In today's episode, Billy and Brian talk to mental health advocate Tandra Rutledge about how we can normalize and prioritize conversations around mental health with our children so we can kick stigma's butt!
If you or someone you know is struggling with depression or suicidal ideation, please contact the National Suicide Prevention Hotline at 1-800-273-8255 (TALK) or Text "HOME" to 741741 to reach a Crisis Counselor.
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This episode uses the following resources:
--American Foundation for Suicide Prevention
--“I Need a Psychiatrist/Psychotherapist but Can’t Afford It. Where Can I Find Affordable Treatment?”
--Mental Health Technology Transfer Center Network
--National Alliance on Mental Illness (NAMI)
--Samaritans Report: "Men and Suicide: Why It's a Social Issue"
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Welcome to The Mindful Midlife Crisis, a podcast for people navigating the complexities and possibilities of life second half. Join your hosts, Billy and Brian, a couple of average dudes who will serve as your armchair life coaches as we share our life experiences, both the good and the bad, in an effort to help us all better understand how we can enjoy and make the most of the life we have left to live in a more meaningful way. Take a deep breath, embrace the present, and journey with us through The Mindful Midlife Crisis.
Billy: Welcome to The Mindful Midlife Crisis. I’m your host, Billy, and, as always, I’m joined by my good friend Brian on the Bass. Brian, how you doing over there, man?
Brian: I am superb today, Billy.
Billy: Yeah, you just came back from a real big bus trip. Where did you guys all go?
Brian: I did. We went through South Dakota, hit all the sights in South Dakota, Badlands and Deadwood and Custer and the Black Hills and all that stuff, and then we rode up through Yellowstone and pretty much to the entire Yellowstone loop and then down through the Tetons and then back over across the United States, Wyoming, South Dakota, back to Minnesota.
Billy: It was a lot of fun to follow on the Instagram page —
Brian: Oh, thank you.
Billy: Yeah, if you aren’t already following Brian and Cathleen and family’s adventures on their schoolie, go to @wejustboughtabus on Instagram and you can take a look at their absolutely fantastic trip. I just got back from Seattle and then took a little trip down to Arlington, Texas, so I could catch a Twins game at the new Globe Life Park and now, once again, I am completely updated on baseball stadiums.
Brian: That’s not exactly on the way.
Billy: It was a detour. I took a triangle through the United States. We kind of wrapped up Season 2 last week with Matt Hazard but we want to continue our conversations that we’ve been having so far so we’re actually extending Season 2 and, today, we actually have a two for one special. We’re going to get two episodes out of our guest today. Our guest is Tandra Rutledge. Tandra just started as a director for the American Foundation for Suicide Prevention which saves lives and gives hope to those affected by suicide. She is a mental health and suicide prevention educator and advocate. She is a clinical mental health therapist with a Master’s in Clinical Psychology. She is also a consultant and trainer for suicide prevention. She is also a parent of a child with ADHD and has done presentations on what best practices are for raising and teaching children with ADHD, and she is actually going to talk to us about teen suicide prevention and parenting a child with ADHD and we are so thankful for having Tandra here. Tandra, thank you so much for being here.
Tandra: Thank you, Billy and Brian. Thank you for having me today. I’m so excited.
Billy: Yeah, we’re excited too. You and I did a little chat maybe about a month ago and I was like you need to be a guest on our show because you are just amazing and I’m so excited for people to hear this episode and hear what you have to share today. We would love it if you would tell us the 10 roles that you play in your life.
Tandra: Ten roles I play, okay. Ten roles. Now, you have to count for me.
Billy: You can go over 10. When we did this before, you had more than 10 so just go ahead and crank them all out because they’re fun roles.
Tandra: Okay. So I am a mother, a wife, a friend. I’m a doggie mom. I’m a sister friend. I’m a runner. I’m a cook. I’m a drama queen. I’m an introvert, Midwestern gal. I’m a boss bae. I’m a daughter. I’m a youth worker. I think that’s 10 —
Billy: And you also have mentor down here too.
Tandra: Oh, yes, I’m a mentor. Yes. I’m a mentor.
Billy: So we always follow up with the three that you’re most looking forward to in the second half of your life but I have a quick question here. First of all, you said you’re a Midwestern gal. Where are you from?
Tandra: So I was born and raised in Ohio, in the Cleveland area, and I currently live in the Chicago area in Illinois.
Billy: Wonderful. How long have you lived in Chicago?
Tandra: For five years.
Billy: Chicago is probably one of my top three cities in the United States. I love Chicago. I love Chicago in the summer.
Tandra: Yeah, it gets pretty cold for most people in the winter.
Billy: If I’m going to escape Minnesota in the winter, I’m not going to somewhere where it’s also cold.
Tandra: But for me, I like Chicago over Cleveland in terms of winter because Cleveland gets more snow typically —
Brian: Oh, lake-effect snow probably, right?
Tandra: Right, it’s that lake-effect snow and Chicago gets colder and I can deal with the cold but the snow just — I get a little annoyed when the snow starts to get brown and dirty. I like fresh snow but when it starts to get all trampled on and dirty, it doesn’t look as pretty.
Brian: Plus it just takes longer to do everything when there’s a lot of snow, you know what I mean? Even to get in your car, it’s like, “Oh, now I gotta dust it off and scrape the windows,” and all that baloney.
Tandra: Walking down the street, walking the dog, doing everything just takes a lot longer. Yeah.
Billy: So then I also have a question here. What makes you a boss bae? Because just in our short conversation so far, I would 100 percent agree with this statement.
Tandra: So maybe I should ask you that question, what makes me a boss bae.
Billy: Because you present yourself so confidently and it’s really unfortunate that our listeners can’t see you on video because you are just owning this. Your presence is just owning this whole interview. It’s so much fun. I know that — we have a very serious topic that we’re going to be talking about but this first segment here, I’m all smiles just because you radiate such confidence and positivity so that’s what makes you a boss bae, in my opinion.
Tandra: So that’s what makes me a boss bae. It has nothing to do with anyone else but me. It has to do with me owning who I am, being confident, comfortable in my skin, being fully present and connecting with other people. That is what being a boss bae means to me.
Billy: Yeah, you are owning it 100 percent.
Tandra: Thank you.
Billy: So you just talked about being a boss bae, which I imagine then connects a little bit here to being a drama queen as well.
Tandra: Well, you know, it does. One of the things that I’ve learned in my almost 50 years, I will be 50 this year, proudly, I’m so excited, is to own the parts of me that I didn’t realize I had. So when your 15-year-old says to you in the car, when I say, “Why are you so dramatic?” and he says, “Because you’re my mother,” I’m like, “Where do you get that from?” and he’s like, “You.” It forces you to really take a look at yourself. And so I started asking people, “So, am I a drama queen?” and my mom’s like, “Yes, all your life.” I’m like, whoa, so that saying out of the mouths of babes so I had to embrace it and I was like okay, I’m a drama queen. I never would have described it but it’s a newer identity that I’m embracing.
Billy: I love it.
Tandra: So that’s where that came from.
Billy: I love it. I love that you said, “You know what, this is who I am and I’m gonna make this work for me.”
Tandra: Just is. I mean, I think I need a little bit of it in the work that I do —
Brian: Yeah, I could see that.
Tandra: — a little bit of that extra, a little bit of that humor, a little bit of that ability to kind of — you know, we deal with some very serious topics and they are serious but how do you talk about it and give people hope and help people feel comfortable and at ease and talking about difficult topics and I think that me being a little bit of a drama queen, I guess, you’d say, and letting people see me and who I am and not just, “I’m this expert in suicide prevention and I’m gonna tell you,” I’m a mama, I’m a real person that has gone through things and has struggled in areas of my life but I believe in the work that we do and I believe in the importance of people connecting and that we can help each other.
Billy: Can you talk about how many children do you have? What ages are they? We’re going to talk about them in the second episode that we do with you but can you give us just kind of a brief background on your family?
Tandra: Yes. I have two amazing boys. My oldest son is 15 and my youngest son is 10 years old, but I have other children who I consider them to be children of mine as well. My two biological children are boys but I have other nieces and nephews and other children who are not biologically related to me that I consider part of my extended family as well.
Billy: Is your house full all the time with children?
Tandra: Since we moved — we moved five years ago to Illinois so it’s less full now because we moved away from a lot of our family and friends but, certainly, yes, our house was center for lots of activity and children and it was nothing for me to gather godchildren and nieces and nephews to come over to do crafting activities and just to hang out and I just enjoy being around children. So I can’t wait when my family grows and I get an opportunity to hang out with my grandchildren and my grand nieces and nephews.
Billy: I imagine that your passion for children is also why you work as a youth ministry worker.
Tandra: Yes, yes. I have been involved in ministry for 20-plus years, yes, teaching Sunday school, Bible class, and really connecting with young people, helping them to understand themselves through the Bible and building the relationship, and I know we’ll talk about when we jump in to talking about suicide specifically, but all of what I do is based on relationships, building relationships and building connections, whether it’s with youth or with adults, but those relationships are really important and really matter.
Billy: So then hearing you do this work in the youth ministry and your presentations and the way that you carry yourself with such confidence, it surprises me that you listed introvert as one of the three that you’re most looking forward to. You said that you’re actually looking forward to becoming more of an introvert and so I’m curious if you can explain more.
Tandra: I know. That one is hard to explain but for the introverts out there, they will get this. So, I am the type of introvert that really doesn’t care for small talk. So there are people, you think of a party, there are people that come to a party or gather, they’re like, “Hey, I’m here. Party over here,” and then there are people like me who actually contemplate whether they want to go, want to know who’s going to be there, how long it’s going to be, what they should wear, do they have to bring something, what’s going to be on the menu, and then if they get up the nerve to go, they don’t go right in the middle, they stand along the sidelines, they have conversations with people, they kind of work the room that way on a one to one interaction and then they time how long they’re going to be there and then they go home and they had a great time.
Billy: I could actually relate to that a bit.
Brian: Yeah, me too.
Tandra: So that’s me. And then the other part that’s me is because I do have a big personality and I do presentations and I’ve spoken in front of small and large audiences, I put everything that’s in me comes out. I give it all up. All of it comes out. And so because all of it comes out and I’m authentically me, I need that time to just go back and I need that time to just, whether you call it refresh, regroup, I need that alone time and so when I say I look forward to being more introverted, that actually means that I know that my work is going to continue and I look forward to opportunities to do more on a bigger scale, especially in my new role with the American Foundation for Suicide Prevention, the opportunities that I get to work on Project 2025, which is a project of AFSP to work towards — it’s a national effort, really, to reduce the rate of suicide across our country by 20 percent by the year 2025 so it’s a bold goal, it’s a national goal, and I am part of the team at AFSP that’s working on that. So imagine the energy that’s going to go into that, the work that’s going to go in that to be part of the amazing team at AFSP and to really be the leader and moving the needle and reducing the burden of suicide in this country. And, because of that, then I’m going to need also still that more time, those quiet still moments for self-care and to regroup. So I’m looking forward to having those alone times but I’m also looking forward to continuing this work that I’m doing now.
Brian: I very much hope —
Tandra: Did that make sense?
Brian: Yeah. I very much hope that not only do you succeed in your goal but I hope you surpass it.
Tandra: So exciting.
Billy: And we will absolutely do our part to help promote whatever you have out there and whatever services and whatever resources that you can share, we will get it to our audience and, wow, what an amazing venture for you to be on.
Tandra: I’m excited about it, there are a whole group of volunteers across the country that are excited about it, and I’m excited to partner with you all to address this issue, reducing the annual suicide rate by 20 percent by the year 2025.
Billy: It’s goals like this, that’s why we originally wanted to start this podcast is we wanted to have conversations around mental health support and normalizing conversations around mental health so we really appreciate the I can only imagine countless hours and the energy that you and your foundation are putting into this goal. All right, so with that, I think this is a good time for us, we’re going to take a quick break and then when we come back, Tandra is going to share her expertise on preventing teenage suicide. Thank you for listening to The Mindful Midlife Crisis.
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Billy: Welcome back to The Mindful Midlife Crisis. We are here with Tandra Rutledge who is the new director of the American Foundation of Suicide Prevention and, Tandra, you just transitioned into this role, can you tell us what you’re doing now and what you’ve done in the past with regards to working in the mental health support field? You talked about your future goal here so where did your work begin to where you are now at this position where you have this very lofty goal that we sincerely hope you accomplish by 2025?
Tandra: Wow, that is a big question, Billy. So, I guess, the goal — or I guess, my passion, because really that’s what it is, so my passion for mental health probably started when I was, and I didn’t even know it at the time, when I was a young girl and I looked around in my family and in my neighborhood and I saw what I came to understand were people who were dealing with untreated, undiagnosed mental health issues and substance use issues and no one was really talking about it. And my family is not unlike many families across the country or in the world, for that matter, where mental health and substance use issues are not talked about and so I think that that was probably where my passion was born because I saw people suffering and I felt like, as a young girl, that that didn’t have to happen, that we could be better. We could be better. And so I started with going to college and wanting to be a therapist and figuring out ways, “What can I do? What can I do to help my community to learn more about mental health and suicide prevention? I know that, within our culture, there’s stigma and then when you look at within the black community, there is stigma and so I wanted for me to see what I can do as an individual to try to address stigma. And the more I learned about mental health, the more I wanted to do, honestly, and I was like, “Wait a minute, we don’t have to suffer? Wait a minute, there’s treatment? Wait, there are signs? We can learn the signs? Wait, mental health is a health issue just like other health issues? Well, why is no one talking about this? Well, wait a minute, let’s talk about this. Well, wait a minute, we can identify the signs and reach out and get help just like if we had a health condition?” and from there, it was like a no brainer for me, and so I’ve been involved in this work for over 25 years of educating and advocating for mental health and suicide prevention as a therapist, and I’ve worked with various organizations, and even in my jobs that I’ve had and I’ve always promoted it and always had been really passionate about education and advocacy and sharing resources and really a high focus on youth and our teens and having conversations about mental health, what it is and what it is not. And mental health has to do with our thoughts, our feelings, and our behavior, and everybody has mental health and it affects how we think, how we feel, and how we behave and it’s a normal part of our functioning and really wanting us to understand how our brain functions and to be comfortable talking about our brain and what our brain needs, just like we talk about our bodies and what our bodies need. And I know that was a long answer but that’s where it started for me and so I’m very excited about the work that AFSP has been doing and then I get to be a part of the work moving forward at a national level to reduce the annual suicide rates by 20 percent.
Billy: You brought this up in your answer and you also brought this up in an interview that I saw you do too where you talked about why might just Americans in general not identify as being depressed or having anxiety.
Tandra: That is very complex and I’m not going to say I have all of the answers to that but some of the reasons that we can probably agree on include things like language. Think about how we talk about mental health, words we use. Think about how media has portrayed people who struggle. Think about some of those things. Think about someone who’s struggling with mental health and the things that they’ve been taught, how they’ve been socialized, the things that they’ve seen, and that makes it difficult for people to speak up. Within the black community, there are layers of other issues that come to play. We look at our health care system and we look at historical issues of racism and trauma and health care and things that have been done and that’s a whole other show when we talk about all those things and there are many organizations working against the stigma and creating conversations and, honestly, teaching people how to have conversations about mental health and being comfortable doing so. And that’s what this is about. How do we address stigma? We talk about it, just like we’re doing right now. We talk about it and we see that the sky is not going to fall, the world doesn’t end, that we talk about it, we talk about the stigma, and we have to give people tools, parents and children, tools of how to do so and that’s some of the resources you’ll find at AFSP’s website. They have a campaign called #RealConvo, which is one of my favorite campaigns, #RealConvo, where it gives you things you can say to have a real convo about mental health.
Billy: Can you share some of those? We’re going to ask you here, how does the language around mental health conditions need to evolve so that we can lessen that stigma so can you share some of those conversations that we can have? And we’ll also make sure that we put a link to AFSP in our show notes so if you want to click on that, you certainly are welcome —
Brian: Which is afsp.org, for everyone’s reference.
Tandra: Yes, thank you for sharing that. And actually, on the AFSP website, there are some guides, really simple guides, how to start and continue a conversation, things that you can say. I’m sorry, Billy, I forgot your question.
Billy: No, no, no, that’s okay. I asked how does the language around mental health conditions need to evolve to lessen that stigma surrounding mental health? And you had talked about how the website has conversation starters so can you share some of those conversation starters? Because, we, actually — this podcast actually helped two brothers who came on to our show, Scott and Lee, it actually opened up a dialogue between the two of them so that they could talk about the brother Lee’s mental health issues with his brother Scott and they shared their story. It was a really powerful story and we imagine that the resources that you have can open up conversations like that for other people.
Tandra: And so that example right there is an example of the power of having a conversation. So I want to go back to the language because I feel very strongly about the language that we use, and then I’ll come back to some tips on the conversation. One of the things that we have to be very thoughtful about when we’re talking about suicide, in particular, first of all, we have to not be afraid to say the word “suicide.” We also have to realize that the language we use matters and so we caution people and discourage people from talking about people by using the terms “committed suicide.” Suicide is a health issue. It’s a complex health issue. It results not from one thing, one reason, one factor but a multitude of issues that converge together. It is not a simple phenomenon for us to understand and so we want to be thoughtful that we don’t use the word “committed suicide” but we simply use words that describe how that person died, much like we do when someone has a heart attack or they die by any other condition. We don’t use that word “committed” for any other health condition, and suicide is a health condition, so we want to discourage the use of “committed suicide.” It’s not necessary and it implies judgment and it doesn’t accurately describe what happened. The person died, they died by suicide, they killed him or herself. And so language matters so I want to make sure your listeners understand that and that we move away from using that word, “committed suicide,” and describe how that person died.
Billy: That’s been a big learning for me in starting this podcast because I think, even at the beginning of this podcast, we were using that phrase and then a listener gave us some feedback and said, “You really should stop using that phrase that way,” and they explained it just the way that you explained it so like moving forward, I’ve tried to deprogram myself from using that phrase whenever we are talking about suicide.
Tandra: Absolutely, and thank you for that and AFSP and I can send you this, has a whole media guide because you’re in media, you’re doing a podcast, and that includes tips for safe reporting and how to talk about suicide so when you have guests on your program that bring up the topic, you as the interviewer know how to do so responsibly and supportively to your guests so we’ll make sure that you get that as well.
Billy: Thank you very much. We greatly appreciate that. Any resources you have to help us be better at what we’re doing would help us out greatly.
Tandra: Absolutely. And so the second part of what you asked me is how to start the conversation and so on AFSP’s website, on our website, there are some really great resources and we don’t have to overthink it. We don’t have to overthink it. I think that for many individuals, we have to get over the fear of having the conversation and many of us think, and especially when you’re thinking of children, you’re thinking of your 15-year-old and you want to have a conversation, we still think that if we talk about it, it’s going to give them the idea, it’s going to put it in their mind, and that’s just not true. That is a myth. So we have to bust all these myths that we have about suicide. That’s not true. You’re not going to plant the idea or give someone who’s not suicidal the idea of suicide if you ask them about suicide. And, conversely, if someone is thinking about suicide, imagine if they’re struggling with thoughts of suicide and you ask them, imagine if you do so with compassion and care, imagine the relief that that person could experience that someone cares and that they’re asking —
Brian: And they’re not alone, yeah. It gives them that feeling they’re not alone.
Billy: Or that someone even recognized, “Hey, you look unwell, let’s have a conversation about why you look unwell. What’s on your mind? What are some things that —” and I think then that elicits asking that question, because I’ve had to have that that conversation with students in the past, it’s like, “All right, are you thinking about hurting yourself? Do you have a plan?” I mean, that’s an uncomfortable conversation to have but it’s a really important one, it’s a life-saving one, and I’m not a trained mental health expert like you but I’ve had to have those conversations and I know that we’ve been able to get students the help that they needed because we were able to open up with that conversation and not tiptoe around it.
Tandra: So, Billy, you don’t have to be a trained mental health counselor to have a conversation. If one of your students was having physical symptoms in the classroom, you wouldn’t pause and have any like, “What? Should I say something? They’re going through something. They’re having problems,” you wouldn’t take a second thought. You would, “Are you okay?” And so it doesn’t require special training, just what you said, “You look unwell. I’ve noticed these things the last few days. Are you okay?” Having an open, authentic, “I care about you” conversation, you don’t have to be an expert. Think about the conversations that you’ve had in your life or that people have had with you in your life, the most powerful ones weren’t with a trained mental health counselor, they were with a friend, a relative who took a few minutes of their time to show you that they’re there for you. This is what we’re talking about. So when we’re talking about suicide prevention and we’re talking about youth and we’re talking about all of the people, parents and siblings and relatives and coaches and all the people that are around young people, we’re saying, “Get educated around what the signs are. Know the things that you need to watch out for that may signal that this young person is struggling.” And I like the word that you used, that they may not be well, like what are some of those signs? What are some of those risk factors? And don’t be afraid to have that conversation. Let young people in your life, all people, really, know that you’re willing to talk about mental health. And so one of the easiest ways to do so to let people know that you’re willing is to be open about your own and talk about your mental health just like you talk about your physical health and be willing to do that. Allow it to come up naturally in conversation.
Billy: That’s where we started with this podcast was I shared my struggles with anxiety and depression and suicidal ideation and Brian shared his struggles with alcohol and pills because we wanted to open up a dialogue for people to hear that, listen, every day, people struggle. I like to think that both of us are pretty successful guys but at the same time, we struggled with mental health and addiction so there are probably people much like us who need to hear those stories so that they can open up themselves. And as I had mentioned before, that actually opened up a dialogue for one of our listeners and his brother and I feel like that is really what the power of a conversation, a real conversation around mental health, can do. Can you talk a little bit about what are some of the barriers to getting mental health support for both teenagers and adults? Are they different? Are they the same? What do those barriers look like and what can we do in order to alleviate those barriers?
Tandra: I think some of the barriers really have to do with access to care, knowing where to go for help. Navigating the healthcare system is challenging. We know that based on your insurance, or lack thereof, wait lists to get care, understanding what type of care there is available can be challenging. What I tell people, everyday people, is that if you know nothing else, there are three numbers no matter where you are in this country that you should know if you’re reaching out to someone who has a mental health concern, and there soon will be a fourth, but 911, if someone is in immediate crisis, there’s a concern for their safety or the safety of others around them. The National Suicide Prevention Lifeline number. That should also be in your, what did you call them? Your —
Billy: Our show notes. We’ve put those in our show notes in the past and we will absolutely be sure to put them in this week’s show notes as well.
Brian: Which is 800-273-8255, for any one listening.
Tandra: 800-273-TALK. Yep. Put it in your cell phone, save it. And then the Crisis Text number, 741741. Hopefully, very soon, we’ll have 988. So no matter where you are in the country, those three numbers, if we know nothing else, we know those three numbers. We know locally, there may be crisis numbers and things like that. I tell people all the time know those three numbers. You should be able to navigate and get help if someone is experiencing a mental health crisis and be able to reach out. We have to advocate for our loved ones and our friends around mental health and, sometimes, that means that we have to go with as a support person to a school and say, “You know, this is serious.” The depression or the anxiety or the symptoms are serious and this parent needs support or resources, we have to push and apply that pressure on our systems sometimes because what we also know is that untreated mental health issues is a huge risk factor for future poor health outcomes, including suicidal ideation, substance use, and other risks. And when we don’t get treatment for children and teenagers for their mental health conditions, it just increases their risk for poor health outcomes. And I know we’ll talk about that when we talk about ADHD and in the work that I do, you see adults who have had histories of struggles in school, you see maybe they are involved in the criminal justice system, maybe they — and you look back in their histories and you see a point, third grade, fourth grade, where they were having struggling, maybe they had a learning disability, maybe they had ADHD, maybe they had anxiety, but no one addressed it because for lots of reasons, lots of reasons, but we have to be a culture that is smart about mental health. We have to because we know that it’s treatable and the resources are available. And for parents out there, we have to educate ourselves and advocate and fight for those resources and there are organizations like NAMI, the National Alliance on Mental Illness, who works tirelessly with families around advocating and has support groups for families. If you need advocates, there are lots of different groups, advocacy groups and support groups for families. There is no reason that anyone who needs support can’t get support and advocacy around some of these issues.
Billy: Well, I think that’s a good time here for us to take a break and then when we come back, we can talk about what are some of those warning signs parents need to look for and how to more directly access those resources that Tandra just shared with us. Thank you for listening to The Mindful Midlife Crisis.
Thanks for listening to The Mindful Midlife Crisis. We will do our best to put out new content every Wednesday to help get you over the midweek hump. If you’d like to contact us or if you have suggestions about what you’d like us to discuss, feel free to email us at firstname.lastname@example.org or follow us on Instagram at @Mindful_Midlife_Crisis. Check out the show notes for links to the articles and resources we reference throughout the show. Oh, and don’t forget to show yourself some love every now and then too. And now, back to the show.
Billy: Welcome back to The Mindful Midlife Crisis. We are here with mental health advocate Tandra Rutledge and she is sharing with us her expertise on teen suicide prevention. Tandra, once again, thank you very much for being here. You filled my love bucket up earlier with some words of affirmation. Can you please share that for the audience so that they can all hear the wonderful things that you said about our show?
Tandra: Absolutely, absolutely. What I said is that I thank you. I thanked you for this podcast because what you are doing fulfills the mission of addressing stigma. By creating this podcast, this podcast was born from you and Brian’s need to share your story and to talk about the things that you’ve dealt with in your life and to create an audience and to give people hope. And so you are, in your own way with this podcast, you are addressing stigma. You’re kicking stigma’s butt because you’re creating a safe space for conversations around mental health and giving people hope that they too can get help, get support, be okay, do well, start a podcast, be successful. So thank you for what you’re doing.
Billy: Well, and thank you for being on the show and thank you for those kind words. In all sincerity, when someone of your stature and expertise gives us a compliment like that, it makes my allergies act up a little bit. So —
Brian: And, frankly, we’re going to steal something you said out of that, kicking stigma’s butt. That’s going to be our tag line from now on.
Billy: I like that. I like that. Thank you very much for that line. We appreciate it.
Tandra: From the boss bae.
Billy: Absolutely. Oh, I love it. I love it. So, before we came back into the segment, we had a good conversation around risk factors and warning signs and the differences between the two and I had asked you about ACEs, which are adverse childhood experiences, and you wanted to talk about all of those things together so we’ll turn it over to you here.
Tandra: Thank you for that. So, yeah, I think that it’s an important discussion and I’m glad you asked the question. So it’s important for us to understand risk factors. So we all know risk factors. You go to the doctor and you know your risk factors for heart disease based on your age and family history, and etc., etc., so risk factors are those characteristics or conditions that might increase your chances of developing a condition. So, in the case of suicide, it’s those conditions or factors that increase a person’s chance that they might take their life. These risk factors are typically important for us to understand because it’s the big picture. It’s the big picture of someone’s life, okay? And it’s important to know, and I want you to think about the last time you went to the doctor for a checkup, you fill out this form or now you do it online, you do your check in online, and have you ever had any of these conditions and you check yes or no because they’re trying to determine and predict your risk for certain health conditions. Well, one of the things that we’re trying to do at AFSP and Project 2025 is we know that we can’t precisely predict who’s going to be suicidal, we don’t know that, but we want to be more thoughtful in our understanding of who is at a greater risk and so understanding the conditions that place people at risk is very important. So, we categorize risk into three buckets, if you will. So there are health risk factors and in that bucket, we put mental health conditions such as depression or PTSD, anxiety disorders. Also in that bucket, we might put chronic pain or head injuries and other health conditions, chronic or serious health conditions. And then also another bucket, we put risk factors in are historical factors, so family history of suicide, family history of mental health conditions, abuse, or previous suicide attempts, loss. That is the bucket where we would put some of our ACEs and traumatic experiences in that historical risk factor bucket.
Billy: When we did our presentation on the Samaritans research, they actually talked about one way that we can support the fight against suicide is by providing training and permission for general practitioners to ask questions like that so that they can get that kind of support, so that they can identify those risk factors. I love that you make that comparison between you go in for a physical checkup, you can go in for a mental checkup too, why not provide general practitioners with some sort of training around asking those questions just like they would with just a regular physical checkup.
Tandra: Exactly, and so that’s what Project 2025 is trying to do. So you got to connect us with Samaritans first, because we want to know what folks are doing, health systems, primary care, mental health care, what they’re doing around suicide prevention because there are tools, there are best practices, there are guides to help health systems move in that direction to really make suicide prevention a key component of health care, which is part of the National Patient Safety goal. It is part of the best practices and we’re trying to help equip healthcare systems with the tools and the resources they need to save lives. So thank you and that was a connection that we can make through your podcast, look at you. You’re kicking stigma’s butt, you’re doing all kinds of things with your podcast.
Billy: Yeah, I’ll share that research with you. I think you might find that interesting.
Tandra: So we had the health factors bucket, the historical bucket, and then there’s the environmental bucket for risk factors and that includes things such as access to lethal means, prolonged stress, stressful life events, and then exposure to suicide or contagion impact. So those are risk factors. And risk factors are different, important to understand but different from warning signs. Warning signs, I really think of warning signs as those immediate things that are happening in the moment or over a period of time, those observable things that alert you that there is a crisis brewing, that that person, to use your word, is unwell. And you see those warning signs in three buckets, if you will. I don’t know why I’m using a bucket analogy tonight but buckets, right? We’ll stay with it. And we see it in what people say, so in their talk, in their mood, and in their behavior. So what they say, so they may say things like they’re feeling trapped or they’re feeling like a burden, they even may say that they want to die or they don’t want to be here anymore. So we’re listening for that. Their behavior, so maybe we’ve seen over time that they’re engaging in more risky behaviors or they’re isolating from family and friends or they’re sleeping too much or not enough or they’re acting recklessly or they’re eating more or less or they’re giving things away so we start to see changes in their behavior that are unlike them as you know them. Those things that we’re like, “Hmm, there’s something going on, there’s something different that I’m noticing.” So changes in their talk, changes in their behavior, and, lastly and equally as important, changes in their mood. Again, changes in that person as you know him or her. So maybe they’re sad, maybe they’re angry, maybe they’re feeling more anxious or humiliated or more irritable. And so if you see changes in their talk or their behavior or their mood that are concerning to you, those things are what we consider warning signs and can alert you that the person is struggling. It doesn’t necessarily mean that they’re suicidal, but as you use earlier in our discussion, that they may be unwell and that there is an opportunity for you to reach out and to identify that you’re noticing some things and you want to check in with them and see if they’re okay.
Billy: What do you say them to the parent that doesn’t know the difference between their teenager just being moody and these warning signs?
Tandra: And sometimes, we write that off as just teenage angst, or we say things like, “Boys will be boys,” or, “Girls are just moody. They’re just…” and we can’t do that. We shouldn’t even be doing the terrible twos, like when people say that, I’m like, no, no. So I think that we have to, and I know this is going to sound, I don’t know how it’s going to sound, I’m just going to say it, like we have to be educated. I was having a conversation with a parent and I said what if parents were just as educated about knowing mental health conditions and things we need to watch out for as we are about the immunization schedule. Your child is going to sixth grade and they need this, this, and this. Your child is going into sixth grade, be watching out for these behaviors. Your child is thinking these things, they might be — like what if that was a part of our education as parents? I think that if our system of care and I think it’s everybody, I mean, yes, it’s up to us as parents to do this but our healthcare system plays a role too. At our well child visits, we should be having these conversations with our pediatricians. It should be provided in our schools so that we know what to look for so that we can understand that, yes, there are some changes that we can expect as our children go through puberty, but then what’s the difference between that and something that might be a little bit more serious? And then even if they’re going through puberty, for some kids, going through puberty might be a trigger for depression, clinical depression, like those life changes, because we know that mental health conditions are health conditions, and then life and loss, we talked about ACEs, the things that happen in our life, affect us and now the child is at puberty and the body changes and the hormones are changing and it could be something that that child needs to see a mental health professional and have an evaluation by a professional to determine what is normal adolescent development that still may require support and what might indicate that they might need something additional, maybe some therapy, maybe some group, maybe some medication to help your child be their best and be successful.
Brian: Everything you’re saying, just framing it that way as a health issue, it makes so much sense to me that it kind of almost makes me mad that we don’t already do this already, you know what I mean?
Tandra: Let’s get angry. Let’s get mad and demand more. Absolutely. That is why I’m doing this word because it’s so simple that we should demand more —
Tandra: — from ourselves, from our systems of care, from our schools. It is a health issue. And the reason we don’t do that, we don’t see it as that, is I know, the stigma, okay, but come on. We have enough research to tell us that it is. So what are we as a society going to do to move the needle?
Billy: Do you have an outline as to what that mental health immunization chart would look like? So you get your shot chart, so what does the mental health immunization, I can’t even say that, immune—
Billy: Thank you. Yeah, leave it to the parent to get it out. What would that look like then? Is it just having conversations, checking in regularly with a mental health provider or we get to the point where general practitioners can have that conversation at the yearly checkup for four-, five-, six-, seven-, ten-year-old children?
Tandra: Well, you know, Billy, that idea just popped in my head so maybe it’s something you and I can work on.
Billy: I’m good with that.
Tandra: Let’s not air all that on the podcast. I don’t want anybody taking that idea —
Billy: All right, that sounds good. That sounds good. I’ve got the next 15 months off so —
Tandra: We can work on that.
Billy: Yes, we can. That sounds wonderful.
Tandra: Because what you said was a great idea.
Billy: Well, thank you. Thank you. Yes, we’re crushing it tonight, Brian. We are rushing yet. Thank you. I think Tandra is bringing out the best in us.
Brian: I give the credit to our guest, really.
Billy: I think she’s bringing out the best in us. So in our conversation that we had with Dr. Yvette Erasmus, she talked about reframing the question, “What’s wrong?” to, “How can I help you?” or, “What do you need for me in this moment?” and so what advice do you give to parents around approaching the topic of mental health with their own children? Is there a right age to have that conversation just like we talked about a second ago here? What should parents be on the lookout for?
Tandra: As a mother of a son who has ADHD, I’m always searching for ways to make sure that I am connecting with him and making sure that I’m checking in with his needs and understanding his experiences. And one of the things that was genius, and I didn’t come up with it, I heard it somewhere else, but I started asking him, “What does your brain need?”
Billy: Oh, I like that.
Billy: I like that.
Tandra: Right? And when I first said it to him, he gave me this look like, “What?” because it takes it off of like, “What do you need?” he’s ten, to thinking about his brain, and, for me, it helps connect him and he said this, he said, “Mommy, when you asked me what my brain needs, I know that my brain is responsible for like how I act and my feelings,” and so it helped him to be able to say what his brain needed and not blame himself. Like, “My brain needs rest, my brain needs time to chill out, my brain needs to calm down.” Isn’t that powerful?
Brian: Really is.
Billy: That’s awesome.
Tandra: And you can do that with a two-year-old or a 20-year-old.
Brian: I’m stealing that. I’m trying it with my kids tonight.
Tandra: Yes, yes. And you explain to them that your brain, going back to that definition of mental health, mental health has to do with how we think, how we feel, and what we do, how we behave, how we interact with one another, how we show up at work, at school, with our friends, and so our brain is responsible for helping us do those things. And so when we’re off, something’s going on in our brain and our brain needs something. Brain might need sleep, might need food, might need a break, but the brain actually helps us to be able to function. It was genius. It was a game changer. So I would add to — I can’t remember the expert’s name —
Billy: Dr. Yvette Erasmus, yeah.
Tandra: I would add to that, “What does your brain need?” and parents having that discussion and I would tell parents, other adults that work with you to trust your gut. If you think your child or someone else is struggling, reach out to them in private, be honest, and say, “You know what, this is hard for me but I am concerned about you. I care about you. Are you okay?” I’ve noticed you haven’t been feeling well or you’ve not been wanting to be around the family.” I was part of a, and I told this pastor I was going to steal this. He had a conference for — May is mental health month and he asked me to participate in the conversation. First of all, let me tell you the title of the segment, it was Prayer and Prozac.
Billy: One or the other. If prayer doesn’t work, get that Prozac.
Tandra: Right, it was Prayer and Prozac, and I was like, “Oh my goodness, I cannot say no to this. It was Prayer and Prozac,” because, very honestly, in the black church, you hear, and that’s a whole other topic, but you hear like, “Well, you just don’t have enough faith, pray about it,” and there can be some stigma around seeking help outside the church and taking medication and that —
Brian: Oh, sure.
Tandra: All of that, but it was it was Prayer and Prozac but his conference, his title of his conference was You Good?
Billy: Oh, I like that.
Tandra: So I stole that so I say to my boys, because I’m a mama and men communicate a little differently and so I play around with my boys and they’re not girls and I know I’m being stereotypical so I don’t want your show to get any letters and notes about this.
Billy: Don’t worry, we already have. We did a whole series on the male brain and the female brain and —
Tandra: Oh, so you got a lot. So I’ll just say this, the way Tandra communicates is very differently than the way her sons communicate and want to communicate. And so I’m always trying to figure out the best way to communicate with my sons that actually gets through to them. And so I started saying, “You good?” and I’ll make funny noises, I’ll change voices, I’m like, “You good? You good? You sure you good? You good? You good?” and they’re like, “Mommy, please—
Brian: I love it.
Tandra: And then I’ll say, “Are you sure? You good? You good. You good? You’re good?” and I’m joking but I’m also checking in on them and it’s not this — like I want them to know are you good and if not, that’s okay. So finding what works for you and your family is so very important. Normalizing the feelings, my kids will hear me say, “My brain needs a nap. I’m gonna go take a nap, my brain is tired.” I use those words so that they get used to hearing it. And, look, the timing doesn’t have to be perfect. I’ll give this example and I know that we’re wrapping up but a couple of weeks ago, my youngest son, and I didn’t know this, was having a hard day. Three things happened in that day. I got a call from the nurse at school, he never goes to the nurse, the nurse said he came to the nurse’s office, complained of a headache, and she let him lay down and he told the nurse that he was tired. She let him lay down, turned the light out, and then she proceeded to tell me that it’s important for him to get eight to nine hours of sleep a night. It made me feel like a bad parent and I was like, “I know this,” and she’s like, “Well, he said he was tired so please make sure he gets enough rest.” I’m like, okay, after feeling like a bad parent. The second thing that happened was he plays flag football, the coach texted me and said, “Hey, I’m just checking on Matt. He said he wasn’t having a good day.” That’s what he told his coach. Kudos to his coach.
Tandra: He didn’t tell his coach anything else, he just — coach saw something, they had a conversation and he said, “I’m not having a good day,” and the coach had mind enough to say, “Let me just reach out to the parents to see if there’s something that they should know about.”
Brian: That’s fantastic.
Tandra: So I put call from the nurse, the coach, and then the third thing is around dinnertime, he was very tearful and I was observing an interaction between he and his dad and he was very tearful and so I put those three things together and I’m observing him and I said in my brain, “He’s not having a good day. There’s something going on.” But two of the three things were other people reaching out. Do you see the power in that?
Tandra: And so that next morning before he went to school, I let him go to sleep, that next morning, I went in his room and I said, “Hey, what was yesterday about?” and he said, “Mommy, I did not have a good day,” and he started to tell me and I said, “Well, what do you think it was?” and he said, “I was tired,” and I said, “Really? Well, what do you think you could have done differently?” and he said, “Well, you are always talking about my brain and my brain needing sleep,” and he said, “And I think I need to go to sleep early, earlier,” and I said, “You know, you’re always trying to stay up late but you just learned that when you don’t get a certain amount of sleep, your brain doesn’t function at its best. Now, do you want your brain functioning like that or do you want your brain functioning at its best?” and he said, “I want my brain functioning at its best.” That’s invaluable for him to learn that and it warms my heart as a mother that adults around him reached out.
Billy: I’ve asked that that question, “You good?” to many a student and the number of students that, like you’ll see them tear up just at the question, “You good?” because somebody asked them and they know that if they open up about it, the floodgates are going to open so then when I see that, it’s, “Let’s go into my office right now, let’s get out of this hallway and let’s go and talk about what’s happening,” and we’ll have a conversation and I think it’s important as an educator, I think sometimes students share things that they don’t want their parents to know but then it’s important to ask that question, “Do you want me to let your parents know about this too because they’re gonna be worried about you? They probably already are worried about you and if you don’t think that they’re worried about you, then let’s put it on their radar so that they know to check in with you when you get home.”
Tandra: And, sometimes, I’ve had the experience with young people where I could tell someone was not well and I asked them the question, “You good?” and they were like no, and I said, “Well, do you wanna talk about it?” and they were like no, but was clearly like visibly upset and so respecting the fact that maybe they don’t want to talk to me, I’m okay with that. And so the next question is, “Is there someone else you wanna talk to?” and the person said yes and I said, “Can you tell me who that is? I can go and get that person,” and I was able to connect them with that person so that they got to the person that they felt comfortable talking to. Also reassuring them is important when they find it hard to talk, because kids don’t want to disappoint the adults in their life and they want to feel safe. Sometimes, they feel like they’re the only ones going through it and people won’t understand. And I always tell adults and parents, imagine how you felt — I mean, when I was a teenager, I felt like my parents didn’t understand anything that I was going through. It’s just the furthest thing, and I wish that they would and so I promised myself even before I had children that I want to be the parent, not that my parents, they were not awful, they were not, they were great parents, but I remember how I felt as a teenager and so I tried to give my children the things that I wish, those little things that I wished my parents gave me that they didn’t know how to give because I wanted to have those things and with the hopes that that will help improve my parenting, that I’m a better parent at that, so it’s important, and AFSP has a guide to have a real convo, how to start, continue the conversation. It’s so very important to reach out, to trust your gut, to check in, and it’s also important as parents and adults to take care of ourselves. That’s a lot. It’s a lot to carry your children or your friends or your neighbors’ emotional stuff. And so we have to make sure that we engage in self-care, whatever that looks like for us.
Billy: So we wanted to get you out on that. What are some self-care strategies that you would suggest to parents, that you would suggest to teenagers to explore so that they can feel mentally well?
Tandra: Well, the first thing I would say is that prioritizing your mental health is the first thing. Prioritizing your mental health, so that means that if you are unsure if your child has a mental health condition that you are scheduling an appointment with a health care provider for an evaluation, you are prioritizing that. That’s the first thing. Self-care, we have to prioritize our mental health. If we think that we have a mental health condition, we have to prioritize our mental health. Get an evaluation by a mental health professional, find a group, a support group, they’re out there. If it’s recommended that you get some therapy, get some therapy, some talk therapy, some art therapy, some dance therapy, there are all different types of therapy. And if it is recommended that you get medication, remember, mental health conditions are health conditions. Let’s have a conversation. Have a conversation with your healthcare provider about the medication. Have a conversation about that. These are health conditions and if that’s recommended, consider it. Seriously consider it, just like you will consider medication for any other health condition. So prioritizing your mental health is the first thing. Also, I think that self-care looks different for everybody and I encourage people, when you’re thinking about wellness, there’s so many dimensions. A lot of people think of physical wellness, like get out there and exercise and, yeah, eat right and eat healthy, and those are very important things, but it may be growing a garden. I did try that during COVID and it didn’t work out.
Brian: I’m not good with plants either.
Tandra: Wait, wait. So, let me tell you what I did. I’m so bad. So I was like, okay, so I can’t grow — I cook with herbs and I couldn’t grow them and they die so I just buy them fresh from the market but I really wanted a nice herb garden and I get jealous of my friend who has this like — she’s like, “Basil, everybody. Look at the basil in my garden,” and I’m just like whatever. So I was like I’m over that and then I said, “Oh, certainly I can’t kill succulents,” So there’s this succulent of the month so I’m telling you, I’m looking at the succulents that are on my deck out here that are dying.
Billy: Brian and I were just having this conversation because his plants in his office are dying and I was talking about how I’ve actually killed a cactus and Brian has an app. What’s that app?
Brian: It’s called Plantin, P-L-A-N-T-I-N, so you can take a picture of the plant and it’ll tell you what it needs, apparently, I haven’t explored it —
Tandra: Well, apparently, that’s not my forte. So we’re talking about self-care. I thought that that was going to be self-care but it’s more frustrating so I cancelled the succulent of the month —
Billy: But recognizing that is self-care.
Tandra: So I think that what I’m saying is the lesson in all that is try some stuff. Try some stuff. I enjoy cooking so cooking is self-care for me. I’ve done silly things with my children, having a dance party, they tell me never to do that in public and to stop but it’s funny. I laugh, and laughter is self-care. I took improv classes to laugh and to learn strategies to make other people laugh. So finding what works for you and what you enjoy is self-care and making sure that you engage in it consistently. And I love hearing what other people do and I sometimes steal what they do and try it and see if it works for me.
Billy: I will tell you that having a conversation with you is self-care for us.
Brian: Yes, thank you.
Billy: So we want to thank you so much for taking the time to meet with us and we look forward to Part 2 of our conversation, which will air next week. Tandra will be back on to talk about parenting a child with ADHD. We cannot wait to have that conversation with you. Thank you again for meeting with us today. You have been just a wonderful resource and we will share all of our resources with you and if you want to share your resources with us and then you and I will join forces to come up with the mental health immunization chart and I will learn how to pronounce that word before then.
Brian: Let’s kick stigma’s butt.
Billy: That’s right. We are kicking stigma’s butt. Thank you so much. What a wonderful conversation this has been. For Brian, this is Billy, thank you for listening to The Mindful Midlife Crisis. May you feel happy, healthy, and loved. Take care, friends.