Meghan Markle sharing suicidal thoughts is a powerful step to helping others, mental health experts say

On national television Sunday night, Meghan Markle shared in an interview with Oprah Winfrey that she had experienced thoughts of suicide before she and her husband, Prince Harry, left England for North America. Her candor immediately sparked a conversation about mental health, as people took to social media to praise Markle for her courage in sharing her struggles so publicly.

For Philadelphia area therapists, Markle’s openness marked progress in how thoughts of suicide are discussed, especially during a time when more people have experienced mental health issues due to the pandemic.

“The fact that she did speak out, courageously so, knowing the world often has a way of minimizing those experiences, is amazing,” said Yusra Aziz, a therapist based in Center City. “Meghan said it took a lot out of her to even say anything about it. And I think so many people can relate to that part of her story, even if they’re not royalty.”

Kathryn Esquer, a psychologist practicing in Snyder County and the founder of the Teletherapist Network, said she was pleased by Markle’s willingness to share that she was in a mental health crisis while pregnant. Data from the Centers of Disease Control and Prevention show about one in eight women experience symptoms of postpartum depression.

“The fact that she came out and said, ‘I had these, as a perinatal woman,’ is incredible,” Esquer said. “The fact that she was able to speak out about it now that she’s in a better place can help others find a way to speak out about it. One of the ways we can decrease suicidal thoughts is to talk about it … they breed in darkness and secrecy.”

It’s also important to recognize that suicide rates are higher in the Black community, said Marquita Bolden, the executive director of Therapy Center of Philadelphia. From 1991 to 2017, suicide attempts by Black adolescents rose by 73%. Markle and Prince Harry have been open about how racist tabloid coverage in the United Kingdom hurt them, contributing to their decision to step away from their royal duties.

“In a larger society where white, heterosexual, able-bodied, cisgender men are the standard by which all other people are judged, Black women, and Black trans women in particular, place very low in the racial hierarchy,” Bolden said in a written statement. “When your existence, your personhood, has been deemed ‘wrong,’ that … causes emotional pain and carries serious mental health consequences.”

During the interview, Markle said that after she had thoughts of suicide, she confided in Harry and reached out to a senior royal to seek inpatient care, but was told it “wouldn’t be good for the institution.”

Telling a loved one about thoughts of suicide can be scary, said Esquer.

“The clients I work with, they’re often fearful that they will be hospitalized or people won’t trust them,” she said. “They’re fearful of the consequences of opening up about thoughts of suicide.”

That’s why it’s important to keep an eye out for any signs that a loved one might be struggling and ask them about it, Esquer said. Signs include poor sleep, a change of routine such as being withdrawn or canceling plans, irritability, or withdrawing from social circles. It can also look like risky behavior, such as increased drug or alcohol use or spending money recklessly.

“There’s no right time to [start a conversation] … if you want that, you’ll be waiting forever,” she said.

Esquer said asking someone about suicidal thoughts does not plant the idea of suicide: “We need to dispel that myth.”

Educating yourself about the difference between passive and active suicidal ideation before the conversation can be really helpful, Aziz said. Passive suicidal ideation means thinking about not wanting to be alive, while active suicidal ideation involves thinking about ways to die or making a plan to die.

“Many people, especially those who have challenges with mental health, will consider suicide at some point in their lives,” she said. “A lot of people grow up thinking there’s something wrong with people who deal with suicidal ideation and plans, which breeds not talking about it. But one of the best things when talking about suicide with someone is to come in knowledgeable, so that you can feel confident.”

While conversations about suicidal thoughts can be difficult for everyone involved, the person offering support “can start to chip away at shame … by bringing [it] to light,” said Bolden.

“Understand that if someone is sharing that they are experiencing suicidal thoughts and urges, there is a part of them that is open to receiving support, and this is always a hopeful sign,” she added.

Bolden shared a few key things to keep in mind if you are supporting someone in crisis: practice nonjudgmental listening, encourage them to keep talking with you and others they trust, offer them loving affirmations, and support them in connecting with a mental health professional.

If you have immediate concerns about someone hurting themselves, Bolden recommended reaching out to a crisis team or accompanying the person to a nearby emergency room.

Aziz said that she was glad to see Markle’s interview spark more conversations around the trauma that comes with being a Black person or woman of color. She pointed out a similar receptiveness after the protests over George Floyd’s death last summer.

The pandemic has also created another opportunity to move the discourse around mental health forward in a productive way.

“COVID has definitely exacerbated suicidal thoughts for a lot of people, maybe in a way that they’ve never experienced before,” Aziz said. “The only way we can start to make a difference now is to have these conversations openly. There is just such a power in being open and honest.”

If you or someone you know is thinking of suicide, call the National Suicide Prevention Lifeline at 1-800-273-8255 or text TALK to the Crisis Text Line at 741741.