How “Safe Messaging” Gaslights Suicidal People


About a decade ago, I entered suicide prevention naively. I believed wholeheartedly that suicide “prevention” was about creating a world worth living in, and thought that the field shared that belief. I read voraciously, trying to understand as much as possible about experiences other than my own. Throughout so much of the literature, safe messaging (ways of talking about suicide that are “strategic, safe, positive”) and concerns about clusters (suicides that occur in close proximity to each other) were prominent. 

The more research I read, the more guidelines I followed, the more I internalized messages about suicide that were in direct conflict with my beliefs and experiences. Suicide was ultimately constructed as pathology. My history with suicide was a problem deep within me to be ferreted out and removed. I was ill, or perhaps corrupted by suicide. It made me vulnerable, fragile, needing protection and oversight. 

It did not matter what drove me to suicide. It did not matter that the world was never built with me in mind. The problem of suicide was inside me. Because the problem was inside me, the world didn’t need to change, I did.

Suicide prevention constructs a reality in which the problems of suicide lie within suicidal people. Within this reality, suicidal people are suicidal due only to pathology, whether that pathology is a diagnosable condition, or just a flaw in thinking or judgment. Sanity is constructed around wanting to live, insanity around wanting to die. Within this paradigm, the suicidal person can never be trusted. They are always already insane. And because of this fatal flaw in judgment or reason, suicidal people need to be kept safe at all costs, at all times. They are fragile, vulnerable, demanding protection, surveillance, and management.

The gaslighting of suicidal people hinges upon this framework that constructs them as insane. Gaslighting is a cultural process that allows non-suicidal people to define reality by pathologizing those who resist. It is a tactic that makes us question our own realities, making us constantly doubt our own experiences.

Safe Messaging as Gaslighting

Two ideas that are central to safe messaging are that:

  1. Suicide is not normal, and is the result of pathology;
  2. People who think about suicide are so vulnerable that seeing content about suicide makes them “unsafe.”

Working in the field, the safe messaging guidelines were bored into me. I was taught to believe unequivocally that these guidelines were about helping people who struggle. As I heard them, over and over, it was difficult not to internalize these beliefs. I felt deeply conflicted, struggling to make sense of my experience in these terms. When I was suicidal, content about suicide was soothing for me. It allowed me to work out some of the suicidal energy that vibrated through my bones. And when I found other people who had thought about suicide, or even heard about people who died from suicide, I felt less alone. Safe messaging tells us that our experiences are abnormal or abhorrent, while simultaneously selling the idea that suicide is a huge public health problem that can affect anyone. 

Gaslighting isn’t a singular event, but a confluence of experiences. I could spend thousands of pages outlining the insidious ways that this construction of reality permeates suicide prevention. One of those ways is detailed in my previous article about the “good survivor.” The good suicide attempt survivor recognizes their own pathology and affirms the system. They prove themselves sane by admitting that something in them was insane, which is why they attempted suicide in the first place. One of the primary tools that has helped enforce standards of good survivorship and perpetuate reality as defined by non-suicidal people is called “safe messaging.”

The National Action Alliance suggests that the following constitute unsafe messaging:

  • Repeated, prominent, or sensational coverage;
  • Details about suicide method or location;
  • Portraying suicide as a common or acceptable response to adversity;
  • Glamorizing or romanticizing suicide;
  • Presenting simplistic explanations for suicide;
  • Including personal details that encourage identification with the person who died

These “unsafe” messages not only conflict with people’s lived experiences, but also with the data and each other. Suicide is the 10th leading cause of death in the United States, and exponentially more people think about suicide than attempt or die from it. Suicide is extraordinarily common, and despite the pervasive suicide prevention motto “suicide is preventable,” it is becoming more common every year.

The guidelines recommend against including simplistic explanations for suicide, but go on to focus on diagnosable “psychiatric illnesses” in the linked Reporting Guidelines, stating that we ought to “refer to research findings that mental disorders and/or substance abuse have been found in 90% of people who have died by suicide,” a claim that the CDC no longer makes. They go on to say that messages can also cause harm by undermining prevention, which is connected to the concept of only sharing “positive narratives.” This means the only narrative that is allowed is a narrative of hope and system reliance. Hope, in this case, is defined not by the experience of the survivor, but by suicide prevention for the benefit of their perceived audience. Yet again, people who are not suicidal get to define reality for suicidal people, constructing hope around their comfort and assurances that suicidal people can be “cured” or “recovered.” Tying hope to recovery, or not being suicidal anymore, reifies the idea that suicide is rooted in a pathology that can or should be fixed. When the absence of suicidal thoughts is not the ultimate goal, there is space for understandings of suicide that move beyond pathology, and more expansive definitions of hope.

The stated purpose of these guidelines is protecting vulnerable people. As it turns out, there may not even be a relationship between this exposure and suicides. In Caitlin WiIlliams’ recent dissertation, she found that: 

“Overall, observational research seems to point to an increase in suicides following well-publicized suicide news articles; however, none of the existing experimental designs (i.e., Anestis et al., 2015; Williams & Witte, 2017; and the current study) have demonstrated any important effects of exposure to suicide news articles… we still do not have direct evidence of a causal relationship between exposure to suicide news articles and subsequent suicidal behavior… Although future research is needed to completely illuminate the relationship between suicide news articles and suicidal behavior, it is ultimately plausible that suicide news articles are not actually causing suicidal behavior. Given this possibility, it will be imperative to approach the dialogue with the journalists and the media in a different manner. Specifically, there are other reasons to be mindful when reporting on suicides, aside from the potential for an imitative effect.”

Additionally, in the rare event that suicide clusters do occur, it is not empirically clear if they have a connection with exposure. So if these guidelines don’t protect people from suicide… what purpose do they serve? I believe that these guidelines, like many of the “Truths” of suicide prevention, serve to help maintain the status quo. They enforce the cultural ideologies that suicide is pathological and suicidal people must be protected from themselves at all costs. They do this, whether intentionally or unintentionally, by gaslighting.

They Make Us Doubt Our Own Experience and Be Complicit in Constructing Their Reality

Safe messaging overrides the reality of people with lived experience with suicide by forcing them to tell their stories through a framework of “hope and recovery.” Our stories must be sanitized, gutted of any details deemed undesirable, like method or the harsh reality that treatment often fails us. The only stories that are allowed are the stories that confirm the work of suicide prevention.

They Pathologize Resistance

Because suicide is constructed as a result of pathology, any resistance to this constructed reality is evidence of pathology. Suicidal people are caught in a trap in which their suicidal thoughts are evidence of their pathology, making them unreliable reporters of their own experiences.

The cultural investment of suicidology in safe messaging is notable. Prevention organizations send safe messaging guidelines to reporters and artists, lambasting those who do not comply with the standards. The field rallied to push Netflix to remove the on-screen suicide in 13 Reasons Why. All of this investment is driven by power and control. 

The illusory idea that we can control suicide by controlling the content a suicidal person is exposed to dominates these guidelines. It begs the question — who is really being protected? The stories of suicidal people are being silenced. In the case of 13 Reasons Why, the suicide is edited out, but not all of the rape, violence, and bullying leading up to it. Suicide being the result of a series of traumas is what gets edited out, not the trauma itself. Does this really protect suicidal people who might have shared experiences with the main character, or does it protect others from having to see the potential consequences of traumatic events?

Suicidology owes us some reflection on why a narrative about exposure, risk, and contagion feels so important. Reparations are in order for everyone who has been told that their stories are unsafe or unfit for the public because they challenge us to think about suicide in nonmedicalized terms, or make visible the ways the systems that are supposed to help end up failing so many people (especially those who are already marginalized). All of us deserve the dignity of owning and sharing our stories without mediation or infiltration by systemic silence and shame. 


Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.


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Jess Stohlmann-Rainey
Jess Stohlmann-Rainey is a researcher, trainer, and advocate serving as the Director of Program Development for Colorado's statewide crisis and peer support lines at Rocky Mountain Crisis Partners. She has focused her career on creating pathways to intersectional, justice-based, emotional support for marginalized communities. Jess centers her lived expertise as an ex-patient and suicide attempt survivor in her work.


    • Has this ever happened in the history of psychiatry? I’ve got a lunatic psychiatrist, who “snowed” me, and was fraudulently listing me as her “outpatient” at a hospital I’d never been to for years, according to insurance companies.

      Then after I’d called her to ask her to stop fraudulently listing me as her “outpatient” at that hospital. She thought it’d be clever to then start fraudulently listing me as her “outpatient” at the hospital I’d had the misfortune of meeting her, after I’d moved out of state.

      Her fraud based partner in crime was eventually arrested, for medically unnecessarily harming many, but that insane psychiatrist was never actually arrested.

      Has any psychiatrist ever been “put in jail for ‘incitement to suicide,’ including those who provide emergency treatment for acute conditions (with antipsychotics)?” Like “snowing” a person with various amounts of nine plus different drugs, for ten for ten days straight?

      The insane psychiatrist I had the misfortune of dealing with deserved to be, but never was, “And that is not an exaggeration.”

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      • I really understand you, psychiatrist who diagnosed me with schizophrenia is listed in the terrorist database (like all of them should)
        it seems that the potential guilt of killing makes these people specific.
        *Snowing a person with various amounts of nine plus different drugs, for ten days straight* – often the result is toxic hepatitis.

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  1. Wonderful, brave article. Yes, it is time to bring this into focus. There’s a lot to chew on here that merits deep thinking, but my initial reaction was around the issue of “shame.” It’s a terrible feeling and is akin to despair, but let’s put it where it belongs.

    To my mind, there is no shame in struggling with life and even wanting it to end sooner than later. Thanks to deeply embedded social programs and systems of abuse and corruption being the mainstream, life can be disorienting and alienating, for example, from intense feelings of “not measuring up,” leading to feelings of unworthiness. These are based on lies from toxic systems, and I believe this can happen to anyone. It seems natural, considering who are the rich and powerful influencing and controlling our society, setting such public examples, and relentless in their pursuit of power. At least, as filtered through the media. Still, what we witness on the world stage seems consistent with what is happening in the collective right now, which has become, literally, explosive and deadly.

    Now, let’s talk about Jeffrey Epstein…

    Tell me again why poor people or lonely people or confused people should feel shame? There is no shame in being human, none at all. Takes courage to live this life and we must be creative about it.

    But shame on these social predators and piranhas who go after children and even go so far as to create a society of sexual predators. Makes me furious to think about the gaslighting society has taken from these vampires–society’s “elites”– and the suffering and tragedies created for people from this shit. To the victims: THEY are the ones who should feel ashamed, not YOU!!!

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  2. Wait, you mean we shouldn’t all listen to David Covington when he compares Ebola contagion to suicide contagion? (And yes, I know his narrative around this is slightly more complex than I’m making it out to be, but really…)

    I appreciate your overall point here, and will add this article to our resource list of articles worth reading on the topic… I have an article in the queue that has a similar message (although I don’t zero in on suicide specifically) called ‘No Graphic Detail.’ It does make me wonder how you have been tolerating the AAS scene, though!

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    • Oof… were you at the conference when he did the Ebola thing? I am excited to check out your article. I taught a Psy D class this summer and had them read your Suicidal Tendencies series. It had a big impact on the students.

      Re: the AAS scene: I don’t know that I do tolerate it, really. Critical suicidology is the area I work in, and there is a whole group for that, but also a contingent of AAS folx working in that space. It is interesting, in that space there are A LOT of people who share my perspectives. I have found the psych survivor movement equally and sometimes more alienating – rampant fatphobia, inconsistent commitment to cognitive liberty, contentious relationship to disability justice, recovery porn (a different kind, the focus on young white women recovering from involuntary treatment and forced drugging to become shining examples of mildly spiritual, white beauty), etc. Maybe I haven’t entirely found my space and people in the movement in the way that I have with critical suicidology. At the moment, I feel like a bit of an interloper.

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      • Jess,

        I was at the National Council conference in Orlando when he offered his Ebola spiel. I missed out on his hazmat suit laden performance piece on the topic at AAS. :p Thanks for using those articles. It’s always good to hear when that’s happening somewhere.

        And fair point re: AAS vs. other movement spaces… I agree that there are *tons* of issues within this world… I guess it’s just harder for me to personally take when we’re talking about a group that is always in the power position and perpetuating so many problematic things, including all that ‘safe messaging’ crap. :p

        Anyway, thanks once again for this piece! 🙂

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  3. From the article “When I was suicidal, content about suicide was soothing for me. ”

    In music
    Just Want To See – Cowboy Junkies

    I don’t want to be no patch on no quilt
    (I just want to see . . . )
    Tear-stained stitching linking memories to guilt
    (I just want to see . . . )
    I don’t want to be no hair on no wall
    (I just want to see . . . )
    Blood-stained note saying ***k you all
    (I just want to see what kills me)

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  4. Thanks for sharing your story, Jess. I agree, “All of us deserve the dignity of owning and sharing our stories without mediation or infiltration by systemic silence and shame.” But the “mental health” workers are all about gas lighting and silencing survivors of suicide or trauma or abuse, and their legitimately concerned family members. Our “mental health” system is a gas lighting system, and gas lighting is a form of “mental abuse,” not “mental health care.”

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  5. Thank you for your community service in articulately advocating against how standard “mental health” care harms society by pathologizing suicide.

    Since psychiatry pathologizes suicide consistent with other natural behaviors that it pathologizes, I am confused about why psychiatry does not include suicide ideation as another mythical DSM diagnosis.

    Best wishes, Steve

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  6. Jess, thanks for speaking such profound truths and revelations on these disturbing issues.
    It’s absurd a person dealing with any life crisis gets blamed for the anxiety that is due to the crisis and said anxiety gets chalked up to the person having a psych “disorder”.

    It’s more absurd and appalling that a person is subjected to gas-lighting when they are so beaten down that suicide seems the only escape from abuse and oppression. I had naively believed psychiatry was about creating a better world and helping people find peace and happiness. Learning and experiencing the ugly truths of psychiatry has shaken me to my core.

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  7. Thanks for this. I have some thoughts.
    First of all Socrates and hemlock. And then we go to the shame of not being buried in sacred ground. The RC has or had a strong lockhold on this. When my sister wanted to choose her burial ground and she looking into nonRC cemeteries I was like wow if your not buried in sacred ground shame for the entire family. This was big. Secrets with disability and or suicide.
    Thomas A Kempis was not given sainthood because when he was exhumed for possible canonization his inner top was marked by scratching so – he might have died of despair / so no sainthood for him. One sometimes had to laugh it’s all so contorted.
    I think what is needed is a clear and open discussion of life. Sometimes and for many it is just god awful and seemingly little to no options and I would say for all of us Trauma is life and if you are unable to work through it which usually means your life time in some cases – the thought of suicide has passed your mind. To deny this is the real tragedy.
    The questions should be who what why when and how and they should be boldly asked.
    And how can it be considered contagion when basically most people have thought in some way shape or form I am outta here.
    There are so many things no one knows or understands. And horrors to those who admit that truth. Because oh my to admit ignorance- really such bad form.
    In my MH system other side of the table journey/ no one asked How has suicide impacted your life? If asked I could say well there might have been a suicide cluster at my grade school parish and could go on to list names of for sites and then the maybes or most likelies.
    And not contagion but maybe some sort of abuse or sex abuse and or addictions.
    And no one asked me after my unintentional or mostly unintentional
    OD of my own story – the steps and what I was thinking and doing before and during. I was just shipped off to a hell hole.
    And most neurons are located in the digestive track so where does that all fit in?
    If one looks back into history one can find that first looks sometimes were fogged or mud splattered and what was really the cause was so much more different than the assigned conclusion.

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  8. Jess Stohlmann-Rainey, not seen your name before, excellent article.

    ” I believed wholeheartedly that suicide “prevention” was about creating a world worth living in, and thought that the field shared that belief.”

    Well, nothing of the Mental Health System works like that, not the drugs, not the psychotherapy. Its always about getting you to accept a so called life which is without honor. The very idea of “healing” is to get you to turn the accusatory finger back on yourself and to exonerate perpetrators. “Recovery” is more of the same.

    “Suicide prevention constructs a reality in which the problems of suicide lie within suicidal people. ”

    Everything of ~Mental Health~ ~Psychotherapy~ and ~Recovery~ works that way.

    We shouldn’t be wasting money putting survivors on drugs or sending them to therapists, we should be sending them to law school, so that we can obtain compensatory justice.

    I say that the most important right now should be talking a hard line stance, No Drugs, No Therapy, No Recovery Programs.

    And then fight to get laws changed, get the drugs off of the market, and start putting some psychotherapists out of business, and then move forward from there.

    One of the promising things I see is that some people are now suing their psychotherapists for “Transference Abuse”.

    Excellent Article! Excellent insights! I am so glad that you have been able to resist!

    Emergency Doctor to Trump: You Are Wrong, Mental Illness Is Not to Blame for Gun Violence Epidemic

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  9. The marching song Fiddler’s Green speaks to the issue of veterans suicides. Have you ever heard the battle cry “Gary Owen”? That’s the name of the tavern at Fiddler’s Green. If you had a pistol and could choose between drinking with friends in a good old-time canteen or being scalped by hostiles in a VA psych ward who could fault you for going to Fiddler’s Green?

    Fiddlers’ Green

    Halfway down the trail to Hell,
    In a shady meadow green
    Are the Souls of all dead troopers camped,
    Near a good old-time canteen.
    And this eternal resting place
    Is known as Fiddlers’ Green.

    Marching past, straight through to Hell
    The Infantry are seen.
    Accompanied by the Engineers,
    Artillery and Marines,
    For none but the shades of Cavalrymen
    Dismount at Fiddlers’ Green.

    Though some go curving down the trail
    To seek a warmer scene.
    No trooper ever gets to Hell
    Ere he’s emptied his canteen.
    And then rides back to drink again
    With friends at Fiddlers’ Green.

    And so when man and horse go down
    Beneath a saber keen,
    Or in a roaring charge of fierce melee
    You stop a bullet clean,
    And the hostiles come to get your scalp,
    Just empty your canteen,
    And put your pistol to your head
    And go to Fiddlers’ Green.

    The origin and author of Fiddlers’ Green is unkown. It was believed to have originated in the 1800’s and was composed as a song
    sung by the soldiers of the 6th and 7th Cavalry. Its first known appearance in published form was in a 1923 Cavalry Journal.

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  10. None of us should ever disclose what we are thinking to the mental health system, psychiatrists, psychotherapists, recovery groups.

    Has to be reserved for trusted comrades, and still even then on a need to know basis.

    Do you want Tangible Results, or just Therapeutic Release? Do you take the things you have experienced seriously, or do you just want a therapist to hand waive them away?

    The less they know about you the better.

    Learning to live in this world is no different than learning to live in a guerrilla war.

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  11. This article is from a year ago but thank you for writing it. This idea that news outlets shouldn’t include the suicide method used, that films and shows shouldn’t use any detail, is so insane. 13 Reasons Why, for example. Including the rape, bullying, conflict at home, and other trauma, but not the suicide itself is somehow supposed to be healthy? It’s insane. Although I understand the episode alteration in that case, since kids seem to gravitate towards that show and vulnerable kids will replicate what they see. But in content not consumed by children and teens, it’s ridiculous. I also think the idea that suicide is somehow inherently wrong is extremely harmful and lacking in compassion. In my darkest times, I would seek out and only consume content involving suicide, and it was the only thing that would give me comfort. When I’m in anguish, content involving suicide is calming to me. I wish this was something that more mental health professionals and people could understand.

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  12. I AM ABSOLUTELY FOR ASSISTED SUICIDE, using suicide help forums to find effective methods of suicide, obtaining the right mix of chemicals, gases and whatever else helps you find an peaceful exit around from nagging, needy, lovelorn, attention seeking, religious, terroristic, unlawful, possessive, violent, deranged people who won’t let you leave them, work, use a car, us a bicycle, believe that they are with “god in the shower’ who take you to a hospital (as the man in th emovie unsane) beat you screaming “sex should be about love” treat you as a possession of their own. I’m ALL FOR IT. I’D NEVER STOP BEING SUICIDAL AROUND CHRISTIANS. I COMPLETELY SUPPORT IT. DO IT>

    I’ve never met people who have absolutely no ability to handle laws, accept basic concepts, need you undivided attention, bleed you, deprive you, give you a cardboard box to sit in where they play with your life for the attention they feel they’re entitled to with NO RESPECT FOR PERSONAL SPACE THE RELIGION OR VALUES OR NEEDS OR FINANCIAN NEEDS OF OTHERS OR MORE SELF INVOLVED PEOPLE ANYWHERE WHO WOULD NEVER PROVIDE A WOMAN WITH A REASON TO CONSIDER ANYTHING BUT SHOVING HER HEAD IN AN OVEN AND A PEACEFUL WAY TO EXIT HIM. I”D RATHER BE LEFT ALONE FROM THIS RAPIST JISIS FREAK TRASH AND LUCKY TO HAVE $5 to my name and sleeping bag and safe location on the sidewalk safe from him.

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