With the summer passing of Congressman John R. Lewis https://www.si.edu/spotlight/john-lewis and this month being Suicide Prevention Month, we got talking at LivingWorks about how the great man and the great month of awareness go together as part of suicide prevention history.
We sat down for a Q&A with LivingWorks President Emeritus Richard Ramsay and learned about the 1990s when people like Congressman Lewis, Jerry and Elsie Weyrauch, and Senator Harry Reid were vital players in the history of American suicide prevention.
LivingWorks: What role did John Lewis play in the suicide prevention field?
Richard Ramsay: He played a huge encouragement role with Jerry Weyrauch in Atlanta when Jerry and his family were trying to start up the Suicide Prevention Advocacy Network (SPAN) in the mid90s. Jerry would have met John as his congressman. This is what I believe happened after Jerry told me his dream at AAS in 1995 of having a Mother’s Day March on Capitol Hill a year later. I think the magnitude of his dream had some scary moments wondering if he had been too ambitious. It was in these moments that John Lewis gave him his much-needed civil rights support to not give up, give out or give in, and to keep on with his dream.
LW: Can you talk a bit about his leadership role in suicide prevention?
RR: Absolutely, the other major role he played was the work he and Senator Harry Reid did. Lewis was the House of Representatives member from Atlanta. He and Harry Reid combined to sponsor two public policy resolutions in the House and Senate. It was the first time that the US Congress had declared suicide as a major public health problem. Each of their two resolutions were passed with unanimous support in 1997.
LW: How important was that? RR: It was a huge advancement—it was actually the policy level statement that gave others; citizen and government departments alike the green light to move toward the realization of a national strategy.
LW: Because you’re connected to a lot of people in the US, can you talk about what the feeling was like when that happened? What were people saying?
RR: My feeling of excitement goes back a few years before when Jerry received a copy of the UN national strategy guideline that we drafted in Calgary. He got it from, Lloyd Potter, a CDC staff and one of the US representatives. The next year, he took the document to leaders in the American Association of Suicidology, and asked them whether the document made any sense. They all said yes. When he asked the follow-up question, “Who was going to make it happen?” They all said, “That’s the 64$ question.” We don’t know.
It was at that point that Jerry as a father who had lost his daughter to suicide, a young physician, in 1987 decided that survivors like him and his family were the ones to try to make something happen. He decided they would mobilize all of the suicide survivors in the United States. Talk about an audacious idea! He had a dream, and actually sent it to me in a note in September of 1995. World Suicide Prevention Day hadn’t even been declared yet. He said, next Mother’s Day, 1996, we’re going to have a march on Capitol Hill and have thousands of petition letters to be given to all of the Hill’s politicians. We are going to petition for a US national strategy—we’re going to make it happen. That was his dream. And, as promised the Capitol Hill march happened as planned. He didn’t stop there. Two years later, he was the drive behind a national consensus conference in Reno, Nevada, the home state of Senator Reid. The conference was similar to our UN meeting. The big difference was in Calgary we had 15 representatives from 12 countries and had a week of working together to draft the document. The Reno conference had 450 people -academics, federal and state government employees, NGO representatives and citizen participants - for only 3 days … a long weekend, Thursday to Sunday. The dynamics were high energy, close to serious conflicts, and hard work collaborations.
They had until Sunday morning to put together a document to be hand delivered to the Surgeon General, David Satcher. He was coming from Atlanta for that purpose only so they had better have one!
Bryan Tanney and I, co-chairs of the Calgary meeting, were invited observers. Informally, we were there to lend support to the organizers in the same way they helped us when we needed a supportive shoulder. At midnight Saturday, I had a prearranged coffee time with the Chairman of the Recommendation Committee, Mort Silverman. He begged off saying he couldn’t take the time right then. I need a support break but I’ve got a recommendations team, about 15 of them. At the moment, trying to get a consensus set of recommendations feels a bit like herding cats. I have no idea whether we’re going to have recommendations ready by tomorrow morning.
The next morning, I was sitting with Lloyd Potter. We were both on pins and needles wondering whether the promised document would happen. We watched Surgeon General Satcher arrive in his full-dress uniform. Finally, we saw Mort and could see he had paper in his hand and I thought to myself, well at least he has something. He delivered the promised recommendations document. The herd of cats had come together. At the time, Dr. Satcher was working on a major mental health reform. He had always said suicide would be included but a separate national suicide prevention strategy was never a consideration. As far as we knew, he left the Reno meeting with no change in that resolve.
A year later, in 1999, he reversed his position saying what he learned from the Reno conference and from the Calgary prepared UN guideline made him realize the country - the US - needed a separate national strategy. He now endorsed a standalone strategy, and two years later, in 2001, the suicide prevention strategy was launched. It was a brilliant development because of its start by suicide survivors that led to citizen groups and government departments working together to come up with the country’s first comprehensive national strategy.
LW: It’s been about 20 years, have we made a lot of headway?
RR: Well, the first thing is the tremendous headway that was made when I look back to meeting Jerry at AAS in 1995, learning about his dream in the note he sent me in September that year and seeing his dream come true in 2001. It was an incredibly short six-year period for someone like me in social work, to see the beginning and end of a citizen-led social movement. Very few like me get a chance to see a social movement of that kind happen over such a short period of time.
Since then, there has been a huge mobilization in the United States that involves public-private partnerships under the Suicide Prevention Alliance. The Alliance emerged out of the original national strategy and was launched in 2010 with plans to have a revised second decade strategy by 2012. I was privileged to be a member of the revision task force. I was the only non-American so it was a real highlight for me to see the revised national strategy launched in 2012. The downside of this accomplishment has been the upsurge in US suicide rates in the last decade. The Alliance is up to the challenge but there is still a long way to go to see the tide turn toward the lowered rate they are hoping for by 2025. I hope that’s what happens but right now I worry about the chances of it reversing that quickly in the next four or five years.
LW: What would turn the tides? RR: I think an expansion of the Suicide Prevention Alliance and the traditional P3s (prevention, intervention and postvention) paradigm needs to evolve —there needs to be significant funding investments by both the public and the private sectors in order to achieve a massive collective effort to change the tide. We, as a society, still treat suicide as a peripheral issue in the core business of organizations; we still treat it as a rarity that doesn’t really require major public or private investments. We are still struggling with whether suicide is something abnormal or a normal part of the human condition that we must pay attention to it and put in the kind of investment that is needed. Other issues, like the opioid crisis, is surpassing suicide as a major public issue. I fear suicide is once again being put into a back room.
We, in Canada for example, now have legislation and policy for medical-assistance-in-dying, but we don’t have the comparable legislation for medical and social assistance in suicide safer living and the development of large networks of safety in our communities—whether it’s multiple training levels and other public policy activities and awareness activities. So, it’s a massive working together effort that has to be implemented. Unfortunately, I don’t see that happening with suicide in the near future. We need in each one of us the never-say-die encouragement of John Lewis more than ever: “Don’t give up, Don’t give out and Don’t give in – Keep On, Keep On.”
Trainers, what do you think? Are you optimistic for the future of suicide prevention and lowering the rates? What strategies do you feel would turn the tide? Let us know at firstname.lastname@example.org and check out an article by the EDC’s Jerry Reed on his time working for Senator Reid in the late 1990s to learn more about those who played a big part in making real headway for suicide prevention policies in the US.