@DocForeman @SkyeMarie3918 & @mmbrown14 Chat: Suicide. Grief. PTSD. A public health approach

@DocForeman @SkyeMarie3918 & @mmbrown14 

Chat: Suicide. Grief. PTSD.

A public health approach

A cautionary note: the background links below and the Sunday night chat may be a very difficult conversation for some.

Suicide, PTSD, Grief_ a public health approach (1) 

Weaving suicide, grief and PTSD together creates a tapestry of trauma.

In less than two weeks, two survivors of the Parkland shooting and a bereaved father who lost a child in the Sandy Hook shooting died by suicide. In that same time frame, another 1,803 youth, adults and elders also died by suicide, each one a tragedy.

Dr. April Foreman, Skye and Melissa Brown will join the SPSMCHAT 2.0 Reboot via YouTube Live Stream to offer their perspectives to the links between suicide, grief and PTSD as well as existing resources for treatment and advocacy. And this is only the beginning of this conversation.

Please take time to review the links below. They will help inform Sunday night’s Twitter Chat & YouTube live stream.



What We Get Wrong When We Talk About the Parkland Survivor Deaths : Discussing PTSD is important to survivors — but so is remembering that trauma can be managed, and help can be found

 Suicide Contagion or “Copycat Suicides” Are A Public Health Issue, & Approaching The Issue With Nuance Is Important

 State spent $69M on mental health after Parkland, but didn’t mention PTSD, suicide

 Three tragic deaths reverberate across U.S. amid steady rise in suicides


Flooding can take toll on mental health


DocForeman Headshot

April C. Foreman, Ph.D

April C. Foreman, Ph.D., is a Licensed Psychologist serving Veterans as a Clinical Outreach Specialist in Technology and Innovation for the Veterans Crisis Line. She is an  Executive Committee member for the Board of the American Association of Suicidology, and has served VA as the 2017 Acting Director of Technology and Innovation for the Office of Suicide Prevention. She is a member of the team that launched OurDataHelps.org, a recognized innovation in data donation for ground breaking suicide research. She is passionate about helping people with severe (sometimes lethal) emotional pain, and in particular advocates for people with Borderline Personality Disorder, which has one of the highest mortality rates of all mental illnesses. She is known for her work at the intersection of technology, social media, and mental health, with nationally recognized implementations of innovations in the use of technology and mood tracking. She is the 2015 recipient of the Roger J. Tierney Award for her work as a founder and moderator of the first sponsored regular mental health chat on Twitter, the weekly Suicide Prevention Social Media chat (#SPSM, sponsored by the American Association of Suicidology, AAS). Her dream is to use her unique skills and vision to build a mental health system effectively and elegantly designed to serve the people who need it.



Skye is the Northwest Regional Director for youth gun violence prevention organization March For Our Lives, on the national team for youth climate justice movement This Is Zero Hour and an advocate for refugee and immigration rights.  She is 22 years old and currently pursuing a bachelor’s degree in International Studies in California.  Although she has been doing advocacy work on the issue of mental health through March For Our Lives California, solutions for preventing suicide contagion came into focus immediately following the suicides in the Parkland and Sandy Hook communities.

Skye is now developing resources in conjunction with the American Association of Suicidology and Brady United for the very specific issues that affect anyone afflicted by gun violence and the intersection of this large community impacted by suicide.



Melissa Brown, DrPH, MPH

Margaret Melissa Brown, DrPH, MPH, is a Behavioral Scientist at the Centers for Disease control and Prevention, National Center for Injury Prevention and Control, working in suicide prevention. She is a graduate of the College of Public Health at the University of Kentucky (UK). Areas of education concentration include health management and policy, research management, epidemiology, health behavior, individual and family development (family studies), and nursing.  Dr. Brown has mentored and collaborated with a diverse group of undergraduate, graduate and doctoral students both within the United States and internationally. Past research has focused on suicide (military, community impact, suicide exposure and bereavement, LGBTQ, prevention and postvention, clergy, posttraumatic growth after suicide), family and community violence, sexual trauma related PTSD, telemedicine, and violence fatality surveillance (NVDRS).


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@SPSMCHAT 2.0 Reboot! Hosts an Open Mic on March 24th, 9:00 pm EDT. It’s #YourTurn.

@SPSMCHAT 2.0 Reboot! Hosts an Open Mic on March 24th, 9:00 pm EDT.

It’s #YourTurn.

Open Mic 3-24-19

This will only be on Twitter tonight. No YouTube live streaming

We have hosted 10 #SPSMCHATs since rebooting on January 13th. The topics have touched on a wide variety of subjects

Tonight, March 24th, we’ll step back, pause and turn the #SPSMCHAT to put the focus to what’s on your mind? What has you excited or upset? If you are troubled about a problem or a gap, what might be done to address the problem or help to fill that gap?

  • What topic/issue that we covered needs more attention, another chat?
  • Is there a report, blog or article that caught your attention this week? Post it! Let’s chat about it.
  • Are you on the road to or have you already arrived at #NATCON19in Nashville?
  • What are you presenting on?
  • Did you listen to a really good podcast this week? Share the link.
  • Did you attend or deliver a training or presentation? Tell us about it. What was your take-away?
  • Are you presenting at #AAS19 or another conference, symposium, workshop, etc.? Tell us about it.

These are just a few suggestions to get the conversation jump started tonight.




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Suicide: a Public Health Approach with @MMBrown14 on March 17th 9pm EDT

Suicide_ a Public Health Approach

Suicide: a Public Health Approach

Sunday, March 17th, 9:00 pm EDT on Twitter (SPSMCHAT 2.0 Reboot!) with simultaneous YotTube Live Streaming

Melissa Brown @MMBrown14 discusses her concepts about wrapping a public health/population level model around suicide as well as the projected work of the new AAS Public Health Committee.

From the CDC Foundation: https://www.cdcfoundation.org/what-public-health

 Public Health connects us all. Together our impact is greater.

Public health is the science of protecting and improving the health of people and their communities. This work is achieved by promoting healthy lifestyles, researching disease and injury prevention, and detecting, preventing and responding to infectious diseases.

Overall, public health is concerned with protecting the health of entire populations. These populations can be as small as a local neighborhood, or as big as an entire country or region of the world.

Public health professionals try to prevent problems from happening or recurring through implementing educational programs, recommending policies, administering services and conducting research—in contrast to clinical professionals like doctors and nurses, who focus primarily on treating individuals after they become sick or injured. Public health also works to limit health disparities. A large part of public health is promoting healthcare equity, quality and accessibility.

For more on a backstory  on the importance of a public health approach, please check out this SPSMChat from November 8, 2015 with Jerry Reed.



From Melissa:

Public Health plays a vital role in addressing the burden of suicide. Suicidologists have welcomed the surveillance, data collection, and research the field of public health has contributed to the study of suicide; however, there are many other skills and resources public health professionals can bring to the table. Suicide rates have continued to rise across nearly all of the US and globally, generating a public health crisis. The scope of the issue requires population-level methodologies to address these rising rates and the populations exposed and bereaved by these deaths. The American Association of Suicidology (AAS) has approved a NEW committee for public health to provide a base of action for population level efforts addressing suicide. A committee for Public Health helps balance AAS by clearly expanding the focus of AAS to include population-level approaches to reduce and address both prevention and impacts of suicide.

Specific actions this committee could contribute include:

  • Provide a platform to recruit and engage public health professionals in suicidology.
  • Provide a knowledge-base for public health research addressing population/community approaches to suicide prevention.
  • Engage researchers in the epidemiology of suicide.
  • Development and dissemination of population level risk-reduction strategies.
  • Evaluate current efforts for suicide prevention to inform and direct future decision-making.
  • Promotion of comprehensive suicide prevention through collaboration.
  • Review of abstracts related to public/population health topics for AAS annual conferences.
  • Provide networking opportunities at the AAS annual conference for individuals interested in population-level approaches to address suicide.
  • Assist in formulating responses to population level events and policies (i.e. natural disasters, celebrity suicides, policies/regulations, etc.) associated with suicide.

As Chair of this new Public Health Committee, I welcome anyone interested in addressing this issue through a public health approach. It is not required for committee members to possess a degree in public health or prior experience. If interested, please feel free to contact me at either mmbrowndrph@gmail.com or oth2@cdc.gov.




Melissa Brown, DrPH, MPH

Margaret Melissa Brown, DrPH, MPH, is a Behavioral Scientist at the Centers for Disease control and Prevention, National Center for Injury Prevention and Control, working in suicide prevention. She is a graduate of the College of Public Health at the University of Kentucky (UK). Areas of education concentration include health management and policy, research management, epidemiology, health behavior, individual and family development (family studies), and nursing.  Dr. Brown has mentored and collaborated with a diverse group of undergraduate, graduate and doctoral students both within the United States and internationally. Past research has focused on suicide (military, community impact, suicide exposure and bereavement, LGBTQ, prevention and postvention, clergy, posttraumatic growth after suicide), family and community violence, sexual trauma related PTSD, telemedicine, and violence fatality surveillance (NVDRS).


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Self-care after a suicidal crisis – Sunday, March 10th, 9:00 pm EDT @lifesnewnormal, @BeyondKeto & @Lenaschatz

Sunday, March 10, 2019 9:00 pm EDT

@lifesnewnormal, @BeyondKeto & @Lenaschatz

self-care after suicide


Self-care after a suicidal crisis

A writer and editor, a professor who transitioned from an academic setting to the world of suicide prevention, a mental health advocate and licensed acupuncturist. Survivors of suicide loss, each has been on a mission, searching for a self-care approach that works for them.

Join us Sunday evening at 9:00 pm EDT as Lauren Carter, Lena Heilmann and Stephanie Willard come together to share their stories and respective journeys to self-care that wrap around health, wellness and personal development, to understanding the importance of sleep hygiene to support mental, physical and emotional health, to alternative care such as Oriental Medicine and clinical aroma-therapy. Each quest was motivated by the loss of a loves to suicide, and in Stephanie’s life, a murder-suicide, but what they’ve learned may be helpful to others.

You can follow The SPSMCHAT 2.0 Reboot! “Self-care after a suicidal crisis” at 9pm EDT on Twitter and/or via a simultaneous YouTube Live Streaming link.



Lauren Carter

Lauren Carter is a writer and editor with a background in journalism and PR. Her work has appeared in newspapers, digital publications, national magazines and anthologies, and she has developed strategic communications for business and higher education leaders.

She became passionate about self-care after struggling with depression for more than 20 years and then losing her mother to suicide in 2010. Desperate for change and recovery, she did extensive research on health, wellness and personal development and ultimately created a daily wellness program that helped her to overcome depression and transform her mindset and her life.

More info on her program is available at beyondketo.wordpress.com. Follow her on Twitter and Instagram @BeyondKeto.



Lena Heilmann

Lena Heilmann lost her sister Danielle to suicide in 2012. In response to the grief caused by this traumatic loss and as a way to honor her sister, Lena transitioned from her role as a college professor to the world of suicide prevention.

Now working in youth suicide prevention in Colorado, Lena incorporates her lived experience and expertise, which centers on her identity as a survivor of suicide loss, with her professional career and with her personal mission. Lena is passionate about understanding sleep as a social justice issue and the importance of sleep hygiene to support mental, physical, and emotional health.



Stephanie Willard

Stephanie Willard is a mental health advocate, story teller, as well as a licensed acupuncturist, Oriental Medicine practitioner, and clinical aroma-therapist. She has been in private practice for nineteen years in Oregon.

On May 8, 2014, she came home to find that her husband had killed their four-year-old daughter and then himself.  She has spoken about her experience at the National Association of Grieving Children’s 2015 and 2018 conferences, the 2015 Portraits of Courage Luncheon for the Dougy Center, and at the 2016, 2017 and 2018 American Association of Suicidology conferences.  She was a keynote speaker at “Life’s New Normal – The Forum” in November 2017, hosted by A Voice at the Table, and at the Massachusetts Suicide Prevention Conference in May 2018. She also created and has taught her class “Tools for Navigating the Roller Coaster of Grief,” combining her many years of alternative care knowledge and her loss experience. She is an active member of the Suicide Prevention Alliance for the state of Oregon, working on prevention and legislative changes as well as on the AAS Impacted Family & Friends Committee.

Stephanie is determined to reach people who are struggling with mental illness (suicide prevention) as well as families who have dealt with the death of a loved one from suicide (suicide bereavement) or murder-suicide.  She has been public with her lived experience and continuous grief process via her blog at www.lifesnewnormal.com and articles in “The Mighty.”. As she brings a “realness” to her readers of what her journey has been, Stephanie has touched people worldwide. She believes that people with lived experience can help educate as well as support others in suicide prevention and bereavement and strives everyday to inspire hope to others. Her story is, above all else, about resilience.



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Suicide & Social Media: the Good, the Bad, the Ugly. Sunday, March 3rd, 9pm ET

SPSMCHAT 2.0 Reboot! Sunday, March 3rd, 9:00 pm ET

 Note from Annemarie @semavav & Tracey @TraceyMedeiros2.

We are “on the road again” Sunday night, March 3rd, so rather than worry about hotel bandwith, we thought this was an appropriate time to pause the YouTube live streaming and revert back to the straightforward Twitter Chat mode.

The topic?

Suicide& Social Media (1)


Suicide & Social Media: the Good, the Bad, the Ugly. It’s your turn to Tweet. What’s real? What’s not? What’s a hoax? What’s censorship? Where’s the research? What are the solutions to help clear the clutter & misinformation?

The phrase “moral panic” has repeatedly popped up across social media platforms in the last few weeks. How do we define that as it relates to social media and suicide? There has been heated debate about censorship versus self-expression (however disturbing). Can there not be comprise? Is there no middle ground?

In response to the chatter, AAS released a new tool:

Suicide and Social Media – A tipsheet for parents and providers

AAS also hosted a Facebook Live event:

“…talking about Instagram’s new self-injury and suicide policies, discussing what constitutes censorship, and whether or not we can effectively navigate moral panic to be successful at preventing suicide.

There were a number of articles written. Two examples:

The Daily Mail published Valerie Baumann’s:

Disturbing online world where vulnerable teens share distressing images that can encourage self-harm and suicide

(But does it encourage self-harm and suicide? Do we have the data?)

Julia Jacobs wrote in the New York Times:

Instagram Bans Graphic Images of Self-Harm After Teenager’s Suicide


And some feel, way too much media coverage that perpetuated what is a hoax, creating more panic.


RollingStone.com published E.J. Dickson’s: What Is the Momo Challenge?

Why parents are freaking out about this terrifying “game”

Wired published Emily Dreyfuss’ How not to fall for viral scares


And then, there was the YouTube cartoons concerns:

Brett Molina addressed the outrage in USA Today:

Mom calls out YouTube videos with hidden suicide plan for kids

And there were more articles, letters from schools to parents, news broadcasts, etc.

So, let’s chat – please share your comments, concerns, and suggested solutions. This is your forum.

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@AspieSurvngLoss and Amelia Lehto @Atoes84 Chat about the #AAS Toolkit “Crisis Supports for the Autism Community.”

Autism, Suicide, Crisis Supports

@AspieSurvngLoss Lisa Morgan and Amelia Lehto @Atoes84 Chat about the #AAS Toolkit “Crisis Supports for the Autism Community.”


Purpose of the Autism & Suicide Toolkit:

This resource was developed to aide crisis center workers in identifying and supporting autistic callers/texters who are in crisis.

A person with autism may or may not disclose their diagnosis to a crisis center worker or even be aware they are on the autism spectrum, yet still need individualized, specific support.

This resource includes ways to identify potential callers/texters who show autistic traits and characteristics, as well as ways to support an autistic person in crisis.

The resource also explains the unique differences in communication, thought processes, sensory issues, and misunderstandings a crisis worker may encounter while helping an autistic person in crisis.(2018, AAS)


Did you know? CDC increased estimate of autism’s prevalence by 15 percent in 2018, to 1 in 59 children

Did you know? The nation still lacks any reliable estimate of autism’s prevalence among adults. As autism is a lifelong condition for most people, this represents an unacceptable gap in our awareness of their needs – particularly in areas such as employment, housing and social inclusion. Each year, an estimated 50,000 teens with autism age out of school-based services.


Toolkit author’s statement: “The decision on whether to use person-first language versus identity-first language is a personal choice. As an autistic adult, I prefer to use identity-first language. I use the word autistic as a descriptive adjective in defining who I am. While other autistic adults may also choose identity-first language, there are people on the spectrum who prefer to use person-first language, not wanting to be defined by autism. In respect for all people diagnosed with autism, I have chosen to use both types of language in this autism-friendly resource to be used in crisis centers as a means to identify and communicate with people in crisis who are diagnosed with autism.” ~ Lisa Morgan

Lisa Morgan

Lisa Morgan

Lisa is author of Living Through Suicide Loss with an Autism Spectrum Disorder (ASD) and a co-author of Been There Done That, Try This! , both published through Jessica Kingsley Publishing.  Lisa is an assistant editor, feature writer, and columnist of Spectrum Women magazine. She is also co-chair of the Suicide and Autism committee of the American Association of Suicidology (AAS), a committee dedicated to helping the autism community with all issues of suicide.  Lisa authored, in collaboration with the committee, a first of its kind autism resource to aid crisis center workers communicate with autistic callers/texters who are in crisis.  She has developed and presented two webinars for AAS called “Crisis Supports for the Autism Community – Starting a Conversation” and “Autism Resources for Crisis Centers”.  Lisa is a speaker and advocate for the autism community in issues of suicide.  She is a member of the Community Council of AASET, Autistic Adults and Stakeholders Engaged Together, a team of autistic adults working together to provide the top priorities of the autism community to guide future research topics. In July of 2018, Lisa was invited to speak at the National Academies of Science, Health and Medicine on lived experience with health literacy issues, and is co-authoring a book on the results of that workshop.

Video Link from the July workshop:




Amelia Lehto

Amelia Lehto is a leader who specializes in suicide prevention and postvention on the local, state and national levels through trainings, advocacy and technology. She is the Vice President for local nonprofit Six Feet Over, Crisis Centers Division Chair for the American Association of Suicidology and works full time for a local Crisis Center.

After experiencing suicide loss at a young age, she discovered that one is not defined by how they died, but how they lived. To quote the famous and family favorite Lorax, “Unless someone like you cares a whole awful lot, nothing is going to get better. It’s not.”


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Suicide, Social Media, and Censorship: Reasonable people diverge on difficult issue. 2/19/19 #SPSM #ImpactedFamily #LivedExperience #SuicideReporting

#SPSM will be having an AAS FB Live hosted “very special chat,”  Tuesday 2/19/19, 9pET/8pCT.

When it comes to suicide, social media, memes from Lived Experience, and censorship, it seems wise to invoke the (now infamous) Thomas Joiner Preamble:

“Reasonable people can reasonably disagree about the nature and solutions of difficult problems. ”

Instagram, and by extension its parent company Facebook, announced changes to their policy, disallowing graphic depictions of self-harm. This change follows the death of Molly Russell by suicide. Molly’s parents, in part, blame self harm content from Instagram for her death. 

This disallowing of self-harm content has, at this time, sparked considerable public debate, as well as debate among Suicidologists.

There was also an amazing article in the Atlantic discussing the fact that memes and images about suicide abound on the internet, and given that you can’t police it all, what do you do?

Notable points raised in the last week:

  1. Molly’s death by suicide was likely due to complex factors. Molly, and everyone really, deserves better science about suicide, and a better care system. Right now there is a lot we don’t know about suicide, and a care system that on its best day is still often inadequate.
  2. Debate over whether or not disallowing images of self harm and suicide is helpful or harmful to people at risk of suicide and/or people with lived experience of suicide.
  3. Debate over whether or not the media guidelines for reporters are meant to be applied to individual expressions about their own suicidality on social media.
  4. Debate over whether or not disallowing this content is censorship.
  5. Relatively little conversation was held about how effective such “censorship” will actually be. I.e. is such a thing “suicide prevention theater” due to a moral panic, or an effective means of preventing contagion and limiting harm?
  6. Relatively little conversation about #ImpactedFamily stages of grieving a suicide, including the urge to “do something” in the wake of a loved one’s suicide death, in the face of an inadequate science and health care system.

We will be discussing all of this in a very special, AAS hosted #SPSM chat, on FB Live. Join the old school SPSM gang (@DocForeman, Tony Wood, Dr. Bart Andrews, and Chris Maxwell), 9pET/8pCT.

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