An herbalists’ toolkit for Crisis

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Suicide. It is not something I see a lot of talks about at herbalist gatherings and events. But it is one of the top causes of death amongst our fellow Americans right now. Yes. And most of us know, in the back of our minds, that it is something we need to grapple with but it’s just so damn upsetting and confusing that it’s not being widely discussed right now.

So let’s start.

What can we, as herbalists, educators or other providers of healthcare in our community do to help? Where can we get more information to support our friends, family, students, clients and–even ourselves? It is a big subject which has no one easy answer, but let’s work together to learn more and shed some light into this darkness.

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So first, herbalists cannot “cure’ suicide. I am NOT alleging that we use herbs to fix this, though I do see herbal allies as one of many potential long-term supportive strategies. I’d also like to see us in discussion around the tension between privacy issues and crisis intervention-the whens, whys and hows.

What I would like to see is the development of 2 main strategies:

  1. Have a plan before the crisis.
  2. Know where to refer to for more help.

So, having a plan means asking ourselves what we will do when someone comes to us in a deep depression, with suicidal thoughts or exhibiting signs of risk factors for a suicide attempt. Learning what these signs are is a good start. Some examples here are serious PTSD, veteran status, serious head trauma, use of certain drugs, both prescribed and illicitly obtained,  history of or current severe depression, past history or past family history of suicide attempts. Check out some of the resources here for more information on risk.

And knowing where to refer means asking some basic questions such as: Do you know a trusted mental health-care practitioner to refer to? Do you have the phone number of a crisis hotline handy? Are you willing to call for emergency services if needed? And who can YOU ask for help if you need support or backup?

I’d love to propose that practitioners and educators who feel comfortable discussing crisis can display a hotline number in the office, facility or place of business. I’d love to see Icarus Projects’ books prominently displayed on our shelves and “You are not alone” stickers and posters in bathrooms.

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I’d love to see us use art, poetry, words and actions to communicate our openness to listening and helping to support people in crisis. And for us to just simply say “Hey, YOU can talk to me about this!”

I’d like to see us foster connections that build trust around mental health discussions. I’d like to see check-ins, mutual aid and people just generally giving a shit whether or not others in our community are OK.

I’d like to see acknowledgement that life itself  IS both dark and light, as well as all shades in-between. That some degree of depression is normal, and that you are not broken if you are not 100% happy. I’d like to talk back to the people who blame others for having “negative” thoughts, which are actually normal up to a point, and who seek to gloss over and dismiss the reality of life’s cycles and the systemic issues that help create feelings of isolation and helplessness.

I’d like to see classes, discussions and/or roundtable workshops on suicide prevention included in our education and our events. Both discussion of long-term mental wellness for prevention and discussion of identifying and taking action  in the crisis moment. We may also want to create a safe practitioner space to talk about our own fears, judgement or triggers about suicide so that we can be our best as listeners.  Let’s work together to shed some light into this subject, to come out (if applicable) as survivors or mourners, to continue to dismantle the shame around the subject and help to build and promote  both new and existing  support structures. This is everyone’s problem. We aren’t well-rounded as healthcare practitioners if we aren’t discussing one of the top cases of death. Let’s not wait until we are in the midst of a crisis to put these numbers in our phone, or these resources  into our practice.

__Important: I am not necesarily in 100% agreement with all of the politics or details within these resources. Hopefully this list will evolve. I merely present this list as a starting point. Thanks for understanding that.___

  1. http://www.TheIcarusProject.net This is my personal favorite resource for  mental health related information. I love and trust the Icarus Project and I strongly suggest their books, pamphlets, and resources. They have a Crisis Toolkit available and they host supportive groups all over the country. Queer/trans friendly and anti-oppressive.
  2. National Suicide Prevention Hotline: 1-800-273-8255, put it in your phone, hang it up in your office. This is staffed 24 hours a day, every day. Often someone in crisis may just need to talk, safely, to sort things out, to get through a crisis, and this is one way to do so.
  3. http://www.onbeing.org, episode with Jennifer Michael Hecht on suicide and discussion of her book Stay, episode includes list of resources.
  4. http://www.warmline.org
  5. http://www.sprc.org Suicide prevention resource center. seems rather mainstream to me  but of course not everyone is a raging anarchist with soil under their fingernails so check it out and decide for yourself.
  6. http://www.Trevorproject.org, specifically focused on LGBTQ youth, 866-488-7386, and they have chat and text options
  7. http://www.AFSP.org , American Foundation for Suicide Prevention
  8. http://www.Suicidology.org this seems to be resources for everyone to learn more, rather than just a focus on people in crisis.
  9. http://www.Surgeongeneral.gov has some resources, including stats and reports, search for the NSSP, National Society for Suicide prevention
  10. Crisis: Journal of Crisis intervention and Suicide Prevention, this is a scholarly journal with research and articles.
  11. http://www.NOPCAS.org is the National Organization for People of Color Against Suicide, for those who may feel more comfortable with this identity
  12. http://www.VeteransCrisisLine.net, 800-273-8255, specific to veterans
  13. http://www.StopSoldierSuicide.org
  14. http://www.Youmatter.suicidepreventionlifeline.org
  15. http://www.JenniferMichaelHecht.com/Stay/

And finally, I want to say this. Wherever you are in your journey of life, whether you have lost someone, have made an attempt yourself or are considering it, or are grappling with this issue in some way, YOU WILL GET THROUGH THIS. You are important, you are resilient and we are connected. There is always a way, and we will find this way. I am open to this discussion, let’s move forward together.

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11 thoughts on “An herbalists’ toolkit for Crisis

  1. Anyone who has trained as an EMT (which incidentally is great for an herbalist as it alerts us to imminent danger and trains for first aid) has access to suicide prevention training. If you hear someone hinting at suicide, ascertain whether they have planned the means and whether that plan is likely (Do they possess the gun or pills they plan to use or have access?) Then talk about who they have reason to live for- a child, parents, a cat, even a plant. If they have brought up the subject, have a viable plan and can’t think of a reason to live then you should probably give them a couple of squirts of mimosa, call 911 then come back and talk with them about why you called (unless you think they will bolt.) If you are a licensed professional you have a duty to report. You may lose a client but save a life.

  2. In less acute conditions I talk about herbal allies, mineralization, Vitamin D, exercise (especially outdoor exercise), light, thyroid balancing and changing toxic work/marriage-relationship/friendship conditions. I would also talk about this while waiting for the EMTs in acute conditions since they won’t hear about it from conventional medicine, then apologize to the client and explain that you are worried for their lives.

  3. I appreciate your bringing up the ethical part. Is it OK to do what is ethical in the moment, and hope for forgiveness once the person is feeling more stable? Is it our obligation to do so? Perhaps. Herbalism does not have the same codified ethical standards the way that some other professionals do, so it is worth discussing.

  4. I wanted to add a resource, which is the “peer respite” movement. People are setting up peer respite centers in communities all across the country (in my own community as well — that’s how I knew about it). These are comfortable and informal places where a person can go for a few hours or up to a few days or weeks for a break from their routine and for peer support. These are not “crisis” centers, but these places seek to be preventive of crisis by giving people a place for respite BEFORE they get to the point of considering or carrying out suicide. The “peers” who volunteer at these centers (often found in a comfortable old house) are people who have “been there” and people who have struggled with various degrees of mental illness themselves. I just think it is a great model for offering support to each other in a disconnected world.

  5. @ the idea of calling the EMTs – Please, no! This can easily result in the individual being taken into either medical or police custody. This is not practicing compassionately.

    A few other options I can think of in that situation:
    1. ask if they have a support network in place
    2. call someone trusted on their behalf, a friend perhaps, and have them come help the three of you make up a plan for intervention
    3. allow the person to have the autonomy to make their own decision. let them know you are concerned and that you care about them but ultimately the decision is theirs.
    4. counsel in skills to reduce emotional intensity
    5. I love the sound of the “peer respite” movement!

  6. I don’t think we can say calling an EMT is always right or always wrong. There are many amazing EMTs, and some less so. So I might say “think before calling for help”. But if an individual does not have the resources to provide the care, backup may be needed. Not everyone has trusted friends.

  7. I agree that there may be situations where calling an EMT is the best option. And yes, many EMTs do great work! But, my concern isn’t about whether or not EMTs are effective at supporting or intervening in suicidal crisis – it’s that contacting them engages the law enforcement as well.

    Calling 911 in most (all?) states means that the police are required to come as well.

    This is 1. really likely to be a triggering event 2. could result in the person being incarcerated against their will 3. could result in the person being hospitalized against their will. 4. Time and time again, police involvement in mental health crisis support has resulted in the death of the individual in crisis.

    If you do not have licensure that gives you a duty to report, you have a variety of options before calling 911. If the individual is a client, it seems like a good opportunity to support them in figuring out what resources are available for support – even calling a crisis line or clergy is likely a better option than emergency medical personnel & police. As a practitioner, I can plan for possible crisis scenarios by having the phone numbers of trusted therapists locally that might be an option for the individual, crisis lines, or other people who might be able to hold space for an individual in acute crisis.

    Some more alternatives to EMS, written in part by some EMTs (this is the first edition, there’s a 2014 version with lots more updates available for purchase through the website!)

    http://www.rosehipmedics.org/wp-content/uploads/2011/07/Alt2EMSdigitalprintMay9.pdf

  8. Thanks for the info, it is good to consider.
    Personally, I’d refer to calling emergency services as a “last resort”.

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