to question,” Brown said. “That’s when we want to help.”

But there’s much more than education.

Telling Your Mental Health Story

Clarity’s 1 in 5 Minds website also has a page for sharing your story.

You can also read other stories. Users can “learn, share, and speak up” using resources that show support to family or friends in need.

“Speaking up helps break the stigma of mental health,” according to the website. “Tell your story. Be part of the solution. Help others know that they are not alone.”

A Safe Place to Talk about Childhood Mental Health

Clarity’s 1 in 5 Minds campaign also created a space for people to gather to talk about mental health.

The safe place is a free mini-conference called Strong Minds, Happy Hearts. The event allows parents and school staff to talk about childhood mental health. People can see their peers going through the same issues, and they won’t feel so alone, Brown said.

This two-and-a-half-hour long program is open to any community member.

Clarity staff provide a light meal and feature speakers who are mental health subject matter experts. They hold the meeting at a local school. Translation services and childcare are offered.

Because Latino families are less likely to access health care services for their mental and emotional needs, providing these services at a familiar location like their child’s school is helpful.

“We want to reach the kids now so that they can grow up to be resilient adults,” said Stephanie Peterson, Clarity counselor.

At a recent Strong Minds, Happy Hearts meeting, Peterson led a break-out session about cyber-bullying. Other topics covered how parents can work with schools to help children.

“When you have children or a child with mental illness, you feel like nobody understands…you go home to your house, and you tell everybody that everything is okay, and you lie. You’re ashamed because you think nobody else can be going through this. But the truth is there are so many families that go through this every day,” expressed a mother on 1 in 5 Minds website. “Once they educate themselves and see other moms and dads are dealing with it, it’s so helpful.”

Mental Health Awareness Month

The 1 in 5 Minds campaign also hosts events every May for National Mental Health Awareness Month.

One of the most colorful events is the month-long Maynicures movement.

You can sign up for Maynicures online. All you do is paint one finger on each hand one color and the remaining four a different color. This represents the 1 in 5 ratio of children with mental illness.

Organizers hope these fun manicures start mental health conversations among friends and family.

The 1 in 5 Pledge

pledge 1 in 5 mindsThe 1 in 5 campaign also urges you to take a pledge to learn, share, support, and speak out for mental health.

Clarity hopes others start their own anti-stigma campaign, using these tips:

  • Provide resources!
  • Use first-person stories
  • Digital presence is important
  • Partner with school districts
  • Collaborate with community partners
  • Offer bilingual resources

“Improving access to mental health care is something that everyone can contribute to in simple ways, such as talking about it openly,” said Fred Hines, Clarity president and CEO.

Take the 1 in 5 pledge today to change the future of children’s mental health!

You can also sign up for the new Salud America! “Trauma Sensitive School Action Pack.” It is a free guide with coaching to help school personnel craft a system support traumatized students!.

Get The action Pack!


“Let's Bust the Stigmas" Surrounding Mental Health

Students helped pass out wristbands at the mental health awareness presentation titled “Let’s Bust the Stigma.” From left to right: Caroline Lewis ‘20, Grace Horn ‘20, Lee Hayman ‘20, and Katie Belfance ‘20. Photo: Samara Benza/The Denisonian

SAMARA BENZA, Features Editor—Mental health and mental illnesses have been topics of conversation both on Denison’s campus and across the country. The conversation hits home to many of Denison’s students and faculty as well as Granville and Licking County citizens, as the epidemic is present in all of our lives.

Mission 34 and Active Minds came together to put on the “Let’s Bust the Stigma” presentation with hopes to raise awareness of mental health and mental illnesses. They also hope to stress the urgency of erasing the stigma surrounding suicide and mental illness. They brought in Penny Sitler, executive director of Mental Health America of Licking County to talk to Denisonians and local Granville citizens about the importance of speaking up and talking about mental illnesses.

Mission 34 was created in honor of the passed Sean Bonner of the class year 2020 who died by suicide in 2018. His parents were in attendance and both spoke regarding the importance of busting the stigma. Heather Bonner, Sean’s mother, said, “it shows strength to talk about anxiety and mental illness, not a weakness.”

Sitler provides astonishing statistics near the beginning of her speech that show the importance of prevention work: one in five people suffer from mental health related problems each year. She explains that people are four times more likely to die by suicide if someone close to them died by suicide. Suicide is the most preventable kind of death but when people don’t talk about it that is when the problems come in.

Sitler stresses the importance of the proper language when talking about suicide. The common way of talking about it is saying “they committed suicide.” But Sitler stresses to stay away from this. Saying someone committed suicide places the blame on them as if they did something wrong; instead say “died by suicide.” Mr. Bonner talked on this point in his speech when he stated that the reason his son died was depression and the effect was suicide. Sitler calls it “people first language” where we focus on the person who is suffering, not the illness or suicide.

Sitler talked about a method called QPR. QPR stands for question, persuade, and refer and was created to offer hope through positive action.

The first step, question, aims at starting the conversation. Asking a friend “are you thinking of suicide?” is a hard question to ask but it is crucial. Sitler states “ask a question, save a life.” She also explains that “there is nothing better than talking to someone who walked the walk you’re walking right now and talking.”

After you ask the question it’s time to persuade. If the friend is considering suicide it is important to persuade them to seek help in whatever form necessary and appropriate.

Finally, refer; refer your friend to a professional who can help them, be it a psychologist, medical specialist, even a pastor.

#B4Stage4 was created to bring awareness to the stigma surrounding mental health. Sitler explains that years ago cancer had a major stigma surrounding it and no one would talk about it. Now, when we hear someone has cancer we immediately say “What can I do to help?” “Do you need me to take the kids or drive you to your appointments?” Sitler wants the same to happen for mental health. She explains that “mental health is something you have not something you are.”

Remember, suicide prevention is everyone’s business and everyone can help prevent the tragedy of suicide.

Follow Mission 34 on Instagram @Mission34SPB and keep an eye out for their website that is expected to launch soon: For more information about Mental Health America of Licking County call 740-522-1341 or visit

States Begin Requiring Mental Health Education In Schools

Amid sharply rising rates of teen suicide and adolescent mental illness, two states have enacted laws that for the first time require public schools to include mental health education in their basic curriculum.

Most states require health education in all public schools, and state laws have been enacted in many states to require health teachers to include lessons on tobacco, drugs and alcohol, cancer detection and safe sex.

Two states are going further: New York’s new law adds mental health instruction to the list in kindergarten through 12th grade; Virginia requires it in ninth and 10th grades.

Nationwide, cities and states have been adopting a variety of initiatives over the past decade to address the rising need for mental health care in schools.

But until this year, mandated mental health education had not been part of the trend.

“We’re seeing a huge increase in youth anxiety and depression,” said Dustin Verga, a high school health teacher in Clifton, N.Y., who was an early advocate for the state’s new law.

“We teach them how to detect the signs of cancer and how to avoid accidents, but we don’t teach them how to recognize the symptoms of mental illness,” Verga said. “It’s a shame because, like cancer, mental health treatment is much more effective if the disease is caught early.”

A report from the Centers for Disease Control and Prevention this month shows the U.S. suicide rate rose by a quarter between 1999 and 2016. That and two celebrity deaths this month — those of fashion designer Kate Spade, 55, and chef Anthony Bourdain, 61 — have raised the nation’s consciousness about depression and suicide prevention.

But mental illness can set in much earlier than adulthood. More than half of lifetime mental illnesses begin before age 14, according to the National Alliance on Mental Illness. Yet the average person waits 10 years after the first symptoms occur before getting treatment.

By educating children of all ages about mental health, the hope is that they will learn how to recognize early symptoms in themselves and their friends and seek help before a crisis develops, said Paul Gionfriddo, president and CEO of Mental Health America, a nonprofit that advocates for better mental health care.

“People are talking more about youth mental health and the effects of trauma on kids, but it’s taken a long time to get traction. I think what we’ve seen recently in terms of school shootings is spurring this,” Gionfriddo said. “It wouldn’t surprise me to see a number of states go in the same direction over the next few years,” he said, referring to New York and Virginia.

The rate of adolescents experiencing major depression surged nearly 40 percent from 2005 to 2014, according to a study by researchers at the Johns Hopkins University School of Medicine, rising to an estimated 2.2 million depressed children ages 12 to 17, according to the most recent federal data.

Teen suicides also have spiked. According to the CDC, the suicide rate among boys ages 15 to 19 increased by nearly a third between 2007 and 2015; the suicide rate among girls the same age more than doubled.

But that only accounts for the deaths. Nearly 9 percent of youths in grades nine through 12 attempted suicide in the past year, according to the CDC’s 2015 Youth Risk Behaviors Survey.

In response, many states have increased funding for school counseling and added psychologists to their health staffs. Others are thinking of doing the same. Republican Texas Gov. Greg Abbott this month recommended adding more counselors to schools following a mass shooting at a Santa Fe school. His is one of 20 states that don’t require school counselors.

And most states have adopted so-called mental health first aid programs to train first responders, primary care physicians, teachers and other school personnel to detect the signs of mental illness and addiction and provide preventive measures including referral to treatment.

In addition, a slim majority of states mandate suicide prevention training for school personnel, and close to a dozen states require annual courses. More than a dozen states encourage and facilitate training, but do not require it.

In New York, it was a nonprofit mental health group that came up with the idea of requiring schools to educate students about mental illness in all grades. That was seven years ago.

The Legislature was immediately interested, said John Richter, the public policy director for the Mental Health Association in New York State Inc. “The problem was finding a way to cut in line ahead of dozens of other competing educational issues.”

It was the opioid crisis and its strong connection with mental illness that ultimately allowed the New York Assembly’s education committee to bring the mental health bill to a vote in 2016, Richter said. Armed with research showing that people with mental conditions often self-medicate with drugs and alcohol, the chairman found an eager audience of lawmakers who wanted to do everything they could to quell the overdose epidemic, he said.

According to the National Institute on Drug Abuse, people with a mood or anxiety disorder are more than twice as likely to develop an addiction to opioids and other drugs.

New York’s law doesn’t prescribe a specific classroom curriculum for mental health, leaving the details up to the board of education. But the state is giving $1 million a year to the mental health association to offer an online mental health resource center and free training services for teachers starting in July.

In the fall, New York public school teachers will be encouraged to incorporate the topic of mental illness into subjects such as science, literature, history and social studies whenever possible, according to Richter. And health teachers will be called on to develop lesson plans that describe the disease of mental illness, methods of treating it, and healthy coping techniques students can use to protect themselves and their friends from the mounting pressures of school life.

“The life students live today is very different from what it was just 10 years ago,” Clifton’s Verga said. “Technology and social media have taken over. Kids are getting cellphones at an earlier age and facing escalating academic expectations and standardized assessments starting in third grade.”

In Virginia, the path from idea to statute was much shorter.

The new law was the brainchild of three students who attended summer classes on political leadership at the University of Virginia. For them, the biggest political issue for high school kids was an urgent need for more mental health resources.

With that in mind, they decided that the best approach would be a statewide educational program that would explain the brain science behind mental illness, help students learn how to improve their own mental well-being, and reduce the stigma around mental health.

They found a receptive legislative sponsor in state Sen. Creigh Deeds, a Democrat from Charlottesville whose son stabbed him and later killed himself after being denied emergency psychiatric services in 2013.

Their bill flew through the Legislature and Democratic Gov. Ralph Northam signed it into law in March. It is set to take effect in the fall.