Angie Fiedler Sutton
Welcome to Destination Change, a podcast where we talk recovery, treatment, and more. I'm your host, Angie Fiedler Sutton, with the National Behavioral Health Association of Providers.

Our guest today is Marlin Rollins. Marlin is a PhD with LPCC, LMHC, and is a member of the California Hospital Association and a licensed therapist with more than 15 years of experience in mental health, dual diagnosis and addiction treatment management. He has served as CEO and COO at some of the largest psychiatric hospitals and addiction programs in the state of California.

In his role as COO and President of Addiction Services with Renewal Health Group, Marlon supports leadership to align operations to meet organization goals. He also advises on strategic planning with the CEO and CFO to help enhance program services. Dr. Rollins is the author of Healing the Impoverished Mind: Building Resilience Through Adversity. He is a suicide loss survivor of his sister Amber who was a nurse and battled addiction. He dedicates his work to honor her memory of caring for others. He is a board member of United Survivors International. He has also served as a BIPOC mentor with the American Association of Suicidology, and is a member of the Steering Committee for the National Suicide Prevention Lifeline.

Dr. Rollins is passionate about enhancing quality of life and well-being through high quality care. As an ordained minister, he uses his faith and experiences to inspire others to seek healing. Dr. Rollins, thank you for joining us today.

Marlon Rollins
And thank you so much for having me. And thank you for all that you do for this community. I really am grateful to have a platform to continue to share and reach out to people. So thank you.

Angie Fiedler Sutton
Now, if I was reading your bio right, you were a minister first and then got into behavioral health. And my reading that right?

Marlon Rollins
That is right. So I got early into ministry, which kind of got me into realizing of kind of the church was a healing place. And so when I was in my late teens, I went to a church and felt called into the ministry. And I served in a Pentecostal church, this is back in Indiana, and then was ordained when I was 21. So I kind of took on the title of elder at 21, which is a little awkward to be called an elder when you're 21 years old. But again, I felt called into it.

And it was there that kind of in prayer like, God, what should I do? I think we all certainly if you're kind of a college student, you're trying to figure out what your purpose is. And you have this spiritual reckoning, if you will. And I was put on a path to say, pursue a degree in counseling psychology, and it was something I had not really thought about. But I kind of dedicated my educational career and went into psychology because they didn't have a counseling psychology program in undergrad. So yes, it started out for me in a ministry and then the ministry led me into pursuing psychology as a profession. So as an young age, not only were you're helping people with addiction and mental health issues, and just struggling with life, in the church, it became a call to, hey, let's let's pursue this as a career. And that's what started my journey into this space now of psychology and addiction, mental health, behavioral health, as we call it.

Angie Fiedler Sutton
Great. Now, as your bio mentioned, your your sister died by suicide, we'll we'll kind of hone in on that a little bit more. We don't want to start out immediately. How many years ago was that?

Marlon Rollins
It will be 10 years this December. And you know. My sister, it ws just her and I growing up, you know, and she was two years older than me. She was a role model for me.

She was a nurse, she was the type of nurse that would do all this stuff that nobody else liked to do. Like, you know, the stuff that smelled bad she would do it. She was really passionate about just taking care of people. And she had her own home health care business. It was called Serenity Home Health. She had the nursing nice license plate on the back of her car. It was really her the core of her identity was saying I'm a nurse. So she was a role model for me in the healthcare industry. And her and I always imagined that we would kind of combined our superpowers, if you will, as as a nurse, and I'm like the therapist, and but growing up, it was just her and I and just being very close together. She helped support me, she was my babysitter half the time, right? So the stuff that you do as an older sister.

So her and I had .... my point is her and I have a really special bond. And we also had a special bond when it came in to helping other people heal. And then tragically, I lost her to suicide after her and I actually worked in the same hospital together. This was back in Muncie, Indiana. I had finished my doctorate degree. And I was planning to take a job actually working as a school or a college counselor for because I was working my master's I was actually working in the school system but my pastor who really was an adoptive father to me, my sister and I, our father, you know, was not home with us probably left when I was in maybe third grade. And so it left this kind of gaping hole.

But I through the church, I found a father and he was a mentor to me. And he became ill soon after I finished my doctorate degree. And instead of taking this new job to move down to southern Indiana, I stayed nearby and worked at the local hospital. And it just so happened, my sister also worked at the same hospital.

My job was a little bit different. I worked in the emergency room, I worked at a community mental health center in a crisis department, answering the phone, doing assessments, doing intakes, going into the emergency rooms, assessing people who were in a mental health crisis, I was always welcome to come on in, take care of this behavioral health or addiction client, can you get them out of our emergency room, that was kind of the experience in that role. I knew I was valued, because the traditional medical model, they didn't want to have a behavioral health client come in and kind of jam up their emergency room, right, and take up the resources, they were not equipped. So my job was to go in as a contractor to see those clients assess them. And as we know, in our lingo, placed them in their appropriate level of care, right, staffed with a psychiatrist, etc.

So I would do that emergency room. And then I would also go up to the, what we call it a mid bed console, where if let's say a client had overdosed, or they had a suicide attempt, they had to be admitted critically then and they were stabilized, I would then go on the emergency room, or excuse me to the medical floor and do an assessment. Same thing, sit at the bedside and listen to their story, do my documentation, be a support, and again, the kind of the idea of being a minister and almost like a chaplain, sometimes people would ask to be prayed for so whatever it was that I could do in that capacity, my main job was to kind of getting the bridge them out of this crisis and move them through to getting the support that they needed.

So but what I would, in my sister, she worked on a transitional care unit, which is basically where people who would were either at the end of life, it was called the Transitional Care Unit end of life, or they had suffered a wound and they were transitioning back home, sometimes people didn't make it when they were at the end of the life. Other times, it was just a really critical point in their life, too. So I would go up and visit her, you know, after my shift or late night, I go sit down at a hospital, do my documentation. So her and I were able to share time together. And at the same time, my pastor, my father, he was ill and several times admitted into the hospital. He was admitted into, he was going into kidney failure, and had a number of strokes and seizures that landed him in the same emergency room that I was working. Sometimes I was actually there when he was being brought in.

I remember on one instance, he actually when I was working towards he actually coded in the hospital. And I remember hearing this call for a specific room number and I'm like, wait a minute, that's my dad. And going up to his bedside thinking he's not going to make it. So you know, he had to recover from the stroke. He was very medically unstable. And I and I started to pray. Really, God, what is it that I should do in the circumstances? What can I do because I was really there to also support and take care of him because he had mentored me all through my education and been a spiritual leader for for me when my father wasn't there. So my sister as a home health care nurse, she took care of him, sometimes she visited in the hospital, she would go, she my dad told me she would come and just get counsel from him and sometimes kiss him on the forehead. Oh, he was sleeping. You know, it was it was just kind of this lovely way in which he took care of him.

So, you know, after praying, I got this revelation to -- I remember very clearly, like sitting down and saying, God, what should I do? And just this voice came to me and said, this urge of donate him, donate a kidney to him. And I was like, Don't even kidding. I was like, Well, how do you know? Well, how's that gonna happen? And I was like, okay, that's what I'm gonna do. So that next Sunday, I made this declaration that I would, you know, seek out and donate a kidney.

And so, long story short, you know, about another year or so later. This is 2012, 2013. He's not really medically ready to get a kidney. But I do go and I get tested and find out. Lo and behold, miraculously, I'm a match. Like, I'm actually a match for him. And we start planning it and the next year 2013 the beginning of the year, I get this news that my biological father, my sister's and I, Amber's father is found dead in Portland, Oregon. We had never heard from him or seen him. And it was heartbreaking, I think for us both and certainly for her as a daughter who knew her father a little bit longer than I did, but I remember telling her that our dad died and it just broke her heart. Like I remember her just kind of sinking back into herself when when I had to tell her, I was tearful about it as well, just because we thought one day we would see him again.

So with his loss, there was grief surrounding that. But with his loss, too, it was like this extra urgency to figure out what I could do to save my pastor dad. Right. And the plan was for as I would go to this kidney transplant, my sister would be, she would be my nurse to take care of me, right? Because I was taking care of him. She was, you know, the hospital was concerned, well, who's going to take care of you take care of him who's going to take care of you? It's like, well, my sister is a nurse, she'll be there, she'll help me, you know, as I'm helping him, and we got this, because and so that was the plan.

And then come. sometime in April, when we were getting ready to proceed with a surgery, I ended up having like a medical crisis, and I write about this medical crisis in the book is really, it's very personal. And I you know, if people are interested in reading about it, it's it's a story within itself that I won't get into detail here. But it stopped the surgery, it stopped us from being able to proceed. And I was devastated, very scared. The next week, my sister went through a mental health crisis of her own. The next week. She had after the grief and loss of our father, she was also going through a divorce from her husband, who was the co-owner of the business that she was in the home health care business. And she had shared with me that she just wasn't doing well. But as a, as a, as a clinician, you you always are taught don't, don't diagnose your family don't, you know, don't be a therapist and your family and when whatnot. So I kind of left alone, I was there to listen to her, but I encouraged her to definitely seek out get help. But between the loss of our father, the divorce, and the stress and conflict that was happening between her ex husband, she ended up in like a mental health crisis.

Now, at this time, I had now moved away from the hospital, and I was working in another city called Indianapolis, where I was the director of a crisis department now, and I was overseeing the inpatient hospital. And we were seeing, gosh, 30 patients a day coming through for a mental health crisis. And our job there, I was overseeing the team that did my job back when I was working in the hospital, basically, in addition to being the Clinical Director for the inpatients -- like 128 bed facility. But I got this call the next week and my sister's like rambling and racing, speech and thoughts, and it's clearly disorganized. And I talked to my supervisor who was the executive director, she was a nurse, too. And I said, my sister's in trouble. I need to go get her so I drove an hour to go pick her up from where she was at, in the in the streets. Her ex-husband was a former was a cop and had her arrested and was put in jail. And she was now out on the streets. And kind of a basically what was could be described as a manic episode. And I took it to a psychologist and she, you know, actually, her and I, that's her psychologist, actually, we're in the same program together. So she knew me when I didn't know my sister was seeing her. But you know, I'm like, okay, I can get her admitted into the hospital now that I'm seeing.

So she does a revaluation. She's like nodding her head like yeah, she is not okay, this is you know, some, you know, symptoms of hypomania were going on and as well as delusional psychosis kind of thing. So I she called the hospital, we did all the backend staffing, kind of stuff to get her there. I put her in the car, she felt a little bit better, but she would, I could see her kind of just going off on tangents and whatnot.

But anyways, this is my precious cargo. This is my sister, now that I'm trying to help her through a mental health crisis. And brought her to the hospital, she gets admitted, she is assessed, she goes through all the stuff that we did, she went in voluntarily at first. And of course, you have to do all your testing and whatnot, we found out that she had drugs in her system. And she tested positive for opiates. And when you test positive for opiates as a nurse, that means you have to be reported to the state. And so she was urged to self report per the medical providers. She did: she called and found out her husband had already reported her, right, out of kind of the spiteful conflict that they had in doing and she was absolutely livid. And she said, get me out of this hospital.

And so she was now ready to go she wanted to go fight back. But she was then put on a hold. So then she was in a cycle. This is her first kind of, you know, adventure, if you will, with the mental health system outside of maybe seeing a therapist on occasion. And now she was having to be flagged and put on a probation of her license because of misuse of of this drug.

So anyways, the divorce ensued. There was a lot of back end stuff of course, now I'm in a case manager I'm also the family member who's the discharge plan is for her to come and stay with me and to help support her. My sister was also a bit stubborn and didn't want to do that, you know, if you've ever tried to take care of a health care provider in the addiction center or in a mental health system, they're difficult patients and they know it, and they are going to tell you what to do. So she was also that type of patient and feeling her trauma feeling underneath that was her pain, her grief her the losses that she'd now was suffering, and struggling with. So she instead of her discharging to me, she wanted to go on her own, and she did.

So she just left you, you know her and I had some words, he said, I'm not coming back with you, you can't tell me what to do, I'm gonna go back and I'm gonna get my license. And, you know, she had her own plan, like we deal with, with some clients who can be really difficult. She was that patient. And it was difficult, because I'm a therapist, but I'm also her brother. And of course, she's gonna pull that I'm the older sister card. But again, it was heartbreaking for her for me to see her not gonna follow through the plan was for actually her to step down and go to what we call our partial hospitalization, intensive outpatient for drug and alcohol use. After her, you know, stabilization was done in the psychiatric hospital. But she didn't do that.

But at this point, now, she had lost her job because her nursing license was suspended and her husband had fired her from her home healthcare business, that she had founded through the divorce. So she was in very much distress about not having this part of who she was. And also dealing with the stigma of I've been in a psych hospital, the stigma of now I have an addiction, right, from what she was before. And she saw it was, you know, a mother, because she had a daughter who was 13 at the time and a provider for her home and doing something she really loved.

So, after she ended up getting back into actually a treatment program back in Muncie, Indiana, it was the same treatment center that actually that I had worked in, she was going to do an IOP/PH because you realize, if she didn't go follow through with getting treatment, she couldn't get her license back. Right. So she started going to the treatment center, and doing her appointments, and, but she was struggling with, you know, not really having stable home because now her husband was separated. So she had to find another apartment.

So all this stuff that addiction and mental health starts to rob away from you, when it comes to your job. And it comes to your, you know, just health and well being your work, when it's not helped in the right way. It feels like it's just so fragile. And so she was now in this space of my life is fragile, and then she was also trying to get some type of assistance to get back on her feet now.

So you know, that went on for a number of months, you know, surgery that I had was now on hold with the kidney transplant, my sister was in no way, shape, or form to be able to support me, right, as a nurse. So all of this now was delayed. And I was dealing with the own stress of being diagnosed with this stigmatizing, you know, medical condition. And I couldn't move forward with a kidney transplant, my sister couldn't support me and my my dad's health was kind of in peril. And I still was going to work every day as a director of this, you know, mental health program. And it was a lot, it was weighing on me significantly, and I started to seek out help for myself, just seeing a therapist and whatnot to kind of get a place where I could, you know, heal, if you will, you know. And I met with a therapist who you know, match my values, you know, we pray every session and, and so on.

So, that for our part for me was really meaningful, at least to have a safe space where I could talk about what I was feeling because I couldn't go to my sister, I couldn't go to my dad who was ill, you know, I'm the boss, if you will. I can't go to my team and put it on their shoulders. They may they knew about my sister, they were concerned about her, but they didn't know what I was dealing with with a medical condition. It didn't know how heavy some of these burdens were for me at the time, in addition to you know, thinking about the loss of my own father.

So at the end of the year, I saw my sister I think it was in Christmas. Actually Christmas Day I went to go see her she was clearly depressed. Like looking back on it. She was like on the couch. She was back with some ex boyfriend, her daughter was staying with her, it was a small house now she was in and we sat down and we reminisced all about all the beautiful things that we did as kids. And we laughed. My mom was there. We teased my mom because that's what we did. When your kids you make fun of your mom how they do stupid stuff. But we always had our inside jokes. And you know, I was concerned about her, but I was there to lighten her day and just say, Hey, I'm still here. I love you. She gave me a big hug said I'm so sorry when I came in the door because of all the stuff that she had was going through.

And you know, I left it at that and you know, then I go back to work and then six ... six days later, I get a call from my mom screaming on the phone saying your sister's done something to hurt herself. And I know she was still not well, and my clinical mine. I'm like, It's okay. My mom's you know, she's reacting, she's upset. Let me find out what's happening. So I remember being clearly at lunch is like one of those moments where you just remember everything, sitting down having lunch getting this call, my mom is frantic. I go back, I say, Well, I know what to do. I'll call the emergency room because I used to work there. Hi, this is Dr. Rollins, here to get report, Amber Rose, you know, blah, blah, blah. And you're like, oh, we can't give any information right now. I'm like, Okay. And I'm like, Okay, well, once you stabilize, I'll just, I'll find out and get back in the hospital. We'll do this again. It'll be alright. I got this. I know, I do this all the time.

And I call back again. And I in the background, I hear in the emergency room - to hear the unmistakable scream of my mother, like screaming, and I'm like, Oh, boy. I know this. I know. You knew, you know, your mother's cry if you will. And it struck me the nurse, she disclosed. She says, she's shot herself with a gun. And that just grabbed my heart immediately, like, oh, no, this is serious, serious. So again, I tell my boss, my sister is in trouble. Now. My boss knows my sister because she was in the hospital earlier that year. So she knows. She's like, go take care of your sister. So I jump in my car. And I'm like, Okay, let me get on my way. And as I'm driving, this is on December 31st, which is also my pastor dad's birthday. And I called and like, I didn't call I just made my way there. And I get a call. And somebody says to me, what would you like to do with the body? And it's the coroner. And I'm like, frozen in my car.

And I don't even remember how I got there from that point forward. Because I was the next person, of course, I'm notification on for our health record. Emergency contract contact. So anyway, so now I make my way to the hospital. And obviously, my mom was frantic, kind of in a numb state, you know, of like, wait a minute, I just saw her last week. And my mom wanted to see her wanted to see the body. I'm like, No, you don't let's let's No, let's not do that. And I'm in a mode of helping my mom. Right? Because her daughter's died.

And come to find out her daughter, my sister's daughter was at home when it happened. And was the person that found her. So I'm like, Okay, where's her daughter, she's 13 years old, she was the most precious thing to my sister's, in my sister's life. Only daughter. So I found that of course, she was taken away, you know, in with her grandmother, father's grandmother. Safe, but the main thing was just to be there to find out what's going on.

So you know, I have this tragic, tragic experience and everything stops, everything stops. And as a minister, now I'm back in a mode of like, okay, I've got to put together a funeral service, because nobody else in my mother's side of the family, which we were raised by had and had died. So but I had as a minister, gone to participate in many funerals.

And this is like now coming into January of the coldest, coldest time of the year. And I remember even organizing the funeral. And it was so cold that they had this whole county shut down. And the other day that we were planning it. And so it was like we all had a real like frozen in space of having just kind of sit in our frozen grief. And still not having answers. And everyone in my family is looking at me because I'm the mental health expert of like, Hey, what happened? Like, oh, she was drugged or no, wait, she didn't kill herself. Somebody else did or something else happened. So what is it like nobody? You know, this, the idea of somebody killing themselves as my sister was a beautiful, fun person. She's way more exciting than I am. And it doesn't make sense. Like, how does this happen? Right?

We know that she was struggling, but we didn't expect this. And you know, so I'm sitting there trying to answer this for everyone for the family as well as get through the funeral. And anyways, I can't tell you the depths of the grief. I mean, you couldn't even touch into it at a given time. Because I was still in the mode of a helper, right. So I'm still a minister. I'm still a director. I'm still an uncle, who has a niece to look after, I have my pastor father and his health.

And you know, I found myself just kind of going through the motions of now this grief on top of grief. And it was a true adversity in the sense of so many things happening in a short period of time. And then being just pummeled with suicide, where the guilt of what did I miss, right? And trying to figure this out because I needed to answers. And then I went back to work, I'm going back to work and my job every day was to help people who were trying to in their life, right are struggling with it or helping families.

And I couldn't even get through the audits on my documentation stuff. If I saw the word suicide, I would just like freeze up. Right, and then seeing a nurse walking down the hall, you know, I would tear up and I remember, it was then again, I worked in an integrated health care system, meaning they had behavioral health and about six other hospitals throughout the city of Indianapolis. And behavioral health was one of the specialties and my job was overseeing the front door of that crisis center.

And it just so happened that we had gotten a grant, a Garrett Lee Smith Grant for $2.1 million to do a Suicide Prevention Program at the hospital where I was working at. And I remember the Vice President, like announcing this. And I was not in a position where I felt like I could do much of anything. Because like I said, I could hardly see the word. And my boss who was a support at the time, was like, you know, whatever you can do to help. Or, you know, we know your what you're going through, and but I would sit in meetings are announcing and I remember the vice present talking about we're going to do suicide prevention, suicide is preventable, suicide is preventable suicide. And I'm like, I just lost my sister, like, and I couldn't even she said that so many times that I had to, like, leave the room. And I'm like tears, you know, people are coming to help me. And you know, I had a great cohort of people who were there, but I couldn't even like fathom the idea.

So my, it was just very raw for me, you know, where sometimes we go to work. And we think we can escape, like, struggles at home, personal stuff, but I couldn't get away from it because I was in the middle of it. So I took a lot of time, I went back to therapy, to kind of work through that. And what really transitioned me when I even call it back to, of course, I went back to where she died. I went through her notes, and I looked at her her personal journey, and she would write things like, I can't stop. Why am I so weak? And she was talking about the addiction, right? While she was in this outpatient program. And it was I called the boss who was my former boss of it and said, "Did you know what my sister ,did you see, clinically?"

They were like, you know, so sorry, you know, will this happen sometimes? And I'm like, this is my sister. Like? No, like, you don't understand? Like, you don't get to make her like, just anybody. Like, what are you guys going to do differently? Like she's writing it down? Like, did you know that there was a gun in the home? Did you know? What did you know? Like, did you do? Are you gonna do anything different? Like, are you just gonna sell like, well, that's, that's what happens. Like, and I was just unsatisfied with that. And so it really stirred my spirit even more, to do more.

And I was asked, we took on this initiative called the Zero Suicide Initiative. And there was the Zero Suicide Initiative Institute. And it was part of the grant was to implement this program. But we also had to market it to the rest of our healthcare organization, it says, we're talking about good and maybe close to 5000 employees, seven hospitals to other some ambulatory sites throughout the city.

So there came a point where I decided that I would tell my story, because at that time, this again, 2014 people were knew about suicide, but we weren't really talking about it, it was still like, that's the behavioral health issue. It's not our problem in primary care, but actually, it was, because people with cancer, people who had maternity had postpartum and you know, all the other medical conditions that people were doing, were also having depression, suicidal thoughts, etc. And we needed to make sure that we were doing Suicide Prevention at every point of care.

And so I went before the nursing leadership team, and I told the story of my sister, and they just everybody was like in tears hearing her because I could relate to her as a nurse. And that moment, showed me that my sister was still with me. And the and the way that she could keep keep helping people was if I became a voice for her. And it helped me knowing that I had a background in psychology because I was a director because I now had this terrible experience. I wanted to figure out how to now enhance this tragedy into creating something to help other people and when I found out and I saw that by sharing her story and sharing my expertise in this field, I was actually helping people.

And even my staff had a greater regard for the fact that they knew that this had impacted me and they so they knew that when I was asking things and wanted things to be better. So I took that energy of saying, hey, let's make it your job like that other person's job, I said, this is my job, and I'm in my team, we're gonna come together and figure out how to do this because nobody's wife, sister, mother, daughter, whatever should have to die by suicide, or, you know, alone and suffering in their pain. And so that's what we committed to do. And I continued to do that with that company. And we put together a very extensive program that was embedded into the EMR. I won't get through all the details of it. But it was extensive, to work on suicide reduction within that healthcare community. And I would say that we did a phenomenal job.

And but I still felt unsatisfied, because as I was in the company, I was like, Well, I needed a position where I can do more. Right, but I didn't know. And then somebody had mentioned to me about working with some of these bigger companies, like fortune 500 years, and I reached out to say, you know, what, I need to be in a position where I can have greater influence. And I sought out an organization that trained me on how to be a COO and how to be a CEO. And then came out to California back in 2016, and was appointed as a COO of Fremont Hospital in the Bay Area. And immediately, when I started asking questions around suicide, suicide prevention, I started to see after my own experience, and what I had learned through this institute, Now mind you, I'd also joined the steering committee for the Suicide Prevention Lifeline. Around 2014, I decided to raise my hand and I jumped on the board.

This is before we went to 988. And this was around the time when Logic put out that song, one 800-273-Talk, right, and there was this big marketing campaign, but the 988 back in 2014, 15, was already being put together, we were trying to we were calling it N11. And but we didn't have a number because we couldn't figure out what number to use. So and then the big marketing came from Logic songs, so all that startups. So in our one year, what nine, because I would say to them, I say if if I was like, I know my sister would not have remembered to call 1-800-273-Talk in the midst of a crisis. Right? Nobody uses 1-800 numbers anymore. So we all knew that this was antiquated.

And, you know, as like, if my sister is in a crisis, and or if anybody else's sister or whoever it is, you can remember 988 right? We know we can do a three digit number, whatever it was, we didn't know at the time, we knew something had to change. So my my mission personal mission like was to figure out how to make treatment better access better when people are in crises. And that's really what started my journey.

And then since then, I've been working with organizations from psych to addiction, on how to integrate suicide prevention, and just better care and advocate for, you know, fair treatment of people who are struggling with addiction and mental health. So you don't fall into this suicidal crisis. I currently I work with Renewable Health Group. And we and this is we do addiction in LA, which is a place called Sanctuary. And then another place in Palm Desert called Phoenix Rising, and we have a mental health program called Montair. And then we have a program in Arizona called Zenith that is for adolescents, and an eating disorder for adults called Trellis in LA.

So now I'm in a position where I'm a part of the leadership for these organizations with renewable health groups that allow us to let's let's talk about as a culture, as a community, as a healthcare provider, how can we make treatment better, and that's what I've been committed to do. And I take my sister's story with me, because I like her still being with me, not so much how she died, but how she lived and really realizing how valuable people's lives are with the increases of suicide that we've been seeing year after year. So that's kind of my story, maybe a lot of it, but that's what happened. And there's a lot more to it, but that's what's behind me and what I do.

Angie Fiedler Sutton
That is definitely very emotional. Thank you for sharing. As I mentioned when we met to talk about possibly doing this, I myself have had a good friend who died by suicide. I'm on the American Foundation for Suicide Prevention, it is the 11th leading cause of death in the US, according to them. And in 2021 there was an estimate 48,183 Americans died by suicide. How do you navigate that? That conundrum of yes, there's suicide prevention, but at the same time, that guilt of there's only so much, you know, could I have done more?

Marlon Rollins
Well, and that's the piece of it is always going into what else could I have done and what could it because I realized that it wasn't just my, my task, that suicide prevention is a whole community, it is a whole health care provider. Right, including the family, right, and the individual. So it's not what I'm doing by myself. It's what I'm doing in conjunction with everything around me, including, like how we do treatment planning how we do safety planning, how are we asking questions about? Do you have access to something lethal at home? Are you having these thoughts?

But my, my biggest struggle was that I'd never asked my sister the question like, are you thinking about? Have you thought about all this stuff that we've been through? Have you thought about wanting to end your life and having that very uncomfortable conversation as a starting point for me. And I realized that as providers, treatment, sexual mental health, we, too struggle with asking our clients that question, like, we're so focused on the diagnosis, and the treatment plan, we forget about asking those important questions about safety. When it comes to are you thinking about suicide.

And so that's the thing that really strikes me. And it's the belief that you can do something it's so when you say that suicide is preventable. And then there's some people say, well, suicide can be preventable. And that's like, Okay, if suicide can be preventable, under what circumstance ... under what circumstances? is suicide? preventable? How can we make it better? And we understand that by the risks that already surrounds suicide, and then looking at how to reduce those risks, and it beyond the healthcare community, there's a lot of things that we're that we could do, that we're not doing, you know, my goal is to ideally talk have those conversations, and to educate people on what else we could do to be more Suicide Safe.

Angie Fiedler Sutton
Now, you mentioned the the suicide hotline, which again, if anyone is feeling suicidal, it is 988, nowadays, there's also a chat version, if I'm not mistaken, do you know much about that? Talk a little bit.

So if you text the word "help" to 741-741 You'll be connected to somebody who can text you, which is great for youth, and maybe take some of the anxiety out of it. Remember, this is a full on, you know, volunteer service at different counties, and you know, different states have different systems set up. But if you text the number 741-741 help to that line, you'll get a text message, and you can engage and it's free, it's confidential. The police are not going to show up at your house, you know, just this is a safe line you can connect to to get the resources that you need. You can even say it if you have an iPhone, if you say to Siri, I need help. I'm thinking about wanting to in my life, it will connect you as well. Siri will come on and ask you Do you want me to call for you? And again, it's not they're not going to come after you if you say it is not recorded in your phone. It's it was set up because people actually were saying that to their phone, to Siri, and Siri didn'y have an answer. So an algorithm was built to design it. So there's ways in which you can reach out for resources through 988, the text line or you know, saying it to your phone.

Angie Fiedler Sutton
Now that for especially with people with like anxiety, especially actually making that call might be the hardest part. So that's part of the reason why I am a fan of the chat myself. Because that way, if if you're not wanting to be verbal, you can still be written text, I guess this is the best way to

Now, In your bio, we mentioned that you work with with BIPOC, which is short for by black indigenous people of color for those who are unaware of the abbreviation. I'm assuming they're at a health risk of suicide as well talk a little bit about that.

Marlon Rollins
Yeah, I mean, sadly, what we've seen, really, in the last just few years, significant increases in American Indian males have gone up. And suicide deaths to one of those highest rates, as well as increases in black male youth has also increased above other groups. And it's really important to understand that if everything was equal, we would see everybody moving in the same direction.

But there is groups, American Indian men, and black men in particular, we're seeing those rates of suicide go up significantly. And we're also just looking at age populations, we're also finding our youth suicide rates also increasing. So as the now the 10th leading cause of death in the United States, you know, and it's not seeming to move in the other direction, we need to be looking at which what do we need to do for those groups differently?

Angie Fiedler Sutton
With that July is BIPOC, Mental Health Month. And I know that when NBHAP sends out our monthly member newsletter, we send out updates of like upcoming months like that and ask where to go to help. I'm on the Mental Health America website right now to talk about what you can do during that. But what do you feel is the number one thing that someone who is in the industry could do to better improve suicide prevention?

Marlon Rollins
So we talked about the word of social determinants of health, what's happening in those communities, how they feel about themselves, how they see themselves socially, what does it mean to get help? We already know that men tend not to seek help over women, we know that, you know, men die by suicide that 3.4 times more than women do. So there's that element of it. But also those that were addiction itself puts people at risk for suicide, especially if you're using alcohol because we know it's a depressant. I don't know how many people I saw in the emergency room that would say, they would get drunk and they were suicidal. And they said, Well, I'm not drunk anymore. But some of those people were drunk, suicidal, and they didn't make it. So the access to alcohol, drugs and alcohol misuse, overuse, especially in American Indian men, we're seeing alcohol use being for those that have died, that alcohol played a role in that death or preceded the suicide.

I think the first thing that we have to do is to normalize having the conversation about suicide and ask it so you ever had you thought? Have you had thoughts of not wanting to wake up? Have you had thoughts of wanting to kill yourself? And then and the industry being able to have conversations: Do you have access to a lethal mean, do you have a plan? So we know that 54% of the suicides happen with a lethal weapon. So we have to ask those questions. Do you have a gun in the home? Or is there access to a gun? Because usually that person who was suicidal is thinking about it. So that's part of it.

And the other thing is making sure that we are checking in on those people more often that have more risk factors, right? Following up sometimes it is just like, Hey, how are you doing? I'm concerned about you checking in, are you okay? Today that makes a big difference. Just even as a health care provider, like when you go home and leave the hospital and somebody calls you or whatever, and says, Hey, how are you doing? I hope you're checking in Is everything okay? You feel cared for. So the message is that we have to send for the, especially for those that are higher risk, even those that are struggling with addiction, that you matter to me.

And we put protocols even in our treatment center where people leave this, we check in on them, after they leave our treatment center and say, Hey, how are you doing? We want to make sure you're okay. And for those that are higher risk for suicide, we certainly check in with them more often. Because moving from treatment center, post treatment discharge is one of the most risky areas.

So, you know, as a health care provider, checking in asking the questions, having a protocol of what you do, really can help intervene. And that's what helps suicide be preventable, at least reduces the risk for it, there are healthcare organizations that have has actually accomplish Zero Suicide for extended periods of time, because they are paying attention to it, their culture is leading for it. And they follow up with patients who are higher risk addiction centers, we need to get better when we're treating people who are on recovery, we tend to avoid it. And people who are in recovery tend to not talk about being suicidal, because if they say it, they are worried that they won't get the treatment, they'll say, Oh, if you're suicidal, you can't come here. That's the most common thing that I hear. So they just don't talk about it. And we need to be able to have the conversation like I've met with clinicians, and they'll sit down and have the conversation with a client who has had a gun. And we're not judging them, we'll say, what was the play and what was processed the emotions behind it, because you need to be able to be open and honest about what's going on. So you can have a good plan to help that individual.

Angie Fiedler Sutton
And I know from past experience, I've had suicidal ideation in the past, thankfully, I am not now. But there's also a different I mean, it's different for the same that it's not necessarily that you don't want to be that you don't want to die, that you just don't want to be alive. How do you start? You know? So if that, you know, that's also a question is that more, like you said, the best way to do that as kind of check in and and, you know, just say, Hi, how you doing? Don't? Don't guilt trip them. Especially, you know, don't be like, I know, the big thing is to not say, you know, please don't kill yourself, I would feel bad. Because that just makes them feel even even worse. Yeah. Do you want to talk a little bit about that?

Marlon Rollins
Absolutely. So you really have to, you know, empathy is a real skill and like, check your own anxiety about asking that question and somebody saying yes to you, and just be present with them. You know, you ask those questions. Have you thought about how, you know, has it ever you ever made an attempt before? You know, be a listener, be somebody who is comforting, but don't judge them and say, oh my gosh, well, you can't do that anymore. You know, listen to it, because right now they're opening up they're talking about it and then come up with a plan.

You know, the one of the things that we I don't think we do enough of is really talking about helping a support system around that individual has what we call protective factors, right? How do they have more resilience against it, against going into a suicidal crisis? Like many times they want the pain to stop so let's talk about what that pain is. Right? So they see the suicide as the only answer. So you as you work with them you and say, Well, don't do that. You just say okay, well, let's talk about what does this look like for you? You know, what would what would life look like if you were to stay around like take them on that journey of obviously sobriety.

We know If they can maintain sobriety, that's going to be a protective factor, right? Having them attached to something, a cat, a dog, you know, making some kind of connection, your faith, having a spiritual, you know, connectedness, this really helps you as well. And then access the follow up help and support, you know, those are the things we have to have conversation, but we have to go into what's kind of that that darker space with them first, and be with them and sit with them and their pain, showing them that we care, allow them to experience it, and then usher them into a place of hope.

But you have to also have that conversation and making sure that they don't have access to something that in the throes of addiction or anger or a breakup that they do something to hurt themselves. And we can't say that they just want attention. Right? Instead of judging it be present with the person who's in pain. That's so so key. So I mean, those are the things that I would say with like working on destigmatizing it. Because the way in which we respond to somebody tells them like oh, like, if they say they're suicidal, or we gotta lock you up, or we're gonna put you in other facility. And they're like, Well, this is why I don't talk about it. This is why I don't open up about it.

So we got to not do that kind of reactive thing. We have to like, allow them to have the conversation and still feel cared for because they're safe. They're safe in that moment. And if they're in a treatment center, with you many times that they're safe, too, right? It's when they've taken real action, they're writing a note like, oh, yeah, I'm gonna do this, then you have to up it, then you have to take those next step. But that should not be the first response. Right? So we have to respond with care before we respond with scare.

Angie Fiedler Sutton
Let's pivot a little and talk a little bit more about your book. You mentioned it briefly. But just kind of what made you decide to write it, give me your elevator pitch about it, that kind of stuff.

Marlon Rollins
Yes, the book, again, is called "Healing the Impoverished Mind: Building Resilience Through Adversity". So in the book, you know, part of it was for me to really heal in regards to telling a story that was pretty powerful to reach other people. So I go into detail and I talk more about my sister's and I's upbringing and what she went through and those kind of final moments leading up to it.

The book is really about how to break the cycles and patterns of mindsets that we get into that lead to us not feeling lost, to lead us to feel lost, and of how to find purpose, how to break out of those reactionary states of being the fear response, the flight response, because we feel threatened in some kind of way. And so in the book, I go over that cycle, and then also provide some insights on how to break out of that to build to build resilience, you know, outline, specifically more warning signs, risk factors as it comes to suicide, and also give some tips on how to develop resilience. It's a great book that can be used actually in a group setting.

So the goal of the book was for me to tell the story, but also use the story to educate people about what you can do to help somebody who's struggling with a mental health crisis and addiction crisis, or just a life crisis, and how to find resilience and deeper purpose through their pain. That's really what the book is all about. I wrote it after after 2020, I've had some time to sit down and realize that we had all experienced that collective trauma. And many people we lost, and I wanted to speak into this space a little bit more and acknowledge that people are a lot of pain.

And my goal now moving forward is to help organizations help other people work on suicide prevention, building resilience, because we're seeing unfortunately, increasing rates of death by suicide even outnumbering the suicide, or seeming homicides that we see in a year in the country. So my goal now is to use my platform and to help organizations to become safer, healthier, and certainly more healthier for their workforces, because we know that healthcare providers in particular, like nurses, are at higher risk for suicide.

Other industries as well, including construction, dentists, and physicians also struggle with suicide, and not to mention our veterans who are at higher risk for suicide because the amount of trauma that they face every day. So again, that's the that's the goal. My personal goal. And the goal of the book is to speak into those places to help people to find deeper meaning because that is a protective factor. When you feel as if your life matters and you know that your life matters. You take deeper value in that and we all deserve to know that even if you don't know what your purpose is, your purpose is to live today. And to know that your soul is here for a reason. And to know how valuable that you are.

And sometimes in the cloud of depression, you can't see how important you are to the person standing next to you. To your sometimes your spouse, your wife, your family. You think that it's better for you not to be here anymore. But I can guarantee you that is the deepest lie. The thing that you should never believe is that you don't matter. Because I guarantee you, if you leave here too soon, the people will inherit that ripple of pain. You're just passing it on. And there are services, there are people that will help you get out of that dark place and find renewed life. I know many people in recovery, who have found new life and a deeper purpose in spite of their addiction, and are just feel like angels on earth. And that transformation is what I'm all about promoting. And I just want to send that message out to anyone who is struggling with whatever life trial you're going through, just to know that you're not alone, and more importantly, that there is a way out. And if you can't see it, close your eyes and imagine what it looks like. And just take one step towards it every single day.

Angie Fiedler Sutton
That was beautiful. I'm glad you mentioned mental health as a journey, because that's part of the reason we named it the podcast Destination Change because the idea of recovery been a journey, it's good to be able to hear that mental health is also a bit of a journey, that it's not one straight, you know, start to finish kind of thing that you have backtrack and mess up just like you do with recovery.

In terms of resources for people who are either in the industry or wanting to get more help, other than the 988 line, what resources do you typically use most often in terms of for what you do?

Marlon Rollins
I've use I mean, DD Hearsh, is a great organization that is kind of one of the helmets are promoting 988, they have support people, for people who are law survivors. There is also room called a colon a coalition coalition of clinicians. So that is a support group also, specifically for therapists providers, who are law survivors. There's another organization called Mourning Glory - M-o-u-r - that provides weekly support for loss survivors. The American Foundation for Suicide Prevention has a tremendous amount of resources online, as well as SAMSHA does, and sprc.org sprc.org, Suicide Prevention Resource Center, they have a tremendous amount of resources specific to certain populations, like American Indians, they have done an extensive amount of research. So if you're looking for protocols, you don't have to make this stuff up. A lot of resources are out there, it's just about accessing and then putting them into your programs.

So those are the ones that I use when it comes to like program design. And then many places offer like free trainings. There's a CALM training - C-a-l-m - which stands for care, I think access to lethal means, as the ALM on that it's a free training that you can get as well as a certification that helps you to have to understand how to have this conversation about reducing access to lethal means. So again, we got to train our workforce better get more confidence in having this conversation around suicide and make sure we're falling out with folks who are really struggling ask the question, when you see the warning signs ask the question. So that's what I have for you.

Angie Fiedler Sutton
Now before we go into how people can get a hold of you. Was there anything that we haven't talked about that you wanted to or something that You thought I was gonna ask that I haven't?

Marlon Rollins
No, I think I've given you everything that's on my heart right now. I appreciate that.

Angie Fiedler Sutton
That's good. Now, how can people get a hold of you if they want to learn more about you? Or if they want to, if they have more questions about what you've discussed? How can people get ahold of you?

Marlon Rollins
Thank you so much, so you can reach me, you know, through social media. I mean, I'm on Instagram, often they're at Dr. Marlin Rollins Mar, ello en all one word, you can also go to my website at Dr. Marlin rollins.com. And you can email me there. If you go to renewal recovery.com That is you'll access my team. And the best way I think is though through my website, email me can also email me at Dr. Marlin [email protected] You have questions.

Angie Fiedler Sutton
I'm going to clarify is that Dr. like spelled out or Dr.

Marlon Rollins
Thank you for saying that. Yeah. So it's Dr. On Instagram, Dr. Merlin, Rollins, D R. Marlon Rollins, Gmail. So try to keep it simple.

Angie Fiedler Sutton
Never assume. {laughs}

Thank you very much for coming. You've been listening to Destination Change. Our guest today was Dr. Marlon Rollins. Thank you for being here. Our theme song was "Sun Nation" by Ketsa, and used via a Creative Commons license by the Free Music Archive.

Please consider rating and reviewing the podcast on Apple Podcasts so we can get more listeners. In the meantime, you can always see more about the podcast – including show notes and where else to listen – on our website, www.nbhap.org. If you have any questions for the podcast, please email us at [email protected]. Thanks for listening.