World Mental Health Day and Suicide Prevention
It’s World Mental Health Day this Thursday and the theme is suicide prevention. A hugely important topic given that every 40 seconds, someone, somewhere in the world, dies by suicide. Think about that. It might take you about 3 minutes to read this blog and in that time, more than 4 people will have ended their own life. As well as the tragedy and lost potential inherent in that person’s life having ended early, the ripples and reverberations into their wider community are enormous and long-lasting, as those of you touched by suicide will know.
I’m a mental health first aid instructor as well as mindfulness instructor so thought I’d take the opportunity of a Mindful Monday to talk a little bit about suicide. If that’s not something you’re ready to read about, then perhaps give this blog a miss.
It’s a hugely emotive subject, not least because it’s so common and therefore many of us are touched by suicide in some way. There are a lot of myths, misconceptions and generalisations about suicide which are often unhelpful. For example the myth that you shouldn’t ask someone if they’re thinking about suicide, in case you ‘plant the idea’ in their head, is damaging because it can make people scared to broach the subject. The reality is that asking about suicide doesn’t encourage it or make it more likely. The opposite is true. Opening up the conversation might prove to be the only opportunity the person has to talk about how they’re feeling, which in many cases has proven to be life-saving. It’s particularly important to understand this in a work setting. The temptation with a colleague you’re worried about, might be to assume that they’re bound to be talking to friends or family about how they’re feeling. But often we keep things from those closest to us, for fear of worrying, upsetting or disappointing those that matter most. This 10 minute video is an interesting discussion of some myths and truths about suicide from the perspective of suicide attempt survivors.
The evidence around suicide shows that people who attempt suicide aren’t always convinced it’s the only option, but often they have exhausted their emotional reserves to continue pursuing those options. This emotional burnout doesn’t happen overnight. If we can help people in extreme distress top up their reserves, sometimes this can be enough to help them keep trying to find their way through the darkness. And topping up these reserves doesn’t necessarily involve anything terribly miraculous. It might be a good night’s sleep, a decent meal or the chance to talk about how they’re feeling with someone who truly listens and doesn’t judge.
Although this burnout doesn’t happen overnight, sometimes people experience the phenomenon of the ‘straw that broke the camel’s back’. When I completed my MHFA instructor training, we heard from a man who’d attempted suicide. He had been struggling with depression for some time, but had managed to continue a plodding kind of functioning on a day to day level. The ‘final straw’ came when his boss ‘tore a strip’ off him in a meeting. After this meeting, he cleared out his desk and made plans about how he would end his life that evening. His story reminds us how important it is to check in with colleagues when they’ve experienced something upsetting or traumatic at work. Might his actions have been different if someone had taken him for a coffee and a chat?
As this man walked home from work that night, he described how everything around him on the busy London street was completely black. He recalled how as the cars drove towards him on what was a dark night, he didn’t have any perception of their headlights shining. He was literally in a ‘dark place’. His story illustrates how people’s neurophysiology can be altered by their state of mind. He literally couldn’t perceive light around him; a strong example of the mind-body interaction. The evidence shows that in order to attempt suicide, a person has to be in a neurological state where they can override their own survival instincts. Some experts have likened this state to other preventable acute medical states, such as hypoglycaemia in a diabetic. And if we knew someone was about to become hypoglycaemic, we would try and prevent it. Why is suicide different? Well maybe it’s partly about the stigma that surrounds mental health. It can be hard for people to reach out for help, for fear of judgement, and it can be hard to reach out to those in need because we might be unsure about what to say. In reality, what you say matters less than how you say it. And saying anything, is often less important than just listening. You don’t need a magic wand, just a genuine desire to listen without judgement and some knowledge about sources of help. If you’re worried about saying the wrong thing, this 3 minute video is useful.
If someone is in an acute suicidal crisis, they need emergency help. The situation will dictate exactly what form this takes, for example whether they require an ambulance, attendance at an emergency department or contact with a crisis team that they’re known to. In less urgent situations, a person should be encouraged to see their GP, another primary care professional such as a practice nurse, or a mental health team if they’re already known to them. Primary care tends to be the ‘gatekeeper’ for more specialist mental health support.
One article I read by a suicide attempt survivor describes a suicide attempt as a ‘freak accident’ where several factors have to align for suicide to happen. These might be a reduced resilience for emotional suffering (perhaps due to mental ill-health, substance abuse, extreme and prolonged stress or a bereavement), a trigger event, and the means to end their life. ‘Interruption’ or alleviation of any of these factors, might be enough to help a person through their darkest time.
If you have mental health first aiders in your organisation, they can be a great source of information and support. Mental health first aiders we’re trained to be able to spot the potential signs and risk factors for suicide as well as knowing where to sign-post to. If you'd like to find out more about getting some mental health first aid training for your organisation, get in touch.
Additionally we have some wonderful charities in the UK offering support to those in emotional distress. These include:
§ Samaritans offer a 24-hours a day, 7 days a week support service. Call them FREE on 116 123. You can also email firstname.lastname@example.org
§ Papyrus is a dedicated service for people up to the age of 35 who are worried about how they are feeling or anyone concerned about a young person. You can call the HOPElineUK number on 0800 068 4141, text 07786 209697 or email email@example.com
§ C.A.L.M.: National helpline for men to talk about any troubles they are feeling. Call 0800 58 58 58.
Remember, you don’t need to be an expert to help save a life.
Take care everyone