For the first several years of its life, my TEDx talk was called "Why We Choose Suicide." That was the title I gave it. The one I stood on stage with in September 2013 at The Royal Conservatory of Music in Toronto. The title that accumulated millions of views and found its way into suicide prevention curricula, university courses, clinical training programs, and living rooms all over the world.

Months after the change, I noticed that the title had become "Why We Need to Talk About Suicide." Nobody had asked me about changing it.

The Surprise

My first reaction wasn't enthusiasm. This was a talk I had written from the inside out. It came from a place of lived experience, of standing on the wrong side of a bridge railing as a teenager. It was also informed by my then work as a mental health clinician, hearing from young people nearly every day about similar experiences. I was trying to put something true and survivable into sixteen minutes on stage, on a red-circle rug.

The original title wasn't arbitrary. It was the question at the centre of everything I was trying to say. To have it changed without any input from me, or even a heads up, felt disorienting. Like arriving home to find the furniture rearranged while you were out. The room is technically the same room. But it's not quite yours anymore.

I don't raise this to relitigate a decision that's long been made. I raise it because the discomfort turned out to be generative. It forced me to really think about what each title is actually saying. It has led me to reflect on what each one does or doesn't do in the world. This is where I've landed.

What the Original Title Was Really Asking

"Why We Choose Suicide" sounds, on first read, like it might be affirming suicide as a rational option. That isn't what I was arguing. The title names an assumption about choice in order to examine what it leaves out.

The word choose is doing philosophical work. The talk opens with a question I lived before I could articulate it: what does it mean to choose something when your perception has collapsed so completely that you can't see any other options? What does choice mean without genuine alternatives?

In the talk, I describe needing something I could feel certain about at a time when I could see very few possibilities. I understand that now as an illusion of agency within profound constriction, not as the freedom to choose among genuine alternatives.

The whole talk builds toward a single question asked explicitly near the end: "Can suicide really be a choice if it's the only choice available?" The answer I reach is that a decision made without perceived alternatives isn't a free choice in the sense we usually mean.

What looks like a choice from the outside is, from the inside, the experience of a mind that has run out of perceived options. Biology, psychology and circumstance converge to create what I called a perceptual field collapse. And it can contract so severely, the big crunch at the end of the universe, that what was once a full and expansive space becomes a single, infinitely heavy point.

This framing also has practical implications. Harvard's Means Matter research summary explains why reducing access to lethal means can save lives during a suicidal crisis. Some attempts happen with little planning during a short-term crisis, but that doesn't describe every person's experience. Making the immediate environment safer is one part of support, not a substitute for ongoing care.

What the New Title Is Saying

"Why We Need to Talk About Suicide" is a different kind of title. Less philosophical provocation, an interrogation of the very nature of choice itself, and more about awareness. And the more time I've had with it, the more I've come to appreciate what it's doing.

The new title asks us to do something: talk about an experience that can become harder to name when shame and fear surround it.

Asking about suicide doesn't mean suggesting it. The National Institute of Mental Health's guidance explains that asking doesn't increase suicidal thoughts or behaviour, and places that conversation alongside listening, helping someone stay safe, connecting them with support and following up. A conversation can open a path to care; it shouldn't be asked to do all the work of care.

When that man in the light brown jacket stopped on the bridge that night, he didn't deliver an intervention protocol. He talked to me. I don't even remember the whole conversation. But he stayed, and he talked, and when I started to fall forward, his hand reached around my chest and pulled me back.

Talking kept him present long enough to save my life.

The Language of Mental Health Is Never Neutral

What the title change also surfaces is a broader question that I think about constantly: who controls the language of mental health, and what does that control accomplish?

Euphemism has a cost. When we consistently soften, redirect, or rename the harder parts of mental health experience, we can inadvertently reinforce the message that those things are too dangerous to name. It implies that some things are too shameful, or dangerous, to say plainly. That message lands hardest on the people who most need to hear that what they are experiencing is real, recognizable, and survivable.

The shift from "committed suicide" to "died by suicide" is a good example of language change that genuinely matters. "Committed" carries connotations of crime and moral failure. "Died by" frames it as what it is: a cause of death, not a verdict. The American Foundation for Suicide Prevention's language guidance captures this distinction clearly. The words we use shape whether someone feels that their experience belongs in a conversation or outside it.

At the same time, I'm wary of language policing that prioritizes the comfort of the observer over the clarity needed by the person struggling. Sometimes the most helpful thing is the direct word. Say what you mean. Sometimes the safer path is the gentler one. Speak the truth behind the words. The practice of being able to tell the difference is part of what it means to talk about mental health with both honesty and care.

What I Would Say to My Fifteen-Year-Old Self

The opening of the talk considers whether knowing more would have changed what I experienced as a teenager. It's a question I've returned to many times, because information and the ability to make use of it aren't the same thing.

That still reflects how I understand my own experience. Knowledge mattered, but it wasn't the whole answer. Someone stopped, stayed and helped me survive long enough for other kinds of support to become possible. I don't want to turn my story into a claim that connection alone is sufficient for every person in crisis.

Both titles point at the same truth from different angles. One asks whether choice is real when perception collapses. The other tells us what to do about it.

Talk with someone, stay present and help them connect with support. Being there matters, even when you don't have a perfect answer.

That's always been the answer. Whatever you call the talk, that's what it's about.

Why Both Titles Still Matter

There's a practical reality worth naming plainly: both titles exist in the world. Scholars cite the original. It appears in academic papers, clinical training materials, suicide prevention resources, and thousands of online discussions. Journalists, bloggers, and advocates have referenced it under both names.

Why We Choose Suicide by Mark Henick. Why We Need to Talk About Suicide by Mark Henick. Both titles refer to the same sixteen-minute talk, given at TEDxToronto on September 26, 2013.

I've noticed a change in how often people encounter the talk, though I can't establish how much comes from its title, platform recommendations or other factors. If I gave it again today, I'd probably do some things differently. I'm still proud of what it accomplished and grateful for the work that came before and after it, whatever the title.

Because if you search for either one today, you should find your way here. To the talk. And to this conversation. That's a good thing.

I'm glad you're here.

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