By Eric Ralls

Parents do not just feed and clothe teenagers – they also set the emotional climate at home. A new study of 583 students in western Nepal links that climate to striking differences in depression, anxiety, stress, and self-esteem.

Globally, one in seven adolescents lives with a mental disorder, and suicide ranks among the leading causes of death for young people. 

The World Health Organization notes that adolescence is the phase of life between childhood and adulthood, from ages 10 to 19.

Parents shape teen mental health

Psychologists use the phrase parenting style, a consistent pattern of warmth and control adults show their children, to describe broad approaches to raising kids. 

Classic work organizes these approaches into three main styles that differ in how strict and how supportive parents are.

The work was led by Rabina Khadka, a public health lecturer at the Manmohan Memorial Institute of Health Sciences in Kathmandu (MMIHS).

Among the parenting styles, authoritative parenting is a mix of clear expectations and warm responsiveness to the child. This approach is often described as the most balanced. It gives teenagers both guidance and room to develop their own judgment.

“Authoritative parenting styles are associated with better mental health and self-esteem among adolescents,” stated Khadka. 

The team’s findings suggest that this blend of structure and support may help teens handle stress and setbacks more confidently.

Depression, stress, and self-esteem

The team carried out a cross-sectional study, a one-time survey of students at a single point in time in Bheemdatt Municipality. They asked teens about symptoms of depression, anxiety, stress, and their sense of self-worth.

About one-third of the adolescents screened positive for depression, and almost half showed signs of anxiety. Roughly one-quarter met the cutoffs for high stress, while most still reported relatively high self-esteem.

To understand these patterns, the researchers used a statistical method that estimates how factors relate to the odds of an outcome. 

The models accounted for many background factors, so the links between parenting style and mental health were unlikely to be accidental.

The same models showed that social context mattered a great deal. Youth who reported being bullied or feeling less close to friends and teachers faced significantly higher odds of psychological distress and lower self-esteem.

The role of predictable boundaries

The study also examined authoritarian parenting, a style that relies on strict rules, firm demands, and little discussion of the reasons behind them. 

Adolescents in these families were more likely to report symptoms of depression and tended to describe themselves in more negative emotional terms.

In contrast, permissive parenting – a style where parents are warm but allow freedom with few limits – was tied to elevated stress in Nepali teens. 

Without predictable boundaries, young people may feel unsupported when school pressure or social problems build up.

Parents strongly affect teen health

Self-esteem patterns added another twist. Teenagers who saw their parents as authoritative reported lower self-esteem.

Teens with authoritarian parents reported higher scores – challenging ideas about confidence and control.

Previous research has also found that parenting style and adolescent mental health are linked, though not always in the same way. 

A recent study of Malaysian pre-university students linked authoritarian parenting and fathers’ education to depression, anxiety, and stress.

Rethinking support for adolescents

Taken together, the Nepal findings highlight the importance of a supportive home environment, a family climate where adults notice changes, listen, and respond calmly. 

This echoes broader guidance from the World Health Organization, which stresses that home, school, and community relationships are central to adolescent mental health.

The results also point to the double burden carried by teenagers who face both unsupportive parenting and bullying at school. 

#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

Providing support for teens

When criticism or control follows a young person from home to the classroom or playground, opportunities to recover emotionally shrink.

Schools and local governments can respond by strengthening counseling services, enforcing anti-bullying rules, and inviting parents into conversations about mental health. 

Families, meanwhile, can practice simple habits such as regular check-in talks, shared activities, and clear but respectful rules.

Ultimately, the research suggests that how adults talk, listen, and set limits at home can shape whether adolescent distress becomes a lasting problem or remains manageable. https://standingabovethecrowd.com/?p=16199

James Donaldson on Mental Health - Men's Mental Health: Why we must talk about men's mental health and suicide prevention

Mental health is still treated as a silent battle for many men. Breaking this silence is essential to prevent emotional distress and rising suicide cases.

Why we must talk about men’s mental health and suicide prevention

Smarica Pant

Mental health is a crucial part of overall well-being, yet it remains one of the most overlooked conversations, especially when it comes to men. From a young age, boys are often told to “stay strong,” “man up,” and “don’t cry,” conditioning them to hide their emotions rather than express them.

These expectations follow them into adulthood, where many men begin to believe that vulnerability is a weakness and that seeking help is a sign of failure. As a result, thousands silently carry the weight of stress, anxiety, loneliness, financial pressures, relationship issues, and unresolved trauma.

When these emotions remain unspoken, they can grow into serious mental health challenges, including depression, substance dependence, and, in severe cases, suicide.

Across India and in many parts of the world, there is a worrying rise in suicides among men, a reminder that the pressure to “be strong” is not a strength, but a silent crisis.

Explaining the pattern, Dr Poonam Santhosh, Consultant – Psychiatry, KMC Hospital, Mangalore, says men often reach out for help much later than women.

“Men’s mental health issues are ignored to the point that they seek help only when symptoms become severe. We see more cases of severe depression and severe anxiety in men, and completed suicides are also much higher in men,” she says.

Dr Santhosh adds that breaking stereotypes is essential.

“Society has built this idea that men must ‘man up’ or should not cry. Men themselves need to challenge this by talking openly about their feelings, seeking timely help, and reaching out when they are struggling,” she explains.

WHY MEN STRUGGLE TO TALK ABOUT MENTAL HEALTH

1. Social conditioning starts early

From childhood, many boys have been discouraged from showing sadness or fear. These beliefs become deep-rooted, making it harder for men to discuss emotional pain later in life.

2. Fear of judgment

Many men worry they will be judged as “weak” if they open up. This fear stops them from sharing feelings even with close friends or partners.

3. Limited emotional vocabulary

Because emotional expression is often discouraged, many men grow up without the tools to describe what they’re feeling. For them, irritation or anger becomes the easiest outlet—even when the root issue is stress or anxiety.

4. Lack of awareness

Men may ignore early signs of depression or burnout, assuming these are just “bad days” or temporary stress.

5. The provider's pressure

Financial stress, job insecurity, and societal expectations to be the “provider” add extra emotional weight.

THE RISING SUICIDE RISK AMONG MEN

Men account for a disproportionately high percentage of suicides globally. Studies show that men are less likely to seek therapy, delay medical help, and internalise stress, leading to a higher risk during emotional crises.

Factors include:

- Untreated depression
- Substance abuse
- Loneliness
- Relationship breakdowns
- Work pressure
- Lack of emotional support systems

#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

The uncomfortable truth is simple: not talking about mental health is costing lives.

BREAKING THE SILENCE: WHAT NEEDS TO CHANGE

1. Normalising emotional conversations

Men need safe spaces at home, workplaces, and social groups where they can express feelings without mockery or judgment.

2. Encouraging therapy

Therapy should be viewed as a positive step toward well-being, not a last resort.

3. Educating families and schools

Children must learn that emotions are not signs of weakness. Changing early conditioning can prevent long-term harm.

4. Promoting mental health in workplaces

Employee assistance programs, stress-management sessions, and anonymous counselling can help men access support.

5. Supporting each other

A simple check-in, “How are you, really?” can sometimes change the course of someone's day.

The conversation around men’s mental health must shift from silence to understanding. It’s time to replace “stay strong” with “it’s okay to ask for help.”

When men open up, seek support, and allow themselves to be vulnerable, they not only protect their mental well-being but also create a healthier environment for their families and communities.

https://standingabovethecrowd.com/james-donaldson-on-mental-health-mens-mental-health-why-we-must-talk-about-mens-mental-health-and-suicide-prevention/

Mental health is still treated as a silent battle for many men. Breaking this silence is essential to prevent emotional distress and rising suicide cases.

Why we must talk about men’s mental health and suicide prevention

Smarica Pant

Mental health is a crucial part of overall well-being, yet it remains one of the most overlooked conversations, especially when it comes to men. From a young age, boys are often told to “stay strong,” “man up,” and “don’t cry,” conditioning them to hide their emotions rather than express them.

These expectations follow them into adulthood, where many men begin to believe that vulnerability is a weakness and that seeking help is a sign of failure. As a result, thousands silently carry the weight of stress, anxiety, loneliness, financial pressures, relationship issues, and unresolved trauma.

When these emotions remain unspoken, they can grow into serious mental health challenges, including depression, substance dependence, and, in severe cases, suicide.

Across India and in many parts of the world, there is a worrying rise in suicides among men, a reminder that the pressure to “be strong” is not a strength, but a silent crisis.

Explaining the pattern, Dr Poonam Santhosh, Consultant – Psychiatry, KMC Hospital, Mangalore, says men often reach out for help much later than women.

“Men’s mental health issues are ignored to the point that they seek help only when symptoms become severe. We see more cases of severe depression and severe anxiety in men, and completed suicides are also much higher in men,” she says.

Dr Santhosh adds that breaking stereotypes is essential.

“Society has built this idea that men must ‘man up’ or should not cry. Men themselves need to challenge this by talking openly about their feelings, seeking timely help, and reaching out when they are struggling,” she explains.

WHY MEN STRUGGLE TO TALK ABOUT MENTAL HEALTH

1. Social conditioning starts early

From childhood, many boys have been discouraged from showing sadness or fear. These beliefs become deep-rooted, making it harder for men to discuss emotional pain later in life.

2. Fear of judgment

Many men worry they will be judged as “weak” if they open up. This fear stops them from sharing feelings even with close friends or partners.

3. Limited emotional vocabulary

Because emotional expression is often discouraged, many men grow up without the tools to describe what they’re feeling. For them, irritation or anger becomes the easiest outlet—even when the root issue is stress or anxiety.

4. Lack of awareness

Men may ignore early signs of depression or burnout, assuming these are just “bad days” or temporary stress.

5. The provider's pressure

Financial stress, job insecurity, and societal expectations to be the “provider” add extra emotional weight.

THE RISING SUICIDE RISK AMONG MEN

Men account for a disproportionately high percentage of suicides globally. Studies show that men are less likely to seek therapy, delay medical help, and internalise stress, leading to a higher risk during emotional crises.

Factors include:

- Untreated depression

- Substance abuse

- Loneliness

- Relationship breakdowns

- Work pressure

- Lack of emotional support systems

#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

The uncomfortable truth is simple: not talking about mental health is costing lives.

BREAKING THE SILENCE: WHAT NEEDS TO CHANGE

1. Normalising emotional conversations

Men need safe spaces at home, workplaces, and social groups where they can express feelings without mockery or judgment.

2. Encouraging therapy

Therapy should be viewed as a positive step toward well-being, not a last resort.

3. Educating families and schools

Children must learn that emotions are not signs of weakness. Changing early conditioning can prevent long-term harm.

4. Promoting mental health in workplaces

Employee assistance programs, stress-management sessions, and anonymous counselling can help men access support.

5. Supporting each other

A simple check-in, “How are you, really?” can sometimes change the course of someone's day.

The conversation around men’s mental health must shift from silence to understanding. It’s time to replace “stay strong” with “it’s okay to ask for help.”

When men open up, seek support, and allow themselves to be vulnerable, they not only protect their mental well-being but also create a healthier environment for their families and communities. https://standingabovethecrowd.com/?p=16197

James Donaldson on Mental Health - Suicide: Stepping into uncomfortable spaces

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/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

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/james-donaldson-on-mental-health-suicide-stepping-into-uncomfortable-spaces/

James Donaldson on Mental Health - Suicide: Stepping into uncomfortable spaces

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/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

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/james-donaldson-on-mental-health-suicide-stepping-into-uncomfortable-spaces/

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/