UVM Child Psychiatrist Believes Positive Psychiatry Can Save Lives 

When people talk about suicide prevention, they don’t generally talk about wellness. They’re likely to talk about lethal means, or the need for immediate crisis intervention. They’ll talk about the importance of asking someone directly if they’re thinking of killing themselves. Each of these are proven strategies to reduce suicide deaths. But what about wellness? Does promoting general well-being have a role in suicide prevention?

September is National Suicide Prevention Month. Find out more here.

David C. Rettew, M.D., is one who believes it does. In his keynote address at the Vermont Suicide Prevention Symposium, the UVM child and adolescent psychiatrist made the case that the principles and practices of “positive psychiatry” have a big role to play in mitigating the suicide crisis engulfing Vermont and the nation. 

“True mental health is more than just the absence of illness,” said Rettew, who is also medical director of the Children’s Division at the Vermont Department of Health. “If we really want to help people, we have to do more than just remove the negative things. It’s the difference between not being depressed and experiencing happiness and well-being.”

Harnessing Wellness Principles for Suicide Prevention

The emerging field of positive psychiatry — an outgrowth of positive psychology — emphasizes universal elements of well-being. Known by the acronym PERMA, these principles are applicable to everyone, regardless of mental health status. PERMA stands for:

  • Positive emotions: feeling joy, happiness, empathy, kindness 
  • Engagement: being actively engaged in something that creates joy or happiness
  • Relationships: having and holding strong connections with other people
  • Meaning: finding a sense of purpose in one’s life
  • Accomplishments: setting goals and taking steps forward.

Brand new Vermont-specific data from the national Youth Risk Behavior Survey reveals the importance of these kinds of positive influences on children’s lives. Youth who reported feeling like they mattered, who ate dinner as a family, or who had a trusted adult in their lives with whom they felt they could talk openly had a 30 to 70 percent less chance of dying by suicide. Each factor reduced the risk individually, and multiple factors had a cumulative effect.

Promoting Protective Factors for Healthy Brains and Bodies

Rettew decries the notion that a focus on positive well-being is seen as “fringey,” particularly with regard to children. “We’re not talking about crystals here,” he said. “But about health promotions that not only build healthy bodies but also healthy brains.” Sleep is one example. Growing research points to the importance of quality sleep to good mental health. One study of 60,000 veterans found a five-fold risk of suicide among those with insomnia. 

“Something we know can help improve mental health in people who are not struggling can also help those who are,” Rettew said. “We miss that sometimes. We think that meditation and yoga are just for beautiful people on the beach.”

How can parents use the principles of positive psychiatry to help their kids who may be struggling? “Think of things not only not to do – like reducing access to lethal means – but also look for things to move toward.” He offered five general guidelines for parents and trusted adults.

  • Do something with children to connect and engage with them. 
  • Model the behaviors you’re trying to bestow on others in your own life.
  • Attend to your own mental health, and explain your own coping strategies to your kids.
  • Try to parent deliberately and mindfully, with less reactivity.
  • Use positive parenting approaches that emphasize warmth, encouragement, and appropriate supervision.

Make Wellness a Family Affair

Rettew also recommends having a family wellness plan in which the family, as a group, assesses their coping strategies and sets goals for daily activities to promote well-being. These might include goals for physical activity or having healthy meals together, or expressing gratitude for the qualities we appreciate in another. Set an example, even if you yourself, as a parent, are struggling.

“Show the people you love and care about that it’s okay to not be okay. That it’s okay to tend to our own mental health. This can be a big step toward preventing stigma around mental health.”

~ David Rettew, M.D., UVM Child/Adolescent Psychiatrist

Positive psychiatry embraces a more holistic approach to child care, Rettew said, and as such, has a lot to offer the field of suicide prevention. “That’s not to diminish other areas of suicide prevention work, but to complement them with our own work of getting people from ‘not ill’ to well and happy.”

Learn More and Find Resources

Vermont Care Partners hosts a statewide network of Mental Health First Aid classes for adults, youth and teens. 

The Center for Health and Learning, which coordinates the Vermont Suicide Prevention Symposium and the UMatters suicide prevention program, among other initiatives.

The Vermont Department of Mental Health offers suicide prevention resources and information.

Read What To Do if You’re Worried About Suicide: A parent’s guide to helping a child in distress, from the Child Mind Institute.

If you are worried about your child, also see the Symptom Checker from the Child Mind Institute, which can help identify signs of psychiatric or learning disorders and guide you to next steps.

Find Suicide Prevention Resources for parents and families at Nationwide Children’s Hospital, including these articles:

For Kids: Stand Up to Stress! is a coloring and activity book for kids ages 8-12, from the National Institute for Mental Health. This free, printable coloring and activity book teaches children about stress and anxiety and offers tips for coping in a healthy way.

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