Content warning: This article deals with depression and suicide.
A few days ago, I came across a post about Stephen ‘tWitch’ Boss on social media. I didn’t stop to read it; it was early in the morning, I was getting ready for work, and I was seeing my first patient in less than ten minutes. So I kept scrolling, through reels, and workout challenges, and filtered holiday selfies. But as I continued to scroll, I saw him there again. This time, on a mental health page, and that’s when reality began to sink in. I still didn’t stop to read the full caption; I didn’t have to (or maybe I just didn’t want to). So I turned off my phone, finished what was left of my morning protein shake, and tried to go on with my day.
But I couldn’t stop thinking about it.
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I just saw him dancing with his wife on Instagram. He has a beautiful family. He’s always smiling. He is just 40 years old, pretty much the same age as me.
As news of his death spread, and particularly about how tWitch died, I observed as other psychiatrists and mental health experts did their best to talk about the thing no one wants to talk about—suicide. But the question most people were thinking about was: How could this have happened to someone who seemed to be so happy? Or as his old boss, Ellen DeGeneres put it, someone who was “pure love and light.” And that’s exactly why it’s so important for all of us to create an environment where talking about mental health is not only normal but expected.
Psychiatrists like me are trained to identify risk factors for suicide. These include having been diagnosed with a mental illness like depression or bipolar disorder, dealing with addiction, being in a toxic relationship, or having a severe medical illness such as cancer. The truth is that you don’t have to fall into any of these categories to be at risk for suicide, and just being born a man automatically puts guys in that category, too. Men die by suicide three to four times as often as women, and suicide attempts are rising, particularly among Black men.
As a Black man who knows both sides of depression—I have struggled with it and I have treated it—I understand personally how difficult it can be for Black men to get help. Perhaps one of the biggest barriers is that some men are hesitant to seek help from a mental health professional who doesn’t look like them. It makes sense; guys want to talk to someone who really gets them. But only about 4 percent of psychologists and 2 percent of psychiatrists in the United States are Black, so it can be challenging.
One of the most important lessons I have learned is that the person you are talking to doesn’t have to look like you in order to help you. Therapists are trained to be curious, ask questions, and listen with a non-judgmental ear regardless of what you, or they, look like.
There is a broader role, however, for all of us when it comes to encouraging productive conversations about mental health, especially when someone we thought had it all together dies by suicide. It’s important that we have these conversations in a way that’s both compassionate and smart.
Here’s how to talk about suicide in order to improve mental health:
Stop the spread
When we learn about a suicide, whether it’s the death of a friend or a celebrity like tWitch, we have to be careful about how we talk about it. That’s because the contagion effect is real. This means that some people may be inclined to mimic suicidal behavior they become aware of by word of mouth or in the media. One thing you can do to stop the spread is to ask people you’re close to how they are feeling about tWitch. Get a conversation going, and if someone tells you they’re having really dark thoughts, encourage them to meet with a professional like a therapist or a psychiatrist. Now may be a good time to check in on people you know who may be dealing with depression or another mental illness; a text or a phone call goes a long way.
Focus on Prevention
When talking about suicide, skip the part about how they died. It’s not useful and it doesn’t promote mental health. Instead, reflect on the person’s life with fond memories, stories, or moments of joy. But it’s important to do this in a way that always encourages suicide prevention. If you share a post on social media, try adding a link to the suicide prevention hotline or hashtagging 988 (the new mental health crisis hotline number). If you’re telling a story about someone you know who died by suicide, end it by normalizing and encouraging therapy. This can offer a much-needed lifeline to people you’d never know are struggling with their mental health.
Learn the Signs
Suicide can be difficult to predict—that includes for psychiatrists like me. Oftentimes, even close friends and family don’t see it coming. Some people who are depressed are very good at hiding it. They go to work, they smile, they appear to be happy. But usually there are subtle signs that are worth paying attention to. If someone you know is talking about death often, or they’re spending more time alone, giving away their valuable possessions, or they stop talking about the future check in on them. Invite them to lunch, or ask them how they’re doing. (Here’s a bit more about what to know if you or someone else is having suicidal thoughts.) Picking up on subtle cues may ultimately save a person’s life.
Learning about a suicide is hard, talking about it is hard, too. But if we all do our part, we can turn tragedy into an opportunity to prevent future suicides.
If you are having suicidal thoughts call 988 to speak to a trained professional. Help is available 24 hours a day, 7 days a week.
Gregory Scott Brown MD is a board-certified psychiatrist and Men’s Health advisor. He is an affiliate faculty member at the University of Texas Dell Medical School and author of The Self-Healing Mind: An Essential Five-Step Practice to Overcoming Anxiety and Depression, and Revitalizing Your Life.