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Tuesday, December 30, 2008

Depression in the Frum Community

With special thanks to AlanLaz for pointing out the follow-up to the story to me, and to many friends, family, and others for all they've shared over the years.

A young man from Toronto, studying in Ner Israel Rabbinical College (Ner Yisroel) in Baltimore, died yesterday. He was 24 years old; married; and according to all those who knew him, an incredibly wonderful young man.

According to the policeman who witnessed the event, he died when he jumped off the Millard E. Tydings Memorial Bridge on I-95 into the Susquehanna River.

This post is not to talk about his tragic death, but the immediate aftermath. Nearly every Jewish website that reported on the story claimed at the time that the young man had been in a one car crash on the windy bridge and been thrown from his vehicle into the water.*

Phil Jacobs of the Baltimore Jewish Times says it perfectly, and please read his whole piece, as it's so important:
What concerned me the most was the initial public comment that this couldn’t possibly have been a suicide, that it was an accident.
What concerns me is this propensity to cover up.
Because what this does is it discourages others who could be suffering from chronic depression from seeking help. No, not the help that their rav can give them, but the help that a licensed clinical social worker, psychologist or psychiatrist could help them with. Or stated differently, the best help the rav could give a troubled soul is a referral to a trained professional.
It is one thing to be sad, but quite another to be depressed. It is one thing to say, “I feel like killing myself,” but it’s quite another to actually find that dark place where a realization that this is “for keeps” still isn’t enough to stop one from ending his life.
There is such a daunting list of reasons why a person living in an insular life wouldn’t seek treatment. I guess going to a “shrink” could end up impacting a relative’s shidduch (dating ability). I guess getting psychological help carries with it a stigma that connects to words such as “weakness” or “instability.”
But then there is the possibility of our old friend arrogance holding power over accountability. If this was, indeed, a suicide, I fear that it was arrogance taking a troubled soul away from us. It’s the same cover, the same hurt that keeps some of us from asking for help we desperately need for ourselves or our loved ones who have been sexually molested, verbally or physically assaulted.
Our rabbis can offer up Rashi or Rambam. But we some need are therapy and yes even medications. That’s not a weakness, that’s a strength that makes sense.
Look around your table this Shabbos. How many people are there? 4? 8? Statistically, slightly over one in four people in this country suffer (about 58 million) from a diagnosable mental disorder in a given year. This rate is not lower in the Orthodox Jewish community. The odds are that around a given Shabbos table, either the person sitting on your right, on your left, across from you, or you yourself, suffer from something like depression**.

I still recall a meal we had once at someone else's house, with a number of others. It might have been a simcha of some sort, I can't recall. The topic of depression came up, and one close friend spoke out against the stigmatizing of it, noting the number just cited of 1 in 4, and then raised their hand stating openly, "Hey, I suffer from depression. I'm also doing what I can to take care of it properly." This was in front of their spouse, family members, and friends. Nobody in the family even blinked - for them, this wasn't a stigma, or "shameful". It was part of life - as with anything, you find someone who can help you and you work at it, whether with therapy, medication, exercise, or something else. I thought this was incredible, and something that is sorely lacking among far too many of us. We stigmatize so much - why? Wouldn't it be better for everyone if all those who needed help felt comfortable seeking it?

A large part of our automatic stigmatizing seems to come from lack of education and fear. We don't understand things like depression, so we're scared of it. Some people think that if someone is depressed they must be somehow "dangerous". Others think that if someone is considered depressed, they must be unhappy, and "who would want to be married to such a person". Sometimes people seem to think that it's "difficult" to deal with someone who suffers from depression. Well, maybe it can be sometimes, and certainly not everyone is equipped to deal with someone who is. Then again, after 4-1/2 years [today!], Serach will tell you that I'm pretty difficult sometimes, and I don't suffer from any mental disorders that I am aware of, and I'm sure that not everyone would be a good match for me, either. (This brings to mind this excellent old post by Pobody's Nerfect - read through the comments.) There's a profound lack of knowledge about depression and an amazing amount of misinformation. I know that I have been corrected many times in the past, and surely I still have much to learn - despite many conversations and having read plenty of material on the subject. The more we know, the easier it is to understand, help, and avoid these stigmas.

I don't know where I'm going with this, but I guess it's to repeat what Mr. Jacobs is emphasizing in his article. We need to stop stigmatizing mental illnesses, we need to be encouraging to each other who need it to seek the help they need.
Mental illness needs the same sort of tender loving care. It is not intangible, it hurts. Depression has physical pain in many instances connected to it. It shouldn’t be treated with shame nor embarrassment. Because if it is treated as a stigma, more “amazing, kind, gentle learned men,” could look for bridges to stop their pain instead of seeking our help.

And that cannot be.
* For what it's worth, VIN has since apologized and corrected the story; YeshivaWorld has not.
** I'm picking depression only because it's more common and I'm most familiar with it.

51 comments:

  1. this is a good time to give a plug for the new Depression & Judaism blog, Borei Hoshech.

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  2. I absolutely agree with you.
    My husband and I both take medication for depression, and had serious trouble getting a decent shidduch as a result. I know many people who were told to lie about this in potential shidduchim.

    I cannot tell you how many people told me during my bad times "well, just pull yourself out of it!" It would be lovely if it worked that way, but it doesn't.

    Depression is caused by a problem with neurotransmitters in the brain, not by lack of trying, bitachon, etc.

    Then again, there are stigmas on any disease in our community. People hide diabetes too.

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  3. I agree that we can't push the underlying issues under the rug, so to speak, and that awareness is key.

    That said, I really don't think it's a bad thing that the news sites covered up. There is no reason everyone has to know that a particular incident was a suicide, especially through such a public venue as an internet news source.
    I know someone who was in a similar situation and the family went through a double hell afterward -- not only did they have to deal with the loss of their family member under such tragic circumstances, but they also had to hear (both directly -!!! - and indirectly) everyone's speculation about what happened and why. Their family was very deeply scarred by the publicity generated. Some of the things I heard people say were just unbelievably cruel.
    Furthermore, I would have to double-check this, but I remember learning that people at risk for suicidality are more likely to consider or commit suicide the more they hear about it. Some people will be preoccupied with these thoughts regardless, but others might not think of it as such a realistic option until they hear about someone else, particularly someone they know or can relate to, who did it. This is why you very often see suicides coming in clusters -- the same community losing several members around the same age in the same year, for instance. It's not coincidental. So maybe it's not such a great idea to put it in the headlines.

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  4. i think intuitively, for good or for bad, we all have an initial reaction- "it can't be." this is b/c we don't really understand what depression etc. is- we think those of us (B"H) who are not inflicted with it- that it's easily over come- just be happy or something silly like that. we don't fully understand that a trained professional is really needed.

    that said- let's say we would have heard that this young man C"V had a heart attack while driving. would any of us have the slightest feeling of denial? no- so what's the difference if hashem took this young man away via a machla in the guf, or in the nefesh? R"L hashem gave this man a machla- why is that any worse than a physical ailment?

    i would like to say about phil jacobs- while i like him and have had to do with him and agree with his viewpoints, i just don't see the connection b/w molestation (which is taboo in the frum community) and this. the connection, cover up- is too large an umbrella in my mind.

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  5. Steg - Yiasher Kochacha.

    Trilcat - Funny, I think diabetes is discussed in that old post. Good comment, thanks.

    Bas~Melech - I'm not objecting to their not blasting headlines about it being a suicide. I think Baltimore Jewish, for example, covered it perfectly, by stating simply that there was a tragic death, and here is the funeral information.

    It's that the other sites used completely false stories to cover it up, because to even give off any other impression would be a horrible thing. This creates/strengthens a major stigma. Even now, after all the reports, you see comment after comment on VIN going back and forth, with people making up truly outrageous stories to avoid it being the same story as was reported in the news, just because of this very stigma.

    I know someone who was in a similar situation and the family went through a double hell afterward -- not only did they have to deal with the loss of their family member under such tragic circumstances, but they also had to hear (both directly -!!! - and indirectly) everyone's speculation about what happened and why. Their family was very deeply scarred by the publicity generated. Some of the things I heard people say were just unbelievably cruel.

    I do understand that, and hence hesitated with this post. I left out the name for that reason as well. I *would* say that I think a straightforward approach from the get-go would avoid much of the publicity - people ask/say (for example at shiva) "Oh, such a tragedy, that place is so dangerous, they should do something about it" or ask questions about "What happened? Do they know how it happened?" and that probably causes a lot more talking and awkwardness. If people simply knew, they could avoid those topics and talk about the person's life and contributions, which they should anyway.

    I'd also tend to think you're right about the clusters in general, but I don't think that that's limited to depression/suicide and I don't think that that's a reason not to discuss things because of it.

    Good comment, thank you.

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  6. NYF - we don't fully understand that a trained professional is really needed.

    Is that true even now? I think people recognize it enough for it to be a stigma, but maybe think that their family member or whomever is the exception who won't need it, etc.? I don't know.

    R"L hashem gave this man a machla- why is that any worse than a physical ailment?

    Well put, thank you.

    i just don't see the connection b/w molestation (which is taboo in the frum community) and this. the connection, cover up- is too large an umbrella in my mind.

    I don't think he meant a connection per se, but rather a similar communal attitude of downplaying issues and their existence in the frum community for fear of how it reflects within the community itself.

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  7. You left out the name, but everyone can read the original story.

    The incident I referred to was very straightforward. It was public and publicized as such. YOU WISH people were sensitive enough to even avoid the subject... never mind talk about the person's contributions! In the very hall of the shiva house, people were making comments about whether they should have been sitting shiva at all, etc. It was disgusting. People need to learn to mind their own business (I am not talking about people who care because they can help. I am talking about the busybodies.)

    I don't know about any outrageous fabricated stories. As far as I recall, the place I read about it said something like "Mr. ____ was tragically killed while driving on the whatever highway" or something. Might be a stretch of the truth but a fairly safe one -- traffic accidents do happen, unfortunately. Better to have people speculate about that than to have them diagnose the entire extended family with manic depression or something, and then start talking about how it's all because of how he was raised, or his rebbeim, and what medication he was on or wasn't, and how the family should have done this or that, and how "I just KNEW there was something 'off' about him" and....

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  8. Bas-Melech, you're right - it's best if people just pay their respects and offer their sympathies regardless of the cause of death.

    However, these other things that happen are caused by the community's refusal to deal with the issues.

    If someone committed suicide, then concerned friends visiting the shiva house should say the same things you'd say in any tragic situation - that they should be comforted among the mourners of Zion and you wish them no more sorrow.

    Moreover, the rabbis have repeatedly said that suicides should be treated like any other accidental death, because the person may well have regretted it in their final moment.

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  9. I'm sorry but in my rarely hmble and currently pissed off opinion there was no reason in this case to publicize what happened.

    Not every case is one of a cover up, sometimes there are actually valid reasons to keep things quiet at the beginning and people should not be so arrogant as to think that they know everything and have the the right view of all the balls in play.

    Sometimes we can pray too much at the temple of the truth is always the best way to go at all times and in all situations...to me that is a fools stance.

    Someone wants to write a piece about depression in the Jewish community - great, more power to you and there is certainly no lack of cases from which to draw...this one should have been and should be left alone for now.

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  10. * For what it's worth, VIN has since apologized and corrected the story;

    Bully for them...toward what end?, that apology is one of the coldest things i've read in a long time.

    YeshivaWorld has not.

    Good on 'em, the right call regardless of their reasoning (and I expressed as much in an e-mail to their editor)

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  11. BasMelech, if there was a question of what actually happened, why did the Jewish news sites have to cover it at all? Does every death (even of a young person) have to show up on these sites? Are we all such busybodies?

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  12. R"L hashem gave this man a machla- why is that any worse than a physical ailment?

    I don't mean to pick on you, nyfunnyman, because you're attitude is certainly a good one, but this comment is actually more harmful than you realize.

    Depression and any other mental illness IS a physical ailment. It is the result of a chemical imbalance in the brain, whether it's Serotonin (depression) or other brain chemicals and/or hormones, there are actual, physical explanations for mental illness. There's no spiritual or non-physical aspect to it just because it happens in the brain.

    This is what bothers me. People have attached a stigma to psychopharmaceuticals which is completely unfair. Would you tell a diabetic not to take insulin? To "get over it" or control himself with willpower, or "snap out of it"? If you would, you are an ignorant, heartless idiot. So why would tell those things to someone who has depression due to low serotinin levels instead of acknowledging that serotonin reuptake inhibitors, like Prozac for example, might help? They are the equivalent of insulin for a diabetic.

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  13. B~M - You left out the name, but everyone can read the original story.

    True, which is why I keep debating whether to take out the links. I thought it wouldn't make sense without them, so I left them in. Not sure about that, though.

    People need to learn to mind their own business (I am not talking about people who care because they can help. I am talking about the busybodies.)

    Agreed.

    As to the rest... I think that's part of it. I agree that the original stories should have been simple: A tragic death occurred, the funeral is ___. Once they did not, however, and then the real story comes out in contrast, it ends up talked about more. As for people writing off the whole family... isn't that just it? Isn't the problem that people don't know enough and start making things up? Shouldn't we be correcting this?

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  14. G - Agreed that not every case is a cover up, and as noted above, I don't think this was a "cover up". And also agreed that we don't always need to be about getting out the truth; as my old boss once said, "Discretion is the better part of valor." (I'll come back to this soon.)

    Re: VIN/YW - I hear you on those, didn't think of it that way. Fair points.

    Noyam - I think that's the point NYF was making; why is it considered *worse* than any physical ailment, when it shouldn't be?

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  15. Bas~Melech, G, et al - The following is an email response I sent to someone who raised similar points to what you have. I'm not taking away from the points, which I think are valid, and the response was tailored to their e-mail, not what you have all raised, so please read it in that fashion. I'm also editing out certain details, and as I do so, I notice it makes my response slightly less clear and not as logical. For that I apologize in advance.

    ~~~~~~~

    I don't know about others, but certainly the intention here was to make a point about depression. As noted in the post, many close friends and acquaintances suffer from depression or similar, and thankfully, most of them seek the help they need. On the other hand, most are not able to be open about it - they are stigmatized if they'd dare say a word.

    The post is not about the young man, which is why I left his name out. I considered leaving the links out as well, but decided that it wouldn't make sense to do so, though I keep reconsidering it.

    Certainly at this point I think it's very hard to say that the fake story will protect the family from any pain. It seems as if the natural has occurred - when one story is told first, and then the other story is told, it ends up being talked about more.

    Someone I know attended a shiva a few months ago of a friend's husband, who had suddenly died of a heart attack at a very young age. In truth, he died of something else. The story of a heart attack there made far more sense, IMHO. In this case, blocking the true story furthers the same problems that exist already, which is a stigmatization of depression. Personally, I think the news reports should have just stated that he died tragically and that's it. By concocting a false story, it made it far more talked about.

    With regards to the specific post, I would say that it should be looked at in the following manner: People who are merely curious, or busybodies, etc. will be Googling his name and hitting the Baltimore Sun story, followed by Yeshiva World, VIN, and the BJT piece. They won't be hitting this post. This post is directed at readers here, and instead of being just about what happened, or about coverups, it's about what we can actually take from something horrible to try and prevent them from happening. It's not comfortable, and it's why I debated posting, then emailed back and forth with someone who'd attended the levaya about it. That person [understandably] didn't want to say what to do when I asked if I should pull it. I'm still not sure, but the more reactions I'm getting, the more I think it should be up there as it is (though again, I keep debating the links).

    From the get go, I think I'd have agreed with you. There's no reason to say anything more than a tragedy happened. To create false stories, however, tends to come back to bite, and furthers stigmas. Once the real story came out, I thought it better to beat back the stigma and try and do something for the future.

    I should make one small addition: While I was composing this last night, and checking how I was putting everything and making sure this made sense, I saw that another blog had it up as well. That blog does not do "delicate", and does not try to make positive out of anything. I'd much rather people get something out of my post then take something from that blog if they're going to be interested in the story.

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  16. What bothers me so much is this consistent knee-jerk reaction from the Lakewood/Baltimore type communities to deny every single tory like this. It doesn't matter if it's rape, spusal abuse, child abuse, secial molestation or suicide. Whenever a story like this comes out they rush to deny it's true.

    I've got news for people. IT'S TRUE. Especially this one, a cop saw the man jump off the bridge. What POSSIBLE REASON would this random cop have to lie about something like this?

    But they think there is some sort of glory in covering it up, like a WASP family trying to make everyone think life is perfect and we all live in these Little House on the Prairie worlds.

    Just like he said in his article and I wrote on my blog. It's not just important, it's life or death that we get it out that, YES it does happen and YES ther eis help for it. Whether medication or therepy. People can be very inward and just because the "look" happy, doesn't mean they don't need help.

    But when we pretend it doesnt happen, they think there is no where to turn and they only have one option.

    It's not pretty, and it's not something anyone LIKES to talk about, but don't turn your head because it makes you sad. Speak up, get involved and be part of the solution.

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  17. Right cause this is the same as cases of rape, spusal abuse, child abuse, secial molestation.

    In all those cases there is a very real victim who continues to suffer by not bringing things to light that woud be to their benefit...how does that apply here?

    He is gone and there are very real people who could be impacted very negatively in our alrtristic search for "THE TRUTH". Get over it, this all about gossip and curiosity not about helping people. Nobody is hurt in the short term by leaving it alone and the same cannot be said of the reverse.

    Like i said above - you want to write an article, go write one. You want to talk about the topic - go talk about it. What does that have to do with this case in the here and now. There will be plenty of time for all of this later, right now it serves no positive function.

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  18. You are saying things that I addressed, multiple times here and in my blog.

    If you DID read my post or my above comment, then you did NOT take anything I wrote to heart or seriously gave it thought. Because otherwise, even if you STILL disagreed with me, you'd have the answers to the statements you asked.

    Let me say this again, and I'll try to make it as simple as possible.

    There is a BIG benefit, and yes, a POSITIVE benefit from discussing this issue while it is FRESH in peoples minds. In 4 months people will forget and they will be yapping about whatever is happening in 4 months.

    THIS IS THE EXACT TIME FOR DISCUSSION.

    I am not COMPARING suicide to rape or molestation. I am comparing the RESPONSES to all these things by the frum community.

    You can't just ignore bad things away. You can't pretend they don't happen because they are sad. THESE ARE VERY REAL AND SERIOUS ISSUES.

    Are you more worried about the family this guy is leaving behind (alive) or the countless more Jewish souls that will take their lives because they felt alone and helpless because so many people ignore that this happens and they feel like there is no where to turn to and jump off a bridge.

    You are doing a disservice to the memory of this person and all the other people who are hurt because of mass cover ups of touchy subjects.

    It's the same reason a kid is molested as a teenager by some perverted yeshiva teacher and because he knows he'lll get ruined if he talks he keeps it inside and then fries out, gets kicked out of yeshiva, stops keeping kosher and shabbos and ends up who knows where.

    We need to stop closing our eyes and looking down at the floor. It's time to take these issues seriously and part of that means changing our approach (your approach) and doing things different. because the way things are right now are terrible and not helping and causing people to feel like there is no where to turn.

    I got news for you, Lakewood aint Pleasentville. Bad stuff happens in this world and if we ignore it we all pay the price.

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  19. That person [understandably] didn't want to say what to do when I asked if I should pull it. I'm still not sure, but the more reactions I'm getting, the more I think it should be up there as it is

    I don't know if I really have much right to an opinion on this because I don't even know who this person was, but from a totally objective (in this particular situation) point of view, I think this is a super important post. Like...really really really important. I'm glad you didn't take it down and I don't think you should.

    In all those cases there is a very real victim who continues to suffer by not bringing things to light that woud be to their benefit...how does that apply here?

    There are victims who continue to suffer in this, too. Like people who really should be getting help and aren't. They are victims of their own depression. Also friends and family members of people who suffer from depression should know that it's not something to take lightly or ignore or brush off. Real stories, as painful and uncomfortable as they are, are what make an impact and make people aware of the seriousness of this issue, especially if they should be dealing with it and aren't, more than theoretical pieces about the subject.

    That's the difference between this post and a post that is just a news story about what happened. It doesn't matter, for the purposes of this post (or any post like it) who the person was or all the details of what happened. Just the incident itself is important.

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  20. Erachet, you're absolutely right. This is one of the reasons that I try to be open about my depression, even if it makes some people uncomfortable and even if some people, including people in my immediate family, see me as inadequate because I can't live a "normal" life without medication.

    Only by being open can we de-stigmatize and find solutions for people who suffer from depression or other psychiatric problems.

    my personal approach is...
    True happiness doesn't come from the people around you. True happiness comes from chemicals in your brain.

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  21. i apologize for my ignorance regarding the fact that depression and the like are mental illnesses. i don't claim to be a trained professional, and would certainly never ever be in the "snap out of it" camp. i am extremely extremely close to 2 people who are battling these issues and understand that i am not equipped to deal with them and also understand the seriousness of the illnesses. my only shortcoming was not considering them physical ailments.

    additionally, there clearly is a difference b/w mental illnesses (which are physical..)and strictly physical ones in that although the mental illness is CAUSED by a physical imbalance, it does not always manifest itself in a way where it is obvious, like a physical illness. thus, it can be hidden.

    but, as a later commentator pointed out- i was merely asking why it was such a stigma- if hashem gave a physical illness no one would be embarrassed to say so, why a mental one?

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  22. I want to point one thing out here; even though this family has a GOLDEN opportunity to raise awareness from their son's death, they are under no obligation to do so.

    When my wife and I lost our twins at childbirth, we found healing in offering to help others going through the same situation. But I would NEVER question someone who chooses to avoid rehashing the pain over and over again.

    There has not been one time that I have spoken to a couple who R'L lost a baby, or was facing premature birth that I did not fully relive my own horror story.

    The community needs to be respectful. The family can become advocates IF and when they are willing.

    Don't make a poster child out of people who don't want to be.

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  23. I agree with Bas Melech, G, and DAG. I don't think the story should be made public if the family doesn't want it to be. They are entitled to their privacy and while there is what to be learned from their tragedy, it is their right to want to keep it quiet. Like DAG wrote, everyone handles nisyonos differently and it's up to them to determine what to do with their's. DAG--I give you credit for using your nisayon to help others. I lost a child a few months ago and have a very hard time talking about it to people who don't know what we've been through. It's mostly the pity and the awkwardness that make me very uncomfortable so I usually don't bring it up. I admire you for deciding to use your experience to help others. Like you said, not everyone chooses to do so and nobody should be forced to.

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  24. I am sorry to hear about your loss, Almost. The awkwardness and darn right stupid things people say DOES make things challenging.

    One more note, one thing that was clear from the outset in our situation is the difference between people who truly wanted to help us, and people looking for the latest gossip.

    People who cared NEVER asked for information we didn't volunteer, but were open for discussion about anything at ANY time.

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  25. I don't think I have much to say that I haven't already; just wanted to thank everyone for their comments and input.

    DAG - I hear your point, which is why I'm trying not to use the young man specifically, but the example and most importantly the reaction to make the points here.

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  26. I needed a place to vent so I am coming here.

    Perhaps there is a reason we don't talk about suicide. That reason is the high prevalence of copying when suicide is publicized.

    In the pursuit of truth, we need to know all the details. To what end I'm not sure. Perhaps so that when there are a bunch of suicides R"L tomorrow we can point our fingers and act all outraged. What we won't realize is that the fingers of blame should be pointed at us because all the talk leads to more suicides not less.

    Yesterday, nobody was on their bully pulpit about depression. All of a sudden people are concerned about stigma. You have organizations and hotlines and help centers. The "community" has done everything it can about mental illness. You won't take away the stigma of mental illness no matter how many articles get published in Mishpacha and the Hamodia. Mental illness is a scary thing to confront and very easy to deny. That's life. Don't blame the community. Blame life.

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  27. I am deeply disappointed at our community’s reaction in this time of tragedy.

    The Jewish way has always been privacy and modesty. Bilaam praised the Jewish people for setting up their tents so they could not look into the private lives of their neighbor.

    And now, in the name of public health, you are ripping the curtains of privacy from the life of a family. When we go to pay a shiva visit we let the mourner guide us. They must talk first and give us a cue as to how they want us to respond. Here you are forcing them to talk.

    There was an attempt by the family to cover-up the details to give them space and privacy during this dreadful time. The initial story was unbelievable - fine - so you let it go and play along - knowing that you can choose to preserve the family’s dignity so that their rawest pain is not exposed to all before they are ready.

    This private space does not stigmatize mental illness. Rather it allows the family to cope and allows people with mental illness to realize that their dignity will be preserved if they reach out for help. Instead we get this clown show of a parade of opinions about a man, a family, a condition, and a community.

    Everyone keeps comparing mental illness to physical illness. Perhaps we need to actually treat the mentally ill like the physically ill. Doctors draw the curtains before they treat someone in the hospital. There are HIPA laws so that even a person’s spouse and family is not privy to his medical records. When we visit someone in the hospital, we look away when their body isn’t functioning as it should. We do not stare and state that it is normal and natural. We don’t discuss another person’s chemotherapy treatments with strangers nor do we pry for details of medical conditions.

    Why do we think it is okay for hundreds of strangers to be doing this type of prying and staring about a man’s mental illness? Have we lost our sense of shame? Have we lost our dignity?

    Our community has come a long way. We have organizations and articles and public information sessions about mental illness. This was not the time or place to advocate for these changes. This was a time to be silent.

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  29. I agree with the way that BaltimoreJewish phrased this: "We are deeply saddened to report the tragic death of Ner Israel Kollel member Zvi Dovid (Fifi) Zahler. Mr. Zahler was apparently driving from his home in Baltimore to Passaic, New Jersey." Phrase it like this, and you let people figure it out for themselves.

    But don't blatantly lie and say this is a car accident when it wasn't; that's ignoring the problem. And to suggest, as an anon does, that the "community" has done everything possible to deal with depression, is ludicrous. The problem will be eradicated from the community when people cease refraining from admitting their depression et al., in fears that they/their children will have problems with Shidduchim.

    We can't save lives unless we know lives are in danger.

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  30. Who did the cover-up? The family? That is their right. They can try to have privacy and everyone else can look the other way. Talking about suicide doesn't prevent suicides. Don't make them your poster-boys because you have an agenda.

    Your analysis for how to "eradicate" depression is both naive and dangerous. We understand that new cases of cancer cannot be eradicated. We don't assume that chemotherapy will cure all cancer patients. Some will die. Mental illness is NOT going away no matter how much we embrace and support the mentally ill. Mental illness is an ugly, painful reality. This can happen to anyone. Schizophrenia and bipolar can begin at anytime. Convincing someone to take medication or go to therapy for a Mental illness will always be a challenge because people in the throes of mental illness are not always rational and the medication has side effects that dampen life's pleasures.

    I think that the way our community reacted is only heightening the stigma. It is letting everyone know that if they reach out for help or if they falter in any public way, their private life and challenges will be discussed by hundreds of complete strangers. If that doesn't send more people underground I don't know what will.

    Everyone is assuming this man was not on medication or in therapy. Was there a press release to that effect? Because sometimes people who are in treatment will kill themselves. Mental illness is ugly. It destroys families. Let's not pretend there is a magic pill or person that makes the pain magically disappear so easily.

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  31. Chaim should look inward at his own community. If it has the same set of problems, that's where his efforts at improvement should start.

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  32. I'd like to make a couple of points in light of the anonymous comments, which had varied points, some better than others.

    I think, however, that some have misunderstood this post and the point of it, though perhaps this is from frustration upon reading some of the other posts and articles that are out there.

    This post was designed in such a way to make a point about the *community*, not the family. Nobody does or should object to the family wishing to keep this particular incident a private matter. Again - from the get go, any reporting should have honored this as Baltimore Jewish did and simply noted the tragedy and funeral information. (And now back to the point.)

    What the community cannot afford to do is actively lie on a public scale, particularly in light of conflicting [real] news reports that are sure to occur. In the end, what happens is exactly what happened here - more talk, not less. This, and any future such situation, should have remained a private matter as far as the family is concerned and a blank matter as far as the community is. Yes, the details would come out later, but people would understand the choice of quiet on the part of the family.

    This did not happen. Rather, people went over the top in continuing to insist that there was no possible way this was true. This serves no positive purpose, and only further stigmatizes things like depression, by reinforcing that it's too horrible to believe that such a thing could happen, and therefore it must not be true. There is a difference between knowing whether the truth should or should not be told and actually recognizing truth in the first place.

    As for the other points, I think they are bordering on silly. Nobody ever made any claims as to whether this young man was or wasn't on medication or in therapy. Nobody is trying to "eradicate" mental illness - they are trying to make sure that it's treated appropriately. Yes, showing the community is willing to understand and work with mental illness makes it easier for people to seek the help they need, and yes, it may help some of them. Saying that there's no magic pill and it isn't going away simply furthers the likelihood they won't seek out such help, knowing how the community otherwise stigmatizes it. And yes, many people have been working to rid this stigma for a long time, even if it isn't on the forefront every single day. It takes situations such as this - and the reactions to it - that remind us of the issues we face.

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  33. What does halacha dictate? Why do most possible suicides have a regular burial in a regular cemetary?

    I think you need to spend some more time learning get a knowledge base before you open you big mouth. This post is highly inappropriate.

    Also, why can't you consider the possibility of (gasp!) homicide? Is one cop (one non jewish cop who cannot be an eid and one is not an eid in any case) soooo believable that you NEEEEED to post this on the risk of causing tremendous pain to PEOPLE YOU DON'T EVEN KNOW.

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  34. What does halacha dictate? Why do most possible suicides have a regular burial in a regular cemetary?


    Patricia -- Not sure if that was a rhetorical question, but I'll try to answer it anyway for everyone's 411.

    I don't know all the ins and outs, but from what I understand one of the reasons for burial, etc, is the witness issue which you brought up. Another reason is because suicide (by halacha) has to be voluntary and it's possible the person regretted it and did teshuva at the last minute when it was already too late to turn back. Additionally, as has been mentioned elsewhere in this comment thread, suicidality these days is usually caused by a mental illness, which, like a physical illness, is not in one's control whether it takes one's life C"V.

    For all of these reasons, suicides nowadays are rarely considered as such according to halacha.

    This is another reason why I have no problem with the less-than-honest news reports -- I think that reporting a death as a suicide is loshon hara of the highest degree. First, it is probably motzi shem ra because it is not truly considered to be the person's sin of killing himself. Secondly, it is considered likely that he did teshuva at the last minute and you can't talk loshon hara about a person's past sins that they have since atoned for. Third, you can't talk loshon hara about a person who is no longer alive.

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  35. As noted, suicide today is not the halachic suicide of the past.

    For the same reason, calling something a suicide would seemingly not be lashon hara; it's not saying something negative about the person, since suicide today is not like suicide of the past.

    Also, why can't you consider the possibility of (gasp!) homicide? Is one cop (one non jewish cop who cannot be an eid and one is not an eid in any case) soooo believable

    Because I have common sense and work within the realm of reality.

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  36. Because I have common sense and work within the realm of reality.

    Basta! I'll have none of that crazy talk on my watch!

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  37. Ezzie, can you elaborate further on why you think it's not LH to say that someone committed suicide? I actually heard the opposite from a well-renowned posek not long ago. Just because it's not necessarily negative, it still might be something the person wouldn't want publicized and that's enough to render it loshon hora. It can certainly affect the way people think of him, whether that's justified or not.

    If you've clarified this and heard otherwise, I'm interested in hearing the reasoning behind it.

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  38. Uri - I'm not saying it is or is not; just noting the logic there as asked by Patricia and discussed by Bas~Melech. Perhaps the Rav was referring to a halachic suicide in your question.

    Moreover, there would seem to be a clear difference between a normal case and the one here, if that is the question, by virtue of the public nature of it.

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  39. Actually, the case the Rav was referring to was very similar to this one--not a halachic suicide and very public.

    I don't know if this exists in the US but here there's a Shmiras Haloshon hotline that one can call to ask any question regarding Shmiras Haloshon to rabbonim who are specifically trained in these halachos. If there is such a thing there, you might want to make use of their services in the future before posting something that you're not sure about. It's dangerous to just assume that something is okay without being 100% sure and in case you're wrong, you also might be machshil your readers.

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  40. Actually, the case the Rav was referring to was very similar to this one--not a halachic suicide and very public.

    How does that make sense?

    Who was this and what was the psak exactly?

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  41. Why does it not make sense? Just because something is public, it doesn't make it mutar to speak about it. The halachos regarding to apei tlas are quite complex and it actually takes some very rare conditions in order for it to be mutar to pass something on. (I don't consider myself an expert in Shmiras Halashon but I recently heard a shiur specifically on these halachos.)

    The psak was, if I recall correctly, that even though it had unfortunately become well-known that the person had committed suicide, it was assur for people to discuss it even if all parties involved already knew about it and that it was assur to pass it on to anyone who somehow had not heard that it was a suicide. He stressed that it was unfortunate that it got out in the first place and that there was no toeles in people knowing that the person committed suicide.

    I'm not saying that I can be 100% sure that in the case you post about, the same psak applies. I'm just pointing out that it might not be so clear that it is mutar to discuss this and that perhaps you should ask before posting such stories.

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  42. Ezzie, I think you consider yourself frum in every sense of the word. Speaking Loshon Hora (possibly motzei sheim ra in this case) about a dead person is a grievous sin, one that is difficult to repair. Most frum people would try very hard not to do that.

    There is also an issue of onaas devarim where you are certainly hurting family memebers. I think "pretty certain" and "I think" are just not good enough reasons to post possible loshon hora in such a public forum.

    Maybe just maybe you should speak to a posek and consider taking this down.

    If someone whispers in you ear "I have diabetes please don't tell anyone" and then he dies and you are pretty sure it is diabetes related and you even read it on VIN. You know you are not allowed to tell anyone? Hilchos loshon hora are complicated DON'T BE YOUR OWN POSEK.

    Come off your high horse and consider the possibility that you are wrong and that you made a mistake.

    Oh, and you are so familiar with the situation and the family that you KNOW it wasn't a homocide? Brilliant.

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  43. He stressed that it was unfortunate that it got out in the first place

    Agreed.

    and that there was no toeles in people knowing that the person committed suicide.

    And that would be different in this case - not to bring it to light in the first place, but once it is, to make something positive come from it, in light of what happened originally. (I think people would need to reread the post to understand that.)

    The sad irony to me, as is often the case, many people would rather discuss whether something should or should not have been written, arguing in a way that actually causes the exact focus they think should have been avoided, then discussing what was supposed to come out of it which would have shifted that same focus away.

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  44. I don't see what the difference is since in that case too the person was reportedly depressed and unmedicated but that's not really my point. My point is the same as Patricia's--it's too risky to decide these things on your own and then post them in public and be machshil others too. It's not for us to discuss whether or not this was mkay to post. It's way too complicated and should be left to people who are more knowledgeable than you and I in these matters. I just want to repeat my suggestion that you consult with a halachic authority next time you feel inclined to post information about someone, even if YOU feel there is toeles to it.

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  45. One last shot.

    Let's say I suspected you of being a pedophile and thought it prudent to post here that your kids should be removed from you home because I suspect you of such. How would that feel? Not too good huh? How would your wife, children, parents and siblings feel? I bet pretty rotten, true or not.

    Now, people would start telling me to take down the post and I would argue that they are sweeping terrible problems in our community under the rug.

    The answer is is that I would have to be very very very sure someone was a pedophile before hurting their family by exposing this to the public and EVEN then I would only be allowed to publicly blasphemise/shame or whatever that person if there was a clear purpose and that wouldn't be decided by ME. I would need to go to a competent posek/rav before destroying someone’s life that way.

    An additional note: Saying that it is not Loshon Hora because it wasn’t his fault he was ill is not true it is still loshon hora go look it up.

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  46. If it was reported that a police officer said they saw me committing such a despicable act, I would hope that you or anyone would do everything in your power to get me away from any kids until the matter was settled. I would certainly hope you wouldn't take the approach that a cop is not a qualified eid and should therefore be ignored.

    Seriously, I heard you, and I think that the way you make points (and the ones you have made) are more than a little bit nuts.

    There is a clear difference between the way you are doing so and the way Uri does so; I suggest you learn from his example. I may not agree with his approach, but he at least has respectfully stated an approach that has sound reasoning.

    If anyone has anything further to say, feel free to e-mail me.

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  47. What does being nuts have to do with it. A shnorrer comes to my door and asks for money should I kick them in the face and say "You're nuts!" (maybe her really is but so what???)?

    I'm practically begging you to remove the part of this post that is about a specific individual and may pain family and friends and you refuse on the ground that "Patricia is nuts"?

    I know who you are, you don't know who I am so I couldn't care less whether you think I'm nuts or not. I certainly know that you're cruel. Better crazy and nuts than cruel and stupid so thank you.

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  48. If you knew me, you'd have probably e-mailed me privately as others have and we would have had a reasonable discussion. Even if you used the comments section, you'd never have used the arguments you have or the tone you have. Check yourself, as the saying goes. Certainly, if you knew me, you would not accuse me of being either cruel or stupid. Whatever you may agree or disagree about regarding this post, to claim that I did so cruelly is foolish.

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  49. Media & Suicide Prevention

    From the World Health Organiztion

    Media play a significant role in today’s society by providing a very wide range of information in a variety of ways. They strongly influence community attitudes, beliefs and behaviour, and play a vital role in politics, economics and social practice. Because of that influence media can also play an active role in the prevention of suicide.

    Suicide is perhaps the most tragic way of ending one’s life. The majority of people who consider suicide are ambivalent. They are not sure that they want to die. One of the many factors that may lead a vulnerable individual to suicide could be publicity about suicides in the media. How the media report on suicide cases can influence other suicides.

    These resources seek to outline the impact of media reporting on suicide, indicate sources of reliable information, suggest how to report on suicide in both general and specific circumstances, and point to pitfalls to be avoided in reporting on suicide.

    IMPACT OF MEDIA REPORTING ON SUICIDE

    One of the earliest known associations between the media and suicide arose from Goethe’s novel Die Leiden des jungen Werther (The Sorrows of Young Werther), published in 1774. In that work the hero shoots himself after an ill-fated love, and shortly after its publication there were many reports of young men using the same method to commit suicide. This resulted in a ban of the book in several places. Hence the term “Werther effect”, used in the technical literature to designate imitation (or copycat) suicides.

    Other studies of the media’s role in suicide include a review going back to the last century in the United States. Another famous and recent case concerns the book Final Exit written by Derek Humphry: after the publication of this book, there was an increase in suicides in New York using the methods described. The publication of Suicide, mode d’emploi in France also led to an increase in the number of suicides. According to Philips and colleagues, the degree of publicity given to a suicide story is directly correlated with the number of subsequent suicides. Cases of suicide involving celebrities have had a particularly strong impact.

    Television also influences suicidal behaviour. Philips showed an increase in suicide up to 10 days after television news reports of cases of suicide. As in the printed media, highly publicized stories that appear in multiple programmes on multiple channels seem to carry the greatest impact - all the more so if they involve celebrities. However, there are conflicting reports about the impact of fictional programmes: some show no effect, while others cause an increase in suicidal behaviour.

    The association between stage plays or music and suicidal behaviour has been poorly investigated and remains mainly anecdotal.

    Imitation is the process by which one suicide exerts a modelling effect on subsequent suicides.

    Clusters are a number of suicides that occur in close temporal and/or geographical proximity, with or without any direct link. Contagion is the process by which a given suicide facilitates the occurrence of a further suicide, regardless of the direct or indirect knowledge of the prior suicide.

    More recently, the Internet has introduced a number of new issues. There are web sites that help a person with suicidal plans and others that try to prevent suicides. So far, no systematic studies have analysed its impact on suicide.

    Overall, there is enough evidence to suggest that some forms of non-fictional newspaper and television coverage of suicide are associated with a statistically significant excess of suicide; the impact appears to be strongest among young people. Nevertheless, the majority of suicides are not reported in the media; when the decision is taken to inform the public about a suicide, it usually involves a particular person, method or place. Suicide is often newsworthy and the media have the right to report it. However, the suicides most likely to attract the attention of the media are those that depart from usual patterns. In fact, it is striking that cases presented in the media are almost invariably atypical and uncommon, and to represent them as typical further perpetuates misinformation about suicide. Clinicians and researchers acknowledge that it is not news coverage of suicide per se, but certain types of news coverage, that increase suicidal behaviour in vulnerable populations. Conversely, certain types of coverage may help to prevent imitation of the suicidal behaviour. Nevertheless, there is always the possibility that publicity about suicide might make the idea of suicide seem “normal”. Repeated and continual coverage of suicide tends to induce and promote suicidal preoccupations, particularly among adolescents and young adults.

    SOURCES OF RELIABLE INFORMATION

    Reliable information on suicide mortality can be obtained from a number of agencies around the world. The WHO data bank contains data starting from 1950, by age and gender. Other agencies that may provide information are United Nations Children’s Fund (UNICEF), United Nations Interregional Crime and Justice Research Institute (UNICRI), United Nations Development Fund for Women (UNIFEM), International Clinical Epidemiology Network (INCLEN), International Society for the Prevention of Child Abuse and Neglect (ISPCAN), INTERPOL, Statistical Office of the European Communities (EUROSTAT) and the World Bank. A number of governmental agencies, national associations and voluntary organizations also provide information: the Swedish National Centre for Suicide Research and Prevention, the Australian Bureau of Statistics and the US Centers for Disease Control and Prevention are examples.

    Reporting of suicide in an appropriate, accurate and potentially helpful manner by enlightened media can prevent tragic loss of lives by suicide.

    The number of suicides is often underestimated. The extent of underestimation varies from country to country, depending chiefly on the ways in which suicide is ascertained.

    Other reasons for the underestimation of suicide include stigma, social and political factors, and insurance regulations, which means that some suicides may be reported under the guise of accidents or death from undetermined causes. The extent of underestimation of suicides is thought to be 20-25% in the elderly and 6-12% in others. There are no worldwide official records of non-fatal suicidal behaviour (suicide attempts), largely because on average only about 25% of attempters need or seek medical intervention. Most suicide attempts therefore go unreported and unrecorded.

    Precautions in using suicide data

    Comparisons are frequently made between suicide data from different countries, but it must be borne in mind that procedures for the recording of mortality data vary greatly among countries, and this seriously affects any direct comparability.

    Suicide rates are normally expressed as the number of suicidal deaths per 100 000 population. If reported rates refer to small populations (e.g. cities, provinces or even small countries) their interpretation requires extra caution, since just a few deaths may radically change the picture. For populations under 250 000, crude numbers of suicides are generally used. Some rates may be reported in age-standardized form. This can exclude suicides under 15 years because of the small numbers, but in many countries there is an alarming increase in suicides in this age group.

    HOW TO REPORT ON SUICIDE IN GENERAL

    Specific issues that need to be addressed when reporting on suicide include the following:

    • Statistics should be interpreted carefully and correctly;
    • Authentic and reliable sources should be used;
    • Impromptu comments should be handled carefully in spite of time pressures;
    • Generalizations based on small figures require particular attention, and expressions such as “suicide epidemic” or “the place with the highest suicide rate in the world” should be avoided;
    • Reporting suicidal behaviour as an understandable response to social or cultural changes or degradation should be resisted.

    HOW TO REPORT ON A SPECIFIC SUICIDE

    The following points should be kept in mind:

    • Sensational coverage of suicides should be assiduously avoided, particularly when a celebrity is involved. The coverage should be minimized to the extent possible. Any mental health problem the celebrity may have had should also be acknowledged. Every effort should be made to avoid overstatement. Photographs of the deceased, of the method used and of the scene of the suicide are to be avoided. Front page headlines are never the ideal location for suicide reports.
    • Detailed descriptions of the method used and how the method was procured should be avoided. Research has shown that media coverage of suicide has a greater impact on the method of suicide adopted than the frequency of suicides. Certain locations - bridges, cliffs, tall buildings, railways, etc. - are traditionally associated with suicide and added publicity increases the risk that more people will use them.
    • Suicide should not be reported as unexplainable or in a simplistic way. Suicide is never the result of a single factor or event. It is usually caused by a complex interaction of many factors such as mental and physical illness, substance abuse, family disturbances, interpersonal conflicts and life stressors. Acknowledging that a variety of factors contributes to suicide would be helpful.
    • Suicide should not be depicted as a method of coping with personal problems such as bankruptcy, failure to pass an examination, or sexual abuse.
    • Reports should take account of the impact of suicide on families and other survivors in terms of both stigma and psychological suffering.
    • Glorifying suicide victims as martyrs and objects of public adulation may suggest to susceptible persons that their society honours suicidal behaviour. Instead, the emphasis should be on mourning the person’s death.
    • Describing the physical consequences of non-fatal suicide attempts (brain damage, paralysis, etc.) can act as a deterrent.

    PROVIDING INFORMATION ON HELP AVAILABLE

    Media can play a proactive role in helping to prevent suicide by publishing the following information along with news on suicide:

    • Listing available mental health services and helplines with their up-to-date telephone numbers and addresses;
    • Publicizing the warning signs of suicidal behaviour;
    • Conveying the message that depression is often associated with suicidal behaviour and that depression is a treatable condition;
    • Offering a message of sympathy to the survivors in their hour of grief and providing telephone numbers of support groups for survivors, if available. This increases the likelihood of intervention by mental health professionals, friends and family in suicidal crises.

    SUMMARY OF WHAT TO DO AND NOT TO DO

    • Work closely with health authorities in presenting the facts.
    • Refer to suicide as a died by suicide, not a successful one.
    • Present only relevant data, on the inside pages.
    • Highlight alternatives to suicide.
    • Provide information on helplines and community resources.
    • Publicize risk indicators and warning signs.
    • Don’t publish photographs or suicide notes.
    • Don’t report specific details of the method used.
    • Don’t give simplistic reasons.
    • Don’t glorify or sensationalize suicide.
    • Don’t use religious or cultural stereotypes.
    • Don’t apportion blame.

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  50. I haven't had time to read all of these comments, but for anyone interested in more discussion about Judaism and depression, you can check out the blog that I edit, which Steg mentioned:

    http://boreihoshech.wordpress.com(The blog is non-denominational and I try to make it accessible to everyone, regardless of Jewish background, but I am observant, if that perspective makes a difference to anyone.)

    Comments welcome!

    And Serach and/or Ezra--if you would like to read and review the blog, I would be most appreciative!

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