Marc Palma looks into the largest self-described ‘right-to-die forum’, and considers what Psychologists should know.

Author's note: This is a descriptive history of a long-running self-described 'right-to-die' forum. It does not endorse the forum or its views; it omits operational details, links and methods; and includes help resources at the end.

Nobody likes to talk about suicide. It's hard, heavy, and often exhausting. We tend to change the subject and hope someone else will handle it. Avoidance, however, doesn't help. According to the latest World Health Organization estimate, someone dies by suicide about once every 40 seconds. That means around 13 people by the time you finish reading this article. Those losses are not individual statistics – they ripple through friends, family, and whole communities. They can never be undone.

Ignoring suicide, then, is something that we cannot continue to do. But how do we go about understanding it? Research and clinical interviews reveal a great deal, but only capture those who are willing to speak with a clinician. For many, especially now, the safer place to talk isn't seen to be a consultation room – it's the internet. 

There, much of the conversation takes place in semi-private corners: pseudonymous threads and niche forums that many clinicians never encounter. Many of these spaces frame suicide as a personal right, rather than stemming from mental torment where recovery is possible and desirable. Consequently, even when clinicians encounter these forums, they hesitate to engage with them in practice because of ethical concerns. 

In my view, understanding means stepping into uncomfortable places, including the digital forums where people gather in self-described 'right-to-die' communities. Ignoring these spaces, even when concerns are valid, not only limits our understanding of suicide but also risks doing a disservice to people there who might benefit from professional support. 

Therefore, to gain better insight into these understudied communities and how they function, I've spent the last 18 months doing research into the largest of those communities. Why are they growing in size? Why are people are turning to digital spaces to talk about suicide? What follows is a brief history of the community, intended to provide a better understanding of their beliefs, followed by key considerations for psychologists, researchers, and policymakers regarding these spaces.

Evolution and philosophy of the forum

The community's roots trace back to a subreddit created in March 2013. The community's founding creed indicated the following: that a right to die exists; that suicide should be discussable without censorship; and that, for some, suicide can appear to be the only logical conclusion. As the community grew, worries about 'normals', non-members who might try to persuade users away from the forum's prevailing views, began to fester; pressure from Reddit also began to build due to the content in the threads not aligning with the company's policies. Eventually, Reddit decided to ban the subreddit outright on 18 March 2018. That same day, an independent site under the same name as the subreddit was created, aiming to continue upholding the group's creed.

The independent site quickly surpassed the subreddit's size of 16,000 members and became the focal point of public scrutiny. Main criticisms of the site were around: 1. How the site allows members to discuss detailed 'methods' on how to carry out suicide, 2. How the site has no real checks to ensure minors aren't accessing the forum despite the rules stating that members must be over 18, and 3. How, even though the site claims to be pro-choice, talk can often skew so far into the negative that it can be viewed as more pro-suicide. As a result of these points, the independent site has weathered several high-profile government and media investigations since its formation, leading to temporary one-day closures and ownership transfers. Most recently, the site has been the target of the UK regulator Ofcom, which has opened an investigation. 

Through all this, however, the site has remained up and active, continuing to grow in membership size. As of the time of writing this article, the site has approximately 60,000 unique members and over 3,000,000 individual posts.

So what does the evolution of this specific community tell us about understanding suicide in less-visible online spaces? 

Reducing harm without amplifying defiance

First, outside pressure often influences where discussions occur more than whether they occur at all. Across bans, investigations, and policy shifts, the group moved and tightened access rather than disappearing, supporting the notion that a significant portion of individuals with suicidal thoughts need a space to discuss their feelings. Historically, these communities have persisted despite attempts to suppress them. In fact, scrutiny tends to harden public identity. In the historical record, external attention (bans, investigations, media coverage) simply reinforces an 'us vs. them' stance by users, something that is viewable all the way back to when the group was first forming. This may make engagement with professional mental health help harder, as an individual may feel like no-one but people on the forum understands them. 

This isn't to say that we shouldn't try to regulate these spaces through policy; rather, that policy needs to be tailored in ways that are effective and that acknowledge that there is a clear desire to talk about suicide in a way that is free from fears of judgement or repercussions. Many users report that they feel these spaces are the only place where they can share how they are truly feeling. The outright banning of spaces like this can therefore prove dangerous, as these members will feel like they have lost what might be their only coping mechanism. Investigating the creation of a safer online environment for sharing these thoughts could prove to be a worthwhile endeavor for those in policy and the mental health field, as the demand and apparent need for such spaces are clear.

Second, for individuals in the mental health field who interact with clients on a daily basis, understanding that these spaces exist and are widely accessible is also important. A practitioner may have a client who is engaging in these online communities without their knowledge, as they may not have realized the space existed in the first place. Asking a client who is thinking of suicide, especially one who seemingly uses the internet a lot, if they engage in online talks about their mental health (in a way that is non-revealing to the existence of these sites in the first place) could, as a result, be something beneficial for mental health providers to do. Asking this question to specific clients who are debating acting on suicidal thoughts is even more critical, as the site and ones like it could prove a significant risk in terms of increasing the risk of action due to them housing threads with specific methodology planning.

Third, there is a plethora of information on these sites that could prove beneficial for researchers. These forums have the potential to reveal the unfiltered thoughts and feelings of individuals who do not participate in research studies or in-person therapy. Proper ethical practices must be followed to ensure that the resulting research causes no harm; however, there is an opportunity to conduct critical research into an underreported and underrepresented, hard-to-reach group of the population.

Finally, the internet appears to be facilitating discussions based on personal autonomy that can lead to harmful behavior. Although the focus here is a suicide-discussion forum, many of the dynamics are familiar to clinicians who have tracked pro-ana communities: an emphasis on personal autonomy framed as a shield against 'outsider' judgement; migration patterns that follow moderation pressure rather than end participation; and in-group language that blurs 'support' and risk. Recognizing these shared features matters. It reinforces the idea that blanket suppression can strengthen identity and drive conversations into harder-to-reach spaces. Alternatively, calibrated, evidence-informed approaches – such as clear age-gating, active moderation that prioritizes distress-signaling over risk-amplifying content, and pathways to care that do not demand immediate disclosure – may reduce harm without amplifying defiance. 

#James Donaldson notes:Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticleFind out more about the work I do on my 501c3 non-profit foundationwebsite www.yourgiftoflife.org Order your copy of James Donaldson's latest book,#CelebratingYourGiftofLife: From The Verge of Suicide to a Life of Purpose and Joy

Click Here For More Information About James Donaldson

Click here to follow James Donaldson's Blog

Creating safer alternatives

In conclusion, for policymakers leading the charge to regulate these sites, creating safer alternatives should be considered a high priority. For practitioners, being aware of the existence of these sites and listening to clients for the underlying narratives common to these spaces (autonomy, belonging, mistrust) or other general signs that an individual is using them is crucial to ensure the safety of clients. Lastly, for researchers, doing more work to understand how these environments shape user sentiment and overall how we discuss suicide in online spaces as a whole should be considered a top priority. https://standingabovethecrowd.com/?p=16193

James Donaldson on Mental Health - How to Handle Holidays After a Death in the Family

Grief can make special days harder

Writer: Rachel Ehmke

Clinical Expert: Jamie Howard, PhD

What You'll Learn

- How might kids feel on important days after someone has died?
- What can parents do to help children process their grief?
- How can families make special days easier for kids?
- Quick Read
- Full Article
- Acknowledge emotions
- Make a plan
- Memorialize
- Ask for help

The year after a loved one has died is especially hard. The first Thanksgiving, Mother’s Day or special event like a graduation can make kids feel sad. You may think the best idea is to skip the celebration. But skipping it can sometimes make kids feel even worse. Thinking and planning ahead can make these hard days easier and even bring some joy to them.

It’s important to let your kids know that it’s OK for them to feel sad. Trying to pretend that everything is fine just makes kids feel like it’s not OK to have feelings. On the other hand, it’s probably best if you don’t let your kids see you at your most upset moments, since they might feel scared.

It’s very normal for kids to go in and out of sadness. They may be sad one minute and want to play the next. That’s very healthy, especially for little kids who might not get exactly what’s going on.

It can really help to plan out the day. Let kids know what’s going to happen and who will be there. That gives kids a sense of control and security. It also helps to include favorite family traditions. Those shouldn’t disappear because a loved one has died. In fact, they can make the day feel special.

Finding a way to talk or share memories about the person who died or do something that they loved can also help kids deal with grief. And parents need help on hard days, too. It’s good to get family and caregivers to take some of the burden off you or just give you a break.

When you’ve lost someone you love, the year that follows is inevitably a year of firsts without that person. Celebrations like the first Thanksgiving, birthday or Mother’s Day without someone who played a major role in your and your family’s life will be especially hard. This is also true for personal milestones, like graduations and first days of school, many of them involving children. What’s the best way to face these days when, rather than feeling festive, you’re feeling the loss most keenly?

Depending on the occasion and your grief, you may even be wondering if you should skip the day altogether. Trying to ignore important occasions can also be painful, so that probably isn’t the best strategy. For families coping with bereavement, it isn’t uncommon to experience moments of joy along with some sorrow on significant days. Thinking ahead of time about how to make the day easier for your family can help.

#James Donaldson notes:
Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.
Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.
Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticle
Find out more about the work I do on my 501c3 non-profit foundation
website www.yourgiftoflife.org Order your copy of James Donaldson's latest book,
#CelebratingYourGiftofLife: From The Verge of Suicide to a Life of Purpose and Joy

Click Here For More Information About James Donaldson

Click here to follow James Donaldson's Blog

Acknowledge emotions

First, acknowledge that this will likely be a difficult day for your family. Recognizing this is important. Sometimes families — both parents and children — feel they need to put on a brave face when they are feeling sad. But it is OK to feel sad and show grief. “As a rule of thumb, avoidance is a bad idea because it makes us feel worse in the medium and long term,” notes Jamie Howard, PhD, a clinicial psychologist who specializes in trauma. “Our emotions don’t really respond well to being closeted. They find a way out.” Hiding your own grief can also make your children feel like the sadness they may be feeling is bad. However, try not to let children see you at your most upset moments, as they may begin to worry about you or feel insecure.

Let the children know that however they are feeling is fine, and they don’t need to hide it. If they want to say, “I really miss him,” that’s OK. On the other hand, kids also shouldn’t feel that they are expected to be miserable all day. It is common and healthy for kids to go in and out of grief, and take comfort in playing. Younger children in particular, who might not realize the significance of the day, will probably want to play and have fun, and that’s fine, too.

Make a plan

Dr. Howard says it’s a good idea to make a plan for how the day will look, and to share that plan with the kids. Making it somewhat predictable, so they know what to expect, who will be there, and what it will be like can make everyone feel like they have a little more control.

If you are churchgoers, you might plan to go to church first thing and then go home and have breakfast. Or maybe you’ll wake up, make pancakes together and then take a walk. If people are coming over for lunch, let the children know who will be coming over. Then maybe next on the schedule they’ll have some free time to play or hang out before dinner.

Do what you can to include favorite traditions when you are planning your day, too. It may feel bittersweet, but people find comfort in traditions, and they can help the day feel special.

Memorialize

Remembering is part of grieving and part of healing, so think about doing something to memorialize your loved one. It will be sad, but Dr. Howard says it can help in the grieving process. In the case of a deceased parent, for example, maybe that means taking the occasion to talk to the kids about how special their mother was, tell favorite stories, and let the kids know that some of the things that she taught them will be with them forever, even though she isn’t here now. If she really liked flowers, maybe you could plant some flowers in honor of her. If she liked to collect things, maybe you could put her collection in a place you’ll pass by it frequently, and think of her.

Ask for help

One very important consideration when making a plan for the day is for parents and caregivers to consider what they can get through emotionally, and what might be helpful to them. Parents should certainly ask for other family members and close friends to be on hand to support them  if that would be useful. Maybe a relative could help make dinner, play a game with the kids, or even just be present  to backstop or take over if a break is needed.

Frequently Asked Questions

How might kids feel on holidays after the loss of a loved one?

What can families do to support kids on holidays after the death of a loved one?

Should you skip holiday celebrations the first year after a loved one has died?

No, you probably shouldn’t skip holiday celebrations the first year after a loved one has died. For families coping with bereavement, it isn’t uncommon to experience moments of joy along with some sorrow on significant days. Just acknowledge that this will likely be a difficult day for your family.

https://standingabovethecrowd.com/james-donaldson-on-mental-health-how-to-handle-holidays-after-a-death-in-the-family-2/

James Donaldson on Mental Health - 24 Tips for Traveling With Children

How to make flights and road trips easier for children with autism, anxiety, and other challenges

Writer: Karen Cicero

Clinical Experts: Margaret Dyson, PhD , Cynthia Martin, PsyD

What You'll Learn

- How can families help kids with mental health challenges prepare for air travel?
- What are some ways to make road trips easier for kids with mental health challenges?
- How can families make hotel stays work for kids with mental health challenges?
- Getting ready to fly
- Getting ready for a road trip
- Keeping kids happy while traveling 
- Choosing and staying at a hotel

Are you planning a family trip this year? If your child has anxiety, autism, sensory issues, or other special needs, the travel industry has stepped up to make traveling less challenging for you. The Child Mind Institute tapped its own experts, as well as travel pros and families who travel frequently, to create this guide to help you make flights and road trips easier all year long. 

Getting ready to fly

Research potential airports. More than 16 U.S. airports — including those in Atlanta, Miami, Seattle, and Newark — have dedicated sensory or quiet rooms that families can retreat to rather than waiting at the gate or in a crowded lounge. Some rooms have bean-bag chairs, quiet music, and dim lights while others offer a more tactile experience and even include a small aircraft mock-up for kids to explore. Before booking flights, check the website of your nearby airports and those in your travel destination to see if a sensory room is available. Note the location of the room within the terminal as well. While sensory rooms are open to all flyers, they may be located in a concourse that is used primarily by a specific airline. In that case, you may want to prioritize booking on an airline that operates out of that concourse. 

Try to avoid layovers. Direct flights will reduce the chance of delays and cancellations and minimize the number of transitions that your child will experience, says Margaret Dyson, PhD, a psychologist who specializes in autism. She also recommends avoiding flights that take off after your child’s bedtime. On major travel booking sites, it’s easy to filter the results by the number of stops and the hours of departure. If you can’t avoid a flight with a layover, be sure to explain to your child in advance that you’ll need to take two planes as part of your adventure.

Do a test run. Airports in Atlanta, Minneapolis-St. Paul, and Kansas City offer travelers the opportunity to schedule a familiarization experience. In Atlanta and Minneapolis-St. Paul, Delta volunteers guide families through TSA security procedures, exploring the terminal, and boarding a plane. The recently remodeled airport in Kansas City opened an “air travel experience room” inside a section of a retired plane so future passengers can practice buckling seatbelts, putting luggage in overhead bins, and opening the lavatory door. Additionally, the Arc Wings for Autism/Wings for All program hosts dozens of events throughout the year at various airports; check thearc.org to see if there’s one near you.

Practice at home. If you can’t take your child to a familiarization experience, you can watch videos so kids “can see and hear how a new experience might pan out,” says Kayla Castro, a special-education teacher and travel agent specializing in trips for families with mental health challenges. It’s a strategy that has helped her teen son who has autism navigate airports as well as attractions they plan to visit on vacation. The Federal Aviation Administration has a well-done “Kids’ First Flight” video on its YouTube channel. Reading children’s books, such as Bearplane! (ages 2–5) and Emma Every Day: First Flight (ages 5–7), may also be helpful. JetBlue and Autism Speaks also partnered on a downloadable travel guide that takes kids through each step in the airport process. Print it out and bring it with you to the airport or create your own visual list of “jobs” your child can focus on when they get to the airport, like getting a bin while going through security or walking through the metal detector. “They’ll know what to expect and can direct their energy in an independent way,” says Cynthia Martin, PsyD, a clinical psychologist who specializes in autism and other neurodevelopmental disorders.

Sign up for the Sunflower Lanyard Program. Staff at more than 240 airports worldwide have been trained to recognize that people who wear this lanyard have a disability that isn’t visible. For information about how to purchase a low-cost lanyard and which U.S. airports participate in the program, go to hdsunflower.com.

Alert your airline. If you’d like to board early with a child who has mental health challenges, it’s best to notify the airline in advance rather than make the request at the gate. If you didn’t do it at the time of booking, go to your airline’s website to find out how to add it to your reservation. Generally speaking, children with mental health disorders will feel more comfortable in a window or middle seat rather than the aisle, where they may be accidentally bumped by other passengers or the beverage cart. If you feel your child may have a better experience boarding toward the end of the process, alert the gate agent and, if possible, send one member of your family in advance to secure overhead luggage space. 

Simplify the security line. Download the MyTSA app on your smartphone, where you can check the current and average wait times to get through the security line. It will give you an idea about what days and times ares the most and least crowded at your airport. Regardless, travel experts recommend that families enroll in TSA PreCheck. Ninety-nine percent of TSA PreCheck passengers wait less than 10 minutes. If adults are enrolled in TSA PreCheck, their children ages 17 and under can join them in the line. Go to TSA.gov/precheck to find out how to enroll; new enrollment costs $78 per adult for 5 years but keep in mind that some credit cards issue a statement credit to help offset the cost. The TSA notes that most applications can be processed in 3 to 5 days. Whether or not you have TSA PreCheck, you can call the TSA Cares helpline at 855-787-2227 about 72 hours before your flight to request special assistance through security.

Strategize luggage. Pack a small backpack for each child to use as a personal item. You might want to include fidget toys, easy-to-contain creative items like Wikki Stix and sticker books, and snacks. In addition, consider designating an adult backpack for the family’s electronics, medications, and a change of clothes per family member. Check most or all of the remainder of the luggage and put an Airtag inside each so you can more easily locate lost luggage.”

Consider the airport size. While regional airports don’t require much walking, those in major cities have a considerable distance from the entrance to the gates. If walking long distances is hard for your child, consider bringing a stroller, which you can check at no charge at the gate. Or you can use children’s luggage that allows for sitting or movement, like a ride-on suitcase or suitcase with a flip-down scooter, says Dr. Martin.

Prepare for delays and cancellations. Before you fly, think about what your options are if your flights don’t take off as planned. Investigate if hotels in the airport itself or on airport property offer “day use” rooms, which could be helpful if you’re faced with a delay of several hours or longer. Be sure to download the app for the airline you’re flying; it’s generally the quickest way to rebook a canceled flight. And visit the U.S. Department of Transportation’s Customer Dashboard for information about what compensation you’re entitled to if there’s a delay or cancellation that isn’t related to weather or something outside of the airline’s control. There, you’ll also learn which airlines commit to seat children ages 13 and under with an accompanying adult at no additional cost.

#James Donaldson notes:
Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.
Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.
Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticle
Find out more about the work I do on my 501c3 non-profit foundation
website www.yourgiftoflife.org Order your copy of James Donaldson's latest book,
#CelebratingYourGiftofLife: From The Verge of Suicide to a Life of Purpose and Joy

Click Here For More Information About James Donaldson

Click here to follow James Donaldson's Blog

Getting ready for a road trip

Look for inclusive playgrounds. Make a note of playgrounds that are near your route. If your child is starting to get antsy in the car, a half-hour stop at a playground may head off a major meltdown. To search inclusive playgrounds by state, go to http://www.accessibleplayground.net.

Charge power banks. Most cars just have one charging port — and it always seems like all the passengers run low on battery at the same time. To prevent having to decide  who gets to use the charger, have a few power banks at the ready to hand out when needed.

Research attractions you’ll be passing by. If your family is a member of your local children’s museum, zoo, or aquarium, you might be able to visit others at no cost or a significantly reduced rate through a reciprocity program. Create a list of what might be open for a stop, so you’ll have options at the ready if traffic gets bad or your child gets restless.

Keeping kids happy while traveling 

Explore the airport. If your airport doesn’t have a sensory room, it may have a children’s play area or other fun novelties to see. For instance, in the Houston airport, there’s a large statue of a cow dressed as an astronaut. Once you’re ready to settle down, look for a nearby gate that’s relatively empty. “Stay there for as long as possible so your child can run around. Bring a beach ball — they can easily inflate and deflate to offer gross motor play,” says Dr. Martin.

Play to your child’s interests. If your child loves maps, for instance, print out an airport map in advance and allow the child to help direct you where to go. Or you can use the map as a distraction while waiting in a long line. While you’re in line to check bags, for instance, you might say, “Help me figure out where the train is to our terminal.”

Bring their own seat. If your child is under 40 pounds, bring an FAA-approved car seat for them to use on the plane. “The familiarity of being in a car seat can make the flight less stressful and it will be easier for your child to remain seated,” says Dr. Martin.

Utilize family restrooms. Many airports and rest stops have family restrooms that offer more space. However, they may have loud automatic flushing toilets and hand blowers that could bother a child with sensory issues. “When possible, carry supplies like sticky notes that can be placed over the sensors of toilets and extra wipes or towels to dry off hands,” says Dr. Dyson. 

Relax screen time rules. “We give up rules around devices when traveling,” says Phillipa Martin, who flies several times a year with her 7-year-old daughter who has autism. Carrie McLaren does the same for her special-needs daughter on road trips. “She can watch movies on the iPad the whole time we’re in the car and then I collect the device when we get to our destination,” says McLaren, who writes about family vacation experiences at carrieontravel.com. Dr. Martin suggests creating a set of apps and videos that are only used during travel. “This way, your child will look forward to traveling because theye get access to a set of special games and videos,” she says. Another option: Listening to an audiobook — especially one that’s set in a place you’re headed — is a fun and sneakily educational way to keep kids entertained.

Help them doze off. Nothing passes the time faster than a nap! Try to re-create your child’s pre-nap routine as closely as possible, even if it means changing them into PJs at a reststop, bringing their favorite blankie or eye mask on the trip, snuggling with them until they drift off, or all of the above.

Bring their favorite foods. “My daughter is very particular about what she eats, and it’s easiest to carry it with us,” says Martin. While you have more flexibility on a road trip where you can pack a well-insulated cooler, create a snack bag for the flight because airlines have limited options and airport lines are often long. Plus, hangry kids (and parents!) are often extra cranky. 

Choosing and staying at a hotel

Find hotels with staff who have special-needs training. A growing number of hotels and resorts have become Certified Autism Centers. To receive the designation, at least 80 percent of the guest-facing staff at the hotel or resort receive training in autism and sensory disorders from the International Board of Credentialing and Continuing Education Standards. You can search member properties at autismtravel.com.

Prioritize a kitchenette. If your child’s diet is limited, look for a hotel that has a microwave and a fridge in the room. “Minibars don’t usually get as cold as mini-fridges, so you might not be able to safely keep yogurt drinks or cheese in them,” Martin warns. If a mini-fridge doesn’t come standard, you can call the hotel directly to see if they offer them upon request. Better still, book a room that has a mini kitchen as well as a table and chairs so you don’t have to eat every meal out. 

Opt for keyless entry. Being able to head straight to your room and bypass the line at the front desk is being offered by a growing number of hotels, including chains like Hilton and Accor. Take advantage of the tech and save your family another wait.

Pack a reminder of home. Since kids love routines and familiar items, consider bringing a scent you use at home, their own pillowcase, and a favorite bedtime story to help them relax.

https://standingabovethecrowd.com/james-donaldson-on-mental-health-24-tips-for-traveling-with-children/

How to make flights and road trips easier for children with autism, anxiety, and other challenges

Writer: Karen Cicero

Clinical Experts: Margaret Dyson, PhD , Cynthia Martin, PsyD

What You'll Learn

- How can families help kids with mental health challenges prepare for air travel?

- What are some ways to make road trips easier for kids with mental health challenges?

- How can families make hotel stays work for kids with mental health challenges?

- Getting ready to fly

- Getting ready for a road trip

- Keeping kids happy while traveling 

- Choosing and staying at a hotel

Are you planning a family trip this year? If your child has anxiety, autism, sensory issues, or other special needs, the travel industry has stepped up to make traveling less challenging for you. The Child Mind Institute tapped its own experts, as well as travel pros and families who travel frequently, to create this guide to help you make flights and road trips easier all year long. 

Getting ready to fly

Research potential airports. More than 16 U.S. airports — including those in Atlanta, Miami, Seattle, and Newark — have dedicated sensory or quiet rooms that families can retreat to rather than waiting at the gate or in a crowded lounge. Some rooms have bean-bag chairs, quiet music, and dim lights while others offer a more tactile experience and even include a small aircraft mock-up for kids to explore. Before booking flights, check the website of your nearby airports and those in your travel destination to see if a sensory room is available. Note the location of the room within the terminal as well. While sensory rooms are open to all flyers, they may be located in a concourse that is used primarily by a specific airline. In that case, you may want to prioritize booking on an airline that operates out of that concourse. 

Try to avoid layovers. Direct flights will reduce the chance of delays and cancellations and minimize the number of transitions that your child will experience, says Margaret Dyson, PhD, a psychologist who specializes in autism. She also recommends avoiding flights that take off after your child’s bedtime. On major travel booking sites, it’s easy to filter the results by the number of stops and the hours of departure. If you can’t avoid a flight with a layover, be sure to explain to your child in advance that you’ll need to take two planes as part of your adventure.

Do a test run. Airports in Atlanta, Minneapolis-St. Paul, and Kansas City offer travelers the opportunity to schedule a familiarization experience. In Atlanta and Minneapolis-St. Paul, Delta volunteers guide families through TSA security procedures, exploring the terminal, and boarding a plane. The recently remodeled airport in Kansas City opened an “air travel experience room” inside a section of a retired plane so future passengers can practice buckling seatbelts, putting luggage in overhead bins, and opening the lavatory door. Additionally, the Arc Wings for Autism/Wings for All program hosts dozens of events throughout the year at various airports; check thearc.org to see if there’s one near you.

Practice at home. If you can’t take your child to a familiarization experience, you can watch videos so kids “can see and hear how a new experience might pan out,” says Kayla Castro, a special-education teacher and travel agent specializing in trips for families with mental health challenges. It’s a strategy that has helped her teen son who has autism navigate airports as well as attractions they plan to visit on vacation. The Federal Aviation Administration has a well-done “Kids’ First Flight” video on its YouTube channel. Reading children’s books, such as Bearplane! (ages 2–5) and Emma Every Day: First Flight (ages 5–7), may also be helpful. JetBlue and Autism Speaks also partnered on a downloadable travel guide that takes kids through each step in the airport process. Print it out and bring it with you to the airport or create your own visual list of “jobs” your child can focus on when they get to the airport, like getting a bin while going through security or walking through the metal detector. “They’ll know what to expect and can direct their energy in an independent way,” says Cynthia Martin, PsyD, a clinical psychologist who specializes in autism and other neurodevelopmental disorders.

Sign up for the Sunflower Lanyard Program. Staff at more than 240 airports worldwide have been trained to recognize that people who wear this lanyard have a disability that isn’t visible. For information about how to purchase a low-cost lanyard and which U.S. airports participate in the program, go to hdsunflower.com.

Alert your airline. If you’d like to board early with a child who has mental health challenges, it’s best to notify the airline in advance rather than make the request at the gate. If you didn’t do it at the time of booking, go to your airline’s website to find out how to add it to your reservation. Generally speaking, children with mental health disorders will feel more comfortable in a window or middle seat rather than the aisle, where they may be accidentally bumped by other passengers or the beverage cart. If you feel your child may have a better experience boarding toward the end of the process, alert the gate agent and, if possible, send one member of your family in advance to secure overhead luggage space. 

Simplify the security line. Download the MyTSA app on your smartphone, where you can check the current and average wait times to get through the security line. It will give you an idea about what days and times ares the most and least crowded at your airport. Regardless, travel experts recommend that families enroll in TSA PreCheck. Ninety-nine percent of TSA PreCheck passengers wait less than 10 minutes. If adults are enrolled in TSA PreCheck, their children ages 17 and under can join them in the line. Go to TSA.gov/precheck to find out how to enroll; new enrollment costs $78 per adult for 5 years but keep in mind that some credit cards issue a statement credit to help offset the cost. The TSA notes that most applications can be processed in 3 to 5 days. Whether or not you have TSA PreCheck, you can call the TSA Cares helpline at 855-787-2227 about 72 hours before your flight to request special assistance through security.

Strategize luggage. Pack a small backpack for each child to use as a personal item. You might want to include fidget toys, easy-to-contain creative items like Wikki Stix and sticker books, and snacks. In addition, consider designating an adult backpack for the family’s electronics, medications, and a change of clothes per family member. Check most or all of the remainder of the luggage and put an Airtag inside each so you can more easily locate lost luggage.”

Consider the airport size. While regional airports don’t require much walking, those in major cities have a considerable distance from the entrance to the gates. If walking long distances is hard for your child, consider bringing a stroller, which you can check at no charge at the gate. Or you can use children’s luggage that allows for sitting or movement, like a ride-on suitcase or suitcase with a flip-down scooter, says Dr. Martin.

Prepare for delays and cancellations. Before you fly, think about what your options are if your flights don’t take off as planned. Investigate if hotels in the airport itself or on airport property offer “day use” rooms, which could be helpful if you’re faced with a delay of several hours or longer. Be sure to download the app for the airline you’re flying; it’s generally the quickest way to rebook a canceled flight. And visit the U.S. Department of Transportation’s Customer Dashboard for information about what compensation you’re entitled to if there’s a delay or cancellation that isn’t related to weather or something outside of the airline’s control. There, you’ll also learn which airlines commit to seat children ages 13 and under with an accompanying adult at no additional cost.

#James Donaldson notes:Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticleFind out more about the work I do on my 501c3 non-profit foundationwebsite www.yourgiftoflife.org Order your copy of James Donaldson's latest book,#CelebratingYourGiftofLife: From The Verge of Suicide to a Life of Purpose and Joy

Click Here For More Information About James Donaldson

Click here to follow James Donaldson's Blog

Getting ready for a road trip

Look for inclusive playgrounds. Make a note of playgrounds that are near your route. If your child is starting to get antsy in the car, a half-hour stop at a playground may head off a major meltdown. To search inclusive playgrounds by state, go to http://www.accessibleplayground.net.

Charge power banks. Most cars just have one charging port — and it always seems like all the passengers run low on battery at the same time. To prevent having to decide  who gets to use the charger, have a few power banks at the ready to hand out when needed.

Research attractions you’ll be passing by. If your family is a member of your local children’s museum, zoo, or aquarium, you might be able to visit others at no cost or a significantly reduced rate through a reciprocity program. Create a list of what might be open for a stop, so you’ll have options at the ready if traffic gets bad or your child gets restless.

Keeping kids happy while traveling 

Explore the airport. If your airport doesn’t have a sensory room, it may have a children’s play area or other fun novelties to see. For instance, in the Houston airport, there’s a large statue of a cow dressed as an astronaut. Once you’re ready to settle down, look for a nearby gate that’s relatively empty. “Stay there for as long as possible so your child can run around. Bring a beach ball — they can easily inflate and deflate to offer gross motor play,” says Dr. Martin.

Play to your child’s interests. If your child loves maps, for instance, print out an airport map in advance and allow the child to help direct you where to go. Or you can use the map as a distraction while waiting in a long line. While you’re in line to check bags, for instance, you might say, “Help me figure out where the train is to our terminal.”

Bring their own seat. If your child is under 40 pounds, bring an FAA-approved car seat for them to use on the plane. “The familiarity of being in a car seat can make the flight less stressful and it will be easier for your child to remain seated,” says Dr. Martin.

Utilize family restrooms. Many airports and rest stops have family restrooms that offer more space. However, they may have loud automatic flushing toilets and hand blowers that could bother a child with sensory issues. “When possible, carry supplies like sticky notes that can be placed over the sensors of toilets and extra wipes or towels to dry off hands,” says Dr. Dyson. 

Relax screen time rules. “We give up rules around devices when traveling,” says Phillipa Martin, who flies several times a year with her 7-year-old daughter who has autism. Carrie McLaren does the same for her special-needs daughter on road trips. “She can watch movies on the iPad the whole time we’re in the car and then I collect the device when we get to our destination,” says McLaren, who writes about family vacation experiences at carrieontravel.com. Dr. Martin suggests creating a set of apps and videos that are only used during travel. “This way, your child will look forward to traveling because theye get access to a set of special games and videos,” she says. Another option: Listening to an audiobook — especially one that’s set in a place you’re headed — is a fun and sneakily educational way to keep kids entertained.

Help them doze off. Nothing passes the time faster than a nap! Try to re-create your child’s pre-nap routine as closely as possible, even if it means changing them into PJs at a reststop, bringing their favorite blankie or eye mask on the trip, snuggling with them until they drift off, or all of the above.Bring their favorite foods. “My daughter is very particular about what she eats, and it’s easiest to carry it with us,” says Martin. While you have more flexibility on a road trip where you can pack a well-insulated cooler, create a snack bag for the flight because airlines have limited options and airport lines are often long. Plus, hangry kids (and parents!) are often extra cranky. 

Choosing and staying at a hotel

Find hotels with staff who have special-needs training. A growing number of hotels and resorts have become Certified Autism Centers. To receive the designation, at least 80 percent of the guest-facing staff at the hotel or resort receive training in autism and sensory disorders from the International Board of Credentialing and Continuing Education Standards. You can search member properties at autismtravel.com.

Prioritize a kitchenette. If your child’s diet is limited, look for a hotel that has a microwave and a fridge in the room. “Minibars don’t usually get as cold as mini-fridges, so you might not be able to safely keep yogurt drinks or cheese in them,” Martin warns. If a mini-fridge doesn’t come standard, you can call the hotel directly to see if they offer them upon request. Better still, book a room that has a mini kitchen as well as a table and chairs so you don’t have to eat every meal out. 

Opt for keyless entry. Being able to head straight to your room and bypass the line at the front desk is being offered by a growing number of hotels, including chains like Hilton and Accor. Take advantage of the tech and save your family another wait.

Pack a reminder of home. Since kids love routines and familiar items, consider bringing a scent you use at home, their own pillowcase, and a favorite bedtime story to help them relax. https://standingabovethecrowd.com/?p=16170

James Donaldson on Mental Health - Psychologist urges honest conversation around suicide in the wake of Marshawn Kneeland's death

By Nicole Nielsen

The death of Cowboys player Marshawn Kneeland by suicide is a tragedy and a reminder that mental health struggles do not discriminate.

Even for athletes or celebrities, suicide continues to claim lives, regardless of fame or success.

Mental illness doesn't spare anyone

"It doesn't matter how rich, or famous, or talented you are," said Dr. Jaya Mathew, psychologist and founder of Wellness 360 in Dallas. "Mental illness kills."

In the wake of Kneeland's death, Mathew said she hopes the heartbreaking news encourages people to have an honest conversation about suicide, which is something many still avoid.

"We avoid it like the plague," she said. "We think almost by saying the word suicide that we're going to cause harm, but we're not. We have to ask the question."

#James Donaldson notes:
Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.
Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.
Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticle
Find out more about the work I do on my 501c3 non-profit foundation
website www.yourgiftoflife.org Order your copy of James Donaldson's latest book,
#CelebratingYourGiftofLife: From The Verge of Suicide to a Life of Purpose and Joy

Click Here For More Information About James Donaldson

Click here to follow James Donaldson's Blog

Suicide statistics show alarming trend

According to the CDC, nearly 49,000 people died by suicide in 2023 — one person every 11 minutes. When a public figure dies by suicide, it can often serve as a turning point for others struggling in silence, particularly men, Mathew said.

"Research does show that more men die by suicide," she said. "High pressure, high stakes, high demand."

NFL has expanded mental health care

While the NFL has taken steps in recent years to expand mental health resources for players, including on-site clinicians, Mathew said loved ones still play a vital role in recognizing the warning signs, such as hopelessness, giving away possessions or sudden isolation. A family member can also offer a sympathetic ear and try to connect them with help.

"It gives them a moment to say someone is paying attention," she said. "If you know someone with lethal drugs or guns, please put them away safely and securely, at a distance."

A call to check on others

Mathew said she hopes Kneeland's death becomes a catalyst for awareness and prevention.

"Let this be a call to action," she said. "As we sit in this sort of collective grief that a young life was lost, let's make a commitment to checking in on one another and asking these questions about mental illness and mental health."

If you or someone you know is struggling, call or text 988 to reach the Suicide and Crisis Lifeline for free help.

https://standingabovethecrowd.com/james-donaldson-on-mental-health-psychologist-urges-honest-conversation-around-suicide-in-the-wake-of-marshawn-kneelands-death/

James Donaldson on Mental Health - Entertainment duo the Kessler twins die by assisted suicide, aged 89

By Issy Ronald, Stephanie Halasz, Sharon Braithwaite

Alice Kessler and Ellen Kessler

EDITOR’S NOTE:  If you or someone you know is struggling with mental health, help is available. Dial or text 988 or visit 988lifeline.org for free and confidential support.

Alice and Ellen Kessler, the German twins who rose to fame in the 1950s as a variety entertainment duo, have died at the age of 89 by joint assisted suicide, advocacy organization the German Society for Humane Dying (DGHS) said on Tuesday.

Local police confirmed to CNN on Tuesday that “there was a deployment yesterday lunchtime in Gruenwald” – the leafy suburb of Munich where the twins lived – but did not say the reason for that deployment.

The twins contacted the DGHS, which provides access to lawyers and doctors, more than a year ago and became members, the organization told CNN on Tuesday.

“The decisive factor is likely to have been the desire to die together on a specific date,” DGHS spokesperson Wega Wetzel told CNN, adding that she wasn’t aware of the precise reasons given by each woman.

“Their desire to die was well-considered, long-standing, and free from any psychiatric crisis,” Wetzel said.

During an interview with Italian newspaper Corriere della Sera last year, the twins said they wanted “to go away together on the same day.” “The idea that one of us might get it first is very hard to bear,” they added.

They wished to have their ashes interred in the same urn too, alongside their mother Elsa and dog Yello, Ellen Kessler told German tabloid Bild last year.

Assisted dying, under certain circumstances, is legal in Germany after the country’s top court ruled in 2020 that an individual has the right to end their life and to seek help from a third party if they aren’t subject to external influences.

How to get help
- Help is available if you or someone you know is struggling with suicidal thoughts or mental health matters.
- In the US: Call or text 988, the Suicide & Crisis Lifeline.
- Globally: The International Association for Suicide Prevention and Befrienders Worldwide have contact information for crisis centers around the world.
-

With their blonde, coiffed hair, long legs and talent for both singing and dancing, the Kessler twins embodied the aesthetic of the 1950s and 60s showgirl.

As children, they attended classical ballet school before fleeing East Germany in 1952 to pursue dance. Shortly after, the twins began their careers at the Lido in Paris, a venue known for its cabaret performances, but they quickly transcended that world.

#James Donaldson notes:
Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.
Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.
Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticle
Find out more about the work I do on my 501c3 non-profit foundation
website www.yourgiftoflife.org Order your copy of James Donaldson's latest book,
#CelebratingYourGiftofLife: From The Verge of Suicide to a Life of Purpose and Joy

Click Here For More Information About James Donaldson

Click here to follow James Donaldson's Blog

Alice and Ellen Kessler reached the height of their fame in the 1950s and 1960s. 

They represented Germany at the 1959 Eurovision Song Contest, appeared several times on “The Ed Sullivan Show,” once featured on the cover of Life magazine, and moved in circles populated by the biggest stars of that era like Fred Astaire, Frank Sinatra, Elvis Presley and Rock Hudson.

“The Ed Sullivan Show” posted a tribute to the Kessler twins on social media, remembering them as “dazzling stars, true legends, and sisters whose grace, charm, and magic will shine forever.”

Fame in Italy

The sisters soon became stars in Italy too. They made history as the first showgirls to appear on Italian television and the first female stars to show their legs on screen, according to Eurovision. However, they had to wear opaque tights due to the strict Christian conservative values of the time, state broadcaster RAI said. Nevertheless, their legs were dubbed “the legs of the country.”

And when they posed naked for the Italian edition of Playboy in 1976, it sold out in three hours, according to Eurovision’s website.

They appeared in Italian movies and in theater, achieving such widespread fame there that state broadcaster RAI released a detailed plan on Tuesday of the ways in which it would cover their deaths, both on the news and by rerunning old television shows starring them.

The sisters’ entertainment careers continued long after the era of the showgirl had waned. As well as making guest appearances on German television, they starred in a musical that played in Berlin, Munich and Vienna from 2015 to 2016.

Their lives were intertwined beyond just their shared career. They lived in “two mirrored, connecting apartments,” the sisters told Corriere della Sera last year, and would meet every day at noon for lunch.

The twins were born in a village that today belongs to Grimma, a town in Saxony.

Tino Kießig, the mayor of Grimma, said in a statement Monday that the town “mourns the loss of these two world-renowned personalities.”

https://standingabovethecrowd.com/james-donaldson-on-mental-health-entertainment-duo-the-kessler-twins-die-by-assisted-suicide-aged-89/

James Donaldson on Mental Health - Genes may predict suicide risk in depression

Depression in young adulthood has a stronger hereditary component and is associated with a higher risk of suicide attempts than depression that begins later in life, according to a new study published in Nature Genetics by researchers at Karolinska Institutet, among others.

“We hope that genetic information will be able to help healthcare professionals identify people at high risk of suicide, who may need more support and closer follow-up,” says Lu Yi, senior researcher at the Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, and one of the study’s corresponding authors.

Depression is a common mental illness that can affect people at different stages of life. The new study shows that depression that begins before the age of 25 has a stronger hereditary component than depression that begins late in life.

#James Donaldson notes:
Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.
Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.
Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticle
Find out more about the work I do on my 501c3 non-profit foundation
website www.yourgiftoflife.org Order your copy of James Donaldson's latest book,
#CelebratingYourGiftofLife: From The Verge of Suicide to a Life of Purpose and Joy

Click Here For More Information About James Donaldson

Click here to follow James Donaldson's Blog

Major genetic differences

The study, based on medical records and genetic data from over 150,000 people with depression and 360,000 controls in Denmark, Sweden, Norway, Finland and Estonia, compared genetics and risk of suicide attempts in people who had their first depression before the age of 25 (early onset) and those diagnosed after the age of 50 (late onset).

The genetic differences between the groups were large. The researchers identified twelve genetic regions that were linked to early onset and two regions that were linked to late onset. One in four people with a high genetic risk of early-onset depression attempted suicide within ten years of diagnosis, which was about twice as many as people with a low genetic risk.

“We show that early-onset depression has partly different genetic causes than depression that affects older individuals and that the risk of suicide attempts is increased,” says Lu Yi. “This is an important step towards precision medicine in psychiatry, where treatment and preventive measures are tailored to each individual.” 

Suicide prevention in healthcare

The researchers now plan to investigate how the genetic differences are related to brain development, stress and life experiences, and whether genetic risk profiles can be used in suicide prevention in healthcare.

https://standingabovethecrowd.com/james-donaldson-on-mental-health-genes-may-predict-suicide-risk-in-depression/