Ep. 434/ Eran Magen. Men’s Mental Health/SuicidePrevention

Sheila Hamilton (0:10)

Welcome back to Beyond Well, I'm Sheila Hamilton, and this is a program for people who want to find out more about our interior lives. And September, Suicide Prevention Month. As you know, I lost my husband to suicide, and so I care deeply about this topic. And I'm so happy today to be joined by Eran Magen. He holds a PhD in psychology from Stanford, and he's the founder of Early Alert. It's an organization that works inside universities, public schools, even the VA to identify suicide risk before it becomes a crisis. I'm so happy to talk to you, Eran, because so many people that I have on the podcast, kind of talk in generalities about mental health, but I love that you actually believe infrastructure has a part in preventing suicide.

Eran Magen (0:55)

Yeah, I think structure has a lot to do with it. Suicide doesn't happen usually out of the blue, with nothing preceding, and so good monitoring and good support can play a huge role in preventing suicidality and ultimately suicide.

Sheila Hamilton (1:07)

I want you to talk at length for as long as you like about Early Alert, but I want to talk first about my frustration. I have been doing this kind of prevention work, talking, writing, looking at the stats, trying to do as much as I can around suicide, and nothing really has moved the needle. It is probably one of my greatest frustrations that especially among men, we have a suicide rate that is almost the same as when my late husband died. Do you hear that frustration?

Eran Magen (1:34)

Yeah. It's so slippery. I think it's slippery just because the root is really deep.

Sheila Hamilton (1:39)

Yeah.

Eran Magen (1:39)

It's not a superficial thing. It's not that there's not enough yellow around us. It's not an easy thing. I think a lot of it has to do with connectedness or disconnectedness. A lot of it has to do with hope or lack of hope.

In order to change those things, you need really fundamental changes in how society or the society around you in particular works.

Sheila Hamilton (2:01)

All of the public awareness campaigns, the reach out for help, all of the discussion on social media about suicide awareness doesn't get to hope. I love that you're just nailing that. I've felt that same frustration that we're not helping people build better economic lives. We're not helping them in relationship. We're not helping them in community.

We're putting people in little silos, stuck with their phones as their main source of inspiration and hope. And I think you've really said something quite profound there. If you could build something that gave people hope, what would it be?

Eran Magen (2:39)

You know, so first of all, I don't want to take undue credit. There are a lot of theories around suicide and suicidality, but my favorite in this topic is one called the three-step theory of suicide, which, as you might guess, suggests that suicidality comes as a predictable outcome of these three steps. There are like three gates along the way. And I didn't invent that one. I just came upon it and thought it was just so elegant. And so the three conditions, let's say, for severe suicidality typically involve experiencing a lot of pain, physical or psychical pain, and then believing it'll never stop, which is the opposite of hope. And then not having anyone that were connected to or even anything that feels important that we're connected to. And these three gates also suggest three intervention points. If you can take away the pain, wonderful, but that's usually hard. If you can give people hope that the pain at some point will go away, that's really great.

That's achievable. And then if you can connect people and keep them connected, that's very achievable. And so these are the three points of intervention. And these are the ones that I keep going back and forth on when I think about different ways to support and prevent, support people and prevent suicidality. The connection point in particular, I think is really important because these regular touch points, if they're real, if they're perceived as sincere and close, in and of themselves checking in on someone is an intervention. It will reduce loneliness, improve connectedness and keep people farther away from suicidality.

Sheila Hamilton (4:13)

It's so fascinating because I just did a really interesting interview on pain management with one of your colleagues at Stanford, and we were talking about the tie between people who are in physical pain. I think when you're talking about mental pain, it's just a completely different ball game because all of the psychopharmaceuticals that we throw at a person's mental illness, all of the interventions, sometimes people will say, it isn't working, I still feel this psychic pain. So does your Early Alert system rank for how people are describing the level of their pain when you're engaging, whether or not their suicidality is imminent?