Effective conversations about suicide and other mental health issues

Melissa J. Pereau, MD, has a passion for helping people during a critical point in their lives, which is why the psychiatrist spends her days working with patients thinking about or who have attempted suicide. As a medical director and psychiatrist at the Loma Linda University Behavioral Medicine Center, Pereau is faced daily with the realities of suicide and how the topic — and other topics around mental health — impacts nearly every community in some way.

Despite its prevalence, a discussion about mental health discussion is often rebuffed due to the sensitivities surrounding it. Although recent high-profile suicides stirred questions that have prompted individuals to confront the issue directly, the problem is wider. Nationally, the rate of suicide has increased by 30 percent since the mid-1990s, according to the Centers for Disease Control and Prevention. On average, there are 123 suicides per day in the United States, according to the American Foundation for Suicide Prevention.

Pereau’s work with patients and their support groups has inspired her to be a voice for mental health awareness. Her work has exposed her to many questions from patients and their friends and families about mental health and suicide. Pereau sat down for an interview to discuss mental health issues, including seeking support, help and tools. Here are some edited excerpts.

How should a friend or family member of someone suffering from mental health issues approach the conversation in a non-harmful way?

Make sure you’re not approaching the person with judgment. Go into the conversation being willing to show your own vulnerabilities and your own weaknesses. Coming from a place of love and care can best help you address the topic of thoughts of suicide or feelings of depression or anxiety.

If someone is avoiding seeing a physician because they believe they’re likely to receive a diagnosis, how can they mitigate the fear of the label?

Someone not wanting to see a mental health professional because they’re afraid of being labeled with “mental illness” makes sense, but it doesn’t help the root issue. It’s also the same as not seeing a doctor for fear of being labeled with diabetes. It still means you have the illness. It still means you need help, and it’s important for you to get the help you need.

What if someone’s circumstances are largely contributing to their emotional pain? How can they know what is caused by their situation and what is due to an underlying mental illness?

Life circumstances can definitely contribute to thoughts about suicide, and a person can become trapped and isolated by those circumstances. Having support and having people to reach out to is more important than anything else in those situations. Not being alone can help in both situations, whether suffering from mental illness or circumstances.

Are there any words or phrases you would advise people to stay away from when talking about mental health?

It’s important to stay away from things that sensationalize mental illness, mental health, details of suicide or details of illness. These things can be highly triggering. Instead, ask what someone is struggling with or what is causing them pain. These questions provide a lot more comfort than going into specifics.

What is a mental health assessment?

An assessment can be done by a variety of different providers, and it looks at current ongoing stressors and ways of dealing with those stressors. Sometimes, it looks at previous life experience, but often it looks at day-to-day experiences, and how far off you might be from your ideal baseline. You can talk to a psychiatrist, a psychologist, a social worker, a counselor or even your primary care doctor.

Should patients have concerns that antidepressants or psychiatric medications will change them as an individual?

Medications that treat mental illness are not designed to turn you into a different person. They are to help get you back to who you were before there was illness. Often, people are afraid to give the medication enough time to work. Some antidepressants can take up to six weeks or longer to work, so talk to your doctor to know what you should expect.

Is it better for someone with a mental illness to be treated by medication or by therapy?

The best management strategy involves medications in combination with counseling and therapies. This “whole person” approach to treatment works to both get you to the root of the issue and balance the chemicals in the brain.

How can a person even begin to cope with the suicide of a loved one?

Stay involved with other people, either by joining a support group, a small group of people you trust. There will often be a tendency to pull away from others, but without distractions, you are more likely to trigger painful memories about the loss. Work toward nourishing and regular eating habits and try to both exercise and rest. Both can help with the pain.

To continue the conversation, watch excerpts of Melissa J. Pereau’s Facebook Live segment, "SUICIDE: Know the Signs. Take Action."

If you, or someone you know is struggling with depression or thoughts of suicide, please make sure they know about the resources and after-hours phone numbers available 24/7, including the National Suicide Prevention Lifeline at 1-800-273-TALK (8255) and the Crisis Text Line at 741-741. Employees and students of LLUH may utilize the Employee Assistance Program by calling 909-558-6050.