#47 | 5 Ways Talking About Suicide Can Save LGBTQ Youth (Mental Health Guidance for Parents)

Welcome to Just Breathe: Parenting Your LGBTQ Teen, the podcast transforming the conversation around loving and raising an LGBTQ child. Filled with awesome guests, practical strategies, and moving stories, host Heather Hester always makes you feel like you're having a cozy chat. Wherever you are on this journey, right now, in this moment in time, you are not alone. And here is Heather for this week's amazing episode.

Welcome to Just Breathe. I am so happy you are here today. I am trying something a little bit new today because my episode that you are about to listen to is really specific to mental health, well-being, and actually very specific to suicide prevention. And I recently learned about an app called Therapy, and I really wanted to promote it, which I know I've never done, but I felt like this was the perfect time to do something like this. So before we get into today's episode, I want to tell you about this amazing app, and I have tried it myself. I'm actually going to gift it to my kids because I think it is so valuable. It is an app that teaches us to improve low self-esteem, cope with anxiety, panic attacks, and other mild psychological problems. You're able to choose a therapy course, listen to audio sessions, and do exercises to reinforce the topic that you have chosen. All you have to do is devote 20 minutes a day to yourself at any time of the day. It's amazing. Therapy also helps get rid of insomnia, fear of flying, and rage attacks. The courses are written by certified therapists and based on the cognitive behavioral approach. So you get a self-therapy coach in your pocket. People undergoing CBT become their own therapists. You learn to understand your behavioral patterns and change them in a healthier way. Download Therapy today and improve your quality of life. I will have a link attached to this episode so you can download it. I promise you, you will be absolutely thrilled with this app. So I now want to introduce my guest for today, who I am so excited for you to hear from. Her name is Cara McNulty. She is a DPA and she is the president of Aetna Behavioral Health, which is part of the CVS Health company. She is passionate about supporting and advocating for our adolescents, teens, and young adults, as well as educating people of all ages the importance of mental health wellbeing. Kara, thank you so much for being here with me today and discussing this really, really important topic. It's very timely as we are in the month of Suicide Prevention Awareness, and I believe that you have some really important, not only information, but tips to share with us today. So I'm really excited to just jump in and learn from you and have my audience learn from you. So I would like to just kind of get started with you telling us who you are and how you got into just being really focused on mental health and suicide prevention specifically.

Well, thank you, first of all, Heather, for having me. I am passionate about mental health and mental well-being, and it's an honor to be here. So, um, I got into this field. I, um, always, I've been drawn to health and I always thought I was going to be a physician. And long story short, what I found is I'm really drawn to looking at populations and how can we improve population health. And so I became a population health scientist and For my first probably 14 years of my career, I only studied children, adolescents, and young adults.

Oh wow.

And I did that because I am drawn to that age group. Um, I am the mother of two teenagers. I see, I know what it's like to grow up in this community. I also know how hard it is for us as adults, let alone young adults and teens, to face our own challenges and to do that in a healthy way. And so I am passionate about supporting children, families, and communities in addressing mental health wellbeing so that everyone can be their best. And I get to do that via my job. I'm the president of CVS Health, um, Aetna, our behavioral health and employee assistance program. So I'm very fortunate.

You are. That is really fantastic. Oh my goodness. And, and you do, you are right in the middle of it with having teenagers of your own. So not only have you studied it in kind of a, um, background or, you know, 3 steps back sense, right? You are in the middle of it, getting to experience it with your own kids, which I think sometimes is, it makes everything a little bit more amplified. Do you find that?

Yeah, absolutely. Yes, absolutely. I often say that parenting and, um, even before I had children, my husband and I have 19 nieces and nephews. Being an aunt and uncle is the most rewarding and the most challenging work that I have done and will ever do.

Yes, yes, for sure. Oh my goodness. Because it's, it's daily something different, right? And, um, and there's always something. So always, always, always, I feel like I put one fire out and one, another one, you know, pops up, right? And, and that's just the, the delight, the joy, the challenge of parenting, right? Um, but I think, you know, what I really, love that you are doing is, or what you've been doing, is this study and this focus on mental health, which I feel like in the past decade, and I think that's probably a little generous, but it has really started to come in the forefront of, oh, this is important. And not just important, but it's, it's equally important to physical health paying attention to mental health. It's not, you know, you're broken. It's not something's wrong with you. It's something that is just part of how you're made, right? So I'm wondering if you can kind of talk about that because you've been studying this kind of through this wonderful emergence.

Absolutely. I mean, Heather, you're spot on. We aren't separate beings. We are our heads, we are our hearts, we are our whole self. And to separate those two out really increases stigma and bifurcates support. And for a long time, that's how we treated mental health, as if it is something separate.

Mm-hmm.

And you'll hear me use the term mental wellbeing because mental wellbeing is at the core of our health. It is at the absolute core. Without strong mental health wellbeing, it impacts your physical health, it impacts your social health, it impacts your ability to connect with others. And so your mental health wellbeing is at the core. And so we can't separate our heads from our hearts, from our physical, from, you know, who we are. So that's number one. And, you know, often people say to me, oh my gosh, you have two teenagers. How can you even, like, isn't it so hard? Oh my gosh, the teenage years. And, you know, one of the things, Heather, that I always go to is how lucky am I to have two teenagers and to be an advocate for teens and young adults because they're the coolest, unique, different, fierce, often unheard group of individuals I believe we have in our communities. And helping them be their best is where we as adults have just an awesome opportunity. And so absolutely, there has been this awareness and rising of the importance for mental health and mental wellbeing. And now is our time. As communities and adults to support these unbelievable young vibrant adolescents.

Right? I love that you said that. I was just having that conversation with my third, she's 16, yesterday, and she was saying, oh, you know, people just, they blow us off. They don't listen to what we have to say. And I said, you know, that is true. I said, but you just keep going because your voices are so powerful and it is a perspective that as adults we lose, right? Once you go through, you know, you get into your 30s, 40s, you lose that kind of just lovely, pure way of looking at things. And they do— they have this fabulous energy, and this— it is so extraordinary. And we can learn so much from them. And I think that is, you know, to your point, such a gift. And so I am wondering, you know, through your work, you were obviously advocating for that, and I am advocating for that. And how do we spread this? How do we make this just bigger?

Right. Well, you know, first we have to start with mental well-being is something we focus on every single day. And that means all of us, no matter who we are, will experience some kind of mental well-being disruption. It might be stress, it might be situational anxiety, it might be feeling as if we don't fit in, it might be substance use, it might be a serious mental illness, but everyone will experience it.. And in life, we'll experience, um, some really amazing things. And with that also comes grief and loss. So everyone will have some kind of mental health disruption in their lives. So important that we acknowledge that this is normal. This is completely normal. Number 2 is that we embrace this, you know, that this isn't something that we shouldn't talk about. This is how do we talk about this even more? And if there's anything that's come out of the pandemic, it is the ability to listen to those adolescent and young teen voices in a magnified manner. I mean, they are telling us what they need. They are saying, I am isolated. I feel lonely. I am scared. I don't understand. And if we listen and if we pay attention, they're telling us what they need. I mean, if you look at the data, the CDC puts out an unbelievable report called the Youth Risk Behavior Survey. And when we look at that data, nearly 10% of youth, grades 9 through 12, thought about at least thought about or attempted suicide once. I mean, 10%. And if you think about during the pandemic, young adults in college, college age, 1 in 4 contemplated hurting themselves. So people are thinking about it. People are lonely. People are scared. And what we have the power to do is bring voice and sound and support and resources to this population.

Right.

We can demystify that you are on your own and you're alone because you're not.

No, no. And I think that that is one of the most important pieces of this is letting them know they are not alone. And I hear you, I see you, I hear you. We can do something about this. There are things that can be done. And so I think that is just incredibly powerful. And I do, you know, even though this is going to sound weird, but I think it is actually one of the weird positives that have come from this pandemic is that there has been this spotlight put on mental health and for our, for our kids, our teenagers are really for our entire population. Right. And so I, I get very excited about that and just so happy when we have these conversations because they're so important.

It's, it's so true. I mean, there is there is so many positives that have come. And we have to think as communities, as healthcare providers, as parents, are we listening? And often I get asked, well, I feel like I'm listening, but help me understand what I can do.

And—

Right. I don't, you know, because as parents, it's, you know, there's a lot you have to know. This parenting, caregiving doesn't come with a, a guide-to book, and as we all know, and, and so I get asked, I get asked a lot. I know if there were only a guide, right?

I'm always like, that was not in the manual, right? No, none of this is in the manual.

Yeah, totally. And I get asked a lot, so as a parent Well, what can I do? Or as an aunt or an uncle or as a community member or a neighbor or someone who works with teens and adolescents. And maybe I can just share a couple of things, you know.

Of course, yes.

We, there has been a myth that if you talk about suicide, that it encourages suicide. And we know that isn't true. Yeah. Talking about suicide, talking about, um, openly about struggles and listening to what people are saying and asking people, you know, I hear you struggling and I hear you, um, saying that some things that concern me. Are you thinking about hurting yourself? Are you thinking about harming yourself? Have you thought about suicide? Those conversations are hard and they take courage. What we know is they don't encourage suicide. What they do is they discourage.

Mm-hmm.

And it helps our young adults and teens feel heard.

Mm-hmm.

So one myth I wanna get right outta the way is talking about it only improves. What happens only improves. So to really debunk that we shouldn't be talking about it and asking those hard questions, it takes practice.

It does absolutely take practice. It absolutely does. And it is hard.

It is hard. And, um, you know, here's the, here's the reality is we don't have to do it perfect. You know, the words don't have to come out beautifully. We just have to, we have to say 'em. Are you okay? I hear you sound like you're struggling. Are you thinking about harming yourself? Have you thought about harming yourself? Are you thinking about suicide? And those things become easier the more we talk about 'em. So that's one piece that I just, is so, so important.

Thank you.

You know, number, number 2 for parents is really educating ourselves. You know, how can we, um, listen and observe and know, you know, maybe when our kids aren't doing well, right?

You know, right?

Like, what's normal being a teenager and where should I have some red flags? And, you know, um, thinking about that, as you know, if you're noticing things like your children are withdrawing, they're not eating, or they're, they're eating a lot more than normal, they're sleeping or they're not sleeping, you know, those, those big shifts in in their routine and not just one thing, you know, adolescents withdraw, they do.

Right.

You know, they—

Yes.

They want space, but it's when you notice numerous things or you notice that they are self-medicating maybe with alcohol or other substances or they're agitated or you're seeing signs of maybe anxiety or depression. When it's things that are compounding, when they're extenuating more than just one circumstance, that's when we want to have the conversation, right? So we need to educate ourselves and, and understand, you know, I mean, absolutely normal behavior for teenagers is to isolate from their parents or to, to not always be excited about things or But when that continues on, right?

And I think that is the big thing right there, because that is— you're right— a very common question. Like, what's the difference between normal, typical developmental teenager behavior and something I should be concerned about? And, and that's it. It's when it continues. And, and really, you know, again, not being afraid to say, hey, I've noticed that, you know, you, your appetite hasn't been the same, or I've noticed that you've been sleeping a lot. Are you really tired from school, or is there something that you want to talk about? And, um, you know, to all of these points, I think that when you name it, when you, you know, say it out loud to them, and, and again, doesn't have to be some perfect thing, but when you start putting words with it, And they're like, oh, okay, I can talk about this. And there's, it's okay to talk about it. There's not something wrong with me, right? Like, this is okay that I'm going through this and there's something we can do, right?

Exactly. That we're normalizing this conversation. And so, you know, as parents and caregivers, again, also not Waiting for the perfect time or the perfect words or the perfect situation. It— this is stumbling, getting it out, because there's not going to be the perfect time. And you know, the more we practice, um, I can tell you my kids now, they must know how I'm starting the sentence because one of them will say, oh, Mom's about to spill the tea. She's gonna spill the tea and ask us how we're doing. And you know what? We just keep practicing at it. We just keep practicing. And now my kids are like, Mom, I need to spill the tea. But it didn't just happen overnight. And we don't do it perfect. And I make a ton of mistakes. And I don't say things right. And I get those words out. And that's what we need to do. As caregivers and loved ones and in community, right? So we as adults educating ourselves, listening, going easy on ourselves, being easy, we're doing the best we can and having those conversations. And then, you know, um, one of the things that's really important for all of us is seeking to understand, you know, as a, as a society It's easier to put, you know, it— we put labels on people and things because it's— it helps us with social norms. That person is this, this person is this. But that's really not how life works. And, um, labels actually trip us up. And so how can we seek to understand? How can we listen, especially when we're working with young adults and adolescents who are LGBTQ, who are experiencing so much change and often more stigma than their peers. How do we listen to understand and support?

Right.

Can be that support system for those critical young adults.

Oh my goodness. Yes, you have hit the nail on the head. And, you know, that is, that is who I work with. That is my community, our parents and allies of LGBTQ teenagers, adolescents, young adults. And I, that is just, that is exactly Right. And I'm so glad you said that. And I'm just wondering if, as you know, suicidal ideation, self-harm, all of these pieces are much more prevalent in the LGBTQ community. Are there some tips that you can share with my listeners, or just resources ideas that you can share for really how, you know, not only understanding their kids, because that's a huge piece, right? Is understanding, but then being able to support and guide them.

I am passionate about this population because these are often LGBTQ voices are often the voices that are silenced. And instead of silencing these beautiful humans, how can we embrace and allow them to share what's happening in their life and their situation without judgment, providing support and removing stigma. And when we think about LGBTQ youth, many go, many go without having one person in their life that they feel they can trust and talk to. And they're afraid to share how they're feeling or what they're going through, whether that is personal change, whether it is stigma in their community or bullying, or whether it's thoughts of suicide or suicidality. So when we think about how do we support LGBTQ as parents and caregivers and community members, again, it's educating ourselves, it is doing our best, it's seeking to understand, but it's also advocating. So as I talked about, this is a group that often their voices are silenced. And so how can we help advocate for beautiful young teenagers who are doing, they're doing what they do best, and that is being themselves. And that doesn't always fit into the perfect community mold. And thank goodness it doesn't, 'cause that's what builds community. And so understanding the resources that are available to you as parents, understanding you're not alone as parents, and that there are resources that I will tell you CVS Health Aetna can provide, and I can talk about those, but also resources in your own community and unbelievable support groups, as I know you know very well, I think about PFLAG as an unbelievable support group— Parents, Families, and Friends of Lesbians and Gays. There are numerous support communities, but engaging with those communities, because people have been on this journey and people want to share, parents and caregivers want to share with one another because we know how hard it is, right? So Engaging in those community resources is really important. There are other resources and tools that are just phenomenal. We as an organization partner with the Trevor Project, and the Trevor Project just does unbelievable work for LGBTQ teens. And if you think about bringing the voice Magnifying that adolescent voice, The Trevor Project does that, but they also provide support for teens who feel they have no place else to go. And so The Trevor Project has a 24/7/365 crisis line that, um, you can call or text and get support as a young adult, and you're going to have a clinician on the other end listening, listening without judgment, listening to support you and helping you with a plan of action. So those are two examples of resources that are really important for parents to know and for teens to know. And, you know, Heather, I can talk about numerous resources, but let me, let me stop there and see if there's a place you'd like me to focus.

Well, I love those. Those are two of my very favorite that, you know, everybody listening knows I talk about all the time because They are so phenomenal and they are so accessible. And I think that's a, a really important piece is their accessibility. And kind of lending to, you know, not everybody is super comfortable jumping into, you know, with other people they don't know and talking about what they're going through. So I love there are options for how, you know, however you are processing what you're going through, which is beautiful. I am wondering if you could possibly maybe just circling back to talking specifically about suicide prevention and just awareness and as a parent, what to look for and, and really, I know, obviously Trevor Project is specific to suicide prevention as well. But How can a parent educate themselves and then recognize signs?

So I'm gonna talk about one resource that we developed, and you can go to CBSHealth.com to download this free resource, and it is a mental health awareness guide for parents and caregivers. And this guide is everything from A to Z. How do we address mental well-being? What are the signs and symptoms when we, um, that we need to look for? What are the resources available? What can we do as parents? How can we help our loved ones cope? We have a compendium, which is the matching piece, and it is Mental Health Awareness Guide for Young Adults. And so that's— I will tell you those two resources are free to anyone, and that is a great place to start. To answer your question, you know, as parents, um, really looking at your children and understanding, um, are things changing? Are they stepping back? Are they changing their behaviors in a way that in your gut you say, huh, that, that's different than I've noticed, or boy, they seem more agitated, or they seem more sensitive, and it continues to go on. Behaviors like self-harm, cutting, pinching, pulling hair, um, obsessed with a certain activity, you know, I need to finish this, I need to finish this, that agitation, those things that just leave you pause and have you saying, huh, that it just does— this doesn't seem like they're okay. And then having that— taking that next step and saying, hey, is something wrong? It's— see, I've noticed that you seem very agitated. I've seen some you know, bruising or cuts. I notice you're sleeping more. And addressing what you're seeing and then saying, help me understand. I'm here to help you. I'm here to help you. And that understanding, that opening that conversation, it is taking that risk and not saying, gosh, this is just normal teenage behavior. I'll wait till nobody I'll wait till the perfect opportunity to talk about this, or I'll wait till we're not running late for school, or I'll wait till it's not Sunday afternoon. There's never gonna be a good time. It's always a good time.

Right.

It's always a good time. We have to make it always a good time. So knowing those resources, looking at those signs, and then taking that action. And then also as parents and caregivers, knowing that if you are dealing with— one, dealing with teenagers is amazing and hard, and that, you know, there is support. We aren't alone. We aren't alone. And whether that is through your place of employment, most, most employers, whether you have their insurance or not, offer employee assistance programs. Which are fantastic resources to get short-term counseling as an adult and even as a young person. You know, an EAP or employee assistance program is offered to the individual that's employed and their family. So utilizing that counseling, and I know the term counseling or therapy, um, people can take very differently. I always talk to my kids and, and anyone, community members and other providers, you know, utilizing counseling and therapy is just like getting your teeth cleaned. It is like exercising. You're, you're exercising your brain and asking somebody else to help you and give you skills and tools to do so. So talking to someone should be as normal as we can. We have to destigmatize that there's something wrong with getting help.

Right, absolutely. I love the way that you said that. It's just like getting your teeth cleaned. I say often, I similarly, it's like going to see my doctor. That is, you know, my, my physical doctor. And then I have my mental doctor, right? It's, it is keeping everything fine-tuned and, and being able to ask questions and understand. Um, so You are— I love that. Just destigmatizing is huge. And circling back, the one, one of the things that I loved is listening to your gut as a parent is so huge because you know your kid, even when they're acting nuts and angsty and teenager-y. Um, you know them and don't quiet that voice. If your gut is telling you something, listen to that and go with it and, and let it be messy because you'd much rather it be messy. It's, I mean, it's always going to be messy. So it's either silent or it's messy. Right.

Gosh, that's so important, Heather. I mean, I love that. You just said that it is messy and life is messy and having teenagers and young adults and being in community, it's messy and that messiness is beautiful. It's hard. It's hard, you know, that it takes a risk to have these conversations. But the more we do these, like anything, the better we get. It's like strengthening that muscle, that muscle of conversation. The more we have these discussions, whether it's with our own kids or in our communities, normalizing that mental health and talking about mental health and getting support for mental health and the importance of mental well-being is core to our physical health. It's core to our social health. And we're not alone. You know, we're not alone as parents. We're not alone as kids. We're not alone as young adults. We are not alone. We do not have to do this alone.

No, we don't. We don't. And I really like your incorporation of 'and.' A lot of things you've said today have been 'and.' So something that is so huge, that it's both, right? And, and embracing that is Right. So critical. So thank you. Thank you. It's very subtle, but it's really, really important. So I wanted to just make note of that. Um, so I'm wondering if there's anything else that you would like to— that we haven't touched on that you really want to make sure that we get out there to people during, you know, not just this important month, but this important time that we're in and learning how to really engage with our children, but also break down stigmas?

You know, a couple of things now more than ever, teens need us to be advocates and us being not only parents and caregivers, but community and Advocating for these amazing young people means we're accepting them in ways that might challenge how we believe and think or how we were raised. So that acceptance, it's also educating ourselves, and there are fantastic resources. I encourage anyone to go to cbshealth.com. We have numerous resources regarding Mental health, adolescent mental health, LGBTQ, the two parent and adolescent guides I talked about, but numerous other resources that really help you, not only for you, but also for your teen. So educating ourselves, but also understanding that we are not alone. And that means that If we want people to know they're not alone, we have, we have to really be courageous and have these conversations. We have to continue to talk about the importance of mental health, that mental health and physical health aren't separate. And in fact, without mental health wellbeing, physical health is impaired. And so it's at the center, it's at the epicenter. And then last, You know, that, that if you or someone you love is contemplating suicide, that there are support, there is immediate support, and there's immediate support through the National Suicide Prevention Hotline, 1-800-273-TALK, or 8255. You can call that at any time. People aren't alone. And I also would ask that as we advocate for our adolescents and young adults, we advocate for each other because this is hard work. And the more we role model, tell our stories, talk about our own mental health journeys, the easier we make it for those next to us, in front of us, behind us, and around us.

Right. Oh my goodness. Thank you. Yes to all of that. Thank you so, so much. I really appreciate all of your insight and, um, this was a lot of incredible information packed into a little over 30 minutes here. So I am just thrilled thrilled to be able to share this, because to your point, this is a piece of, you know, educating not only ourselves, but as many as we can, right? And, and learning how to just be there for others and to let others know that they are not alone and to just live your truth, live in your own authenticity, because that allows other people to do it as well. So thank you. Thank you so much for being here today.

Oh, Heather, thank you for having me and thank you for the work and the voice you share. That voice helps us all feel we can be our true selves and show up in this world as we are. And what a better gift to give. So thank you.

I hope you enjoyed today's interview. I know it was really packed full of absolutely amazing and valuable resources, tools, and information. Everything will be linked in the show notes as well as on my website, so please take some time to click through those and really take this opportunity to learn. As always, I would love for you to leave me a review, and I will have that link as well in the show notes and, um, on my website and take a look and, and poke around my new website because it is absolutely wonderful and I'm just delighted with how it has turned out. So thank you again for joining me and we will see you next time.

Thanks so much for joining Heather Hester today. Remember to just breathe. Take a few minutes every day to calm and center yourself. Reach out anytime with ideas, questions, questions or feedback. Please rate and review Just Breathe on your favorite platform. Subscribe to Heather's website, www.chrysalismama.com, to receive her monthly newsletter and stay informed. Join the private Just Breathe Facebook community to chat with other parents and allies, and share with anyone who needs to know that they are not alone.