So You Want To Give A Talk On Mental Health

Fritzi Scheff demonstrating Magnavox for Fifth Liberty Loan in New York City, 1895

This was originally posted on The Pastry Box Project

Since I started giving my Open Sourcing Mental Illness talk in May of 2013, I’ve presented it 17 times. Doing these talks has been one of the most rewarding activites of my entire life, and I feel incredibly lucky to be in a position to do it.

On my own and as part of the Prompt campaign, I’ve had a number of people talk to me about speaking about mental health within the tech community. It’s awesome and exciting to see people willing to share their own stories, because it means things really are changing. At the same time, I’ve often wanted to sit each person down and have a good hour talk with them about what they need to know going in.

When you get up in front of people at a tech conference, you’re presented as some sort of expert. When you’re talking about something like mental health – a topic many of us are afraid to bring up around strangers – you’re viewed as something of a leader. With those expectations comes a lot of responsibility. Here are a few things I’ve learned to do, and not to do.

Don’t pretend to be a mental health professional

You really need to know what you know, and what you don’t know, before you get up there. If you’re not a trained mental health professional, you don’t know much. You know your own experiences, but somebody told me once that using the toilet doesn’t make you a plumber. Your experiences are 100% valid, but only apply to you – you have to be extremely careful about applying them to anyone else. Talk about your experiences, but make it clear that experiences vary dramatically. “This is what it was like for me. It’s not like this for everybody, and it may not be this way for you.”

Don’t tell people how to solve their problems

You’re almost certainly not qualified, and could do enormous harm by endorsing any particular course of treatment. Time and again I’ve seen people urge treatments – or avoidance of treatments – because they personally had success with them, including:

  1. take drug X
  2. never take drug X
  3. never take any medicine
  4. stop eating sugar
  5. drink lots of water
  6. exercise
  7. see a therapist
  8. never see a therapist
  9. move (because it’s your environment that’s affecting you)
  10. pray

Do some of these work for some people? For sure. Some of these things have aided me personally. But I would never suggest to anyone that any single one of these actions would fix them, because 1. the causes of mental illness are confoundingly complex, and 2. because I am not a mental health professional. I have no business telling you what will work for you, personally. I can tell you what’s worked for me, but that may not mean anything to you. Never advocate for a “cure.” It doesn’t work like that.

Encourage seeking help, and explain how to do it

While you shouldn’t advocate for a particular treatment, you absolutely should advocate for getting help from professionals. You also should have ideas of where to start. The Get Help section of MentalHealth.gov is a great place to start for people in the United States, for example. If you’re speaking at a user group or regional conference, try to find resources specific to the area. Note that this may require you to make a telephone call and talk to a human being.

Get your facts straight and sourced

People are going to be listening to you as an authority. If you make assertions beyond your own experiences, you must have them backed up with real data from scienctifically legitimate sources. Be skeptical of what you read, and don’t cherry-pick stuff because it tells the story you want it to tell. Some good places to check out are the World Health Organization, MentalHealth.gov, the National Institute for Mental Health, and Mental Health America.

Tell people ahead of time if you’re going to talk about difficult-to-hear subjects

When I give my talks, it’s not uncommon for me to look into the crowd and see some folks crying. Talking about this stuff is hard, and when you do, you will be connecting with some people’s deepest pain. If you’re going to be talking about particularly tough stuff, such as suicide or self-mutilation, you should let people know ahead of time – either at the beginning of the talk, or in the description. I have at times spoken in detail about my own experiences with suicidal ideation and near-attempts in more detail than I should have – not because the topic should be avoided, but because people in the audience may not have been prepared.

People are going to come talk to you

Every single time I give my talk, multiple people reach out to me. Some do it in person, and some do it electronically, but they always do. They all have different stories and different experiences, but almost all of them are reaching out because they probably have never seen someone speak openly about these issues. Those people who reach out to you will have lots of different things going on. They may tell you about their sister, or their son, or their aunt, or their father. They may tell you about themselves, and they may tell you more than they’ve ever told anyone else – let alone a stranger.

People will come to you with their problems and ask you for help

Many of the people who reach out are going to ask you for advice. They’ll ask you how to find help. They’ll ask how they tell their boss about what they are going through. They’ll ask you how to get convince their sibling to seek treatment. They’ll ask you how to deal with the suicide of a friend.

I have tried to give the best advice I can. I don’t try to solve their problems, but I try to give them options. I tell them they aren’t alone, and there is help out there, and here are some places they could try. I tell them that they can’t control what other people do, and that it’s not their fault.

I don’t always have an answer. Sometimes I have to say “I’m sorry… I don’t know.” Those are the hardest. Those are the ones that stick with you days later.

Learn to listen

I talk a lot. I have learned to listen. It can be really hard to listen, particularly if you’re the kind of person who wants to fix things as fast as possible. I have this tendency myself.

You have to listen. You have to listen with empathy and without judgement. Shame is the most common thing you’ll encounter when talking about mental health. People need to feel safe to talk about it. Help them feel safe by looking at them, and listening, and praticing empathy. It is more important that you listen than try to fix them.

Be prepared to deal with crises

Since I started acting as mental health advocate in the tech community, I have been approached a handful of times by people who are going through a mental health crisis – where they are in a very bad place, and have the potential to do things harmful to themselves (either physically or socially). It is extremely difficult to know what to do and what not to do in these cases.

I believe that by speaking about mental illness, it is far more likely you will encounter a situation like this. You need to be prepared for it. I strongly advocate taking a Mental Health First Aid course before speaking. Not only will it give you lots of great info to pass on in your presentation, but it will prepare you to deal with mental health crises.


If you have other ideas, please share them with me and I’ll add them in later versions of this article.

From Within

I hope that writing about this will help someone dealing with similar issues.

I have generalized anxiety disorder, but I often struggle with depression. The pattern in recent years for depressive episodes is that they are triggered by a series of high-stress situations that lead me to feeling hopeless, often because of guilt about how I have handled them (I have problems with reacting aggressively when I feel overwhelmed with anxiety). The anxiety, then, slides into hopelessness. I feel completely drained of positive energy. I feel no joy in things that typically excite or please me. I see no reason to be optimistic. Failure is an inevitability.

I know this is not true, but I see no way to escape this state. I have knowledge and evidence to the contrary, but I simply cannot believe it. My mind won’t let me find any solace in it.

I push myself because others rely on me, but what I want to do is call in sick to work and hide forever. I want to cry and cry in hopes that this black shit that’s spread throught me drains through my tears, but doing that in the middle of a coworking studio seems… uncouth.

I don’t have good coping skills for when I feel like this, and that cripples me. I feel stuck here with no clue how to escape.

I have suicideal ideation. Flashes of attempts invading my thoughts. When you feel worthless and hopeless, it’s difficult not to imagine this as your only release. I know it is bullshit, but my mind is stuck in this state.

Just 24 hours ago I was excited and happy. Why can’t I feel that way again?

I guess I wrote this for myself too. Maybe I’ll see a light and follow it out of here. I hope so.

It's So Easy To Be A Dick

A group of men watching two men fencing

Originally posted on The Pastry Box

Twitter is a fabulous medium for tossing out random thoughts. Great for people with ADD like me – much easier than blogging. 71k+ posts in a little less than 8 years will tell you I’m a fan. In general I think it’s been a positive thing, but there are… some issues.

There’s this thing with interacting only via text where I believe we tend to worry less about how our words may affect others. Maybe it’s because we don’t have to see a confused or pained expression on the reader’s face. This is exacerbated on an intentionally curt medium like Twitter, where expressing a nuanced, complex idea is particularly problematic. The writer can’t easily anticipate potential confusion and address it when they have 140 characters1.

So on the reader’s side, you strip out nuance and language that makes it easier to judge intent. Pair that with the tendency I have, and I think many others do, to take written communication in the most negative way possible, and things can get really nasty, really fast.

This often has come up in the context of software or tools I’ve made. When I was working on Spaz, I often read rather curt messages from users about the open source software I gave away for free. A couple choice quotes:

twhirl sucks. So does spaz. Hello feedalizer. You might just be my new friend
spaz sucks. testing tweetdeck now
Spaz sucks, Tweetdeck wins

I did an impromptu presentation one time entitled “Users Are Assholes” just for this reason. Thing is, they’re not assholes: they’re just being insensitive, because they’re not thinking that a human being just like them worked hard on this. I am pretty sure they wouldn’t like anyone saying that the project they had put hundreds of hours into and given away for free “sucks.” Not many people wouldn’t take that personally. I definitely lost my temper plenty of times over stuff like that.

I’m not going to just excuse the sometimes-fucked-up stuff I wrote or did when I was triggered, though. I have to take responsibility for my actions, even in the light of a trigger like that. Yes, it can be difficult not to, but to quote Sri Nisargadatta Maharaj:

Whatever happens, happens to you, by you, through you; you are the creator, enjoyer and destroyer of all you perceive.

I am responsible for how the expressions of others affect me, and being a slave to them is a terribly unpleasant state of being. I know, because I’ve struggled with it for nearly 40 years.

The other thing I found is that if you avoid responding in kind, but instead offer an empathetic response, you often can immediately change the tone of the conversation. If, however, I respond negatively, I almost always have reinforced the existing negative perception that existed, or I found that the person didn’t intend something so negative as I took it, and now they’re wondering why I’m being such a dick.

I also find it helpful to suggest moving the medium to one which is less prone to mistaken inference. If it’s possible to get the conversation off of a text medium, that’s great (although potentially creepy). If not, something more verbose like e-mail or SMS or IM or whatever the kids use these days is probably a lot better and less likely to turn into a shitstorm.

As Dalton says in Road House:

If somebody gets in your face and calls you a cocksucker, I want you to be nice. Ask him to walk. Be nice. If he won’t walk, walk him. But be nice. If you can’t walk him, one of the others will help you, and you’ll both be nice. I want you to remember that it’s a job. It’s nothing personal.

So, to sum up:

  1. Human beings read what you write.
  2. Try to be cool to them, and make it less likely they will be upset about what you write.
  3. When someone writes something you don’t like, yelling back rarely helps, and is still not okay.
  4. Avoid responding in kind to a perceived negatives. Offer empathy in response to negativity/hostility.
  5. Try to change the medium if the current one isn’t working.

1 One might say “so don’t write about that stuff on Twitter then.” Yeah, but it’s so easy

Save Lives With Mental Health First Aid

Image from page 211 of "American national Red cross text-book on first aid and relief columns; a manual of instruction; how to prevent accidents and what to do for injuries and emergencies" (1908)

This was originally published on The Pastry Box Project on June 6, 2014.

If we want to make tech companies safe places for those struggling with mental health issues, I believe it is essential that our leads, managers and C-level executives become certified in Mental Health First Aid (International Programs).

I’m someone who has dealt with my own depression and anxiety disorders for the last 25 years. I was certified in an 8-hour course just a few weeks ago, and it is one of the most important things I’ve done to increase my ability to empathize with and help those who struggle with mental health issues. I've learned techniques to assess and aid people in crisis and non-crisis situations.

From the MHFA site:

I’ve taken regular first aid, and I’ve used both, but certainly the opportunities to use Mental Health First Aid are much more abundant. - Nathan Krause, Pastor

If you are a team lead, a project manager, a C-level executive, or similar, it is in your power to make your workplace a safe environment for your coworkers. You can empower them to seek help, free of stigma and shame. Your willingness to get certified will make their quality of life better, and will save lives.

Please stand with me now. Make a commitment to get certified in Mental Health First Aid

If you want help bringing this program to your workplace, or have any other questions, I will help you. Contact me at ed@OSMIhelp.org.

Your Home Town Needs You

[Sylvia Sweets Tea Room, corner of School and Main streets, Brockton, Mass.]  (LOC)

This was originally published on The Pastry Box Project on April 6, 2014.

The time-honored tale of the web developer has the young, white male making web sites as a kid, taking computer science courses in college (maybe releasing a couple mobile apps in school), and moving to the Bay Area as soon as he graduates. He gets a job at a medium sized startup or, if he’s lucky, a Big Name like Google or Twitter or Facebook as a junior dev. He might get to work on something people have heard of. And it’s all very exciting with the nerf guns and the Friday evening keg parties and the Hacker News comments and pounding out code well past 5pm. He is, by traditional definitions, a success. This is what he should be.

I’m white and male. I’m not young anymore, for sure. And I’m really glad my story isn’t at all like the above.

For a number of reasons — mostly anxiety — moving away after college to work at a big Silicon Valley company had no appeal to me. I liked living where I did in the midwest. It wasn’t perfect, but I liked my community. I was good at what I did, and I liked being able to help people with the knowledge I had.

When I did move, I moved all of two hours away. Same very red state, another college town. It’s not perfect, but I liked it. I worked at the university for 9 years, and liked what I did, because I was good at it and I could help people with the knowledge I had.

After 9 years I started to itch a bit for something new, and I got an offer to leave that I couldn’t turn down. I cried when I left because I wasn’t going to see my friends every day anymore. It was hard. This was my place. It treated me well. But, I was going to work remotely, so my new startup wouldn’t take me to a new town. I was happy about that.

While I was working at the University I started attending a couple tech conferences a year. Eventually I was lucky enugh to speak at some. I loved doing this, because I got to meet a lot of people who loved doing the same things I did. But then I’d go home, and I was bummed because it seemed like there weren’t many people near me who were into those things.

That startup didn’t last long, but I still stayed in town and got another remote gig. I worked at a local coffee shop every day, coding most of the time, and sometimes helping the owner with his email or fixing the settings in the WiFi router. I met a lot of people, some of whom studied or worked at the university, and a lot who didn’t. I learned a lot about this community I had been in for a decade, but didn’t really know a lot about, because I spent all my time in the university.

Universities are weird in that there are lots of very smart, interesting people who often don’t know what’s going on in the building next to them. There are lots of kids learning interesting stuff who get offers to work at Microsoft or Google even before they graduate. People live here, but they never really learn what’s going on around them.

Turns out, there were a lot of smart, cool people who are doing cool stuff right around me. Some of them were into the same things I was. Some of them were not. But I knew I could learn things from them, and they could learn things from me. And the things we both didn’t like about our community, we could work together and change.

So I started going to a local tech meetup. I gave a couple talks there. I started my own open source group because there wasn’t already one in town. I got to know people who were doing work like me, and shared ideas. Gradually I started to make my own community a little more like the tech conferences I liked attending so much. I knew what I dug, and I met a few other people who dug it too, so we made it happen in our own community.

Right now I’m in a brand new coworking space that’s opened up in our downtown. I wasn’t deeply involved in it, but I talked to the organizers a little while they were planning, and I signed up to be a member as soon as I could. Already we’ve had meetings in the first couple weeks about how we can help K-12 schools in the area with the knowledge we have. I was able to help out the team building new web sites for the local catholic schools org get the hosting support they needed. In two weeks the open source group I started is hosting a talk by GitHub engineers to introduce people to using git. Here. In this small college town.

I also joined the school board for my son’s non-profit public charter school. It’s hard work and it takes a lot of my time, but I know that I’m doing something that has enormous impact on the lives of the kids who go there and their families. I have skills and knowledge that can make a difference here. So I do what I can.

Sometimes you need to leave. You need to learn about yourself. You need to change your environment to know what you can do. That’s totally fine and okay. You need to figure out what you want to do and where you want to be.

But there’s a decent chance that Silicon Valley and Brooklyn don’t need another you. There are plenty of people willing to go there to be part of whatever they’re selling. But your home town isn’t so lucky. They need you. What you have really can make a difference. You can do something for them that no one else can. You can change their lives. You can make your community a better place. You can make it the place you want it to be.

Success is not what other people tell you it is. It’s what you decide it to be.

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