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Content warning: suicide
We are living in extraordinary times and there is continued and significant uncertainty about what the coronavirus pandemic means for individuals, communities and economies across the globe.
Uncertainty heightens existing pain and creates new pain. We know that people are experiencing all sorts of different situations, whether that be social isolation, confinement in a violent relationship, redundancy, loss and financial concerns amongst others.
It is now we have to be absolutely alert to the heightened risk of suicide.
Globally somebody dies by suicide every 40 seconds, which means if you read at an average speed by the time you have finished reading this blog – assuming you read to the end – about seven people will have taken their own life. That is a very sobering thought.
When I first joined MHFA England almost three years ago I talked to the team about my motivation for joining our organisation – like so many people I have personal experience of suicide and suicide ideation in my personal relationships, friendship and peer groups.
The last year has intensified the conversations about mental health, whether these are about anxieties around the impact of Covid-19, unemployment, staying at home during lockdown, or loneliness, grief and loss.
However, we are still not good at talking about death, even more so suicide. And most of our professionals in the caring and key worker professions received little or no training about suicide. I was struck when I did the Suicide First Aid course that after about 90 minutes the trainer said, you have now received more training about suicide than most people including health professionals.
The cultural silence about suicide causes enormous harm. Let’s be frank, this silence kills.
It wasn’t until I did the Mental Health First Aid training followed by Suicide First Aid training that I felt I had the skills to intervene.
Yet the evidence about what works is robust and straightforward;
Assess suicide warning signs – this includes someone declaring intent or being obviously distressed but can also be sudden unexplained recovery, withdrawal or goodbyes.
Ask the question directly – if you have concerns that someone is having suicidal feelings ask them the question directly ‘are you having thoughts of suicide?’
Explore and assess the risk level – ask why they feel this way and find out if they have a plan or the means.
Find out if they have support – find out if they have a support network or existing crisis plan. Remind them of helplines such as the Samaritans 116 123.
Assisting in a suicidal crisis – ensure your own personal safety and make sure the person is not left alone. If you deem the person is a risk to themselves seek immediate help through 999 or take the person to A&E. And remember – confidentiality does not apply to suicide.
A few years ago a friend asked me to go and see him at the weekend. Things were not great and he was struggling. We talked a lot. I asked what I could do to help. He said he would be OK. I asked again. He said again that he would be OK. We hugged and I left feeling really uneasy. My stomach was churning but we both had things to do that evening and he assured me he would be OK. We messaged regularly over the following days. He died by suicide within the week.
I often wonder with immense sadness, regret and guilt if he would still be alive if instead of asking what I could do to help, I had simply asked the question ‘are you thinking of killing yourself?’.
Asking the direct question is the piece of the jigsaw I didn’t understand. And it isn’t commonly understood amongst the general public.
Now I do understand, and I know that suicide prevention is not – and cannot be – the responsibility of public health professionals or Samaritans volunteers alone. It is the responsibility of all of us. We all have an important life-saving part to play.
Never has that knowledge been more important than it is now in these challenging, unsettling and extraordinary times. That one straightforward question, ‘are you thinking of killing yourself and do you have a plan?’ has saved many lives already, and will save many more. We can all be brave enough to ask it and then, with the right training, know how to support someone in crisis.
For more information, head to the Samaritans website for free advice on having a difficult conversation about someone's mental health.
To mark World Suicide Prevention Day, we are holding a webinar on 10 September 2021 at 12:00pm on the topic of suicide, the stigma surrounding it and what we can do to support employees in the workplace. Register here for free.