Saving People From Suicide: An Occasional Letter? Really?

how to prevent suicide


uicide, the dodgy and darkest villain. Ever higher the death toll climbs, reducing life expectancy in the U.S., with virtually no rhyme nor reason. Even psychiatry hasn’t a clue how to quell the epidemic. But could the solution be found in something so incredibly simple that darned near everyone overlooked it? See what you think…

Whiteside’s reply to Amanda got right down to business: ‘If you are planning on killing yourself this evening or weekend, I need to know.’

A savvy client brought an article to my attention: “The Best Way to Save People From Suicide,” written by Jason Cherkis. The very fine piece recently appeared in HuffPost’s magazine, Highline.

The article is fascinating and powerful, so I had to bring you this summary, as I encourage you to, later, give it a read.

Let’s. Get. Busy.

“The Best Way to Save People From Suicide”

Mr. Cherkis opens his piece with a hard-hitting introduction of two of his main characters. And, remember, this is non-fiction.

Amanda, a 29-year-old nurse, decided at 5:30 on a Friday morning she was going to take her life when she got home from work.

Before leaving her apartment for the day, she emailed the following to her new therapist, Ursula Whiteside: “Not a good night last night, had a disturbing dream…Got to try and get through the day, hope I can shift my mind enough to focus. Only plan tonight is to come home and take a nap.”

A Very Different Sort of Therapist

Ms. Whiteside is, well, a very different sort of therapist. For instance, she’s okay with emails from clients in between sessions – and replies. Hence, Amanda’s message on the day she planned on dying.

Though typically upbeat and highly expressive in her emails, sensing something was up, Whiteside’s reply to Amanda got right down to business: “If you are planning on killing yourself this evening or weekend, I need to know.”

Sure as heck, Amanda got home from work, waited for darkness to fall, put on her PJs, brushed her teeth, swallowed dozens of pills, laid down on her bed, and drifted-off to sleep.

After multiple attempts to reach Amanda, and not hearing back, Whiteside called the police. And some six hours after she ingested the pills, Amanda was found. Way out of it, but alive.

Jerome A. Motto, MD: The Foundation

how to prevent suicide

Jerome A. Motto, MD

Midway through her undergraduate work, Whiteside transferred to the University of Washington so she could study under Marsha Linehan, the creator of dialectical behavior therapy. DBT is a powerful therapy designed for those struggling with situations such as borderline personality disorder and self-harm and suicidal ideations and behavior. 

Along her academic journey, Whiteside discovered the work of Jerome Motto, a long-ago retired psychiatrist and suicide researcher. Go figure, Linehan was into his work, as well.

Dr. Motto was the only American to devise an experiment that dramatically reduced suicide deaths. No, his technique didn’t involve a complicated, long-winded manual or a billion dollar pharmaceutical project…

Very simply, Motto sent occasional letters to those at risk.

Ursula Whiteside was stunned, saying to her own therapist, “Oh my God. What if this is what we should be doing? What if it’s that simple?”

So how did Motto come up with his idea? Well, he was an Army officer serving in Europe during World War II. And his greatest solace during a very difficult time came in the form of letters from a woman with whom he’d gone out only a handful of times back in the States.

Turns out she wrote tons of letters and they kept coming, even when he didn’t reply. His deep attachment to them surprised Motto, and he became driven to figure-out why. I mean, they weren’t love letters, the woman just wrote about commonplace things.

The Suicidal, The Alone

After the war, Motto got himself through med school, chose psychiatry, and found he was especially drawn to suicidal patients. And his belief was they were made to feel alone.

Motto came upon the work of German psychoanalyst Hellmuth Kaiser, who argued that the most disturbed patients could be helped if they felt a sense of connection, even on an unconscious level. And that got Motto thinking about the comfort-factor of the letters he received during the war.

Motto wondered if the simple act of showing people he was there for them, expecting nothing in return, would make suicidal patients feel less isolated, less in conflict with themselves.

And that led to securing a grant for a massive, long-term suicide research project.

It didn’t take long for Motto to write the first letter to a suicide survivor discharged from a psychiatric facility. He wrote, “It has been some time since you were here at the hospital, and we hope things are going well for you. If you wish to drop us a note we would be glad to hear from you.”

Enclosed was a self-addressed envelope without a stamp. Motto stated, “That’s important, because some of these persons were so sensitive that putting the stamp on the envelope would be pressure, that they’d feel obligated that we wouldn’t waste our stamp.”

In all, 24 letters would be mailed to each study patient over five years.

The Bottom-Line

Motto’s experiment was working, as patients were writing back. And then came what Motto called “the bingo letter” – a perfect encapsulation of the study’s aims…

A man living in San Francisco had 18 months earlier replied with what Motto called a “kiss-off” letter. But to the most recent letter he replied in five typewritten pages. His first sentence: “You are the most persistent son-of-a-bitch I’ve ever encountered, so you must really be sincere in your interest in me.”

Cutting to the chase, Motto’s work was unprecedented in the history of suicide research. For example, in the first two years following hospitalization, the suicide rate of the non-contact (control) group was nearly twice as high as that of the contact group.

But there was more. The work demonstrated that people who attempted suicide, and wanted zero to do with the mental health system, could still be reached.

All Done

Cherkis wraps-up his piece chatting with Ursula Whiteside at her bungalow in Seattle. And he got to meet Amanda. She and Whiteside stay in touch, even though they stopped working together two years after the suicide attempt.

Regarding Whiteside, Amanda said, “I thought she was naive. Everybody else I’d worked with seemed overwhelmed and scared and frustrated…I always worried that I was too much.”

Ursula Whitesides’s take on suicide? “I think people die when they feel completely alone.”

So could the suicide solution be found in something so incredibly simple that darned near everyone overlooked it? I’m thinking so.

Please take the time to check-out Ursula Whiteside, and team’s, work at Now Matters Now. You’ll find plenty of suicide and general problem resolving resources – for you and others.

Be sure to read Jason Cherkis’ “The Best Way to Save People From Suicide.” There’s a ton of info I couldn’t include here.

Dr. Motto’s image:

Looking for more interesting and useful mood and anxiety disorder-related tidbits? You’ll find them in hundreds of Chipur articles.