Suicide Prevention with Mary Chase Mize, PhD & Holly Tubbs

When we are confronted with this kind of existential pain, or need, that seems to outpace our capacity to respond, looking away or going to sleep is unfortunately a very human response. So, we’ve created this book as an invitation and we hope that churches engage with the content. We hope that they’ll be inspired and empowered to do the work of keeping watch and practicing community-based suicide prevention.
Easton: This is For People with Bishop Rob Wright.

Rob: Hello, everyone, this is Bishop Rob Wright. And this is For People. Today, we have a fantastic offering. We have Mary Chase Mize, PhD, and Holly Tubbs, who is the head of youth ministry in the Diocese of Atlanta. Hello, to you both.
Mary Chase Mize: Hello, thanks for having us.

Rob: I am so excited to have you both here. And today, we’re talking about suicide and suicide prevention. We have a book that is coming out really soon. It’s in the review, sort of stage station right now. We’re reviewing it, tweaking everything, dotting I’s and crossing T’s.

But we want to have a fulsome conversation about suicide, the intersection of faith, and mental health. And so, because we’ve been having that conversation in the Diocese of Atlanta, it’s high time that we actually develop a resource that can help lots of people around middle North Georgia and beyond. So, Mary Chase, let’s start with you. Why is there a need to have a conversation about suicide and suicide prevention? What’s happening in the world and specifically in the U.S. with folks and suicide?

Mary Chase Mize: In the United States and the world, suicide is a major public health issue. It’s actually the second leading cause of death among kids who are 10 to 14. It’s the third leading cause of death among teens and young adults. And it’s actually the second leading cause of death among folks aged 24 to 34. Also, older adults, especially people over the age of 85, have one of the highest rates of suicide completion. And it really is a leading cause of death across the lifespan. And the work the diocese is doing and providing suicide prevention will no doubt create a community that can help keep folks safe across the lifespan from suicide. And the church can be a strong protective place for those folks.

Rob: So, that’s on the hopeful side of things that if we equip people to have these kinds of conversations, to get alongside people who may be at risk or vulnerable, then we can provide neighborly support, right? We can be the beloved community in this way.

But before we get to that side, let’s just dig a little deeper in the numbers. You say, that the overall rate of suicide mortality has increased 30% in the last 20 or so years? Why? What’s going on? How is my neighbor doing?

Mary Chase Mize: Our neighbors are hurting. And like you mentioned, we’ve seen this increase in suicides over the last two decades. Those are the ones we know about. We can look at that contextually. Another way that we can help understand how our neighbors are doing and how people are hurting and where suicide comes into the picture is to understand why people die by suicide? Thomas Joiner, who’s one of the leading suicide-ologists of researchers in the world, he came up with the interpersonal theory of suicide. And in simplest terms, according to this theory, people die by suicide because they want to and because they can. They have the desire for suicide, and they also have the capacity to do it. They have the capability to do something that would result in their death. And that desire comes from two factors, when you feel like you don’t belong and when you have this perception that you’re a burden to other people in your life. That’s where the desire for suicide can show up. And those factors, we call them thwarted belongingness, or feeling like you don’t belong and you’re alone, and perceived burdensomeness feeling like you’re a burden to others.

Rob: So thwart of belongingness.

Mary Chase Mize: Yep, thwart of belongingness. And that’s really where we have this human need to belong. And when that need goes unmet, that is what thwart of belongingness is. And perceived burdensomeness is that perception that you, someone who’s having thoughts of suicide, maybe feels like they have more value in their death than in their life. And that’s where suicide desire comes from. And suicide can’t happen by desire alone. There has to be this capability and this capacity to actually do something that would result in death. That’s the third factor that goes with feeling like you don’t belong and feeling like you’re a burden. So, feeling like you don’t belong, feeling like you’re a burden, and having the actual capacity to endure life to die by suicide, when all of those things happen at the same time, that’s where we see suicides and near fatal attempts.

Rob: Sure. The name of the book, the resource that we are going to share is called, Keep Watch, which is based on that wonderful prayer from Complin, one of our last prayer services of the night, Keep watch dear Lord with those who work, or watch, or weep this night.

So, this book is supposed to be opening up our eyes to those who may be experiencing thwart of belongingness and proceed burdensomeness, right? And that’s what we are doing. We are keeping watch. We are increasing our sensitivity, perhaps our vocabulary, our Lexicon to be able to sort of get alongside people. Is that right?

Mary Chase Mize: That’s exactly right. And I’m really proud of this book. Had the pleasure of collaborating with Holly Tubbs on this and the goal of this resource is to equip the church community, you know, lay folks, clergy, to equip them with awareness and understanding of how to help people in their community who could be at risk of suicide. And we know from research, suicide desire is something that can change when you have an appropriate intervention, which is really responsive to intervention, suicide desire is.

And in Keep Watch, we’ve outlined a plan for how to equip folks at every level in your church, with ways to identify, and know who might be at risk of suicide, to be able to recognize them, and see them. And also respond to them. Actually, do something to help. And this is informed by a lot of research and a lot of evidence based practices to really build this layered approach to suicide safety.

Rob: Yeah, I like that part about it. You know, part of the resources teaching us, you know, the would be beloved community, those aspiring to be, those who understand that is consonant with Jesus of Nazareth, right? Is to provide a community where people have safe harbor, refuge, support, care, and are deeply known and valued. You guys, in this resource provide in some ways of vocabulary about say this, and not that. Give us a couple of examples of that.
Mary Chase Mize: So, some of the ways we share some vocabulary around suicide intervention and prevention is to change the way we talk about suicide. So, an example of this could be, instead of saying someone committed suicide, which is often what we say or hear and often how suicide is talked about. Instead of saying committed suicide, consider saying that someone died by suicide. And we offer this as a way to change some of that vocabulary around suicide intervention and prevention. Committed can be a stigmatizing word, you know, we think someone committed a crime. That’s something bad. That has a lot of stigma around that. And that can be just one way of changing how we talk about suicide that can actually break apart some of the stigma of suicide.
Another thing that we discuss in Keep Watch, is the importance of asking someone directly if you are worried about them. If you are worried that they are thinking of suicide, to ask them directly about suicide. To name it clearly and ask it directly. If you’re worried about them, if you’re worried that they’re thinking of suicide to ask them directly about suicide, to name it clearly, and ask it directly. Being able to name suicide specifically, can be lifesaving. Being willing to make suicide prevention visible in your congregation, visible from the pulpit, using the platform of the pulpit to communicate, you know, this is a place where we can openly talk about suicide. And we can help.

Rob: So, let me drill down right there. I think what you are inviting us to do with this resource is for people, like myself, who get the microphone, you know, on Sunday. You’re asking me to break the silence and to commit a sermon or teaching series perhaps, or an education moment, fellowship hall moment around this specifically, is that right?

Mary Chase Mize: That’s exactly right. So, imagine someone sitting the pews, and this person who is sitting in the pews is thinking of suicide. They may be feeling like they don’t belong. They may be feeling like they are a burden. They may really feel like they would burden someone if they ever shared how they truly felt. Maybe they’ve experienced something, you know, that we know can increase suicide risk, a risk factor. Maybe they’ve experienced and survived a trauma. Maybe they’re working through an addiction. Maybe this person is just drenched in shame and showing up at church might be the part of them that wants to live, but just doesn’t know how. So, imagine how powerful it could be for that person to hear from the pulpit, that this is a place where we can talk about suicide, and we want to talk to you, and we can help you.

And one thing, you know, I’ve mentioned this earlier, but I really do wish that– One thing I wish everyone knew about suicide and suicide prevention is that it’s okay to ask someone if you’re thinking about suicide if you’re worried about them. It’s okay to ask that question. You’re not going to give someone the idea of suicide by asking. And it’s not going to make things worse, it actually can help them. These are some things that we talk about in Keep Watch that we really unpack. We also provide some guidance on what to do in the moment if someone is having thoughts of suicide, how to get folks connected to resources and really how to mobilize these beautiful systems that exist in the church, systems of clergy, of laypersons, of youth groups, of different ways to connect and belong. How to equip the body of Christ to mobilize resources of mental health in the community. That is really something that we’ve worked hard to map out in this book.

Rob: Mary Chase, you really got me going here because you used one of my favorite words, which is to mobilize. If we pay any attention to what Jesus did, he mobilized people, right? And so, the other part about that, which really gets me going, is that you’ve touched on what I think is the best definition of leadership, which is the capacity to mobilize people to address tough problems. And here’s the kicker, especially problems they’d rather avoid. So, what I hope we are going to do with this resource is that we are avoiding the temptation to be silent, right? We are avoiding collusion, right, with letting this thing grow in a quiet, dark space, right?

And then, the piece that you mentioned some time ago, you talk about raising the roof. Well that reminds me of that wonderful gospel where a lame and sick person, carried to Jesus by his friends and they literally poke a hole in the roof, right? And lower him down in front of Jesus. And so, in some ways, we are doing that work now. We are taking a friend to Jesus. We are taking numerous friends to Jesus so that we can participate in Jesus’ healing.
Mary Chase, thank you so very much. I’m going to turn to Holly Tubbs in just a moment after a break.

Easton: Hi, listeners. Thanks for listening to For People, a space of a space of digital evangelism. You’re hearing the ministry of Jason McGee. Jason will be with us leading a mass choir with Imagine Worship on October 3 with Presiding Bishop Michael Curry at St. Barts NYC. If you are local in the area, we encourage you to attend. Like to register in episode description. And now, back to For People.

Rob: We’re back friends, and we’re with Holly Tubbs, who is the youth missioner of the Episcopal Diocese of Atlanta. Holly.

Holly: Hello, thanks for having me.

Rob: Absolutely. Now, Holly, you and I’ve been talking about this project. And so, I’m so proud that we’ve gotten it off the ground. And you and Mary Chase have done sort of yeoman’s work with others, who have sort of gotten this book to draft stage. And so, let me ask you a question, why is this important? You’re fairly new with the Diocese of Atlanta in your capacity as youth missioner. And so, why is this one of the first big things that you wanted to get done?

Holly: Well, you’re right about being new. I’m coming up on one year with the Diocese of Atlanta in a few weeks. It’s a little surreal but very rewarding to be getting a project of this scope and importance off the ground at the time we’ve had.

You asked two questions that I heard, why and why me? As far as, why me, I have spent my entire life in the church. And I have had my own journey with suicidality. And I live with some of the risk factors that surround that. I’ve also had my own experiences with some of the less helpful messages that we, as the church sometimes give people around mental health and suicide. And as far as my work now goes, I mean, it’s true that if you look at the title, youth missionary, you might not see how this is obviously in my lane, until you consider that anxiety and depression, which are huge risk factors for suicide, they were significantly impacting young people even before the pandemic. In 2019, one in five teens reported experiencing major depression. And you know, suicide rates and depression rates for young people just aren’t getting any better. So, this is something that’s impacting not just our young people, but certainly our young people. This is a generation that is profoundly impacted by suicide. So, any well positioned youth ministry or college ministry is going to involve some type of prevention. So, in that sense, it is in my lane. But I would also add that this impacts all of us, as Mary Chase mentioned earlier. So, it is in all of our lanes.

Rob: No, that’s wonderful. And you know, what we have learned, tragically, it was a tragic and costly learning. But what we have learned both in death by suicide of a teen and death by suicide of a clergy person who was much beloved of the youth in her in her parish or congregation is that we need to be better prepared to have these conversations. Because it’s happening in our midst. It’s happening to our neighbor. What we know is is that suicide has touching so many families. We know that depression, bipolar disorder, all of this is touching so many of us. And I have personal knowledge of this. My wife wrote a couple of books about clinical depression. She shared her journey about all of that. So, there was a lot of learning that my own family had to do. Our kids had to do about mommy and clinically depression. And one of the things that we had to learn is that there’s no easy fixes. And I think for a generation of us, it is, you know, our default is, well, you just got to outwork it, you know. The world is full of setbacks, there’s everybody’s got across the bear, you know, suck it up, so to speak. And what we learn when we sort of go deep with loved ones and people in our community, you can’t outwork this. There are things we can do, of course. But you can’t just outwork it. It is one of those things that we’re going to live with if we are suffering from anxiety or depression. We are going to have to hold it, figure out how to old it. And hold it as well as we can. But to know that our young people, in particular, are holding that kind of, you know, intense anxiety, depression, etc., you know, perhaps in greater numbers than ever before. So, I think it is squarely within the work of someone who’s doing youth work.

Holly: It is. And you know, in terms of holding anxiety and other types of mental anguish, you mentioned that the name, Keep Watch, comes from prayer. And that’s true. It also comes from the story of Christ’s evening in Gethsemane. Where Jesus tells Peter, James and John, that his soul is crushed with grief to the point of death. And he asks them to keep watch with him. And they can’t. And you know, I’ve read all four gospel versions, there might be a perfectly valid reason for this, all of the writers mentioned that the disciples were tired, which sounds a little defensive to me. Like, okay, we know it’s about look, we didn’t keep watch with Jesus. But it had been a bit bleak, and we’d been walking all day, we were stressed, etc., etc. But I can see a world in which exhaustion was not the only factor there because in this story, Jesus is experiencing extreme distress as he cries out to God. To the point it says, of sweating blood. And so, I can imagine that seeing the Son of God, seeing your rabbi in such a state would have been really unsettling and scary.

And so, reading that story, through the lens of suicide prevention in the church, I can identify with the disciples, because when I am confronted, when we are confronted with this kind of existential pain, or need, that seems to outpace our capacity to respond, looking away or going to sleep is unfortunately, a very human response. So, I get why, you know, it can be hard to engage and why it’s uncomfortable to hold those kinds of things.
But we see in this story, that the power of keeping watch, of sitting with someone in their distress, and being a voice of life, that’s something that we can’t always measure the impact of in the moment. You know, and you mentioned earlier that one of your favorite words is mobilize. And there are three parts to that, right? There’s invitation, there’s inspiration, and there’s empowerment. So, we’ve created this book as an invitation. And we hope that as churches engage with the content, either through the book, or through parish trainings that I will mention later, we hope that there’ll be inspired and empowered to do the work of keeping watch, and practicing community based suicide prevention.

Rob: No, I mean, it’s all three of those are constituent parts of mobilize, right? I mean, you need the inspiration, you need the commitment to stay awake. I love that thing. What I loved about this, this resource, and what I love about us as the Diocese of Atlanta doing this work, there is an intersection of faith and mental health. And sadly, there are not nearly enough resources.

And so, when my wife, you know, we finally got her diagnosed as clinically depressed. And I had to sort of go through that learning time with her, with clinicians, etc. You know, I returned to my congregation with new eyes. You know, I grew up with the sort of shorthand kind of– which many of us have grown up with. It’s sort of like, I remember being told, hey, there are two types of people in the world. You know, people who are crazy and people who are not crazy. And what I’ve come to learn over the years is that there actually are two kinds of people, diagnosed and undiagnosed, right? And so, as I began to look out on this congregation looking at the numbers, people who have entertained thoughts of suicide, who have had attempts, etc., and I looked out at 500 people and realized just numerical I was talking to people who have had these thoughts. We have sat somewhere in their heart and head, and perhaps a trust confidant with these thoughts, or perhaps felt contained like Mary Chase talked about. And felt there was no safe place to talk about that. And so, there’s a capacity that has to increase in us to be able to see, you know. And again, we do know, however, that there are going to be some people for whom their desire to die by suicide is going to outpace our ability to intervene. And so, what does the resource say to that?

Holly: Yeah. Well, in the book, we talk about something called postvention. Which is a community’s response to a suicide attempt or a suicide loss. So, basically, a community’s response to when our prevention efforts don’t work. Now, there are a few different pieces of postvention. There’s, of course, the care we provide to the suicide survivors. This is either the person who has survived an attempted suicide, or the loved ones of the person who has died by suicide. And this is where we as the church surround the hurting and provide practical support in partnership with mental health professionals
And then, the second part of postvention is community care, how we talk to each other. Not just about our own mental health, but how we talk about others, including those who have suicided or attempted suicide. You know, are we talking about these people and this issue with discretion and compassion and curiosity and sensitivity? Are we recognizing that this is not something that we have to hide. This is a matter of deep pain and desperation, and it deserves to be honored and acknowledged. I have lost a few friends to suicide, a few church friends to suicide. And what I remember the most from the aftermath of those deaths were the whispers. There were these things we said out loud, and those were all the socially acceptable church things.
But then there were the things, we kind of halved swallowed. And whispering about those things, whispering about suicide, and the pain that’s attendant to that, is itself a message. It tells us that it’s not safe to talk about this. It’s dangerous to name the pain in the room. And at this point in history, we know that just does not work because whispering about things stigmatizes them. And stigmas keep people stuck and scared.

It also sends a message theologically, that our God isn’t big enough to hold those things. And I think we see in good seminary and in a lot of other places, that God is more than capable of holding our pain, and our grief, and our mental health stuff, and suicide. And so, you know, acknowledging the fear and the pain around this, we are not only acknowledging that God is big enough to handle it. But we are also shining some very bright lights in some very dark corners of our own community. And this is the kind of care that reflects God’s mandate to us through Jesus to love our neighbor as ourselves. So, you know, we can’t solve every problem. Practicing suicide prevention does not mean that there will never be another person who, you know, engages with suicidality. But what we can do is everything we can do, and that’s what this resource really is trying to equip us for.

Rob: It’s interesting, when my– So, my wife, wrote a book called, Me Depressed. I mean, she has this amazing resume. And of course, a fantastic husband and all of that. And she found herself surprised that she was suffering. And she was diagnosed. I mean, really took her, you know, took her back. And so, she did what, you know, what an overachieving Jamaican would do, she wrote a book about it, right? But as she went around and talked about, you know, this adventure, this journey that she was on as this highly competent person, a person who grew up in the church whose father was a clergy person, now married to a clergy person, raising the kids in the church. And yet, she found no really sort of robust resources about how to talk about having faith, and at the same time having, you know, mental health challenges.

And so, when she would go on this sort of book tour, talking to all kinds to various places– First of all, we were surprised at how many invitations she got. We couldn’t keep up with them. We couldn’t keep the books in stock, right? So, that was number one.
But number two, you talk about whispering. She would always come back. And she would tell me about the people who would come up to her afterwards, you know, over cookies and punch afterwards, with the whisper. Right? This has touched me, this has touched my family, I have thought about this, etc. And so, it really is pervasive.

So, as far as I’m concerned, it is spirituality, malpractice, Christian spirituality malpractice to collude with the silence. So, the church has got to be a place where we can talk about the Good Friday’s of our life, as well as the Easter Sunday’s.

You know, Barbara Brown Taylor was on the podcast some years ago now. And she talked about, you know, this false notion of full solar theology, which is, you know, happy clappy, you know, the sun will come out tomorrow type of thing. And how that is missing the mark and people’s real lives. In fact, what it’s doing, it is saying that there is a big sign outside the church saying, we have nothing here for you and your real life. So, if you want to come in and participate in this mass delusion for an hour and 15 minutes, come on in. But if you got real stuff, you know, leave it at the front door for an hour and 15 minutes, right? So, I love this line that you’re picking out from the Gospel where Jesus is friends felt inadequate in face of Jesus’s soul crushing suffering. And so, this resource points to how you and I can increase our capacity.

Yeah. So, when you are thinking about teams, because all of this has to be– We can’t all just be individual book readers. We ought to all read this resource. But then you are talking about teams. What is the vision there for the teams?

Holly: Well, in the book, we talk about the keep watch team, which is a core group of clergy and lay people in each parish, who are charged with being gatekeepers. So, a gatekeeper is someone with relationships in the community, who is able to identify, and help someone at risk of suicide. So, depending on their level of training, this help could be anything from, you know, asking someone about suicide, having a conversation with them, and then connecting them to a support resource. It could go from that all the way to, again, depending on your training, to facilitating an intervention.

Overall, though, the purpose of having a team like this is to empower our congregations to practice suicide prevention, to invest in their mental health culture, and the conversations that are happening in their parish. And to make sure that all of us are holding ourselves accountable around the work of suicide prevention in the church and how we’re engaging it. This team should consist of people of different ages and stages, kind of representative of the congregation so that they can provide some peer support to anyone needing to talk about suicide. They also need to be fairly visible in the community so that there is a constant reminder that this is a resource available to anyone who would need it. We want to build or reinforce church cultures, in which we can have open and transparent conversations around mental health, mental distress, and suicide.

Rob: You know, what’s interesting is that when we take these words thwart of belongingness, and we lay that over some of the gospel stories. I mean, you see the garrison demoniac, you see the guy walking among the tombs, and one has to wonder now, you know, was that about thwart of belongingness? Right? I mean, you know, these gospel lessons are there for us, if we can sort of see them a little bit deeper and better for us to have the conversations that we actually need to have.

You know, and I don’t want to end with this, but I think it’s an important gift is is that, you know, in the appendices of the resource, you’re actually going to have an example of funeral liturgy there. And I just thought that was so thoughtful, that you’re going to give people a way to sort of view– Because when we were doing them a couple of years ago, we were really making that up as we went along. Of course, we had The Book of Common Prayer as a resource, but there were marks that it didn’t necessarily hit. So, say a little bit about this liturgy that you’re planning, that you’re offering.

Holly: Yeah, sure. So, when I began this project, one of the main drivers behind the content, one of the main questions that I kept asking myself, you know, as I engaged Mary Chase as the subject matter expert, and did some of my own reading, so I could try to keep up with her. The question was practicality. Is this practical? Is this realistic? Is this something a clergy or lay person in a parish could actually do without interrupting what they’re already doing? So, in addition to the main content, our appendices are full of additional resources around these kinds of practical matters. Helping someone in a panic attack, talking to kids about suicide, knowing as a clergy person when to refer someone to a mental health care provider and when not to. And it also includes, as you mentioned, funeral planning. And as far as funeral planning goes, we’re providing a list of approved scripture and hymns that keep suicide survivors in mind in terms of the messages that they’ll hear in the service. We also include a beautiful sermon from the funeral of a young person at St. Timothy’s Episcopal Church in Winston Salem, North Carolina, that was preached by their Rector, the Reverend Stephen Rice, who very graciously allowed us to include this work of his in our book as a resource for others.

So, we do hope there’s a lot of practicality in here. And overall, we just don’t want any clergy or ministry people to see this resource as another thing they have to do, another box they have to check on top of all of the other work they’re already doing. My dream for this is that it is a resource that will inform the work that’s already happening with some practical help along the way, and some invitations to lay people to engage and amplify our suicide prevention work.

Rob: Yeah. As we’re wrapping up here, tell us when the resource will be available and where folks can get it?

Holly: Well, we are in the final stages of producing the content. So, I will tell you what we hope to have happen. And then, let’s just see. We do hope that by mid-September you will be able to purchase this book on our website, either physically or digitally. The digital version will be available on Kindle through Amazon as well. And then for parishes in the Diocese of Atlanta, we’re also offering this content in the form of a congregational training. So, we recommend that you use the book, you know, either in a congregational or book study setting. You can also do it as an individual, if you so choose. But recognizing that for parishes, buying a bunch of books is not always financially or logistically feasible. So, Mary Chase and I are going to provide some training that will present an abridged version of the book content for churches at cost. We just want to get this content out there. We want churches to benefit from it. And we want everyone in our diocese to feel inspired and empowered to engage in this life saving work.

Rob: And I just got to say, publicly, I’m so proud of you two. It’s an amazing resource, I sat down and read it in one sitting, I mean, and it’s something that I need to reread. It’s just beautiful. I mean, it rounds out some of the things I thought I knew, it raises the ceiling height, on, you know, I hope, my ability to be sensitive in those moments that inevitably I will encounter as we live with people in this particular age.

And let me just say, lastly, why I’m also very proud of this is because it is at that intersection of mental health reality, the legitimate reality of mental health, and as well as faith and how those things live together. And so, for people who want something more concrete, I would simply say, in our church, we talk about the baptismal covenant, which is we are baptized and we make these promises. And we continue to make these promises. And these promises are reference points for us as we live our life as life unfolds. And so, when I think about, Keep Watch, I think about proclaiming by word and example, the good news of God and Christ and that you do belong and you’re not alone. And there are resources and friends, right? And there are people who will try to stay awake with you. Because you do have dignity, I think about what you seek and serve Christ and all persons loving your neighbor as yourself. If I happen to be in these kinds of dark nights of the soul, I would love somebody to care for me. Therefore, you know, I want to care for some other neighbor who finds themselves in those kinds of dire straits. I mean, and on and on and on. I mean, this is one of those very practical ways when we can actually see that our baptismal covenant is a living, breathing thing, and needs flesh and blood on those words every day.

Mary Chase and Holly Tubbs, thank you, thank you, thank you so very much for this resource and for your good work.

Holly: Of course, thank you.