Suicide Prevention: Reducing Risks and Sharing Resources

Welcome to OIB-TAC’s monthly webinars, where our presenters share valuable information and helpful resources to support professionals working with older adults who are blind or vision impaired. Let’s check out this month’s webinar.

Michael Nadorff: So welcome to our presentation today on suicide and vision impairment. My name is Michael Nadorff. I'm a professor of psychology at Mississippi State University and a clinical psychologist. And my area of research is suicide and suicide prevention. And with that, I'd also like to introduce my doctoral student Chandler McDaniel.

So Chandler, if you'll introduce yourself.

Chandler McDaniel: Hello, as stated, my name is Chandler McDaniel. I am a doctoral student in the clinical psychology program at Mississippi State University. Um, and my research area, it looks more at, uh, public safety psychology. So right now I'm actually working at a prison in Florida completing my pre doctoral internship.

Um, and throughout this presentation, I will be giving just some kind of context and some thoughts as I come in with a lived experience piece of being visually impaired myself.

Michael Nadorff: Very good. So, kicking off, just looking at suicide, I think it's often helpful to start with numbers just to give a sense of the magnitude of the problem.

So, I thought I'd run through the numbers first and foremost. So, you know, if we looked at the most recent year where we have data, there were over 49,000 suicides, and that sounds like a lot. It is a lot, but it's hard to get a sense of exactly how big that is, until you look at it in reference to other causes of death.

So I don't do this in any way to minimize any of these other causes of death, but just to give context for it. And especially I want you to think about the efforts we do in prevention for these other causes of death. So, you know, one of the things that, um, people sometimes think about is lightning. So, you know, lightning is pretty rare, but it happens.

You know, as far as deaths by lightning. You know, we'll clear out full football stadiums if there's lightning in the area. So you'd assume that, you know, lightning probably causes quite a few deaths. It does cause some. It causes about 51 in any given year. So, again, just look at the magnitude of the difference.

Another one is fire. You know, we have fire drills that we do. And every, you know, room in the house or every bedroom is required to have a smoke alarm, which is good because there are 3,000 people that die by fire every year. Drownings. You know, a lot of people are worried about drowning, obviously, and that's why we have lifeguards.

And it's good because there are 4,500 people that die every year. Now, the ones that, you know, tend to surprise people depending on where you live. So homicides is a big one. So, um, we know, you know, if you live in a big city, you're certainly going to hear a lot about homicides on the news, and there are a lot of homicides.

So there are 19,000 homicides every year. And then the one that usually surprises people the most is motor vehicle accidents. So, overall, there are 40, 000 deaths due to motor vehicle deaths, which is significantly lower than suicide. And actually, there's a literature suggesting that the, uh, the rate you see there, uh, the suicide number is probably drastically under reporting, probably by about 25 percent due to stigma.

So the thought is if you look at motor vehicle deaths, for instance, if you have it where someone drives off the road and there are no tire marks, you know, no brake marks, are you as a coroner going to assume that that person fell asleep at the wheel and it was accidental or that that was a suicide attempt?

Without any other data, if there's no letter or anything else, you're probably going to assume it was accidental. So, with it, there are probably some of those motor vehicle deaths, for instance, that were actually, um, they're actually suicides. Overall, it is the 11th leading cause of death, and the second highest for adolescents and young adults.

It's not to say that the rate is highest in adolescents and young adults. It's actually highest overall in midlife, but specifically if you really look at subgroups, older adult white men have the highest suicide rate. But as far as causes of death, just because thankfully young adults don't die as much, suicide is the second leading cause of death.

Chandler, anything I missed or anything you wanted to add on this?

So, one of the things that really stands out about suicide is that the suicide rate has gone up every single year, um, minus a couple over the last decade. And I say minus a couple because really it was just during COVID we saw a brief decrease in suicide, but it's since recovered and this last year was again the highest suicide rate we've ever had in the U.S.

And when you look at over the last ten years, the rate is actually up about 23%. So, this is not a little increase. This is, percentage wise, huge. You know, you think of any other cause of death, you know, just how much of an outcry there would be if there was a 23 percent increase in it. And, I do believe that suicide, you're hearing more about, you're seeing more in the news and you know, you're seeing more prevention. But again, it's because there's this huge increase. And what's especially notable is we see the increase across the board. As you can see, men, women, caucasian, non caucasian. But where it really stands out is youth. So again, even though youth don't have the highest suicide rate as far as the increase that's where we're seeing our greatest increase. Chandler, any thoughts you have on this?

Nope, okay. I know you have thoughts later, so that's okay. So, one of the things that's really fortunate timing for us is, um, instead of going through a bunch of different studies, there just this year was a, um, a meta analysis, which is a study of studies looking at, you know, 31 different population based studies of over 5.6 million people. So, it combines the data from all of these studies to look at the impact of visual impairment on suicide risk. And what we see is that there's an increase in risk across the board for suicidal thoughts, which is what suicidal ideation is, suicide attempts and also death by suicide. And we see if you're not familiar with odds ratios, basically a score of one means that you're as at risk as another group and anything above is higher risk.

So a score of two here means that you're at double the risk of suicidal thoughts, two and a half times the risk of suicide attempt, and just under two times the risk of death by suicide. And what we saw here that was kind of interesting, uh, and again, I think it relates to that last slide, is that there was an association with age so that actually, the group with highest risk among those with visual impairment was adolescents and young adults.

Chandler, any thoughts on that?

Chandler McDaniel: Yes. So, um, whenever we think about age, right, and we think about adolescence, one of the reasons for this is because there's so many, biological and psychological changes occurring at adolescence, right? You're going through puberty. You know, you're learning who you are.

You're really trying to figure out, um, you know, who you are as a person, what you stand for, things like that. But then also just, anecdotally speaking, I remember being an adolescent and also being visually impaired. One of the things that really stood out to me was feeling very isolated and feeling very, um, different than my peers and, you know, them not necessarily understanding when I say I can't see that, what I mean by that. And so, you know, anecdotally speaking, that was something that was really difficult. And I think that would likely be relevant to this as well.

Michael Nadorff: I think there's also something too, and I'm curious your feelings on this about being what we call off time. So the thought is just the more something is abnormal with everyone else in your developmental group, the harder it is. So, as we get older, you know, like some amount of visual impairment is more common. You know, a lot of people end up needing reading glasses and, you know, it just becomes more of a common thing. But when you're young and you have this disability, that's much more abnormal.

Chandler McDaniel: Absolutely. I absolutely agree with that.

You know, when you're, uh, younger, that's definitely less prevalent. Um, and you know, when you're a kid, nobody wants to be. the, the different one, right? Everybody wants to fit in. And I think that that's something that definitely plays a part in this as well.

Michael Nadorff: So one of the big questions that comes up now is why?

Why is it that those with visual impairments are at higher risk of suicide? And so with that, we're going to talk about some of the literature on disability broadly. And then get into some of the theories of suicide. So this was actually a study that my lab did many moons ago, where we were looking at suicide acceptability in those with a disability.

So this was a vignette based study. So what that means is that people, our participants were given stories of people dealing with either challenges or stressful events in their life. And there are two groups. There's a group that just had that but did not have a disability, and there's a group that had a disability in addition to having that stressful life event. And what was shown in our study is that suicidality was viewed as more acceptable by those who had a disability. So, you know, when we looked at those that had a disability, you know, in those vignettes, people said, Yeah, if they choose to end their life, that, that made sense.

That was higher for those cases where there's a disability present than when there wasn't. And one thing that surprised us, but we thought was interesting, is that, um, that was across the board. So that wasn't just those that didn't have a disability, that included those that also either had a loved one with a disability or they themselves had a disability.

So overall, just the presence of having a disability was linked with higher suicide attemptability, and this is important because we know that the more you view suicide as an option, the greater risk you're at. And so, our goal with bringing this up isn't to say, you know, we should shame people.

We should make sure that they don't think suicide is an option. We should, you know, really urge, you know, we do want to urge them not to, but the thought is not trying to build stigma around suicide, but rather, are there ways we can build hope? Are there ways we can help people see that there are other options and there are other ways that, you know, we can find a solution. Um, and we'll talk about that more as we go on, but Chandler, are there pieces here that really stand out to you?

Chandler McDaniel: Yeah, additionally, not just, you know, decreasing stigma for suicide, but also decreasing stigma for disability. Um, there's research that suggests that increased stigma, um, increased perceived stigma, right? Also is related to more, uh, higher levels of suicidal ideation and suicide attempts um, across ages,

Michael Nadorff: So, getting into some of the theories. So probably the best known suicide theory is Joiner's Interpersonal Psychological Theory of Suicide. And this is that there are really 2 pieces. So there's those that have the desire to die. And those that have the capability to die by suicide. So first looking at those that have the desire to die.

There are two parts of that. So there's thwarted belongingness, which is, it's a fancy way of saying loneliness, disconnectedness, that sort of thing. And then there's perceived burdensomeness. So this is feeling like your death is worth more than your life. That people around you would be better off if you weren't here. So those two factors interplay to make someone desire to die by suicide.

And then there's a third piece, which is those who are capable of actually enacting lethal self harm. Thankfully, most people are not able to overcome, you know, self preservation. It's our greatest instinct, but there are those that can. And what we see here in this little, um, diagram is that there are those that can overcome it.

And thankfully, most of those don't desire suicide. But you have this small spot where they intersect, where people have both of these feelings, and they have the ability to enact lethal self harm. And that's where we see our greatest risk of suicide, Chandler, what are your thoughts?

Chandler McDaniel: Yeah, I think um within visual impairment specifically the ideas of thwarted belongingness and perceived burdensomeness are particularly relevant Right.

Thwarted belongingness. We've kind of touched on a little bit that isolation, that feeling like, um, you know, you don't belong. I know for me personally, my, um, uh, visual issues are genetic. The family that I grew up with primarily, they don't experience any sort of visual impairment.

And so by having, you know, that kind of solo experience and not having really anybody to talk to about that, um, really was difficult and made me feel alone and made me feel very, you know, like, like I didn't belong. Right? Um, and then similarly, right, perceived burdensomeness. I think whenever we talk about perceived burdensomeness in relation to, visual impairment, um, the idea that you might have needs that are kind of considered more or, um, extra, right, is what they kind of use in the literature, um, is often cited as well.

Michael Nadorff: Going way back in time is Durkheim. So Durkheim was a sociologist who gave us one of the first theories of suicide. And one of the things I like about this that more modern theories have moved away from is it kind of, it's one of the few that shows that there are different types of suicide. Much like, you know, there are different types of cancer and we don't treat cancer all the same way.

I personally believe suicide's the same way. There are different driving factors. So the suicide of, you know, a teenage girl and an 80 year old man very well may have different predictors and risk factors and, you know, all those sorts of things, and the way we need to intervene may be different. So, I like thinking of what are the different drivers of suicide, risk factors for suicide.

And so what we see here is on the social integration, this step you'll see, it just looks very much like Joiner's. So, you have basically your belongingness and burdensomeness. But on the moral regulation side, the anomic, um, really stood out to us. As far as sudden changes in social position of an individual due to abrupt changes in society that lead to a lack of social direction.

Chandler, what stood out about that to you?

Chandler McDaniel: Yeah. So one thing that we know, uh, when we look at research is that sudden changes, um, and traumatic events, um, and things like that can be related to increased risk for suicide. And that includes, um, the onset, the sudden onset of a visual disability, right? So if somebody is in an accident or gets diagnosed with a degenerative visual disease, right? Um, that's something that would fall into this anomic category, right? Because they have this sudden change, um, that they're coping with, which could lead to increased risk for suicide.

Michael Nadorff: So Aaron Beck talked about the impact of hopelessness, and I think it's worth bringing up because I don't feel it as fully encompassed in any of the other theories.

So, Beck and colleagues showed that, um, if you look at those who were hopeless and follow them over time, um, they were able to correctly identify 91 percent of those who later died by suicide. So hopelessness is a very strong risk factor. And those who have high hopelessness were 11 times more likely to die by suicide than those who had lower scores.

So again, it's a very strong risk factor. Um, and I do think it fits with Joiner's theory, it's just I don't think the Joiner's theory with the belongingness and the burdensomeness, I don't think that fully encompasses the impact of hopelessness as well. Um, and when we get to interventions, you'll see a lot of the interventions we talked about really focus on hopelessness and how to build hope for this reason.

Uh, Chandler, what are your thoughts on hopelessness and especially, you know, new diagnosis and, just as you go through the process of experiencing, um, the ups and downs, um, just the impact that hopelessness may play.

Chandler McDaniel: Yeah, absolutely. Um, I think targeting hopelessness whenever we talk about interventions is particularly important, especially when we talk about, .... Um, you know, new diagnosis, but also, um, in adolescence as well, right? They have their whole life ahead of them. Um, they, you know, are experiencing all of these new and cool milestones. And depending on the severity of the visual impairment, you know, you might not be able to experience those new milestones, for example, getting your driver's license, things like that.

Um, I can think of one specific example when I was 16. Um, There was a period of time where they thought that my, um, vision condition was not something that they could, um, help anymore. And that my vision was just going to slowly get worse and worse until I went blind. Um, and keep in mind that I was 16 years old.

Um, I had, I had actually just gotten my driver's license, I think maybe two months before this happened. Um, I also, I was, I grew up a competitive dancer, right? So I had just made the varsity dance team and was going to football games and all of this stuff. And, you know, I was looking at colleges, I was planning my life and I was figuring out, you know, who, again, who I wanted to be.

And, In that moment, it really felt like all of that could be gone. And that was probably one of the scariest moments of my life, to be completely honest. And I remember feeling very, very hopeless. And I remember, you know, not doing well mentally after that for a while. And, um, you know, I was very grateful to have a therapist that, um, you know, was a blind ally.

And, um, she really helped me, you know, find that hope again. So kind of going back into the, um, interventions that we're going to talk about. That- spoiler alert- is one of them. Um, but I think hopelessness is something that very much needs to be targeted, particularly, um, in the population of individuals with disabilities, because it's something that, you know, anecdotally, but also research has shown, uh, individuals with disabilities experience hopelessness at a much higher rate.

And that's, I mean, as Dr. Nadorff just stated, something that is very, very pertinent to suicide risk.

Michael Nadorff: One thing I was wondering if I can get you to talk a little bit more about, and I know it's a little different than your setup, but I'm thinking especially of those with new, new onset disability, you know, just when you're in that transition period, or, you know, just any thoughts on the helplessness and helplessness you feel there, versus after you've had some time to learn to adapt and you know, learn new ways to do things.

Chandler McDaniel: Absolutely. Yeah, so I was born with my vision issues. But during that period of time where I, you know, thought my vision was just gonna get worse and worse, you know, the initial period the, the probably I would say the first month of, um, you know, after receiving that news that, you know, your vision, isn't going to get better.

In fact, it's just going to continue to get worse. Um, was really, really rough. And I was emotionally, I would say in crisis mode. However, after that, right, just naturally with time and with the progression of things, you know, even though my, uh, situation hadn't necessarily changed, um, yet, I was able to kind of like get through that emotion.

And I was able to kind of, okay, this is what, you know, life is like, where do we go from here? Right? So there was almost this kind of ebb and flow of the way, um, you know, my emotions felt within that.

Michael Nadorff: Excellent. So, related to that, I think it really leads in nicely to David Rudd's Fluid Vulnerability Model.

So this is a suicide theory that's different from the others. All the others have been trying to explain exactly how suicide happens, and this more looks at the timeline of suicide. And the thought is that suicidal episodes are time limited. So, it's not just that someone is always suicidal, it's that this can ebb and flow.

And also, there are likely, um certain baseline risk factors that, you know, play a role as well. So I think it's really nicely illustrated by this. So the thought is that people may have different baseline risk factors. So this should be things like the presence of a disability. It could be, you know, family history of suicide, um, presence of a mental illness like depression or those sorts of things.

So there are things that just may put someone at higher risk than, than others. But then there's the acute risk part where there's a major stressor or something that happens. You know, you fail in class, you have a new onset of disability, you lose your job, or a major, major pandemic happens, you know, a lot of different things can happen.

So why is it that in those same circumstances, some people will become suicidal and others will not? And the thought is that, you know, you can have the same acute thing happen to you. And it just depends on where your baseline risk is, and if that throws you over the threshold. And this helps explain a couple things.

So it's, one is that, again, those who are at really high risk of suicide, usually it just means that they're at higher baseline risk. That doesn't mean they're constantly going to be at high risk of suicide. It's going to ebb and flow. And so much of what we can do is just try to help get them through whatever that crisis period is, whether it's days or hours.

It's usually not much more than that. Just to try to get them to the other side of whatever the stressor is in order to help them. Chandler, any thoughts on this one?

Chandler McDaniel: I think you summed it up perfectly. Um, I think honestly, the time period where I thought that I was gonna go, you know, blind fully and, um, that kind of heightened emotional state that I was in, I think is, you know, a perfect example of that kind of fluid vulnerability model. You know, not necessarily as intensely when we talk about, you know, suicide mode, suicidal mode. However, um, you know, that kind of already being at that increased risk baseline and then having that kind of acute thing happen. So I think, yeah, you summed it up perfectly.

Michael Nadorff: So with that, we didn't want to leave on a downer. So we want to talk about what can you do? So specifically, we thought we talked about strategies that a lay audience can actually do to make a difference in this, and there were a couple that stood out to us, um, with varying amounts of empirical basis that we'll talk about.

Um, so those were public awareness ads. Um, positive affirmations or small interventions, and also assistance with problem solving and adaptation. So, you know, one of the things we see a lot of is your public awareness ads. So these are, um, you know, you may see signs, you may see billboards, um, with the suicide prevention hotline.

 You know, we do a lot of different things to try to get the word out about, you know, the aids that are out there. And it made sense that these are probably helpful. Um, and there is some effect, just maybe not as much as we'd like to see. So what studies have shown is that there's a modest effect on attitudes about the causes of mental illness and treatment.

So what this means is as far as, you know, you're going to see a decrease in people thinking that having a mental illness is a moral flaw or that, you know, they're always going to be this way and they can't recover. Um, our messaging is very good at helping people realize that recovery is possible.

Treatments are available and those sorts of things. So it's good for changing some of those beliefs, which fits in some of that suicide acceptability that we talked about earlier. If you believe that there are ways you can overcome this, then suicide, the ultimate outcome, you know, like the ultimate solution, is less appealing if you know there are other solutions you could try first.

Now, with that, it's not a silver bullet, for lack of a better term, as far as intervention. So, that's why I include this bottom quote, where when you look at these interventions, they have no detectable effect on primary outcomes such as decreasing suicidal acts or intermediate measures such as treatment seeking or increased antidepressant use.

So, are these really driving people to, you know, increase going to treatment, increase in calling the suicide hotline? Maybe on the hotline we're actually getting more information showing that that does seem to be driving some of that, but we're seeing less of an effect on behavior. So why do I mention that?

Yeah, am I saying don't do public awareness ads? No, I think they serve an important role and I think they can be helpful in changing the views of people in regard to suicide and making sure when they are ready for treatment that they know how to get treatment. I think that's very important.

But I also think that just putting more money into public awareness ads is not going to solve our problem. Um, at this point, people pretty much know that there's a suicide hotline. They can find it pretty easily. Um, you know, so how do we move past just awareness to get people to act Chandler any thoughts on this?

Chandler McDaniel: Uh, yeah, so kind of, uh, similar with the public awareness campaigns, or ads, maybe not necessarily, uh, you know, awareness, but providing resources in public. Um, you know, yes, the suicide hotline number, things like that. People know that exists. However, you know, perhaps for individuals who are visually impaired, um, or disabled in some other way, maybe they don't have access to as many public resources as, um, you know, other individuals would, right? Research shows that loss of autonomy is a really big thing, particularly with visual impairment.

So being able to go out by yourself and, you know, Uh, do those things. Um, so they, honestly, there's a solid chance that that might be beneficial for this population. With that, though, the CDC actually recommends using these ads, but for individuals with disabilities in primary care settings.

So in doctor's offices, um, in this case, in optometrist, ophthalmologist offices. I can't speak for other people who are visually impaired, .... But I know for me, I go to the ophthalmologist at least twice a year. And that is the one doctor's appointment I do not miss and I do not reschedule. Right?

So providing resources, perhaps in that context, you know, like Dr. Nadorff said, it's not going to be the end all be all, it's not going to change everything, but I do think that that might be helpful in that specific context. Um, particularly if they are framed in a way and created in a way that are accessible, uh, for individuals who are visually impaired, right?

So maybe having like a QR code so that they can scan it or will get big on their phone, right? On their device with their font. Using larger font sizes, using colors that are often, um, you know, associated or, um. How people who are colorblind have difficult seeing so keeping in mind that, but I do agree overall with Dr. Nadorff's consensus of, um, you know, we got to do more. We got to do more.

Michael Nadorff: Oh, and I like what you bring up with the more targeted places as far as where to put them and without stealing too much of our thunder from a future slide I think what's especially helpful is maybe a little bit less of the resources that apply to everybody but more on the resources that really apply just to this group. So if there's specific support groups or resources that people may otherwise not be aware of, those are really good places to make sure that those are there.

Chandler McDaniel: Absolutely. Yes.

Michael Nadorff: So Caring Letters Study. This is one of my favorite studies, and I really like it because it shows that very minimal interventions can have a huge impact. So this was a study that was done by Jerome Motto where there's people after discharge from a inpatient facility, got letters, um, initially monthly, and they eventually tapered to quarterly, and they did this for five years.

These letters were very simple. It's just saying, you know, it's been this long since we've cared for you. We hope you're doing well. If there's anything you ever need or anything we can do to help, please let us know. That's all this letter was. And so they compared those that had these letters to those that didn't. And they found a significant difference in suicide rate for those that got the letters than those that did not. So something as simple as just sending the letter reminding them that you are there and that resources are available can be a huge thing. So when you think, you know, what can an individual do?

Checking in on people, just doing little things like phone calls, texting, um, you know, these play a huge role, especially when you think back to Joiner's theory of belongingness. If you have that connection, if you know someone's there and cares for you. And that if you need something, someone's there to help can be very meaningful, especially if you're struggling with a loss of autonomy.

Just knowing who are people that are willing to help, those that really want to know if you're struggling and need something, uh, is very impactful. What do you think, Chandler?

Chandler McDaniel: I think you're right on the money with that, especially when we talk about, um, you know, individuals who are visually impaired, right?

Research shows that they're much more likely to experience that, um, loss of autonomy and feel socially isolated, right? And so having somebody reach out and saying, Hey, like, I'm thinking of you, right? Or, Hey, you know what, if I come and get you and you know, we go get coffee or something like that would be super helpful.

I know in the past, um, I personally don't really like to drive after dark. Um, and so because of that, right, sometimes, you know, I'd get, I'd get left out of some things. Um, however, as I've gotten older, right, I've started to, acquire more friends who just, you know, kind of understand that I don't like to drive after dark.

I don't see super well after dark. And so it's just kind of, they always come and get me, right? It's, they're always like, yeah, okay, I'm on my way to come and get you. Right? And it's kind of their version of a caring letter, right? Their version of, um, hey, I'm thinking of you. And you know, I see you, for lack of a better word.

You know, I notice you and I want to be there for you and meet you where you're at. And I personally have found that to be, um, the, one of the biggest things that makes me feel included and makes me kind of feel less isolated when it comes to my vision.

Michael Nadorff: Oh, and I think one thing too, and I'd love to have you touch on is, you know, there are those where this comes naturally, and that's fantastic. But there are also a lot of those where it's just not on their radar. So how do you, um, try to assertively just suggest these things , or help educate your friends or family so that, you know, because so many people would want to do that and they don't know what you need and they don't, you know, how do you help them get to that spot where they can help you?

Chandler McDaniel: Yes, this is, I'm laughing solely because this is a, something that I have had to learn throughout the years. Um, I used to not be very good at, you know, talking about that stuff with friends and family, and I've gotten a lot better at it over the years. So first and foremost, to be honest, practice I think is probably the biggest thing. Practicing talking to somebody else about this, right?

Just doing it more. And having an honest, just upfront conversation about it. Um, of hey, you know, like I, you know, for me personally, I'm very comfortable disclosing a lot of my vision, um, related issues. However, I know that's not the case for everyone.

However much you're comfortable disclosing to your friends or family, like, "Hey, you know, I sometimes feel really isolated or I feel sometimes feel a little left out because, you know, I struggle to drive myself places after night or I don't drive or, you know, um, things like that.

Is there, you know, is there any way that we could figure something out so that I'm included more. Right? Could we, you know, do things at my house? Could we do like a weekly game night at my house or would you be willing to come pick me up every once in a while? Right. Things like that.

Um, so I found that, Practicing that actually in the mirror, it sounds really cheesy. It works, um, has been really helpful. But just having honest conversations with my friends and family, um, has been really beneficial and I, again, I can't speak for everyone, but I personally have not had an experience. since I was like 16 and, you know, we were all teenagers who didn't have a fully developed prefrontal cortex at that point. Since then I haven't had anybody react negatively. It's always been, "Oh my gosh. Yes. Of course. We want you there. Oh, my gosh. Yes. Of course. I'm so sorry. We didn't think of that."

Right? Things like that. Um, and so, not only has practice helped, you know, actually getting the physical words out of my mouth, figuring the verbiage I want to use, figuring what I do want to share and what I don't want to share, but also just lessening that overall feeling of isolation and that overall feeling of that overall feeling of loneliness with my vision because, you know, even if there is an instance where let's say like, hey, you know, they can't come get me or, you know, ubers are too expensive or, you know, something like that where I can't participate.

Right? I have enough data points previously to show. Okay. Well, they care about me and they want me there this time. It just didn't match up. Right. It just, it wasn't in the cards this time. And so it overall arching helps lower those feelings of isolation.

Michael Nadorff: Excellent. So one of the themes we know from the broader disability literature is those that struggle the most and were friends to suicide are those that are less likely to use adaptive devices or asked for help.

So I think it's a nice segue. So Chandler take us away on this slide.

Chandler McDaniel: Yeah, absolutely. This is probably my favorite slide out of all of them to be honest. I love talking about this stuff. Um, so when it comes to how do we help the individual overcome their challenges, right? Assistance with problem solving is going to be a really big thing.

Educating, right? Not only your friends around you, like we talked about in the last slide, but also linking with adaptive devices. I know for me, I was very adament that oh, I don't need accommodations. I don't need help for way too long. Dr. Michael Nadorff can attest to that um, and, you know, when I decided okay, like actually this This is something that I needed, right?

Once I finally kind of came to terms with that actually having those adaptive devices was really helpful. Having things that, you know, will read small texts to you. Um, having things like audio books, I listen to primarily audio books now, right? Things like that.

Super helpful. One, uh, assistive device that I found is called Be My Eyes. It's actually an app that connects low vision and blind individuals, um, and visually impaired individuals with sighted volunteers. So if, you know, somebody who's visually impaired or blind, if they are, you know, they need help doing something, right?

Like if they need help setting up, you know, their computer, right. Um, they can go on the app and for free, request a volunteer to come help them set that up. Right. And so, having that help and also having that social interaction, things like that, all very beneficial and very good for, um, solving those problems.

Linking with someone with a similar background. I personally found this to be one of the most helpful things when I was about, I would say 16, whenever I got the news that my vision at the time, you know, we thought it wasn't going to get better. I actually went on Facebook and I found some support groups, um, for kids with visual impairments.

And that was super helpful to see everyone else's experience to, you know, learn more about what different services were offered. Right. So again, thinking with connecting to those adaptive devices, there was stuff that these kids were using that I didn't know anything about. And I was like, oh my gosh, that's a thing.

Right. And so kind of killing two birds with one stone there. It was super helpful. Um, support groups, um, especially if it is a acquired visual disability. And honestly, I would even go so far as to say, you know, at least for me, somebody who was born with it, there is, you know, a grief with that, at least for me, there was a grief of, okay, you know, I personally will never be able to see 20/20.

I will never be able to experience that. Right. So even if it's, you know, support group for grief, for other people with visual impairments, things like that, I personally have found that super helpful also. And then I talked about it a little bit before, but there's also blind ally therapists. Psychology today has a really, really cool and really good feature that I share with everyone that I can talk to, um, that is called Find a Therapist, and you can filter by different settings.

Um, one of them is blind ally, right? So these are people who, um, are, you know, experienced and working with individuals who have visual impairment and who, um, are experiencing similar issues, right? So they've experienced that themselves. They've worked with clients in the past who have had that, right. It's not their first rodeo.

And so, um, that I think is really, really beneficial. And then in that same vein, right. Finding a meaning and hope. I know hopelessness is kind of something that I really touched on. And so helping people find that meaning and find that hope and kind of on that note, I did want to say, you know, as somebody who does experience visual impairment , I will say, learning about suicide and a visual impairment and all of these things, it can be a little disheartening to be completely honest to hear.

Oh, so what do you mean? I'm, you know, two times more the risk or what do you mean? You know, it can feel sometimes a little doom and gloom. Going through these slides, I had to take some breaks and be like, all right, I'm gonna come back later, you know? But with that, I think, it's also important to think about this stuff not necessarily as a form of, "Oh, you know, I'm at a higher likelihood for this stuff." Like that sucks, but almost as a way of giving yourself grace of like, "okay, well, yeah, I'm struggling today." That's okay. I know that this is a potential thing and that it doesn't mean that I'm going to experience depression or anxiety or, you know, all of these other things that people who have visual impairments are at a higher likelihood of experiencing. Right. But it's okay to be upset about this. It's okay to be. It makes sense that I'm struggling with this today. And I found that that really has been helpful.

So, you know, finding the meaning and the hope and thinking about it in terms of grace rather than a sentence to be filled out.

Michael Nadorff: And with that, we'll move over to any questions that people have. Thank you for your time.

This has been OIB-TAC’s monthly webinar. Thanks for tuning in. Find recordings of our past webinars on our YouTube channel, and discover all of our many resources at O I B hyphen T A C dot O R G. That’s OIB-TAC.org. Like us on social media and share our resources with your colleagues and friends. Until next time.

Funding statement: The Older Individuals who are Blind Technical Assistance Center (OIB-TAC) is a development of the National Research & Training Center on Blindness and Low Vision (NRTC) at Mississippi State University, focused on agencies serving older individuals who are blind. This grant, H177Z200001, is funded by the Rehabilitation Services Administration (RSA) under the U.S. Department of Education. 

Contact us: For more information about OIB-TAC, please visit our website, www.oib-tac.org. Also, visit our other NRTC websites, www.blind.msstate.edu and www.ntac.blind.msstate.edu. Visit NRTC on Facebook at www.facebook.com/theNRTC and on X/Twitter at www.twitter.com/MSU_NRTC. Our mailing address is P.O. Box 6189, 205 Morgan Avenue, Mississippi State, MS 39762. Our phone number is 662.352.2001.