Championing transformational change at the VHA and The Mighty

Dr. Tracy Gaudet

Dr. Tracy Gaudet is the Executive Director of the Office of Patient-Centered Care and Cultural Transformation at the Veterans Health Administration, and she is the person who invited me to participate in a plenary panel discussion about how her team’s Whole Health Model is helping to re-conceptualize healthcare within the VHA by focusing on what matters most to the veterans rather than what is the matter with them.   This transformational approach to care delivery aims to improve the experience and well-being of veterans receiving healthcare services.  

Dr. David Shulkin

Our panel addressed the Secretary, and 600 other senior leaders from the VA, assembled for their annual leadership summit Monday and Tuesday of last week.  It was an honor and a pleasure to share the dais with the veterans, and to contrast my journey through the civilian mental healthcare system two decades ago, while in the midst of a suicidal crisis, with the stories of veterans experiencing care based on the Whole Health Model.  I was grateful for the opportunity to provide my insights to such an influential audience in service of helping veterans struggling with suicidal impulses.

photo credit: Eugene Russell, VA Photographer

A dear friend introduced me to Dr. Tracy Gaudet and her team’s unconventional approach for providing integrative, proactive, whole person-centered care to our nation’s veterans a couple of years ago.  Reading a document that describes their Whole Health Model, and how it could help with the fight to reduce suicide, changed the course of my life.

I had all but given up on working to be an agent of change committed to reforming our current healthcare system, but learning about her team’s approach to helping people maximize their well-being gave me hope that change was possible.  I was inspired, and within a year, I had left my full-time position as a project leader in  information technology to focus on suicide awareness and prevention and mental healthcare reform.  I became a board member of the Philadelphia chapter of the American Foundation for Suicide Prevention, and a Zero Suicide Champion for the Suicide Prevention Resource Center’s life-saving paradigm for helping care providers vitalize their suicide prevention regime.

My journey through a mental healthcare system that had placed my care provider and my problems at its center, revealed obvious opportunities for improvement.  The Whole Health approach places the healthcare consumer at the center of the care delivery model, and champions proactive measures to promote and sustain health and well-being, rather than reactive ones aimed at managing the symptoms of a malady.  You can read more about how Dr. Gaudet and her team are driving cultural transformation within the VHA via “well-being innovation” in her own words here,  and you can watch the entire Whole Health panel presentation from last Tuesday morning here.  I believe Dr. Gaudet included me on the panel, in part, because of my public criticism of the mental healthcare system that treated me subsequent to nearly dying by suicide two decades ago.  [“Mental Illness” is a Harmfully Misleading Phrase that Causes Suffering By Design ] It’s hard for me to express how grateful I am to have had the opportunity to share such unconventional ideas with such a powerful and influential audience.  

I am always grateful when people in positions of power enable me to reach an audience.  I was grateful when Michael Kasdan shared my writing with The Good Men Project audience.  I was grateful, and honored, when someone at Mad in America was compelled to share my writing with their readership.

 

Weeks before I shared some of my status quo-challenging ideas about mental healthcare with Secretary Shulkin and the senior leadership of the VA, I submitted a slightly modified version of the aforementioned article to The Mighty – a for profit media company aiming to help people “face disability, disease and mental illness together.”  They declined to publish the article.

In May of this year, I co-wrote an interview article entitled What is mental illness? with author and Guggenheim Fellow Christopher Lane, who wrote Shyness: How Normal Behavior Became a Sickness a decade ago. You can read an excerpt from that piece on my blog here.  I was in contact with an editor from The Mighty about the article via email while Chris and I were writing it.  I sent the editor a draft of the piece during the first week of June, and I have never heard back from her since.  I attempted to connect with her publicly about the article on Twitter, where we have communicated in the past, but she remains unresponsive.

I suspected that the reasonable criticisms of the biomedical narrative of “mental illness” throughout our What is mental illness? piece might not be well-received by The Mighty.  Reading article after article, on TheMighty, written by well-meaning, but arguably misguided advocates touting the validity of the biomedical narrative of “mental illness” convinced me that the media company’s leadership may be positioning themselves to profit from advertising psych meds to suffering people.  It concerns me that more people may be misled, like I was twenty year ago, to believe that their suffering necessarily stems from an impossible to pinpoint disease of the brain that is certainly responsible for their suffering.

It’s hard to believe how lucrative simply marketing pharmaceutical medications to people in psychological and emotional distress has become in this country.  The thriving multi-billion dollar direct to consumer (DTC) psych med advertising business increased almost 10% in 2016 to $5.6 Billion according to data from Nielsen, and that figure doesn’t even include money spent on digital advertising.  The impact of this reductionist narrative propagated by the manufacturers of psych meds is evident in many stories you’ll find on The Mighty.  Article contributors prone to blaming or scapegoating their ostensibly malfunctioning brains for their suffering are commonplace.  In fact, particularly eloquent advocates are celebrated and awarded for their activism.

Unfortunately, more often than not, stories published by The Mighty downplay, or completely ignore, evidence pointing to the complex interplay of biological, psychological and environmental factors that lead people to experience the symptoms commonly associated with the condition descriptions found within the American Psychiatric Association’s bible, the Diagnostic and Statistical Manual of Mental Disorders.  Sadly, it’s not hard to find evidence that giving people powerful psychoactive drugs often serves to increase people’s suffering in many cases.  See the chart above for billions of reasons why suffering people continue to pay for treatments that may harm them instead of help them.

I don’t know why the editorial staff who work for Megan Griffo, The Mighty’s editor-in-chief, were not inclined to publish the two aforementioned articles that I submitted, but I stumbled upon a Mad in America post by Twilah Hiari yesterday that may offer some insight.

Her account of a comment made by The Mighty’s Chief Revenue Officer confirmed that my suspicion about The Mighty’s strategy to profit from advertising psych meds may be accurate:
The Mighty’s Chief Revenue Officer’s comment reminds me of one made by a world renowned panic and anxiety expert, Isaac Marks, when he was telling Christopher Lane about a conference he attended in connection with the DSM-III task force he served on back in the 1970s.  Marks shared a recollection with Lane about a comment made by the CEO of Upjohn Pharmaceuticals.  He was discussing the potential inclusion of new disorders in the DSM when he said:
There are​ three​ reasons​ ​why ​Upjohn​ ​​is​ ​here​ ​taking​ ​an​ ​interest​ in​ these​ diagnoses.​ The​ first​ is​​ money.​​  ​The​ ​second ​​is​ ​money.​ ​And​ ​the ​third​ is money.
Like Ms. Hiari I don’t question the good intentions of the people working at The Mighty, but I am afraid that until we transform the way many people apprehend the role that psychological and environmental factors play in various forms of human suffering, our mental health care system will continue to harm many of the people it aims to help.

An open letter to Vynamic CEO Dan Calista: fixing (mental) healthcare

Dear Dan:

I graduated from Archmere Academy in Claymont, Delaware, in 1989 with thirty AP credits, and then headed to Notre Dame.  After three and a half years in South Bend, I graduated Magna Cum Laude with a double major in English and Computer Applications in 1993.  I thought I was going to be a lawyer, eventually, but figured I would work for a while first, so I pursued opportunities in information technology.  I received job offers from Arthur Andersen Tax Technology Group in Chicago, Andersen Consulting in Philadelphia, Price Waterhouse in Washington, D.C. and Ernst & Young in New York City, but I accepted a position with The Travelers in Hartford primarily because their “ACCENT Program”  (accelerated entrance into management) was the hardest job offer to win.  Motivated primarily by the fact that I was “college-sick” after leaving my best friends back at Notre Dame after graduating early, I left The Travelers after just five weeks to become the Director of Information Systems at a fast growing restaurant chain in Delaware — Grotto Pizza.

Four years later in 1997, I was the youngest Principal consultant at American Management Systems’ 1 Chase Plaza office, located just a couple of blocks from Wall Street.  I spent most of ‘96 and part of ‘97 living and working in Zurich for Credit Suisse —  my B2B bill rate was $250 an hour.  Then, on the morning of March 2nd 1998, a warehouse manager in Secaucus, New Jersey, named Norman found me inside of a running rental car that I had turned into a makeshift carbon monoxide gas chamber the night before.  I had a near death experience in the back of an ambulance, enroute to the Jersey City Medical Center, and I woke up a couple of days later in the ICU.

I’m writing to see if you’d be open to having a conversation with me about how we might work together to save lives and reduce suffering by helping to transform mental health care in this country.  I am already doing this work on a volunteer basis on a number of fronts.

I am a board member of the Philadelphia Chapter of the American Foundation for Suicide Prevention, who is working with John Madigan (AFSP VP of Public Policy) to leverage my relationship with Vice President Biden to garner political will for a massive increase in public funding for suicide prevention.  I was high school teammates with both of VP Biden’s sons at Archmere Academy.

I am a Zero Suicide champion working with Dr. Tracy Gaudet, the Executive Director of the National Office of Patient Centered Care and Cultural Transformation at the VHA.  I’m participating in Dr. Gaudet’s panel discussion on Whole Health and suicide prevention in the military in September at the VA’s National Leadership Conference.  Secretary Shulkin is committed to reducing the suicide rate at the VA, and he’s asked Dr. Gaudet to organize a panel of experts to address the VA leadership on the subject.  I’m also working with Dr. Gaudet and David Wright from GetWellNetwork to propagate the Zero Suicide framework via GetWellNetwork’s interactive patient care system.  The VHA already utilizes GetWellNetwork’s platform in over forty facilities. GetWellNetwork’s founder and CEO, Michael O’Neil, is one of my closest friends.  We met at Zahm Hall as freshman at Notre Dame in May of 1989.  

I’m in conversation with Keppler Speakers to begin giving talks nationally at universities and colleges before the end of the year with the aim of reducing the U.S. suicide rate.  Here is a video of me practicing the first half of the talk I will be presenting at my alma mater in South Bend.

As far as I can tell, I am the only person on Earth who is leveraging the genius of Albert Einstein to transform humanity’s understanding of the human condition and “mental illness.” I believe that Einstein left humanity an unheralded prescription for peace that almost no one noticed:  acknowledge that human beings don’t possess free will.  If I am ever invited to speak on the TED Talk stage, I suspect it will be because I am committed to spreading the ideas that I outlined in this piece on Medium.

My writing about suicide prevention and mental health care reform has been published by The Good Men Project and Mad in America, thus far.  Christopher Lane (Guggenheim Fellow and author of Shyness: How Normal Behavior Became A Sickness) and I are wrapping up an interview piece entitled “Creating ‘Mental Illness’” that looks back at a critical event in mental health care history at the center of his book Shyness:  the third revision of the APA’s Diagnostic and Statistical Manual of Mental Disorders or DSM-III.  A work in progress excerpt of that piece is included below.

The attached resume doesn’t include my current consulting engagement.  I was hired to  turnaround a failed client reporting enhancement project at one of the top 10 wealth management firms in the U.S. based on fiduciary assets.  My engagement sponsor is the C-level fixed income officer of the firm responsible for managing a $27 Billion portfolio.

I’ve known Scott O’Neil, CEO of the Philadelphia 76ers, the New Jersey Devils and the Prudential Center coming up on thirty years now.  Scott is Michael’s older brother, by one year, who was at Villanova while we were at Notre Dame.  We met in 1989 when Scott was visiting Michael in South Bend to watch a Notre Dame football game.  I mention this fact because Scott is connected to Mairead Hanna on LinkedIn. I haven’t touched base with Scott about this yet. I was compelled to reach out to you cold first.

If you’re open to having a conversation with me to determine if it makes sense for us to seriously consider joining forces in some way to save lives and go after the triple aim in HIT together, please just let me know.  I would greatly appreciate the opportunity to speak with you.

Thanks a lot for your time and consideration.

Sincerely,
Francesco

Francesco Bellafante
American Foundation for Suicide Prevention Philadelphia Chapter Board Member
Zero Suicide Champion
Theory of Mind ~ leveraging the genius of Einstein to end suicide and to maximize well-being
iameinstein.com

Excerpt from:

Creating “Mental Illness”

By Christopher Lane and Francesco Bellafante

How does someone know if they have a mental illness?  How does their doctor know?  Psychiatrists don’t utilize blood tests or brain scans to diagnose their patients.  Instead, they necessarily rely on subjective observations about how their patients seem.  That, plus they listen to stories told by their patients, and others, in order to identify symptoms of mental disorders.  Given our relative ignorance about how the most complex object in the known universe functions, how does a psychiatrist know that a particular feeling, behavior or pattern of thinking and behaving is a symptom of mental illness?

The human brain is made up of about 86 billion neurons that interact in complex ways with one another and with other neurons throughout the central nervous system.  Absolutely no one can cogently explain how a human being’s neurons interact with the rest of its body and the world that body inhabits to give rise to subjective, conscious awareness of that world. Consciousness remains an enduring mystery.  Given these facts, how does anyone objectively draw a dividing line between mental wellness and mental illness?  What amount, degree, or kind of neurosis, psychosis or distress is a natural part of the human condition? How do we know when a person’s behavior or their psychological and emotional state is indicative of psychopathology?

What is mental illness?  Is it a disease like any other resulting from a defective or malfunctioning organ or system of the body?  Or is mental illness too often a phrase used to mistakenly pathologize and stigmatize the human condition itself?

Two influential books that shape humanity’s understanding of what it means to be mentally ill are ones that most people have never heard of let alone ever read. They are the International Classification of Diseases and the American Psychiatric Associations’ Diagnostic and Statistical Manual of Mental Disorders.  Hundreds of nuanced descriptions of different patterns of thinking, feeling and behaving define the bounds of what constitutes “mental illness” or “disorder” for billions of people.  While some question the inclusion of certain kinds of behavioral disorders within the pages of any catalogue of medical diseases, the stories told by psychiatrists citing the conditions defined in these nosologies are respected as scientifically-validated, unquestionable medical truths by many others, in large part thanks to billions of direct-to-consumer advertising dollars spent propagating this narrative.  Exceptionally effective professional storytelling tactics are employed by for profit enterprises marketing powerful mind altering substances to people experiencing anything from a lack of ease in life to paralyzing distress or despair.

I grant that attempting to assuage people’s distress and despair with psychopharmacological treatments may be well-intentioned, but evidence abounds that giving people powerful mind-altering drugs serves to increase people’s suffering in many cases.  In fact, some psych meds prescribed for mental disorders can cause death by inducing something called Neuroleptic Malignant Syndrome.  I was given an injection of Haldol once, without my consent, that could have induced this potentially fatal syndrome within me.  I am grateful I was not informed of the life-threatening nature of the “health care” I was receiving before I was involuntarily injected with a substance that could have killed me.  I share what I’ve learned about these books with the hope that more people will think more critically more often when they speak and write about “mental illness” and “mental disorders.”

The story behind how the ICD and the DSM came to include certain mental disorder descriptions is a fascinating one.  It was 1893 when the International Statistical Institute adopted the International List of Causes of Death.  By the end of 1949 the World Health Organization published the sixth edition of the International Classification of Diseases or ICD-6.  This version was the first to contain a section for mental disorders.  Three years later, in 1952, the American Psychiatric Association’s (APA) Committee on Nomenclature and Statistics published the first edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM).  As the APA’s DSM History page on its website explains, “It contained a glossary of descriptions of the diagnostic categories and was the first official manual of mental disorders to focus on clinical use. The use of the term ‘reaction’ throughout the DSM reflected the influence of Adolf Meyer’s psychobiological view that mental disorders represented reactions of the personality to psychological, social, and biological factors.”

(Source:  https://www.psychiatry.org/psychiatrists/practice/dsm/history-of-the-dsm)

Thirteen years later, in 1965, Sir Aubrey Lewis, a British psychiatrist responsible for the mental disorder section revisions of ICD-8 removed the word “reaction” from the mental disorder names.  This seemingly insignificant nominal change represented a seismic shift in defining mental illness. Christopher Lane from Northwestern University, a 2005 Guggenheim Fellow, wrote about this seminal event in Shyness:  How Normal Behavior Became a Sickness (Yale, 2007).

“The revisions to ICD-8 were bold, even cavalier, and had lasting consequences.  Consulting few outside experts, a situation unimaginable a generation later, the person appointed to update the manual quietly eliminated the term reaction from many diagnostic labels.  As a result, diagnoses like schizophrenic reaction, which in DSM-I had referred to sporadic psychiatric incidents, evolved almost overnight into schizophrenia, even if the person’s symptoms were rare or not especially violent.  The same was true for terms like paranoid reaction, which the DSM-II task force determined henceforth would be known simply as paranoia.  When I asked Robert Spitzer about these revisions, he confirmed my suspicions, ‘ICD-8 was written by one person, [Sir] Aubrey Lewis at the Maudsley [Institute of Psychiatry, London], and he didn’t have the word ‘reaction’ in the eighth edition, so DSM-II didn’t either. ‘No,’ Spitzer added, ‘there was no discussion at all’ on the  DSM-II task force about the viability or consequence of adopting these changes.  Turning phrases like ‘schizophrenic reaction’ into simple nouns (‘schizophrenia’) may seem insignificant.  But as Spitzer concedes, it was a ‘major shift’ in approach, because it altered at a stroke the very meaning of illness for clinicians and patients.

Robert Spitzer was a Professor of Psychiatry on the research faculty at Columbia University in New York City.  In 1974, he became the chair of the APA’s task force responsible for revising  DSM-III.  Spitzer played a major role in leading a faction of psychiatrists on the task force to significantly revise, and add to the number of disorders defined in the DSM-III, swelling the count of conditions contained in the growing catalogue by an eye-popping 46%.

Year          Edition            # of disorders             % growth

1952          DSM-I               106                                      n/a

1968          DSM-II             182                                      72%

1980          DSM-III           65                                        46%

It has been a decade since Lane penned his assiduously researched and insightful account about this transformation of the APA’s Diagnostic and Statistical Manual of Mental Disorders.  His penetrating explanation of how a small group of psychiatrists privately collaborated in the 1970s to revise the organizing document behind their profession is as amusing as it is unsettling.  The incredible but true tale Lane tells about how shyness came to be viewed as an illness is more akin to political farce than erudite debate about how to classify different types of mental disorders, ostensible or otherwise.  Lane gained unprecedented access to the APA’s archives, and found documents detailing disturbing facts about the lack of scientific rigor employed while revising the third edition of this influential document.  He frames this battle over this revision of psychiatry’s diagnostic bible as one driven by deeply-rooted internal conflicts within the field.  Neuropsychiatrists argued for the radical expansion of the diagnostic criteria into many different disorders with specific symptoms while their Freudian colleagues favored a psychodynamic approach with fewer, and more broadly defined categories that recognized the biological, psychological and environmental factors that coalesce into human distress and despair.  While neuropsychiatry clearly won this battle in the pages of DSM-III, Lane’s writing about the inner workings of Spitzer’s task force illuminate how a supposedly scientific process devolved into one guided more by individual personalities, professional agendas and profit potential.

Reflecting on the legacy of Robert Spitzer shortly after his passing in 2015, Lane wrote a post on his blog about a significant exchange between Spitzer and Isaac Marks, involving the inclusion of Panic Disorder in  DSM-III as a stand-alone illness.  Marks “the world-renowned expert on panic, fear and anxiety” was flatly against the inclusion of Panic Disorder as a separate illness.  From Lane’s blog post:

“Though committed to treating and understanding panic, Marks was steadfastly opposed to its being represented as a stand-alone disorder. He was similarly opposed to the formal identification of Social Phobia/Social Anxiety Disorder as a separate disorder, not least after seeing his own research on the subject (pointing to a different conclusion) cited as a reason for the change. The evidence that Social Phobia should be separated off had not been overwhelming and little had been published since that implied otherwise. But on both counts, Marks was overruled. ‘The consensus was arranged by leaving out the dissenters,’ he said to me ruefully, after Spitzer had told him in the men’s room at that key Boston conference that he ‘wasn’t going to win. Panic [disorder] is in. That’s it.’ ‘Never mind about the pros and cons intellectually,’ Marks continued, characterizing Spitzer’s apparently cavalier rejection of his expertise and objections. “Don’t confuse me with the data. It’s in.”

The Boston conference had been paid for by Upjohn Pharmaceuticals, maker of Xanax, a drug that became widely prescribed for Panic Disorder. As the CEO stood up to give his opening remarks, Marks recalled, he admitted quite openly: ‘There are three reasons why Upjohn is here taking an interest in these diagnoses. The first is money. The second is money. And the third is money.’ Despite concern that his research was being misused, to ends he could not support, Marks was, he said, ‘disinvited’ from subsequent discussions. Panic Disorder and Social Phobia/Social Anxiety Disorder weren’t just included in DSM-III, but, as he feared, given such low diagnostic thresholds (including, in 1987, public-speaking anxiety for SAD) that millions of American adults and children became eligible for a diagnosis, with Xanax, Paxil, and other medication among the most frequently prescribed treatments.

After the fact reflections of people involved in the DSM-III task force reinforce the notion that the conditions described by the disorder names defined within the pages of any version of the DSM are certainly unlike other diseases and illnesses that plague humankind in obvious and important ways.  “There was very little systematic research [involved], and much of the research that existed was really a hodgepodge—scattered, inconsistent, and ambiguous. I think the majority of us recognized that the amount of good, solid science upon which we were making our decisions was pretty modest,” said a consultant on the revision task force.  Others involved commented that, “The poverty of thought that went into the decision-making was frightening… In some cases, the people revising DSM-III [were] making a mental illness out of adaptive behavior.”  In 1984, four years after DSM-III’s publication, psychiatrist George Valliant warned that the “disadvantages of DSM-III outweigh its advantages,” characterizing the revision as one that “represents a bold series of choices based on guess, taste, prejudice, and hope.”

An open letter to the leadership team at Mindstrong

Dear Mindstrong leadership team:

I am a seasoned IT project leader who has spent most of his career working in finance.  I am in the process of transitioning to working full-time in mental health care.

I am a board member of the Philadelphia Chapter of the AFSP, and I am working with John Madigan (VP of Public Policy) to leverage my relationship with Vice President Biden to benefit suicide prevention.  (I was high school teammates with Beau and Hunter Biden.)

I am a Zero Suicide champion working with Dr. Tracy Gaudet, the Executive Director of the National Office of Patient Centered Care and Cultural Transformation at the VHA to propagate the Zero Suicide framework via GetWellNetwork’s interactive patient care system.  GetWellNetwork’s platform is already installed in over 40 VHA facilities and the company’s CEO, Michael O’Neil, is one of my closest friends.

I am an acquaintance of Karan Singh, Ginger.io’s co-founder.  I signed up for Ginger.io months ago, and discovered a critical software defect that was likely impacting users struggling with racing thoughts.  Several weeks later I met Karan in San Francisco and he told me about Dr. Insel’s interactions with the team at Ginger.io.

I am a suicide attempt survivor who had a near death experience in 1998, who is committed to causing the suicide rate to go down.

I am writing because I want to help Mindstrong transform behavioral healthcare in this country and beyond.

I would appreciate the opportunity to speak with some or all of you about how I might be able to do this.

Sincerely,

Francesco Bellafante
incredulity@gmail.com

Francesco Bellafante
American Foundation for Suicide Prevention Philadelphia Chapter Board Member
Zero Suicide Champion
Theory of Mind ~ leveraging the genius of Einstein to end suicide and to maximize well-being
iameinstein.com

 

Is building the Golden Gate Bridge suicide deterrent net a myopic misappropriation of money?

If you are part of the suicide prevention movement, you are likely aware of the fact that work to attach a suicide deterrent system to the Golden Gate Bridge commenced recently.  While reading the piece about this seminal event by Samantha Schmidt published in the Washington Post, I found the exchange pictured below in the comments online.

 I replied to “Kompromat” as follows:

I’ll grant that the claim about finding other means to die by suicide is contradicted by empirical evidence, but I’m curious what scientific studies you’re referring to regarding the other two claims. More than 1500 Americans die every single month due to suicide via a firearm – a death toll of over 1.7 million lives lost over 80 years. Claiming that $200 million is “too high a price” to pay to save hundreds of people from dying by suicide, when thousands or tens of thousands of lives might be saved if this money was directed to firearms means restriction programs seems like a reasonable claim. Unfortunately so too is the claim about life being too painful for too many people to endure.

If/when a suicide occurs at the Golden Gate Bridge after the net is completed, it will surely be the most sensationalized suicide in US history, won’t it? This event, if/when it occurs will also be the most demoralizing, and most costly, financially speaking, for the suicide prevention movement, I imagine.

I think spending over $200 million dollars on this net sets the stage for a suicide prevention movement calamity. The net will be 20 feet below the bridge, right? Imagine a suicidal person at the ceremony commemorating the net’s completion. Imagine this person has a ten foot metal cable concealed under her clothing. One end of the cable has a fastener capable of being quickly attached to the bridge’s railing, the other end is looped around her neck.

Surely, the installation of the net at the Golden Gate Bridge increases the chances of a horrifically tragic event like this happening. The only reasonable reason to spend over $200 million on this project is to create a suicide means restriction symbol.

It seems reasonable to claim that given:

1. the fungibility of money,
2. the relatively minuscule number of lives lost to suicide at the bridge versus suicide by firearms nationally (58 every single day) and
3. the patent increase in the likelihood of the most sensationalized suicide ever, occurring at the bridge, to ill-effect to the cause of reducing the suicide rate…

that a suicide prevention investment of this magnitude for this purpose is so myopic that it’s a moronic misappropriation of money.

Make no mistake, if I could snap my fingers, and cause suicide deterrent systems like the one being built at the Golden Gate Bridge to magically exist under every single bridge on Earth where a suicide has occurred, I would.

That said, surely a life lost to suicide at the Golden Gate Bridge is not more valuable than any other life lost to suicide, right?  In the work of stopping suicide, it’s an absolute value numbers game, isn’t it?

The resources at our collective disposal to prevent suicide are scarce.  For example, The American Foundation for Suicide Prevention, the largest private national non-profit involved in the fight to stop suicide has an annual budget that’s only about $18 Million.  The AFSP is going after reducing the suicide rate in a strategic way to make the best use of the limited financial resources it has at its disposal.  They have a practical plan to reduce the U.S. suicide rate by 20% by 2025.  A primary focus in that plan is to aggressively address lethal means restriction as a way to save lives.  The most common way to die by suicide in this country is by firearm, and the AFSP has recently started working directly with the National Shooting Sports Foundation.  Their collaboration has led to a breakthrough firearms lethal means restriction program.

The AFSP is working with representatives from local gun shops, shooting ranges and hunting clubs to educate retailers and the firearm-owning community on suicide prevention and firearms.  The pilot program, involving community-based AFSP chapters in four states, is the first time a national suicide organization has collaborated with gun retailers, range owners and the firearm-owning community about suicide prevention and firearms.  Many of the strategies of the pilot program will utilize co-developed resources through a new partnership between AFSP and the National Shooting Sports Foundation, the trade association for the firearms industry.  “One of the first areas identified through Project 2025, our initiative aimed at reducing the annual suicide rate 20 percent by 2025, was a critical need to reduce the number of suicides using a firearm. But, we know we can’t do it alone,” said AFSP CEO Robert Gebbia. We will work alongside firearm retailers and range owners and the firearm-owning community to better inform and educate them on warning signs, and what to do if someone may be at risk for suicide.”

I will stipulate that there is a non-zero chance that if the suicide deterrent system at the Golden Gate Bridge is completed that not one single human being will ever again die by suicide at or on the bridge or the net.  That said, given my personal experience with suicidal thoughts and behavior, as well as my experience with other extreme states of highly creative consciousness, I doubt that the net will be the end of suicide at the Golden Gate Bridge.  It would surprise me if the completion of the net is not followed by a suicide at the bridge, assuming that its completion is not marked and forever marred by one.

Dying by suicide by jumping off of the Golden Gate Bridge is one of the most predictably sensational ways to die by suicide on Earth.  Investing in a suicide deterrent system with a price tag of $204,000,000 is a sensational way to deal with a sensational problem.  Not seriously considering how such a sensational act may presage the most sensational suicide of all time seems myopic to me.

I call on all of my brothers and sisters in this movement to save lives to consider thinking more critically and analytically about how we apportion the scant financial resources we have at our disposal to cause the suicide rate to go down as quickly as possible.

An open letter to President Obama about suicide prevention | frank talk about mental health | episode 9

November 14th, 2016

Dear President Obama,

Beau Biden was my captain on the tennis team in high school, and Hunter and I nearly won a football state championship together back in 1988.  As a self-declared brother of their father, you are undeniably an honorary member of our extended Archmere family.

I remember the moment during the early morning hours of August 23rd back in 2008 when I got the text message announcing that Joe Biden was your running mate, and I will never forget the moment later that year when you were elected president.  It was that night that I committed myself to getting into a position to leverage my personal connection with Vice President Biden, before you both left office, to the benefit of an important but underserved cause in this country:  suicide prevention.

My namesake and paternal grandfather died in a mysterious explosion at the factory where he worked two days after Christmas in 1951.  Within a year my fourteen year old father-to-be was working two jobs, and giving $40 a month (about $350 in 2016) to his mother to help support her and his two younger sisters.  He joined the Army after graduating from high school where he learned how to be a land surveyor.  After returning from his tour in Europe, he met my mother-to-be, bought a small land surveying firm in Delaware, and started a family.  My father ran the business while my mother ran just about everything else at home.  My parents, two high school graduates, paid for every penny of their four children’s education, which included private grade schools, the same private high school attended by the Bidens, and the colleges of our choice.  Good luck, hard work and love have made the story of Judy and Franco Bellafante an unequivocal example of the American Dream.

I enrolled at the University of Notre Dame in the fall of 1989.  Archmere and AP tests gave me a 30 credit head start, and I earned a Bachelor of Arts in just three and a half years, graduating Magna Cum Laude with a Phi Beta Kappa Honor Society induction to boot.  Mr. Tom Brokaw closed his commencement address to the class of ‘93 in South Bend like this, “It’s easy to make a buck; it’s harder to make a difference.  We need your help.  Go Irish!”  Four years later I became the youngest Principal out of 350 staff at a financial IT consulting firm located a couple of blocks from Wall Street.  I was 26 years old, and my bill rate was $250 an hour.  I won’t deny that I worked hard, but Mr. Brokaw was right.  The advantages afforded me had made it easy for me to become someone who billed in excess of half a million dollars a year in consulting fees.  Back then being successful at my job was paramount to me, while “making a difference” had been temporarily relegated to a distant backburner.

Less than a year later and a few weeks before being accepted into UCLA’s Anderson School of Management, a foreman at a warehouse arriving for work in Secaucus found me clinging to life inside of a running rental car that I’d turned into a makeshift carbon monoxide gas chamber the night before.  I had a near death experience in the ambulance on the way to the hospital, and I woke up a couple of days later in the ICU.  Suffice it to say that my suicidal crisis stemmed from an unshakeable belief that I had become unable to live up to expectations I had for myself as a result of being the beneficiary of so many advantages and so much privilege.  Countless hours of introspection and study over the ensuing years have made me a “lived experience expert” regarding how some young people, with no prior trauma and with many apparent advantages, feel so self-loathing and so hopeless that they become suicidal.

In April of 2015 I left my day job in IT to work full-time in suicide prevention and mental healthcare advocacy.  I became a volunteer in the speakers bureau of the Greater Philadelphia Chapter of the American Foundation for Suicide Prevention.  I began to share some of the lessons I’ve learned since my suicidal crisis by giving talks at Philadelphia area schools and businesses aimed at lowering the suicide rate and reducing the stigma surrounding mental illness.

In June of this past summer, I was on Capitol Hill with hundreds of volunteers from the AFSP advocating for more federal funding for suicide prevention.  Thanks to Hunter and an assistant of the Vice President, I was poised to introduce the executive leadership of the AFSP to the Vice President and his policy staff when the mass shooting in Orlando derailed our plans to meet.  

You are taking questions from the press for the first time since the election as I write this message to you, and I’m compelled to share the following as if I was at the presser and you had just called on me.

Based on 2014 CDC statistics, about 58 Americans die from self-inflicted gunshot wounds every single day—a death toll nine lives greater than the deadliest mass shooting in U.S. history.  Annually that’s 21,334 lives lost to suicide via a firearm.  Comparatively just half as many Americans died by homicide via a firearm in that year, and only 18 Americans died in mass shootings in all of 2014 according to Mother Jones reporting. Imagine that at 12:00 noon tomorrow, 58 Americans simultaneously die by suicide via a firearm.  Imagine that twenty four hours later it happens again—58 simultaneous suicides via a firearm occur at 12:00 noon. Twenty four hours later it happens yet again.  

Am I right to assume that if this slight and absurd modification to the details surrounding the daily tragedy of firearm inflicted suicide occurred in reality, that you would be compelled to say and do things to try to prevent suicide that you have yet to say or do?

If so, why not consider adding more achievements to your team’s list of accomplishments in suicide prevention before leaving office?

There is still time for you to try to change what this picture looks like in order to bend the rising U.S. suicide rate curve.

research-chart

You are an elocutionary potentate and a transformational leader of humanity.  I imagine that you have inspired millions of Earthlings to serve the public’s interest in ways that they might not have without your influence.  I am grateful to include myself in this group.  Your vision for the future of this country inspired me to do the hard work to try to make a difference for others by being the change that I wish to see in this world.

With the election behind us, I’m happy to report that I am in the process of rescheduling the meeting between the AFSP executive leadership and Vice President Biden.  I will be sure to share the time of that appointment with you and your staff once it’s scheduled just in case you might be available to join us.

Thank you for all that you have done to prevent suicide and to improve mental health care in this country.  Thank you for being a constant reminder of the positive difference that someone can make in the lives of others.

Sincerely,

Francesco Bellafante
American Foundation for Suicide Prevention, Greater Philadelphia Chapter Board of Directors
Zero Suicide Champion
frank talk about mental health ~ leveraging the genius of Einstein to stop suicide and to maximize well-being
iameinstein.com

Open letter to VP Biden from one Auk to another | frank talk about suicide | episode 6

Dear Mr. Vice President:

We’ve been crossing paths since I was 12 years old, but the first time we spoke to one another was just last year.

The first time I saw you in person was in line for a movie at the former Concord Mall theater on 202 near Naamans Road.  It was the spring of ‘83 and Coppola’s The Outsiders had just opened in theaters.  I was 12 years old, my brother Mark and Beau were 14, and Hunter was 13.  Mark and I were in line right behind you, Dr. Biden, Beau and Hunter.  You guys ended up getting the last four tickets for The Outsiders, and even though we were underage, the woman at the box office let us buy tickets for the R rated comedy, Joysticks, which was not nearly as good a film, believe me.

Then during high school at Archmere, at football games with Hunter and tennis matches with Beau, and various other events, I saw you more times than I can recount.

Then in early 2012, when the football team that Hunter and I played on together that lost to Laurel 7-2 in the state championship game was inducted into the Archmere Athletics hall of fame, I saw Beau for the last time when you both showed up at the Patio that night.  I took delight in the fact that with not a single spare seat in the house that night, you took a seat on the stairs, and that was no big deal.  I chatted briefly with Hunter that night, but I’m sad to say that I didn’t say hi to Beau.  But I do recall the last time I saw and spoke with him.  I’m not sure what year it was, but I was driving through Philly when I saw Beau walking alone on the sidewalk, and he saw me see him.  So I pulled over, put my hazards on, jumped out of my truck and ran back to have a quick chat.  I don’t remember what we talked about really, but I do remember being lit up by the chance encounter…  because… well, Beau was Beau.

Anyway, it was last year when I personally met you for the first time when I offered you my condolences at Beau’s wake.

A couple months later I sent an email to Hunter that I want to share part of with you now:

The obvious horrible circumstances aside, I was grateful to have had the chance to spend the few moments that we spent together at Beau’s wake; it meant a lot to me to see you and to personally express my condolences to you and your family.  I also want to let you know how touched I was, blown away really, by your amazing tribute to your brother at the funeral.  The entire ceremony was such a beautiful tribute and celebration of Beau and his life.  I was so grateful to be able to see it, not to mention to know that people that may not have known Beau could see and hear you and everyone else that spoke, so that they could understand what kind of son, father, brother, friend and public servant… what kind of person your brother was.  I also wanted to take a moment to share something else with you.  Beau’s wake was the first time that I ever spoke with your father, and as I was getting close to the front of the receiving line, I debated taking a couple extra moments to thank him for his decades of service to the people of Delaware and this country, but I decided against it in the interest of time.  I wanted to thank him for living such an inspiring life and for dedicating himself to public service and for being a living example of the difference that one person can help make, for others.

So, thank you.

Just this past summer, with the help of Hunter, I got this letter in front of your scheduling assistant.

Dear Mr. Vice President:

Nine years after I graduated from Archmere Academy I nearly died by suicide when I was 27 years old.  Eighteen years after my suicidal crisis I am grateful to be a Philadelphia chapter board member of the American Foundation for Suicide Prevention (AFSP), the leading nonprofit at the center of the fight to reduce the mortality of suicide in this country.  Our mission is to save lives and bring hope to those affected by suicide.

In a couple of weeks hundreds of AFSP volunteers will visit Washington D.C. to meet with lawmakers to advocate for increased federal funding for evidence-based suicide prevention programs.  The AFSP has an ambitious goal and a practical plan to reduce the U.S. suicide rate by 20% by 2025.  I am writing to ask you to please consider meeting with the leadership of the AFSP before you leave office.  Robert Gebbia, our CEO, Dr. Christine Moutier, our Chief Medical Officer, and John Madigan, our Vice President of Public Policy would greatly appreciate the opportunity to brief you on our strategy to save the lives of thousands of Americans.  If your schedule permits, a brief meeting with you on June 14th would undoubtedly energize our growing group of thoughtful, committed citizens dedicated to reducing suicide.

We are convinced that our movement is approaching a tipping point in garnering the political will necessary to halt the rising U.S. suicide rate.  Your help in raising awareness about this preventable cause of death will hasten the arrival of the day when suicide is no longer one of the top ten causes of death in this country.  Thank you for your time and consideration, and thank you for being a living example of the positive difference that one person can make in the lives of others.

Sincerely,
Francesco Bellafante
Archmere Academy Class of 1989

The date we were hoping to arrange the meeting for was June 14th, which turned out to be two days after the worst mass-shooting in our nation’s history.  Timing is everything, but there is still time to make this meeting happen before you leave office, if your schedule permits.

Your work with the #CancerMoonshot is inspiring.  Tragically, but not surprisingly the suicide rate for cancer patients is about double the national average.  Worse yet, a study has found the suicide rate to be 13 times higher for patients during the first three months after their diagnosis.

The leadership of the AFSP and I are grateful for all that you, Dr. Biden and the Obamas have already done for the suicide awareness and prevention cause,  but the days when the father of two of my teammates from high school is the Vice President of the United States are quickly drawing to a close.

I promised myself when you and the President were elected that I would get myself in a position to leverage my personal connection to you for the benefit of this cause before you left office.  So, from one Archmere Auk to another, I’m asking you to please consider meeting with these extraordinary leaders from the national non-profit at the center of this winnable fight to stop suicide.

Sincerely,

Francesco Bellafante
American Foundation for Suicide Prevention
Board of Directors, Greater Philadelphia Chapter

What can corporate leaders do to reduce suicide?

Based on 2014 statistics, 117 Americans die by suicide every single day.  These deaths are preventable.

Suicide costs this country $44 Billion a year in lost productivity and medical costs alone, and the pain and suffering experienced by survivors in the wake of a suicide eludes accurate measurement.

This country loses over 42,000 lives to suicide every year.  Please consider taking any if not all of the following life-saving steps to reduce the number of preventable suicide deaths in the United States:

  • If you don’t currently provide your team members with a  way to reach out anonymously for help from a counselor integrate the American Foundation for Suicide Prevention’s (AFSP) Interactive Screening Program with your Employee Assistance Program.
  • Utilize the AFSP’s Talk Saves Lives presentation to educate your team members about the warning signs of suicide and why and  how to get help when they see them in themselves or others.
  • Encourage your team members to advocate for increased public funding to reduce suicide.
  • In the unfortunate event that you lose a team member to suicide avail yourself of the AFSP’s survivor support services as needed.
  • Until we garner enough political will to dedicate the public funding necessary to dramatically reduce the suicide rate, please support reputable, well-managed suicide awareness and prevention nonprofits like the AFSP to save lives.

Arresting the rising U.S. suicide rate and saving thousands of lives lost to this preventable cause of death are feasible goals within our collective reach.  Please join the growing number of people personally taking ownership of reducing the number of suicide deaths in this country.

Please join us in the fight to bring about the beginning of the end of suicide.

Please visit AFSP.org for more information.