The next day, a school administrator gave him a letter that had been delivered to the office for him. “Dear Stan,” it began. “You don’t know me but what you wrote in your poem changed my views on a lot of things. I was thinking about suicide before I heard your poem. I now know that I have a purpose in life and that people do care about me.”
For Collins, the experience was “a little spark that opened my eyes to how many people are struggling.” He started volunteering with the Yellow Ribbon program and he keeps the letter framed in his office “to remind me why I do this work.” Suicide prevention work turned out to be a calling he never left.
In his freshman year in college, he became the youth coordinator for the Yellow Ribbon program in San Diego and also got involved with its national and international suicide-prevention efforts. His volunteer work turned into a job and he spent the next 10 years visiting schools to lead trainings for staff and give presentations to students.
One highlight came early in that work. In 2001, at the age of 20, he traveled to Washington DC and testified before a Congressional hearing alongside then-Surgeon General David Satcher, who had just released a groundbreaking report, the National Strategy for Suicide Prevention.
“It was a formidable experience in my life,” Collins says. “People actually did want to hear the youth’s perspective.” But he also remembers that some of the senators “just didn’t get it — they wanted to attribute suicide to music from Marilyn Manson or Nirvana. And I was like, ‘No, you guys are so off. It’s not that music is causing suicide; it’s that people who are having thoughts of suicide resonate with this music.’ And I realized we have a lot of work to do.”
He kept at it, but about a decade ago, he thought he might have to leave the field and go back to his teacher training. After all, he was pushing 30, getting paid very little and thinking about having a family. Then he started getting offers from various suicide prevention groups he’d worked with over the past decade.
He agonized about what to do, and then a cousin suggested a new way forward: He should set himself up as a consultant and work with them all. It turned out to be a good path.
He loves working with groups such as Each Mind Matters and Suicide is Preventable. In 2012, he helped create a program called Directing Change, which invites young people to create one-minute suicide-prevention films and enter them in a competition. In the first year, Collins says, the group hoped for 50 submissions and ended up with 400. In 2020, they received over 1200.
“The films are all over the spectrum: how to support a friend, how to reach out for help, how to recognize the signs,” Collins says. “There are also stories about youth who are worried about friends and reach out” — a theme that is especially resonant for him.
One project he’s been working on is helping more than a dozen counties develop strategic plans for suicide prevention. Part of that work is to look at how school counselors, first responders and family members respond to people showing signs of suicidal thinking or planning.
“Often, in the past, if somebody’s suicidal, the response has been you call 911,” Collins says. “Or you take them to a hospital. There are circumstances where that’s the right response but a lot of research and best practices in suicide prevention say that’s not the right response for most people in most situations.”
“Take a kid at school that mentions suicide,” he continues. “The teacher does a referral to the counselor. The counselor calls law enforcement. Law enforcement — who’s not a mental health professional — is now doing a suicide risk assessment, transporting the kid to a hospital. This whole process is traumatic. When they get to the hospital, they’re looking to treat a mental illness which may or may not be the case. Suicide is not always a result of mental illness.”
If school counselors and others are trained to do risk assessments, they can figure out what level of care this person needs. “They might need law enforcement and an emergency room,” Collins says, “but most of the time they just need a referral to a mental health professional and better connectedness to family and friends. We also need to make sure that mental health professionals have proper training. A lot of mental health professionals have not received training about ongoing care for people who are having thoughts of suicide. The focus shouldn’t be on whether I send this person to the hospital or not, but how do I support this individual through safety planning and collaborative work together.”
The biggest lessons Collins takes from his work — and the message he works hard to share — is that suicide prevention is a collective responsibility and that one of the best ways to help people who are in distress is to listen, create safe space and allow them to express their pain.
“We need to allow people to feel safe to have those conversations and know they won’t be stigmatized, that no one’s going to call the cops,” Collins says. “They’re not going to be taken in an ambulance to a hospital because that might not be what they need. We focus so much on suicide but in my opinion, suicide is not the problem. It’s the pain causing the thoughts of suicide that’s the problem.”
He tells people: “Don’t underestimate the role you can have in suicide prevention among friends and family. It’s not about convincing someone not to die, it’s about helping them find a reason to live.”