The Power of Language

During a meeting this week with primary care and suicide prevention experts from across the country, the topic of language came up. The field of suicide prevention has its own language, its own “terms of art.” How that language is used can exclude the very people we’re trying to engage in this work.

Interestingly enough, the same topic came up in several of this week’s discussions related to updating Alaska’s state suicide prevention plan. There was concern that the language we use in our planning and prevention work might be confusing or even off-putting to the very people we want to engage.

In suicide prevention, a “survivor” is someone who has lost a loved one to suicide. A person who survives an attempt to commit suicide is referred to as an “attempter.” So, in order for there to be a survivor, someone has to die. That just doesn’t make sense.

Suicide prevention is broken into three categories: prevention – intervention – postvention. When I started this work, I wondered “what the heck is postvention?” I learned it’s a label created for how we respond after a suicide to prevent the domino effect often seen after someone dies by suicide.  If the point is to prevent additional suicides, why isn’t it just “prevention?”

This laguage issue is a possible barrier to bringing primary care providers into the suicide prevention effort. Suicide prevention focuses on preventing death in a time of crisis – kind of like the way emergency rooms treat people.  This focus on the end, and the emergency nature of the end, of the spectrum has made it hard to get primary care providers involved in this work. Their job is to diagnose and manage diseases, not do triage and emergency medicine. So why would they focus on what are thought to be exclsuively mental health emergencies?

Maybe if we explained that suicide responds to the same protocols and interventions as other chronic diseases, that would make more sense. You wouldn’t treat hypertension without checking (and rechecking) a patient’s blood pressure. You wouldn’t treat hypertension without explaining to the patient what he can do to help lower his blood pressure. And you wouldn’t treat hypertension without connecting the patient to the services and supports he needs to improve his condition. All those things – screening, patient education, referrals  — work to help someone early on to prevent the crisis that can lead to suicide.

There is a movement to help people stay healthier so they avoid the health conditions that can end up in the emergency room (heart attacks, strokes, etc.), Shouldn’t suicide prevention include a similar focus, helping people stay mentally and emotionally healthy so they don’t end up in that place where they are considering suicide and need emergency services?  And shouldn’t we use common language?

Maybe we need to think about how we talk about suicide, and find ways to use empowering and common sense language in this work? If so, how would we do that?