The Hidden Pandemic

Losing my sister to suicide during COVID-19 taught me that there is another pandemic — suicide, the second leading cause of death among people ages 15-24 — and that our education system and society fail us every day with its shameful lack of suicide prevention awareness. 

Losing my sister to suicide during COVID-19 taught me that there is another pandemic — suicide, the second leading cause of death among people ages 15-24 — and that our education system and society fail us every day with its shameful lack of suicide prevention awareness. 

I was in the car with her just us two. 

“So why were you in therapy?” I asked, trying to get something out of my typically quiet sister.

“I was in therapy for suicidal thoughts,” Kelly whispered.

“Oh my goodness. Do you still have those thoughts? Are you okay now?”

“Yeah… I’m fine now.”

“Thank God. I’m so relieved to hear that.”

Kelly (left) and Belinda (right)

And that was it. The conversation I would do anything to go back to. 

I can’t believe I didn’t ask her a flood of follow-up questions: “Do you ever still have those thoughts? How severe are those thoughts? Have you ever attempted or thought of ways to end your life? Do you have the help and support you need? How can I help you? Please know you can ALWAYS turn to me when you are feeling suicidal. Please.” I have so many regrets that I couldn’t possibly list all of them.

Instead, after the mention of suicidal ideation, we moved on to more frivolous topics.

Almost a year later, Kelly died on August 23, 2020, amid COVID-19, to suicide. Before her passing, my family was able to spend a few days with her in the ICU, crying, talking to her, kissing her, holding her hand, telling her we loved her, and saying goodbye. 

I have no doubt in my mind that the pandemic affected her mental health and pushed her over the edge. Suicide is the 10th leading cause of death in our nation. According to the CDC, “suicide rates increased 33% between 1999 and 2019, with a small decline in 2019. It was responsible for more than 47,500 deaths in 2019, which is about one death every 11 minutes.” This rate has unsurprisingly gone up during the pandemic.

Suicide is the second leading cause of death among youth ages 15-24

Of course, it takes more than one person to help someone severely depressed. It takes a community. There needs to be education from the ground up. Society at large, universities and jobs, families and friends, therapists and everyone in between should be there for someone who is thinking about ending their life. Every person in this position should have that kind of support. It should come without stigma and shame. If that were the case, we would lose far fewer people.

At Kelly’s funeral, my father admitted, for the first time, that mental illness is real. He tearfully apologised to Kelly for not having taken her depression more seriously in the past. 

As a Chinese-American, I can say without hesitation that mental illness and suicide are not discussed enough in the AAPI community. AAPI Women Lead reports, “AAPIs have the lowest help-seeking rate of any racial/ethnic group with only 23.3% of AAPI adults with a mental illness receiving treatment in 2019. In a survey of AAPI adults with mental illness, 73.1% did not receive treatment.” Barriers to seeking help include the stigma, high cost, insufficient insurance, immigration status, language barrier, mistrust of healthcare providers, and more. 

The thing is: mental illness and suicide are not talked about enough in any community. A suicide hotline is not enough.

We should have full-on suicide prevention programs starting from junior high school or earlier. We should learn how to recognize depression in ourselves and others, how depression is a very serious matter, how to seek help, that there shouldn’t be any stigma or shame attached to mental illness, and how to help a loved one who is going through depression or is suicidal. I am actually at a loss for words at how our education system and society at large fail us in this regard. 

When someone at my high school took their life my sophomore year, there was an awkward and sad morning announcement about it. And nothing else. No “here’s how to seek help if you’re feeling suicidal” assembly. No “mental health awareness day.” Nothing. This is shameful and shocking when looking at the statistics presented earlier. I’m certain that almost everyone has either lost a loved one to suicide or knows someone who has. This pandemic should be addressed, and the earlier, the better. We should have suicide prevention courses in school or programs that educate us the way after-school drug abuse awareness programs did.

The American Foundation for Suicide Prevention (AFSP) is a helpful resource to which my family has donated a significant amount of money in Kelly’s honor. It has a “Talk Saves Lives” program that — in an hour or less — provides participants with a clear understanding of this leading cause of death. It includes education on the most up-to-date research on suicide prevention and what people can do in their communities to save lives. The website says participants will learn common risk factors and warning signs associated with suicide, and how to keep themselves and others safe. AFS also supports requirements for regular suicide prevention training in schools K-12. 

“AFSP urges that states require schools to have comprehensive suicide prevention, intervention, and postvention policies in place. Policies guide and support school personnel in knowing when and how to refer students for additional help and in responding safely when a suicide or suicide attempt occurs in the school community,” stated on the website.

These programs are vital, especially now, as we continue to survive through COVID. There have been several pieces about how peoples’ mental health has declined as the pandemic roamed on. Gen Z’s mental health is taking the biggest hit it’s ever taken; “63% of 18–24-year-olds in the US reported experiencing anxiety and depression, with a quarter of young adults resorting to increased substance use to deal with stress. The same number (25%) even reported that they’d considered suicide in the past thirty days.”

This doesn’t just affect Gen Z. My family has been experiencing poor mental health from losing my sister, going through COVID, and other challenging life reasons. Now, instead of suffering in isolation, we’ve come together. My family has become a lot closer and more empathetic after Kelly’s loss. We are more sensitive to one another’s struggles and pain. But I’d still rather Kelly be here, a million times over. There is no silver lining to a tragedy like this. There is only the need for more empathy, awareness, and education.

All images were provided by the author in memory of Kelly Cai

If you are having thoughts of harming yourself, please contact the National Suicide Prevention Line, as it is currently the most prominent immediate resource. Other resources include American Foundation for Suicide Prevention (AFSF), National Alliance on Mental Health (NAMI), National Institute of Mental Health (NIMH), Suicide Prevention Resource Center (SPRC), and the Centers for Disease Control and Prevention (CDC)

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