WEBVTT 00:00:13.779 --> 00:00:16.339 Hello, and welcome to Listen Up People, a podcast 00:00:16.339 --> 00:00:19.100 of the USC Suzanne Dworak -Peck School of Social 00:00:19.100 --> 00:00:21.839 Work. I'm Dr. Eric Rice, professor and associate 00:00:21.839 --> 00:00:24.339 dean for research. Today, we're going to be talking 00:00:24.339 --> 00:00:26.899 about suicide prevention, a subject that has 00:00:26.899 --> 00:00:29.600 been a large focus of my own research. And so 00:00:29.600 --> 00:00:31.379 I'm happy to have my guests with me today to 00:00:31.379 --> 00:00:34.039 talk about this particular topic. For those of 00:00:34.039 --> 00:00:36.340 you who are less familiar, more than half of 00:00:36.340 --> 00:00:39.280 people who die by suicide never tell anyone about 00:00:39.280 --> 00:00:41.820 their suicidal thoughts beforehand. So a core 00:00:41.820 --> 00:00:44.039 challenge of suicide prevention today is how 00:00:44.039 --> 00:00:46.560 to identify those people most at risk of falling 00:00:46.560 --> 00:00:49.479 through the cracks and design upstream interventions 00:00:49.479 --> 00:00:52.020 to help them. My guests today are two of the 00:00:52.020 --> 00:00:54.700 world's leading experts on suicide and suicide 00:00:54.700 --> 00:00:58.140 prevention. They're both listed on Stanford Elsevier's 00:00:58.140 --> 00:01:01.020 list of the top 2 % most influential scientists 00:01:01.020 --> 00:01:04.040 in the world. I'd like to welcome back to the 00:01:04.040 --> 00:01:06.620 show both Dr. John Blosnich, who's an associate 00:01:06.620 --> 00:01:09.099 professor and the director of the Center for 00:01:09.099 --> 00:01:12.280 LGBT Health Equity at the school. And with him 00:01:12.280 --> 00:01:15.920 is Dr. Carl Castro, professor and director of 00:01:15.920 --> 00:01:18.519 military and veterans programs, director of the 00:01:18.519 --> 00:01:20.700 Center for Innovation and Research on Veterans 00:01:20.700 --> 00:01:23.200 and Military Families, and director of the Rand 00:01:23.200 --> 00:01:26.760 USC Epstein Family Foundation Center for Veterans 00:01:26.760 --> 00:01:29.620 Policy Research. Welcome back, guys. Yeah, happy 00:01:29.620 --> 00:01:31.560 to be here. Happy to have you both here today 00:01:31.560 --> 00:01:34.409 as well. for sure. Like I said at the top, I'm 00:01:34.409 --> 00:01:36.250 excited to talk about this topic because it's 00:01:36.250 --> 00:01:38.150 something that's very near and dear to my own 00:01:38.150 --> 00:01:40.569 set of interests. And I've had conversations 00:01:40.569 --> 00:01:43.010 with both of you over the years about this, but 00:01:43.099 --> 00:01:45.859 for the benefit of our audience. Maybe we can 00:01:45.859 --> 00:01:47.980 start with the question that I've been leading 00:01:47.980 --> 00:01:50.219 off these shows, which is really what brought 00:01:50.219 --> 00:01:52.659 you to do this kind of work. So maybe I'll turn 00:01:52.659 --> 00:01:55.400 first to Carl. Carl, how did you get interested 00:01:55.400 --> 00:01:58.079 in doing work specifically around suicide and 00:01:58.079 --> 00:02:00.859 suicide prevention? You know, Eric, as you know, 00:02:00.959 --> 00:02:04.859 I served in the military for over 30 years. And 00:02:04.859 --> 00:02:08.300 when I first joined the military, suicide rates 00:02:08.300 --> 00:02:12.050 in the military were among the lowest. in the 00:02:12.050 --> 00:02:14.509 world, not just in the United States, they were 00:02:14.509 --> 00:02:18.530 extremely low. For example, in the mid 1980s, 00:02:18.689 --> 00:02:21.750 suicide rates were about eight per hundred thousand 00:02:21.750 --> 00:02:24.689 for active duty personnel. So to put that in 00:02:24.689 --> 00:02:27.750 context, they're now in excess of 20 per hundred 00:02:27.750 --> 00:02:30.729 thousand. And so the military thought they had 00:02:30.729 --> 00:02:34.370 sort of solved the suicide problem. And in fact, 00:02:34.389 --> 00:02:37.289 I was actually in the room. where the decision 00:02:37.289 --> 00:02:41.830 was made to end all military -related suicide 00:02:41.830 --> 00:02:44.610 research. Wow. But then all of a sudden, when 00:02:44.610 --> 00:02:47.530 the wars in Iraq and Afghanistan started, we 00:02:47.530 --> 00:02:50.310 started seeing this increase in suicide rates. 00:02:50.330 --> 00:02:54.689 So it was moving up into 12 per 100 ,000, 14 00:02:54.689 --> 00:02:59.810 per 100 ,000, 15 per 100 ,000, given how many 00:02:59.810 --> 00:03:02.289 people don't like change. We spent another five 00:03:02.289 --> 00:03:05.430 or six years debating whether or not that increase 00:03:05.430 --> 00:03:08.449 was a real increase or whether or not it represented 00:03:08.449 --> 00:03:12.569 normal fluctuation in suicide rates. And then 00:03:12.569 --> 00:03:15.969 all of a sudden, I got put in charge of funding 00:03:15.969 --> 00:03:19.949 suicide research. Then I really immersed myself, 00:03:19.949 --> 00:03:23.870 right? And then you realize that we had to kind 00:03:23.870 --> 00:03:27.330 of relearn all of the things that we had forgotten. 00:03:27.710 --> 00:03:30.669 Because what I found very interesting, when you 00:03:30.669 --> 00:03:33.189 would talk to leaders in the military, like, 00:03:33.310 --> 00:03:35.530 why do you think the suicide rates are so low? 00:03:35.669 --> 00:03:37.629 Now, this is when they were low. They said, oh, 00:03:37.650 --> 00:03:39.370 well, it's because we have great leadership. 00:03:39.669 --> 00:03:42.490 We have a real world mission. They're doing things 00:03:42.490 --> 00:03:45.569 that are meaningful in life, the camaraderie 00:03:45.569 --> 00:03:48.370 and cohesion that exists in the military. That's 00:03:48.370 --> 00:03:50.210 why they're low. But when they started going 00:03:50.210 --> 00:03:52.530 up, they didn't say, well, we think they're gone 00:03:52.530 --> 00:03:55.699 up because leadership is stumbling. morale is 00:03:55.699 --> 00:03:58.800 down, right? They started introducing new causes. 00:03:59.340 --> 00:04:01.759 And then you quickly realize that nobody knows 00:04:01.759 --> 00:04:04.659 really what, there's no single cause for suicide. 00:04:04.919 --> 00:04:07.379 So that then sort of, okay, let's step back and 00:04:07.379 --> 00:04:09.560 start over. So that was kind of a long -winded 00:04:09.560 --> 00:04:12.300 way of saying how I got involved in military 00:04:12.300 --> 00:04:15.400 and veteran suicide. But it sort of started from 00:04:15.400 --> 00:04:17.480 the beginning when we thought we had solved the 00:04:17.480 --> 00:04:20.220 problem and then realized that we hadn't. Wow. 00:04:20.360 --> 00:04:23.199 Wow. John, I know you've also worked with veterans, 00:04:23.360 --> 00:04:26.120 but that's not always the main focus of your 00:04:26.120 --> 00:04:28.560 work. How did you get interested in suicide prevention 00:04:28.560 --> 00:04:31.560 work? Well, it actually started with veterans. 00:04:31.680 --> 00:04:33.279 So my background in public health, I was always 00:04:33.279 --> 00:04:35.800 interested in violence prevention and I was studying 00:04:35.800 --> 00:04:37.540 more interpersonal violence. But then I had a 00:04:37.540 --> 00:04:40.860 mentor, Rob Bossart, sociologist trained and 00:04:40.860 --> 00:04:43.079 worked in suicide prevention. And he was like, 00:04:43.259 --> 00:04:44.819 you got to come over to this side of violence. 00:04:44.899 --> 00:04:46.120 You got to come over to this side of violence. 00:04:46.160 --> 00:04:50.029 This is this is a tough problem. and so he recruited 00:04:50.029 --> 00:04:52.209 me for a postdoc and I went to the University 00:04:52.209 --> 00:04:54.610 of Rochester to work specifically in a suicide 00:04:54.610 --> 00:04:57.009 prevention program and they put me half time 00:04:57.009 --> 00:04:58.629 at the University of Rochester and half time 00:04:58.629 --> 00:05:00.670 with the Center of Excellence for Suicide Prevention. 00:05:01.329 --> 00:05:03.230 It was more than getting off the ground at that 00:05:03.230 --> 00:05:06.050 point. It was an interesting time to be in the 00:05:06.050 --> 00:05:09.199 VA to see how the alignment and the allocation 00:05:09.199 --> 00:05:12.300 of resources were being devoted to suicide prevention. 00:05:12.459 --> 00:05:14.180 There's no other, hands down, and I'll stand 00:05:14.180 --> 00:05:17.439 by this statement, there's no other system in 00:05:17.439 --> 00:05:21.120 the world that has put more resources, people, 00:05:21.519 --> 00:05:23.279 and infrastructure towards suicide prevention 00:05:23.279 --> 00:05:25.420 than the VA, hands down. People can have differing 00:05:25.420 --> 00:05:26.899 opinions about how effective they think that 00:05:26.899 --> 00:05:29.519 it is, but... no other healthcare system in the 00:05:29.519 --> 00:05:33.139 world has done as much. So it was just a unique 00:05:33.139 --> 00:05:36.980 time when I was, in a way, switching what I was 00:05:36.980 --> 00:05:39.000 studying. But the more that I learned about it, 00:05:39.060 --> 00:05:42.040 you know, and having personal experiences in 00:05:42.040 --> 00:05:43.680 this field, sometimes you don't want to think 00:05:43.680 --> 00:05:45.600 about those kinds of things, and then kind of 00:05:45.600 --> 00:05:48.500 research becomes research. But it's really striking 00:05:48.500 --> 00:05:52.139 to think about it as a phenomenon that we as 00:05:52.139 --> 00:05:55.980 humans are wired to survive. Right. And somehow 00:05:55.980 --> 00:05:59.480 we are the only species that for some people, 00:05:59.639 --> 00:06:02.259 they override that wiring. Something happens 00:06:02.259 --> 00:06:05.660 and that is unusual and we don't fully understand 00:06:05.660 --> 00:06:08.240 it. And so part of it was, you know, my, my pull 00:06:08.240 --> 00:06:10.360 into this is how do we, how do we prevent this? 00:06:10.360 --> 00:06:13.029 Of course, not just from the individual. who's 00:06:13.029 --> 00:06:15.470 feeling distress, who's feeling hopelessness, 00:06:15.509 --> 00:06:17.610 but also thinking about the people who are going 00:06:17.610 --> 00:06:20.290 to be left if or when they die. From a public 00:06:20.290 --> 00:06:22.290 health professional standpoint, that is almost 00:06:22.290 --> 00:06:24.269 the bigger footprint that we are left to deal 00:06:24.269 --> 00:06:26.329 with. And my opinion is we don't deal with it 00:06:26.329 --> 00:06:28.949 well at all of what happens after someone dies 00:06:28.949 --> 00:06:31.110 from suicide, let alone how much we try to do 00:06:31.110 --> 00:06:33.029 to prevent an individual from dying from suicide. 00:06:33.569 --> 00:06:34.870 So when I tell them what I do, they're like, 00:06:34.949 --> 00:06:37.470 oh my gosh, it must be so sad. And it is, it 00:06:37.470 --> 00:06:40.029 can be, but. I'll keep doing it until the doors 00:06:40.029 --> 00:06:42.350 fall off and they haven't yet. So here I am. 00:06:42.430 --> 00:06:44.769 Yeah. No, that's that's great. I mean, I know 00:06:44.769 --> 00:06:47.310 the two of you are so dedicated to this and it 00:06:47.310 --> 00:06:49.550 is a challenging topic for people to talk about. 00:06:49.589 --> 00:06:51.649 I know in I have shared this with you guys in 00:06:51.649 --> 00:06:53.730 the past. I mean, in my own in my own life, my 00:06:53.730 --> 00:06:56.629 father died by suicide and I for a long time 00:06:56.629 --> 00:06:59.610 didn't want to work on suicide as a topic because 00:06:59.610 --> 00:07:02.810 it felt too close to home to my own experiences. 00:07:03.050 --> 00:07:06.480 And finally had a Ph .D. student. who really 00:07:06.480 --> 00:07:08.620 wanted to do work in the topic and he convinced 00:07:08.620 --> 00:07:13.220 me that he also had some survivorship experiences 00:07:13.220 --> 00:07:15.759 and that it was really an important thing to 00:07:15.759 --> 00:07:19.230 do. as somebody who was somebody who had lived 00:07:19.230 --> 00:07:21.050 through this experience of seeing somebody that 00:07:21.050 --> 00:07:23.750 you love go through death by suicide or suicide 00:07:23.750 --> 00:07:26.829 attempts that. And so, yeah, it's as you like 00:07:26.829 --> 00:07:29.350 to say, John, not to not to dim a bright room, 00:07:29.529 --> 00:07:34.129 but it is sometimes, you know, it's a heavy topic, 00:07:34.129 --> 00:07:35.629 but it's a really important one. And as Carl 00:07:35.629 --> 00:07:37.910 said, you know, that when the rates go up and 00:07:37.910 --> 00:07:40.529 up and up and up, you know, we have to do something 00:07:40.529 --> 00:07:43.149 about it. So, Carl, you know, when you said you 00:07:43.149 --> 00:07:45.850 wanted to sort of restart thinking how that we 00:07:45.639 --> 00:07:48.620 conceptualize the problem. I think a lot of people 00:07:48.620 --> 00:07:51.120 who are listening to this might be very interested 00:07:51.120 --> 00:07:53.980 in what is a very unique set of insights that 00:07:53.980 --> 00:07:56.800 you bring to this about what some of the root 00:07:56.800 --> 00:07:59.480 causes of suicidal thinking for some people who 00:07:59.480 --> 00:08:02.579 are in the military or veterans are around a 00:08:02.579 --> 00:08:04.839 concept you call moral injury. Can you share 00:08:04.839 --> 00:08:06.959 more about that with us, please? I'd be happy 00:08:06.959 --> 00:08:09.759 to. And I just want to say that this linkage 00:08:09.759 --> 00:08:13.839 to association of suicide and moral injury isn't 00:08:13.839 --> 00:08:17.180 something that I discuss. Many, many other folks 00:08:17.180 --> 00:08:19.459 had made this connection. In fact, this connection 00:08:19.459 --> 00:08:23.139 was made for the first time probably 15 years 00:08:23.139 --> 00:08:26.420 ago. But, you know, in science terms, that's 00:08:26.420 --> 00:08:29.220 pretty new. right? Because, you know, scientists 00:08:29.220 --> 00:08:32.000 are slow to pick up. I remember my graduate school 00:08:32.000 --> 00:08:34.419 advisor said you have to tell people five times 00:08:34.419 --> 00:08:36.460 something before they get it. You can't just 00:08:36.460 --> 00:08:38.139 tell them once and then they got it. You got 00:08:38.139 --> 00:08:39.879 to tell it again and again and again and again 00:08:39.879 --> 00:08:42.080 to where they can tell us. At least. At least. 00:08:42.320 --> 00:08:44.059 And, you know, one of the things when you think 00:08:44.059 --> 00:08:47.320 about this association around moral injury, which 00:08:47.320 --> 00:08:50.200 is a new concept in and of itself, and you try 00:08:50.200 --> 00:08:53.879 to explain what could be going on, you know, 00:08:53.879 --> 00:08:56.419 and then you look at all of the various risks 00:08:56.360 --> 00:08:59.419 factors associated with someone who dies by suicide, 00:08:59.559 --> 00:09:02.179 you know, failed relationships, mental health 00:09:02.179 --> 00:09:05.480 issues, physical health issues, legal issues, 00:09:05.980 --> 00:09:08.419 financial issues. I mean, it's like, what do 00:09:08.419 --> 00:09:10.740 all of those things have in common? And in my 00:09:10.740 --> 00:09:14.440 thinking about moral injury and the way I conceptualize 00:09:14.440 --> 00:09:17.080 it and think about it, it's sort of an assault, 00:09:17.360 --> 00:09:20.200 a threat to one's sense of self. And if you think 00:09:20.200 --> 00:09:23.500 about someone who dies by suicide, as John so 00:09:23.500 --> 00:09:27.240 eloquently put, you have to override what we 00:09:27.240 --> 00:09:30.320 call the survival instinct. Well, what can override 00:09:30.320 --> 00:09:34.000 that? And what can override that is a disruption 00:09:34.000 --> 00:09:36.740 to one's sense of self, one's sense of preservation, 00:09:36.960 --> 00:09:39.740 one's sense of wellbeing. And that's how I think 00:09:39.740 --> 00:09:42.799 about moral injury. And I thought, well, is this 00:09:42.799 --> 00:09:46.240 what could be happening when people decide to 00:09:46.240 --> 00:09:48.940 take their life? And whether it's a quick decision 00:09:48.940 --> 00:09:51.019 or impetuous decision, there's certainly lots 00:09:51.019 --> 00:09:53.720 of other factors involved. When I think about 00:09:53.720 --> 00:09:56.879 it, I say, well, then one way of bolstering up 00:09:56.879 --> 00:10:00.659 people is to give them a strong sense of self. 00:10:00.960 --> 00:10:04.379 a strong sense of control, a strong sense of 00:10:04.379 --> 00:10:07.860 you decide how you live your life. And we say 00:10:07.860 --> 00:10:10.259 this all the time in social work, empowerment, 00:10:10.759 --> 00:10:13.720 but also give them control of when they explicit 00:10:13.720 --> 00:10:16.759 control of how they end their life. And that 00:10:16.759 --> 00:10:18.659 scares a lot of people because you don't want 00:10:18.659 --> 00:10:21.200 to give that control to certain people. But I 00:10:21.200 --> 00:10:24.399 think that's sort of what you have to do. you 00:10:24.399 --> 00:10:27.580 have to acknowledge the reality. I think it was 00:10:27.580 --> 00:10:31.080 George Orwell said, you can deny the facts as 00:10:31.080 --> 00:10:33.820 much as you want, you can deny the reality as 00:10:33.820 --> 00:10:36.720 much as you want, but there it is. And it's sort 00:10:36.720 --> 00:10:39.320 of accepting the rates have gone up, and you 00:10:39.320 --> 00:10:41.539 can try to say they haven't gone up, but they 00:10:41.539 --> 00:10:43.960 have gone up. And it may take us two decades 00:10:43.960 --> 00:10:47.779 to acknowledge that. I still am having flashbacks, 00:10:48.000 --> 00:10:51.179 semi -traumatic experiences, arguments with very 00:10:51.179 --> 00:10:53.659 senior people about why these increased were 00:10:53.659 --> 00:10:56.299 real. And so sometimes just getting people to 00:10:56.299 --> 00:10:58.759 agree they were going up. That took seven years 00:10:58.759 --> 00:11:02.220 of fighting. And so you lose seven years of doing 00:11:02.220 --> 00:11:04.840 something. And then you realize also that what 00:11:04.840 --> 00:11:08.179 we're doing isn't working. And I'm looking at 00:11:08.179 --> 00:11:11.100 you, Eric, and John. We have taken basically 00:11:11.100 --> 00:11:14.519 the same approach for suicide prevention in the 00:11:14.519 --> 00:11:17.740 military, and the Veterans Affairs uses the same 00:11:17.740 --> 00:11:22.100 approach for the last 40 years. and it hasn't 00:11:22.100 --> 00:11:24.940 worked. And I'm not optimistic if we do it for 00:11:24.940 --> 00:11:27.179 another 40 years, it will all of a sudden start 00:11:27.179 --> 00:11:29.899 working. So this got me thinking, what can we 00:11:29.899 --> 00:11:32.700 do differently? How can we think about this differently? 00:11:32.980 --> 00:11:35.700 So what we are doing, because as John said, the 00:11:35.700 --> 00:11:37.720 Department of Veterans Affairs is the leader 00:11:37.720 --> 00:11:40.460 in this area. The military, the active duty military 00:11:40.460 --> 00:11:43.379 also has a very robust program. But I agree with 00:11:43.379 --> 00:11:45.919 John that the VA probably has the best program. 00:11:46.320 --> 00:11:48.940 But the military also has a very big program. 00:11:49.000 --> 00:11:52.080 but they're not really making progress. And why 00:11:52.080 --> 00:11:55.679 is that? So this is why, how can we apply this 00:11:55.679 --> 00:11:59.059 concept of moral injury to this problem and perhaps 00:11:59.059 --> 00:12:02.059 develop a different approach? So I'll stop there, 00:12:02.080 --> 00:12:03.720 because I know that was, again, another very 00:12:03.720 --> 00:12:06.480 long response to a very - No, no, it's great. 00:12:06.659 --> 00:12:09.379 And I want to come back to that in a minute. 00:12:10.259 --> 00:12:13.379 But before I do, I just want to acknowledge that 00:12:13.379 --> 00:12:16.850 I think you and John - And myself, I think would 00:12:16.850 --> 00:12:21.250 agree that what's been going on is great and 00:12:21.250 --> 00:12:23.970 people are doing things as best as they can, 00:12:24.009 --> 00:12:26.970 but there's still a gap that needs to be filled. 00:12:27.669 --> 00:12:29.669 And trying to think about different ways of approaching 00:12:29.669 --> 00:12:33.070 this is very much an exciting and important thing 00:12:33.070 --> 00:12:35.950 to do. And I think, John, you know, Carl thinks 00:12:35.950 --> 00:12:39.230 about things more from the perspective of psychology, 00:12:39.470 --> 00:12:41.490 right? But you think about things more from the 00:12:41.490 --> 00:12:43.690 perspective of public health. And so your take 00:12:43.690 --> 00:12:46.509 on what needs to happen, I think, is coming from 00:12:46.509 --> 00:12:48.590 a different place. Can you tell us a little bit 00:12:48.590 --> 00:12:51.570 about how you conceptualize the state of the 00:12:51.570 --> 00:12:54.809 field and what needs to be addressed? A lot of 00:12:54.809 --> 00:12:58.700 the effort in suicide prevention is around clinical 00:12:58.700 --> 00:13:01.259 services, which is life, that is life -saving, 00:13:01.320 --> 00:13:03.840 that is necessary. So Zero Suicide Initiative 00:13:03.840 --> 00:13:07.340 is probably the biggest one, focuses on training 00:13:07.340 --> 00:13:10.700 primary care physicians, nurses, people within 00:13:10.700 --> 00:13:13.340 healthcare to recognize warning signs, screen 00:13:13.340 --> 00:13:15.659 people, refer them to care. You know, all of 00:13:15.659 --> 00:13:17.840 that is necessary, but all of that requires someone 00:13:17.840 --> 00:13:21.220 to come into a clinical center. And we need to 00:13:21.220 --> 00:13:22.840 build that up and continue to develop resources 00:13:22.840 --> 00:13:25.919 to doing that. Uh, but my perspective is people 00:13:25.919 --> 00:13:27.879 have to survive to get there. And that's what 00:13:27.879 --> 00:13:30.480 I kind of turned my attention to is. And why 00:13:30.480 --> 00:13:32.620 coming to social work felt like from public health 00:13:32.620 --> 00:13:36.019 and social work felt like a really fortuitous, 00:13:36.019 --> 00:13:38.580 you know, open door, um, meeting people where 00:13:38.580 --> 00:13:41.120 they are, which is a core tenant of social work 00:13:41.120 --> 00:13:43.279 and being able to find people in distress wherever 00:13:43.279 --> 00:13:45.840 they are. So really like the. You know, the tagline 00:13:45.840 --> 00:13:47.620 for the project we've been working on is going 00:13:47.620 --> 00:13:50.720 out and finding disruption. So Carl had alluded 00:13:50.720 --> 00:13:53.000 to some of those sorts of social disruptions 00:13:53.000 --> 00:13:56.059 that often precipitate suicidal crisis. You know, 00:13:56.139 --> 00:13:58.200 a spouse files for divorce, someone loses their 00:13:58.200 --> 00:14:00.740 job, you get an eviction notice. A lot of these 00:14:00.740 --> 00:14:03.139 things can pile up for people that then, you 00:14:03.139 --> 00:14:05.100 know, they begin to feel these sorts of things 00:14:05.100 --> 00:14:09.019 that we know raise their risk, entrapment, humiliation, 00:14:09.559 --> 00:14:12.440 sense of defeat, hopelessness, all of these things 00:14:12.440 --> 00:14:15.200 that begin to erode. their sense of options, 00:14:15.399 --> 00:14:18.700 their sense of self. And so the thing I started 00:14:18.700 --> 00:14:21.559 thinking about was, so when this happens to people, 00:14:21.679 --> 00:14:23.679 where do they go? Ideally, we would want them 00:14:23.679 --> 00:14:26.039 to get to these clinical centers for mental health 00:14:26.039 --> 00:14:28.779 treatment counseling. But if... you're going 00:14:28.779 --> 00:14:30.379 through a divorce, if you're going through an 00:14:30.379 --> 00:14:32.259 eviction, the person you might be interacting 00:14:32.259 --> 00:14:34.980 with the most is probably an attorney, maybe 00:14:34.980 --> 00:14:38.100 even a bank or a loan officer. And so that's 00:14:38.100 --> 00:14:40.000 what led into this thinking about a concept of 00:14:40.000 --> 00:14:42.259 industries of disruption. So, you know, I want 00:14:42.259 --> 00:14:43.940 to acknowledge something that Carl said too. 00:14:44.000 --> 00:14:47.080 This is not necessarily a new discovery. It's 00:14:47.080 --> 00:14:49.759 just a different way of packaging this. Suicide 00:14:49.759 --> 00:14:53.419 research has been well aware that community partners 00:14:53.419 --> 00:14:56.679 are integral into spreading prevention and that 00:14:56.679 --> 00:15:00.259 non -clinical sectors have been on the radar 00:15:00.259 --> 00:15:03.700 but not necessarily in my opinion, operationalized, 00:15:04.000 --> 00:15:06.200 not activated. It's been a, well, we know these 00:15:06.200 --> 00:15:08.980 things exist, so these could probably be really 00:15:08.980 --> 00:15:11.440 important places to target. So we started talking 00:15:11.440 --> 00:15:13.539 to people. We interviewed and surveyed family 00:15:13.539 --> 00:15:16.419 law attorneys, bankruptcy attorneys, housing 00:15:16.419 --> 00:15:19.240 counselors, employment counselors, and even the 00:15:19.240 --> 00:15:21.659 self -storage industry, because they all comprised 00:15:21.659 --> 00:15:23.440 what we thought of was industries of disruption. 00:15:24.139 --> 00:15:26.360 We've thought of industries of disruption as 00:15:26.360 --> 00:15:28.919 three core components. One is that the folks 00:15:28.919 --> 00:15:31.019 who work in these jobs, their daily grind, they're 00:15:31.019 --> 00:15:33.820 not nine to five is helping someone get through 00:15:33.820 --> 00:15:36.000 life disruption. If you're a family law attorney, 00:15:36.360 --> 00:15:40.200 your nine to five is custody, separation, and 00:15:40.200 --> 00:15:42.299 then asset division, right? That's what they 00:15:42.299 --> 00:15:44.799 do constantly. That is their job. Probably not 00:15:44.799 --> 00:15:47.019 a great way to spend your day. Some people, that's 00:15:47.019 --> 00:15:48.279 what they love to do. That's great that they 00:15:48.279 --> 00:15:49.879 can help people get through that, but that's 00:15:49.879 --> 00:15:51.700 what their daily grind is. So the first part 00:15:51.700 --> 00:15:53.419 of that definition of industries of disruption 00:15:53.419 --> 00:15:55.259 is that that's their daily grind, helping people 00:15:55.259 --> 00:15:57.059 through life disruptions. The second thing is 00:15:57.059 --> 00:15:59.120 that that service or provision that these sectors 00:15:59.120 --> 00:16:01.929 are providing is not directly over the plate 00:16:01.929 --> 00:16:04.149 for mental health. It may be related to it, but 00:16:04.149 --> 00:16:06.370 that end service is not counseling. That end 00:16:06.370 --> 00:16:08.970 service is not psychotherapy. I'm an attorney. 00:16:09.009 --> 00:16:11.009 I'm here to get you a divorce. I'm here to get 00:16:11.009 --> 00:16:12.909 you your half or get you whatever, but that's 00:16:12.909 --> 00:16:15.529 what my job is, which kind of leads to that third 00:16:15.529 --> 00:16:18.090 piece of our definition, which is they have little 00:16:18.090 --> 00:16:20.649 to no training in mental health or suicide prevention. 00:16:21.429 --> 00:16:24.110 But here, the nature of their job every day is 00:16:24.110 --> 00:16:27.570 that they are frequently and very closely in 00:16:27.570 --> 00:16:30.169 contact with people navigating a really personal, 00:16:30.529 --> 00:16:32.610 sometimes devastating thing that happens in their 00:16:32.610 --> 00:16:34.570 life. And so we talked to them. How frequently 00:16:34.570 --> 00:16:37.529 does it come up? A lot. So in a survey we did 00:16:37.529 --> 00:16:41.070 with about 350 or 60, I can't remember, we're 00:16:41.070 --> 00:16:43.250 still kind of cleaning the data. The family law 00:16:43.250 --> 00:16:46.330 attorneys, 40 % of them had ever had a client 00:16:46.330 --> 00:16:49.309 die from suicide. So personally presenting, died 00:16:49.309 --> 00:16:52.190 from suicide. This number went up when you asked 00:16:52.190 --> 00:16:55.590 them about a phenomenon in their profession called 00:16:55.590 --> 00:16:59.110 across the table. So a divorce is two party, 00:16:59.389 --> 00:17:00.809 two people are at least coming to that party. 00:17:01.070 --> 00:17:03.490 And so while their client may be okay, it's the 00:17:03.490 --> 00:17:06.369 person across the table. So that exposure to 00:17:06.369 --> 00:17:08.950 suicide goes up even higher to about 50 % at 00:17:08.950 --> 00:17:11.700 that point, half of them, because the person 00:17:11.700 --> 00:17:14.480 across the table, that person died from suicide. 00:17:14.660 --> 00:17:16.720 And that's just one example. So that was our 00:17:16.720 --> 00:17:19.460 perspective of listening, really dusting off 00:17:19.460 --> 00:17:22.809 this idea and approaching it in a really in a 00:17:22.809 --> 00:17:25.269 truly intentional way of we want to hear what 00:17:25.269 --> 00:17:27.890 they have to tell us. And they have some harrowing 00:17:27.890 --> 00:17:30.630 things to tell us. But my job is what does this 00:17:30.630 --> 00:17:32.690 help button look like for you? I'm not here to 00:17:32.690 --> 00:17:34.369 make you into a counselor or therapist. They 00:17:34.369 --> 00:17:36.349 don't want to be turned into that. Many of them 00:17:36.349 --> 00:17:38.829 feel like they're forced into that role. What 00:17:38.829 --> 00:17:41.009 will it take to get them to lean in when they 00:17:41.009 --> 00:17:44.170 hear a client or a customer is in distress? And 00:17:44.170 --> 00:17:46.309 what does that help button look like? That's 00:17:46.309 --> 00:17:49.119 kind of what I'm envisioning my job to be. I 00:17:49.119 --> 00:17:50.380 don't know what it's like to be an attorney. 00:17:50.460 --> 00:17:52.000 I don't know what it's like to be a housing counselor. 00:17:52.420 --> 00:17:54.220 I'm just here to help. So what would that help 00:17:54.220 --> 00:17:55.720 button look like? That's what our project is 00:17:55.720 --> 00:17:57.819 mainly about. And I think it's been really eye 00:17:57.819 --> 00:17:59.680 -opening for me in our conversations when you've 00:17:59.680 --> 00:18:02.779 been talking about these spaces like family law 00:18:02.779 --> 00:18:06.759 or self -service industry, self -storage industry, 00:18:07.259 --> 00:18:10.180 which, you know, these are probably not places 00:18:10.180 --> 00:18:12.819 where most of us think about that you could you 00:18:12.819 --> 00:18:15.500 could develop these sorts of prevention programs. 00:18:16.109 --> 00:18:21.210 to come back to you again and ask about as you 00:18:21.210 --> 00:18:25.349 were developing your thoughts around moral injury 00:18:25.349 --> 00:18:27.589 and trying to think about suicide prevention 00:18:27.589 --> 00:18:30.309 for veterans and folks in the active duty military 00:18:30.309 --> 00:18:34.009 about this change. John just describes her finding 00:18:34.009 --> 00:18:37.210 a new place to do these disruptive interventions, 00:18:37.390 --> 00:18:40.599 but What is it that you're proposing to do to 00:18:40.599 --> 00:18:43.259 disrupt this process as well? Well, that's a 00:18:43.259 --> 00:18:45.880 great question. And let me just say that I'm 00:18:45.880 --> 00:18:48.839 in a hundred percent agreement with what John 00:18:48.839 --> 00:18:51.420 approach is and what we also should be doing. 00:18:51.599 --> 00:18:55.880 But I take the other extreme approach. And what 00:18:55.880 --> 00:19:00.019 I think about is in terms of dark moments, the 00:19:00.019 --> 00:19:03.119 Stoics talk about dark moments in life. We all 00:19:03.119 --> 00:19:06.539 go through these dark moments, these failed relationships, 00:19:06.700 --> 00:19:09.750 these divorce. these division of assets, these 00:19:09.750 --> 00:19:12.750 firing from your job. As a student flunking out 00:19:12.750 --> 00:19:15.829 of college, these are all dark moments in life. 00:19:16.089 --> 00:19:20.089 And what I think we need to do also, not instead 00:19:20.089 --> 00:19:23.130 of what John proposed, but in addition to what 00:19:23.130 --> 00:19:27.309 John proposed, is prepare individuals for these 00:19:27.309 --> 00:19:31.210 dark moments. Prepare them early. In grade school, 00:19:31.589 --> 00:19:34.390 second, third grade, fourth grade, life is filled 00:19:34.390 --> 00:19:37.700 full of setbacks. We're sort of now bumping up 00:19:37.700 --> 00:19:40.640 against resilience, but I'm very deliberately 00:19:40.640 --> 00:19:45.089 not using that word. What we all suffer from 00:19:45.089 --> 00:19:47.329 these failed relationships, but not everybody 00:19:47.329 --> 00:19:50.089 dies from suicide who has a failed relationship. 00:19:50.089 --> 00:19:53.009 In fact, we know suicides, even though they're 00:19:53.009 --> 00:19:56.269 around 40 ,000 a year in the United States, they 00:19:56.269 --> 00:19:59.450 are still fairly rare events. And we shouldn't 00:19:59.450 --> 00:20:02.970 lose sight of a lot of people do have these setbacks, 00:20:03.150 --> 00:20:05.670 these dark moments, and they recover from. And 00:20:05.670 --> 00:20:08.670 what you want to give is everybody this sense 00:20:08.670 --> 00:20:12.190 of power, this sense of confidence that no matter 00:20:12.190 --> 00:20:15.559 what dark moments they face and it could be things 00:20:15.559 --> 00:20:17.700 that they brought on themselves like engaging 00:20:17.700 --> 00:20:20.180 in criminal activity and they get caught. They 00:20:20.180 --> 00:20:23.299 can still recover from these dark moments and 00:20:23.299 --> 00:20:27.420 suicide shouldn't be your first or second or 00:20:27.420 --> 00:20:29.799 third or fourth or fifth or sixth or seventh 00:20:29.799 --> 00:20:32.579 option to go to. It should be so far down on 00:20:32.579 --> 00:20:34.579 the list of things you can do to recover from 00:20:34.579 --> 00:20:38.299 it. It doesn't even enter your thinking. So preparing 00:20:38.299 --> 00:20:41.259 people for dark moments, building their confidence 00:20:41.259 --> 00:20:44.160 up that they can recover from dark moments and 00:20:44.160 --> 00:20:47.039 go on and have a great and wonderful life. That 00:20:47.039 --> 00:20:51.559 is what my area is pushing, but it's not instead 00:20:51.559 --> 00:20:53.859 of what John said. It's in addition to not only 00:20:53.859 --> 00:20:56.359 what John said, but what the the treatment folks 00:20:56.359 --> 00:20:58.619 are doing and all of the other efforts, because 00:20:58.619 --> 00:21:03.359 it's a very, very complex problem. And what I'm 00:21:03.359 --> 00:21:06.339 suggesting is just one element of addressing 00:21:06.339 --> 00:21:09.779 this very complex problem. Yeah. Complex problems 00:21:09.779 --> 00:21:14.980 are abound in our field in social work. I think 00:21:14.980 --> 00:21:17.839 we live in a society that likes simple solutions. 00:21:17.859 --> 00:21:19.980 So it's nice for you to point out, Carl, that 00:21:19.980 --> 00:21:23.119 you are not providing the silver bullet, but 00:21:23.119 --> 00:21:26.980 another piece of the arsenal, so to speak, that 00:21:26.980 --> 00:21:29.400 we need to be bringing in to bear on this problem. 00:21:29.720 --> 00:21:31.940 And you also said something that really struck 00:21:31.940 --> 00:21:34.660 me from some of our previous conversations, Carl, 00:21:34.680 --> 00:21:36.160 when you said this about this dark moments. I 00:21:36.160 --> 00:21:39.019 know, John, you've used the line with me a few 00:21:39.019 --> 00:21:43.059 times that you are doing work with good people 00:21:43.059 --> 00:21:46.299 in their worst moments. Can you expound on that 00:21:46.299 --> 00:21:49.019 a little bit? I think it's a really useful perspective 00:21:49.019 --> 00:21:51.319 that really mirrors what Carl's saying about 00:21:51.319 --> 00:21:54.539 the folks that you've been studying. Yeah, so 00:21:54.539 --> 00:21:56.980 that's saying, I don't know if it originated 00:21:56.980 --> 00:21:59.880 with actually a family law attorney, Maurice 00:21:59.880 --> 00:22:02.759 Kuttner. He said, criminal law attorneys see 00:22:02.759 --> 00:22:05.359 bad people at their best and family law attorneys 00:22:05.359 --> 00:22:09.480 see good people at their worst. And I think what 00:22:09.480 --> 00:22:12.559 Carl is saying is very apt, you know, having 00:22:12.559 --> 00:22:15.299 people, you know, not just reconceptualize their 00:22:15.299 --> 00:22:17.799 sense of self whenever they have these setbacks 00:22:17.799 --> 00:22:20.339 or these disappointments, you know, but the, 00:22:20.539 --> 00:22:23.000 the ability to reach out for help, which is also 00:22:23.000 --> 00:22:24.859 a huge barrier for a lot of people, especially 00:22:24.859 --> 00:22:27.140 when we talk about veteran populations and it's 00:22:27.140 --> 00:22:28.859 a two way street, people reaching out for help 00:22:28.859 --> 00:22:31.740 and then making sure that we have a system and 00:22:31.740 --> 00:22:33.160 professionals in place that are there to meet 00:22:33.160 --> 00:22:35.400 that need when someone does reach out. You know, 00:22:35.400 --> 00:22:38.480 these are incredibly complex problems that then, 00:22:38.480 --> 00:22:40.400 of course, the solutions are also going to be 00:22:40.400 --> 00:22:42.880 born out of incredibly complex systems. And when 00:22:42.880 --> 00:22:47.940 the stakes are this high, that urgency and that 00:22:47.940 --> 00:22:50.619 determination that we are perfect. when we do 00:22:50.619 --> 00:22:53.019 this is we got to have more hits and strikes 00:22:53.019 --> 00:22:55.500 on this. And but it's a lot of moving parts all 00:22:55.500 --> 00:22:57.980 at the same time. Yeah, I'm so impressed that 00:22:57.980 --> 00:23:00.859 the two of you are thinking about really, I suppose, 00:23:01.319 --> 00:23:05.779 moving ahead in this work in a way that brings 00:23:05.779 --> 00:23:09.019 solutions to people closer, closer to the moments 00:23:09.019 --> 00:23:10.339 of crisis. Maybe that's not even the right way 00:23:10.339 --> 00:23:12.559 of saying it. In some ways, it's earlier in the 00:23:12.559 --> 00:23:15.460 process. So it's not quite so much at that last 00:23:15.460 --> 00:23:17.559 minute. But I mean, Carl, you were talking about 00:23:17.559 --> 00:23:20.359 the way in which you're trying to give people 00:23:20.359 --> 00:23:22.819 new ways of thinking about dealing with the adversities 00:23:22.819 --> 00:23:24.180 that they deal with in life. And I know, John, 00:23:24.180 --> 00:23:26.400 you're really trying to reach out to people when 00:23:26.400 --> 00:23:28.900 they're in these moments of crisis, but before 00:23:28.900 --> 00:23:31.559 they reach that breaking point at which we may 00:23:31.559 --> 00:23:33.920 not be able to help folks as well. And Eric, 00:23:34.000 --> 00:23:37.599 the point that John is making is so spot on. 00:23:37.900 --> 00:23:40.960 One of the things that we how we handle dark 00:23:40.960 --> 00:23:44.460 moments is knowing when to reach out to folks, 00:23:44.880 --> 00:23:47.779 when to get help. If you can't solve a problem 00:23:47.779 --> 00:23:50.220 yourself, what are your resources, who can you 00:23:50.220 --> 00:23:53.180 go to, who can you contact to get help? And as 00:23:53.180 --> 00:23:56.440 John pointed out, the stigma, and this is what 00:23:56.440 --> 00:23:59.880 we call the resilience paradox, is all of the 00:23:59.880 --> 00:24:02.680 resilience training that happens in the military, 00:24:03.000 --> 00:24:07.099 and really in life, works against someone raising 00:24:07.099 --> 00:24:10.359 their hand, asking for help, or taking a knee 00:24:10.359 --> 00:24:12.880 and taking a break. Because if you're resilient, 00:24:13.079 --> 00:24:15.460 you should be able to solve your own problems. 00:24:15.720 --> 00:24:19.819 You shouldn't need any help. So if you get stuck 00:24:19.819 --> 00:24:23.359 in that phase of resilience and not understanding 00:24:23.359 --> 00:24:26.980 that at some point we all will feel overwhelmed 00:24:26.980 --> 00:24:30.660 where we need help from others, you know, I always 00:24:30.660 --> 00:24:32.279 attribute people say, well, how did you become 00:24:32.279 --> 00:24:35.579 a professor at USC with a lot of help from a 00:24:35.579 --> 00:24:38.819 lot of other people? I'm not one of these people 00:24:38.819 --> 00:24:41.460 who say I did it all by myself, nobody helped 00:24:41.460 --> 00:24:44.619 me, because I know that's not true. And that's 00:24:44.619 --> 00:24:47.079 true in life. When I was in the military, people 00:24:47.079 --> 00:24:50.220 helping me be successful. I have teams of people 00:24:50.220 --> 00:24:52.960 who, although I may get the credit, it's totally 00:24:52.960 --> 00:24:56.279 unfair because I had so many people helping me 00:24:56.279 --> 00:25:00.380 and encouraging me and supporting me. And yes, 00:25:00.480 --> 00:25:03.039 we can point to success, but really what you 00:25:03.039 --> 00:25:05.339 want is like, when things go really bad, who 00:25:05.339 --> 00:25:08.079 can you call? And you see a lot of these elements 00:25:08.079 --> 00:25:11.279 in suicide prevention efforts with the hope box, 00:25:11.640 --> 00:25:15.519 and who would you call in a crisis? People are 00:25:15.519 --> 00:25:18.740 building on this concept of trying to reach out 00:25:18.740 --> 00:25:21.480 and stay connected. And Eric, I know that's your 00:25:21.480 --> 00:25:24.319 work, social connections and the importance of 00:25:24.319 --> 00:25:26.680 those connections to staying healthy because 00:25:26.680 --> 00:25:30.779 we are social critters. In addition to a critter 00:25:30.779 --> 00:25:32.759 who will take their own life, we're also people 00:25:32.759 --> 00:25:36.079 who like to be around people. And I don't necessarily 00:25:36.079 --> 00:25:37.880 mean you have somebody has to be around you all 00:25:37.880 --> 00:25:40.740 the time. Some people need that. That's OK. Others, 00:25:40.779 --> 00:25:43.039 you know, on occasion, I like to be around people. 00:25:43.480 --> 00:25:45.279 So I was I was I was laughing because I was thinking 00:25:45.279 --> 00:25:47.519 like, well, you know, we like to be around other 00:25:47.519 --> 00:25:50.099 people. But as academics, there's some part of 00:25:50.099 --> 00:25:52.440 us that likes to also sit by ourselves in a room 00:25:52.440 --> 00:25:55.720 and write papers that an imaginary audience might 00:25:55.720 --> 00:25:58.920 read or sort of oddballs in that respect. But 00:25:58.920 --> 00:26:01.980 but it's true. You know, we are all fundamentally 00:26:01.980 --> 00:26:06.200 social animals and fundamentally we have survived 00:26:06.200 --> 00:26:08.920 as a species because we've learned how to rely 00:26:08.920 --> 00:26:12.380 on our communities. And John, your thoughts about 00:26:12.380 --> 00:26:16.720 bringing that reminder of those communities and 00:26:16.720 --> 00:26:18.700 those connections to people in their dark moments 00:26:18.700 --> 00:26:21.079 when they don't need it, I think is a beautiful 00:26:21.079 --> 00:26:25.079 way of tying some of those thoughts in. And I 00:26:25.079 --> 00:26:27.599 don't wanna just abruptly end a conversation 00:26:27.599 --> 00:26:29.680 that personally I know the three of us could. 00:26:29.900 --> 00:26:32.759 keep having for a couple of hours. I want to 00:26:32.759 --> 00:26:35.819 give you each an opportunity to talk about something 00:26:35.819 --> 00:26:39.700 in your own research or your own perception about 00:26:39.700 --> 00:26:42.519 suicide and suicide prevention work that you 00:26:42.519 --> 00:26:45.829 feel you know, our listeners who may be less 00:26:45.829 --> 00:26:49.569 familiar with this area of work should know about. 00:26:50.230 --> 00:26:52.470 So I'll give you a second to think that through, 00:26:52.470 --> 00:26:55.349 but maybe Carl, I'll turn to you first and then 00:26:55.349 --> 00:26:58.009 end with John. John, is there, Carl, is there 00:26:58.009 --> 00:27:00.849 something that you would like our audience to 00:27:00.849 --> 00:27:03.890 know about the work that you do or about suicide 00:27:03.890 --> 00:27:05.849 prevention work in general that you think would 00:27:05.849 --> 00:27:09.509 be helpful for them to know as we close out our 00:27:09.509 --> 00:27:12.430 conversation today? I will just say this, there's 00:27:12.430 --> 00:27:15.450 no... easy answer to this problem. If there was 00:27:15.450 --> 00:27:18.170 an easy answer, we would have found it already, 00:27:18.170 --> 00:27:21.089 and it wouldn't be a problem. When we find the 00:27:21.089 --> 00:27:23.829 answer, we'll say it's an easy answer. But until 00:27:23.829 --> 00:27:27.349 we find the answer, this is not an easy problem. 00:27:28.210 --> 00:27:30.690 No country in the world has solved this problem. 00:27:30.789 --> 00:27:32.990 I've traveled all over the world looking to see 00:27:32.990 --> 00:27:35.410 what other people do. No one has solved this 00:27:35.410 --> 00:27:37.730 problem. Now, some countries may not have a bigger 00:27:37.730 --> 00:27:41.849 problem, but there's no solutions that are easy. 00:27:41.950 --> 00:27:44.289 to address this issue. So I don't want anyone 00:27:44.289 --> 00:27:46.210 thinking, oh, all you have to do is give me an 00:27:46.210 --> 00:27:49.009 app and then I'm good to go. All right. And I 00:27:49.009 --> 00:27:51.089 know folks have tried that. It could be part 00:27:51.089 --> 00:27:54.410 of the solution. So I would just encourage people 00:27:54.410 --> 00:27:57.349 don't think there's a quick fix. It's difficult, 00:27:57.910 --> 00:28:01.509 complex problem. But we want all ideas because 00:28:01.509 --> 00:28:04.730 these ideas can contribute to a collective solution. 00:28:05.089 --> 00:28:07.109 Well put, Carl. Well put. John, what would you 00:28:07.109 --> 00:28:10.200 like to say to our listeners as a parting thoughts. 00:28:10.460 --> 00:28:12.299 You know, sometimes I start to think about what 00:28:12.299 --> 00:28:14.359 the, you know, what the challenge to this would 00:28:14.359 --> 00:28:16.259 be in thinking about the many different solutions 00:28:16.259 --> 00:28:18.619 that there could be. And the thing that we arrive 00:28:18.619 --> 00:28:21.759 at that I arrive at seems both simultaneously 00:28:21.759 --> 00:28:24.460 simple, but also maybe the most difficult. And 00:28:24.460 --> 00:28:26.319 it's kind of like where we are as a society is 00:28:26.319 --> 00:28:28.930 that connection piece. You know, we're allegedly 00:28:28.930 --> 00:28:31.430 more connected than ever because we have a phone 00:28:31.430 --> 00:28:35.049 in our hand all the time. We're constantly allegedly 00:28:35.049 --> 00:28:37.789 connected to everyone else's lives via Instagram 00:28:37.789 --> 00:28:41.789 or wherever. But the rates of people reporting 00:28:41.789 --> 00:28:45.210 loneliness are so high. And I don't fully understand 00:28:45.210 --> 00:28:48.259 what's going on there, right? And to engage with 00:28:48.259 --> 00:28:50.759 people and connect with people, it's not an easy 00:28:50.759 --> 00:28:52.799 thing, as Carl was saying, it's not an easy thing. 00:28:52.880 --> 00:28:55.119 And it's not only about the person, it's about 00:28:55.119 --> 00:28:58.200 yourself. In suicide prevention, gatekeeper training, 00:28:58.319 --> 00:29:00.779 it's about training people to ask the question, 00:29:01.000 --> 00:29:02.400 are you thinking about ending your life? Are 00:29:02.400 --> 00:29:04.480 you thinking about killing yourself? But being 00:29:04.480 --> 00:29:06.559 ready and prepared if someone says, yes, and 00:29:06.559 --> 00:29:09.769 that's about you and how you... You can feel 00:29:09.769 --> 00:29:11.730 that you respond to that you can stay there for 00:29:11.730 --> 00:29:13.430 that person You're confident in your ability 00:29:13.430 --> 00:29:15.369 to hear them and stay with them and sit with 00:29:15.369 --> 00:29:17.730 them in that, you know So I think that's another 00:29:17.730 --> 00:29:20.789 component to this this world of suicide prevention 00:29:20.789 --> 00:29:23.009 research that we don't often I don't often think 00:29:23.009 --> 00:29:24.750 about and I have to remind myself because we're 00:29:24.750 --> 00:29:26.710 always focused on the person who's in distress 00:29:26.710 --> 00:29:29.210 the person who's in distress and My own work 00:29:29.210 --> 00:29:31.289 is trying to get people around the person to 00:29:31.289 --> 00:29:34.630 engage but that necessarily requires self -reflection 00:29:34.630 --> 00:29:37.900 of are you going through that thought experiment 00:29:37.900 --> 00:29:39.880 and making sure that you have that in you to 00:29:39.880 --> 00:29:42.200 do that. And I don't know how we get more people 00:29:42.200 --> 00:29:44.940 to come to this to just, you know, humans being 00:29:44.940 --> 00:29:47.680 bros and just, you know, being there for one 00:29:47.680 --> 00:29:51.420 another. It seems like an ever deeper ask for 00:29:51.420 --> 00:29:54.319 people in an ever busier world, but I hope we 00:29:54.319 --> 00:29:57.400 can find some way. Beautifully put. And I think 00:29:57.400 --> 00:30:01.650 maybe I want to also say that there are resources 00:30:01.650 --> 00:30:05.490 for those folks who are, you know, perhaps experiencing 00:30:05.490 --> 00:30:08.890 suicidal thoughts or who are have a loved one 00:30:08.890 --> 00:30:12.630 who is in particularly the 988 helpline is a 00:30:12.630 --> 00:30:14.289 place that people can go. I think it's always 00:30:14.289 --> 00:30:18.809 important for us to acknowledge that people listening 00:30:18.809 --> 00:30:22.480 to a podcast like this. may themselves be experiencing 00:30:22.480 --> 00:30:24.799 some suicidal distress or know somebody who is. 00:30:24.940 --> 00:30:29.920 And so that 988 hotline is the most available 00:30:29.920 --> 00:30:33.940 resource that we can offer that's memorable, 00:30:33.940 --> 00:30:37.420 I think, in the context of a podcast. And I really 00:30:37.420 --> 00:30:39.220 just want to thank both of you for the amazing 00:30:39.220 --> 00:30:41.380 work that you do, the dedication that you have 00:30:41.380 --> 00:30:45.400 to the communities that you serve, and what delightful 00:30:45.400 --> 00:30:49.299 colleagues you are to talk about such a An important 00:30:49.299 --> 00:30:51.980 topic that is so hard to talk about, but to talk 00:30:51.980 --> 00:30:56.299 about it with both compassion and humor and all 00:30:56.299 --> 00:30:59.880 of that. It's really lovely. So I want to thank 00:30:59.880 --> 00:31:03.440 our listeners for tuning in today. And if you 00:31:03.440 --> 00:31:05.960 want to learn more about upstream suicide prevention, 00:31:06.119 --> 00:31:08.099 as well as the other research that's happening 00:31:08.099 --> 00:31:10.519 at the USC Suzanne Dworak-Peck School of Social 00:31:10.519 --> 00:31:14.329 Work. You can visit our school's website at 00:31:14.329 --> 00:31:18.410 dworakpeck.usc.edu. If you have questions for our guests 00:31:18.410 --> 00:31:21.109 on the show or you want to support our transformative 00:31:21.109 --> 00:31:25.029 research and programs, please email us at 00:31:25.029 --> 00:31:28.109 listenuppeople@usc.edu. And let me just say one more time 00:31:28.109 --> 00:31:30.750 to both Carl and John, thank you both so much 00:31:30.750 --> 00:31:33.329 for showing up and having this wonderful conversation. 00:31:33.369 --> 00:31:35.910 And I hope we'll have more like it in the future. 00:31:36.150 --> 00:31:37.390 My pleasure. Yep, same here.