April is Mental Health Awareness Month and, while people generally agree it’s an important issue to discuss, the stigma surrounding topics like depression, anxiety and suicide makes it difficult to start those conversations — especially in Utah where so many stereotypes peg us as a wholesome, happy and preternaturally nice people.

But the statistics reveal a flip side: Utah has a depression rate that is higher than other states (one in five) and is ranked seventh for suicide in the nation.

And if you’re female, the numbers are more concerning. Our research at the Utah Women & Leadership Project — hosted at Utah Valley University — shows that women report significantly more poor mental health days per month than do men in every age category, and our state is the fourth highest in the nation for female suicide. Before we can create change, we must create awareness and reduce the stigma surrounding mental health challenges.

One finding that might surprise people is the link between perfectionism and mental health issues. A close friend of mine recently went to therapy to get help for her deep depression and the counselor said, “You can’t be depressed! You’re succeeding at work, your marriage is solid, you volunteer at church and school.” The lie of perfectionism is that one can appear to have it all on the surface, but down deep the impossible expectations and desperation to please others can literally kill.

Journalist and author Jane Clayson Johnson explores the idea of “toxic perfectionism” in her recent book “Silent Souls Weeping: Depression — Sharing Stories, Finding Hope.” She explains that when we try to maintain a façade that we have it all together, it becomes difficult to share our challenges because we would have to drop the “mask.” This leads to an isolation that makes us much more prone to depression and suicidal ideation. For the kids who don’t fit the mold, who aren’t “perfect,” whether due to their beliefs, sexuality or physical appearance, the shame can be especially harmful.

Silence around mental health is never productive. When it comes to teenagers and self-harm, many of us are afraid that in talking about these issues, especially suicide, we run the risk of increasing the behavior. A recent Wall Street Journal article explores the tragic story of a cluster of teen suicides that took place in Herriman in a 12-month period. Initially the high school decided not to openly discuss it, fearing it might cause more youth to follow suit. But the silence neither prevented further suicides nor promoted mental health. In fact, studies show the reverse is true: talking about these tough topics actually reduces self-harm.

So what can we do? As individuals we can share our own struggles to remind friends and family that everyone faces sadness. As parents we can reassure our children when they fall short of expectations that they are still worthy of our love. As a community we need to promote education and help those in need find access to the right support. Each of us can help heal and strengthen our state, one hard conversation at a time.


Susan R. Madsen | Utah Valley University

Susan R. Madsen, Ed.D., is the Orin R. Woodbury Professor of Leadership & Ethics in the Woodbury School of Business at Utah Valley University and the Founding Director of the Utah Women & Leadership Project.