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‘Someone that could really relate’

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A few days after making a wonderful speech at the American Association of Suicidology conference in April, an “out” attempt survivor was abruptly fired from their job at a crisis center. After five years of promotions and no disciplinary actions, the person was told their “skill set” no longer fit and was escorted from the building.

This was outrageous, and it made us wonder whether crisis centers across the U.S. value lived experience of suicidal thinking.

The results are mixed. We relied on individuals’ experiences for this post, but we look forward to the results of a new survey the National Suicide Prevention Lifeline is doing among its more than 150 crisis centers. The survey asks what centers are doing to include and support attempt survivors, and the first results are expected this month.

An advisory meeting of attempt survivors, convened by the Lifeline in 2007, specifically suggested that the Lifeline engage attempt survivors as crisis line workers.

The center that fired the crisis worker is a member of the Lifeline network. The Lifeline, however, has no say over members’ employment practices.

Some people who work with crisis centers across the U.S., including attempt survivors, have told us about positive experiences:

“Having prior experience with receiving help has not been a barrier to being hired but in many cases an asset,” a worker in Iowa wrote.

“In my experience, most people who are survivors of suicide loss or survivors of suicide ideation/attempts have not only been able to handle suicide calls well, they have excelled,” a crisis center director in New York wrote. “Often they are the best possible person for a suicidal person, or someone who is worried about a suicidal person, to talk with.”

“I disclosed to my supervisor prior to being hired and she was enthusiastic about having someone that could really relate,” a worker in Virginia wrote.

“Several of the staff, of course myself included, and many of the current counselors have lived experience, which is in part what brings us to this work to begin with,” a worker in California wrote.

The American Association of Suicidology’s standards manual for crisis program accreditation doesn’t have a clear position on including people with lived experience., but it says programs with the highest rating would include them on their boards and seek their input. Otherwise, “it is important to screen for the individual’s emotional readiness to provide crisis work and attitudes in approaching persons in crisis.”

A soon-to-be-released national report by an attempt survivor task force with the Action Alliance for Suicide Prevention stresses the need to include people with lived experience throughout suicide prevention efforts, including crisis services.

But discrimination against people who disclose their suicidal attempts or suicidal thinking does continue.

The former head of a crisis program on the West Coast explained how people would not be hired, or taken on as volunteers, if they mentioned lived experience. Some people who disclosed, especially about a recent attempt, while working for the program were forced out.

At the same time, this person was an attempt survivor, but they made sure to keep that experience quiet.

My own experience was surprising. Shortly after my last attempt in early 2011, I contacted the Samaritans in New York to volunteer. It’s a two-step process: You submit an electronic form showing interest, then you receive a packet telling you when to come for interviews.

I didn’t disclose on the form, but during the interview I disclosed about my attempt and was told to wait at least six months. (This appears to be common practice for crisis centers.)

Months later, I tried again. This time, I disclosed on the electronic form. No invitation packet came. Eventually, I called and left a message asking if I wasn’t invited because I was an attempt survivor.

Soon afterward, the executive director called. We had never met, never talked before. He didn’t know me. And yet, he told me I would not be able to volunteer.

I would be “eviscerated” by the training, he said. That word has stayed with me.

After the firing in April of the crisis center worker, I tried the Samaritans again. I didn’t disclose on the electronic form. I was invited to the interviews, where I filled out a more extensive application and disclosed there.

Here are some of the application questions:

“What abusive situation, health problem or personal crisis or traumatic experience have you been through yourself?”

“Have you ever called Samaritans or any hotline? If yes, when, for what reasons?”

“Are you now or have you ever been involved in AA or another ’12 step program’?”

“What experience(s) have you had personally, directly … with regard to suicide, including your own …?”

“Have you recently consulted or are you presently seeing or under the care of a doctor or a mental health professional? If yes, please state the following: when, under what circumstances, for how long, diagnosis, any medications and how long you have been taking them, etc.”

A look at a couple dozen volunteer applications for other crisis programs across the U.S. shows simpler ways of asking about lived experience, if a program asks at all. Some applications are more on point, asking how certain crisis situations should be handled or what the applicant’s point of view is about, for example, chronic mental illness. (Then again, a Baton Rouge crisis center asks about attempts and says, “May we contact your therapist?”)

I had two interviews on my Samaritans visit. The first was brief and focused on logistics. The second was much longer and focused on my mental health experience. Why had I attempted suicide, and when? What did I do afterward? And so on.

Between the interviews, when we were waiting to be called, we chatted about lived experience. I asked a Samaritans person if they welcome people with experience of suicidal thinking.

“We don’t talk policy,” he said.

Days later, I received a form letter rejection.

The conversation with the Samaritans executive director makes me wonder why an “out” attempt survivor would not be allowed to even apply.

Let’s end with some legal context in plain language:

It is illegal under the Americans with Disabilities Act and Section 504 of the Rehabilitation Act for an employer to fire, refuse to hire or otherwise treat unequally a qualified employee or applicant because of mental disability, including suicidal thinking or suicide attempts.

These laws also protect people who are regarded as having a mental illness, regardless of whether a diagnosis has been made.

Volunteers may also be protected. An organization that receives federal financial assistance pursuant to Section 504 cannot discriminate against its volunteers on the basis of mental disability. Volunteers may also be protected under the ADA where they receive significant non-wage compensation (worker’s compensation or insurance coverage, for example), or where the organization regularly hires volunteers into paid employment.

Volunteers for state and local government programs or activities may also be protected from discrimination on the basis of disability under the ADA.

The Washington, D.C.-based Bazelon Center for Mental Health Law, a leading national organization advocating for the rights of people with mental disabilities, is focusing resources on addressing discrimination in the workplace, licensing, volunteering and other areas.

“Everyone has the right to be free from discrimination and stigma in the workplace or while contributing their time to a cause they believe in,” says Emily Read, senior staff attorney.

7 Comments Join the Conversation

  1. Thanks for posting this. It seems very odd to me. I can’t help wondering what he meant by “eviscerated”. It would be great it you got through and then found out and told us. He clearly doesn’t think someone with past experience can “take it”, which I think is wrong. That sort of thing would make you stronger, I’m guessing.

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  2. This is an excellent article. As the former manager of a crisis center, I suggest that the NSPL Network develop standards for crisis call centers regarding the use of people with lived experience as both staff and volunteers and “encourage” and/or require affiliated center to use it. Many volunteers, interns and staff members would only come out as attempt survivors or survivors of suicide after they were hired due to the fear that their history would be held against them. Attempt survivors and survivors of suicide are some of the best phone crisis counselors. Please we must all work to overcome the stigma, shame and intorerance associated with suicide.

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  3. The most persistent discrimination of people with lived experience of suicide and/or mental health challenges is in professionalized mental health care and suicide prevention settings. The irony is that so many of us working in these fields have lived experience ourselves. Individual crisis centers must take a hard look at themselves and their policies. If you believe that people can recover after a crisis, then you must be able to believe that a person in recovery can be a capable volunteer or employee. More than capable, from what I’ve seen.

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  4. It’s not the first time I’ve heard of people being fired for disclosing that they are suicide attempt survivors but I was so disturbed after reading this blog that I literally had to step outside into the warm sunlight and take some deep breaths. Outrageous would be an understatement.

    The next thing I did was spend about 45 minutes researching words like “peer specialist,” “peer to peer” support, “lived experience.”

    Some facts I found:

    Peer support was recognized by Centers for Medicare and Medicaid Services as an evidence-based practice in 2007 (7 years ago).

    In 2003, the President’s New Freedom Commission on Mental Health Report recommended
    using consumer providers, stating, “Because of their experiences, consumer providers bring
    different attitudes, motivations, insights, and behavioral qualities to the treatment encounter.

    Peer Specialist Toolkit:

    http://www.mirecc.va.gov/visn4/docs/Peer_Specialist_Toolkit_FINAL.pdf

    “As part of a Federal initiative to move the concept of recovery from policy and vision statements into practice…” http://www.samhsa.gov/recoverytopractice/

    Recovery to Practice is a SAMHSA-Funded Project to bring recovery principles into behavioral healthcare.
    “Recovery-oriented practices are based on an appreciation of each person’s right to determine, to author, his or her own life [and of] the central role that choice plays in defining who and what we are …Implementing high-quality and effective psychiatric rehabilitation and other evidence-based practices is not enough to accomplish transformation if the status and role of people in recovery is not also dramatically transformed from that of a passive ‘mental patient’ to that of an empowered citizen.”
    – Recovery to Practice Project Director Larry Davidson. Ph.D.

    As the executive producer of a newly released documentary that expresses the need to include the lived experience and voice of the attempt survivor in treatment and strategy planning, I can see that the systemic barriers are higher and deeper than I ever imagined. I also believe that there is a peaceful revolution stirring and the we can initiate changes. And by doing that, we will save lives.

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  5. I’m not surprised — because the same thing happens in a majority of public and private employers across vast and different sectors of our economy. It is especially rampant within the Department of Defense and the Armed Services (continued higher than normal suicides and suicide attempts). The rejection, stigmatization and discrimination of, and by, family members, friends, coworkers, employers, etc is very real, and causes additional problems when a suicide survivor is already at their weakest. I know, I walk the path daily.

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  6. I came to this web site looking for help and support. I am new to all of this “lived experience” talk but am well versed in suicidal thoughts and attempts. I have no idea what I am going to do after reading this about crisis centers firing/refusing to hire people like me, I do know that crisis centers/hotlines will not be anything I reach out to. I am also well versed in “alone” and that is exactly where I will stay.

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  7. One of the few evidenced based practices for people who are often suicidal is DBT and it was developed by a woman Dr Marsh LInehaln who didn’t disclose her own extensive mental health history (she was hospitalized for two years in high school) and her repeated suicide attempts and suicidal ideation even when she was driving to work to run a research trial into suicidal behavior at the University of Washington.

    It was only last year shortly before she semi-retired that she came out publicly via a New York Times article in 2011 http://www.nytimes.com/2011/06/23/health/23lives.html?_r=0 (although many of her graduate students were aware of her history (and the very visible scars on her arms)

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