Digital and Community Solutions After a Physician Suicide

June 11, 2018
David Carreon, MD

,
Jessica A. Gold, MD, MS

In the final part of our discussion with Janae Sharp, Janae further discusses the loss of her physician husband to suicide and how best to support others through grief.

PSYCHED! PODCAST

In the final part of our discussion with Janae Sharp, Janae further discusses the loss of her husband and how best to support others through grief. She details some unique differences in responses by others when her husband died by suicide (eg, no GoFundMe pages, but requests for donations!) and emphasizes the importance of other survivors and their stories to her and her new community. She responds to the question of whether she is "sensationalizing" her husband’s death, but focuses on her ability to do good as a result. She is particularly interested in digital solutions and discusses a few that she has been working on here. Finally, she explains what she feels the role of psychiatry is in this important topic.

Part 1: Surviving a Physician Suicide

Part 2: Physician Suicide and the Need to Talk About It

TRANSCRIPT

Welcome to PsychEd, a podcast about psychiatry that covers everything from the foundational to the cutting edge, from the popular to the weird. Thanks for tuning in.

David Carreon: You've been through such a difficult experience just in what happened, but what are things that people did or didn't do that were helpful after the suicide? How did people support you or fail to support you? And maybe more generally, how do people support or fail to support families who've had someone die by suicide?

Janae Sharp: Oh, that's a great question. It was hard because the first few days, people ask you what they can do. The first few days, you're really in the closet, not recovering at all. That was hard and it was hard for me to feel like my children were getting less. That was heart-breaking how some people supported it. People who had lost someone though, they were really good at following up and being thoughtful.

I had a friend who would send me articles about grief, and she did that for several years after John's death, just randomly saying, "Hey, I saw this and I was thinking of you." That's something I always tell people is important to schedule something further out, like six months from then and say ... Think of what you would do right after someone dies. Maybe you would go to their house and help them. Maybe you would make them a meal. Don't do it the day after, schedule it for a year later. Schedule it for the next birthday of that person, for any holiday is hard for people.

Purposefully do something instead of asking what you can do because we're socialized to not accept help and when you have grief, you don't always know what you want, it's too overwhelming. The people that were the most supportive were the people who had been through some kind of death and understood the cyclical nature, that some dies will be hard and some days are easier. That it's harder the second year when everyone has forgotten, and you're still taking your kids to a grave, or talking to your kids about their dad who's dead. So just keep that in mind.

I did have some friends who were really supportive and still understand that it's a permanent loss. It's not always permanently devastating. It's not always so immediate as right when they die, but they're still gone. So that's what I tell people.

Jessi Gold: Yeah. And then you mentioned that you were surprised afterwards, like some of the bad reactions, or some of the lack of things that you maybe thought would be around or given to you that weren't.

Janae Sharp: Oh yeah. Well, some of that is surprising because like with suicide prevention, some people they'll reach out to you. Some people asked us for money to donate to suicide prevention, and that was really overwhelming. If you look up things like GoFundMe, they raise less ... or like a memorial for kids ... they'll do it a lot of times if someone dies of cancer, but not necessarily with a suicide death.

That stuff was hard and then it's so strange talking about finances ever. When you're like, "Oh, wow. That's interesting that my kids didn't have a memorial fund." But then, you survived so what do you say? It's this horribly tacky topic where like, "Oh, that's weird." And then people are asking you for money for like awareness and ... Actually, Loss Survivors are the number one funder of suicide prevention initiatives. You're also a number one funder then for a topic that is really hitting you personally, and it kind of makes you ... it's kind of off-putting, but it's also ... now I like want to help those things. It's like the people who are hurting you in some ways, also some of those people were the most supportive. I don't know if that answers the question.

David Carreon: No, it does and I think that I've heard mental illness described as the no potluck disease. The no casserole disease.

Janae Sharp: We did not have funeral potatoes.

David Carreon: Yeah, it's like you get cancer and you get a casserole. You have a broken leg, you get a casserole. But you get mental illness and you get no casserole.

Janae Sharp: Yeah, you just can't post on Facebook, "Guys I just really could use a casserole today because of my depression. I am sad about something from five years ago still." Oopsies.

Jessi Gold: I can imagine, too, that like some people can say posting at all is sensationalizing a personal topic. What would you say to somebody who would say that?

Janae Sharp: Maybe it is. Maybe I should post something like, "Oh, and this is an inspirational story," and also life-coaching. If you think about it too ... because I thought about that. We've started like MD Suicide where people are sharing stories, and I shared our story and talked to my friend who helped me create that website, you know, "Do we want to make sure we're protecting stories of the children?" And I did talk to my kids and get their input on it. But in the end, I'm paying for my children and creating their world, and that's a choice everyone has to make for themselves. If they feel like they're sensationalizing it, then hopefully they're sensationalizing it and trying to help people at the same time.

If not, it's sad that we're so stingy with our attention and positive energy, that we think someone asking for help or asking for attention, is something negative. I also think, in terms of sensationalized stories, it's interesting when media wants more views, but they don't necessarily want to help. Like if someone wants to sell software, but they don't necessarily care about your story.
When people are sharing their own story, you know that they have a personal interest, so take that for what it is. Like I do have a personal interest in this, and it has impacted my life directly. That also means that ... maybe it is just sensationalizing them.

Jessi Gold: Right.

Janae Sharp: That's how it is. Like you get to pick-

Jessi Gold: Sensationalizing for good or something.

Janae Sharp: Yeah, I mean, people should maybe worry a little less about that and share their own story. I don't think that hurts people as much as lying about something and carefully remaining silent. Some of the stories that people shared online, that I read after John died, made a huge difference for me. So you have to find a balance. Everyone has to find a balance.

Hopefully, I have friends who will call me out if they feel I'm getting too wrapped up in those things and I do. I also have to make that decision for myself. Is that bad? You're like, "So people can say it's just for attention." I'm like, "Well, maybe it is. Maybe it is for attention." You share your story to be able to share it, and for people to know your story, and know you. I think that's a very basic need with humanity, to be known and to connect with people. I think that when you have suicide death, that need for connection and to be known is not met.

David Carreon: Yeah, I think you're absolutely right about the need for connection. Sort of, a lot of the things you've talked about and mentioned today have been about how sometimes community has come around and supported, but sometimes it hasn't. But I guess, how has this changed the community that you had before or put you into communities that you hadn't been?

Janae Sharp: I think it's actually had a huge impact on my community. I've been able to meet some people who are really supportive and Suicide Prevention, amazing people. Some of the friends that I'd had for a long time had a harder time dealing with the death, and they didn't have that same connection. That's really hard to see how it will change your support group but it's also ... It's good and bad, but I feel like I've been able to connect with people who really care too about burnout, and about improving a system, and care about doing that work, and want to do stuff together. That's been amazing.

Jessi Gold: I know you're really interested in digital solutions to things. What do you think is different about that, and what do you think makes that a kind of an untapped resource for this community?

Janae Sharp: Oh, I think digital solutions are interesting just because we have lower barriers. If you think about it, the things you'll say to someone on your Facebook posts, you might not say to them online. Or the things that you'll text people, you wouldn't always say that to their face.

There's a place to be more honest, but also if you feel like you have these questions about depression or about suicide, and you don't know who to talk to them about, then digital tools can offer you that community support that might not be available somewhere else.

I think one of the other important things to remember, for me, is how quickly some social media tools or those things can connect you. Because if you have a question about something, you can find answers a lot quicker. So I think it's a great opportunity, like we set up a virtual support group, which it's better with your time, but it also helps people in terms of that barrier to entry being lower.
I do think in-person connection is best, but there are people who would never have those connections because they don't have time or they have some other barrier that would keep them from being involved. I think it's important to ... digital tools can enable them to be involved when they might not otherwise get any help.

David Carreon: Yeah, I think that's a fascinating new dimension. I know that a lot of the talk has been around how there's some ... at least in our field ... magic in the room if you're physically face-to-face present. Some people say even if there's a video camera present for training purposes, that that takes away the magic. Certainly being in a different room when you're doing teletherapy, that completely ruins things. Your experience with the online support group has been that there is ... maybe not as good as face-to-face ... but there is still something there?

Janae Sharp: Yeah, it might not be as good as face-to-face, but some people don't wanna be face-to-face because they aren't really ready for that level of directly combating their problem. Maybe they're not ready for that.

Jessi Gold: And from your perspective, I know that maybe your support groups aren't run by psychiatrists, right? What do you think the role of psychiatry is in all of this?

Janae Sharp: I think they can help.

Jessi Gold: In what way?

Janae Sharp: No, we work with a licensed clinical social worker currently and psychiatrists ... we're always looking for people to get involved. I think psychiatrists should be more involved, and I think they should be overseeing most of the clinical development, and we worked with a psychiatrist to develop some of it. Obviously, they have expertise in identifying medications or identifying things that other people might miss.

I would need to talk to more psychiatrists about how they should improve it. Because I have talked with some about improving the measurement tools, and improving the design, and making sure the tools are efficient but not as much about how to really work together.

David Carreon: Well, we really appreciate your coming on to talk with us and just wanted to give you one last opportunity to ... Is there anything you would say to a young doctor or young trainee who's just getting started? Any advice you'd have?

Janae Sharp: I think my advice to them is to keep an open mind and to actively seek out the best workplace solutions that they can. If they find themselves getting hopeless, to be brutally honest, more than they would normally be and think of that. I also think new physicians are less tolerant of some the things that are creating these horrible environments. They are great activists for improving the mental health and improving the workforce for all physicians.

Jessi Gold: Yeah. If there's one thing that you would say like what psychiatry gets wrong, what would you say that is?

Janae Sharp: I think psychiatry also takes itself too seriously.

Jessi Gold: Totally.

Janae Sharp: They take it so very seriously, and they're already a group where they've been fighting for validation. If you can't diagnose many of your classmates with some form of crazy, then I don't know if you really went to school. But I would tell them to be more vocal about how psychiatry interacts with burnout, and be more critical of other specialties, and be really self-aware of their own limitations. Is that bad to tell them to be more critical? I probably shouldn't do that.

Jessi Gold: I don't think so. What's your favorite book? This is a random question.

Janae Sharp: My favorite book? Well, I really like Tad Williams. He's a fantasy writer.

David Carreon: Nice. And another rapid fire question. Somebody who you admire, a hero of yours either from fiction or real life?

Janae Sharp: Oh, that's a great question. I have a lot of people that I really admire. One of the people in suicide activism that I really like, her name's Dese'Rae Stage, and she shares stories of attempt survivors, Live Through This, and she was super supportive. So she's someone that I really respect in the space as someone who cares about individuals. That's one person I really admire.

David Carreon: Our last question for the interview. What is the largest quilt you've ever made?

Janae Sharp: Largest quilt? You know it's interesting. When we lived outside of Philadelphia, we made about 2,000 quilts for under-served people, and the largest quilt I've ever made is just little bit bigger than a king size quilt I made for myself.

Jessi Gold: 2,000's a lot.

David Carreon: That's a lot of quilts. I was not expecting 2,000 quilts.

Janae Sharp: We made a bunch. It wasn't just me, but it was a really cool thing to be involved in.

Jessi Gold: Totally.

David Carreon: Excellent. Well, Janae, we really appreciate your time and thank you for joining us on PsychEd.

Jessi Gold: Thank you.

Janae Sharp: Thank you.

Janae is always looking for collaborators (she wants more psychiatrists!) and donors, so if you are interested in getting involved contact her at Janae@sharpindex.org. For additional information or to learn more about Janae’s work for physicians, survivors, and families please visit the following websites: MDsuicide.com and Sharpindex.org. Find her on Twitter @CoherenceMed.