Opening the dialogue about suicide
Yesterday was World Suicide Prevention Day 2017. This year’s theme was take a minute, change a life. But how many of us are aware of the issues that surround suicide, and what are we doing about it?
Globally, close to 800,000 people die a year by suicide (World Health Organisation). This equates to 15,000+ per month, 2100+ per day, 90+ every hour and one every 40 seconds. This global public health issue cuts across class, gender, race, and affects all cultures. It also cuts across age – whilst we may think of suicide as an adult issue, one of the youngest people recorded as having taking their life was just six years old. A report in 2013 also found that a third of our young people had suicidal thoughts. With this in mind, we need to become more aware of this as an issue across the lifespan and generations.
Nationally there were 6,639 suicides in the UK and Republic of Ireland in 2015 (Samaritans 2017), and suicide is also the biggest cause of death in young people under 35 in the UK, with 1,659 reported in 2015 (Papyrus). In contrast, 1,740 people were killed by a road traffic accident in 2015 (perhaps a testimony to how much work has been done over the years to improve safety and prevent road deaths). Suicide was only decriminalised in 1961, and stigma and taboo still surround this subject. The figures show that this is a big issue. For this reason, we need to look at how we can increase awareness and understanding in order to support prevention.
‘The clear message we have heard throughout our inquiry is that suicide is preventable. The current rate of suicide is unacceptable and is likely to under-represent the true scale of the loss of life.’ (Chair of the Health Select Committee, Dr Sarah Wollaston MP, 2017)
This statement, made by the Health Select Committee in March about the need for action to support suicide prevention, neatly sums up the situation as it stands. In its report on suicide prevention, the Committee highlighted the need to reach people who are at risk of suicide but are not in contact with health services. Only one in three people who take their life by suicide are seen by a GP, and it is clear that we need new approaches to support prevention that don’t just rely on GPs, social workers, or health and social care practitioners, whilst ensuring that clinicians have improved training in the recognition and assessment of suicide risk. The committee also acknowledged the work of the voluntary sector, who play ‘a vital role in suicide prevention as do those groups working in non-clinical settings’.
I believe that an approach encompassing GPs, social workers, health and social care practitioners and voluntary organisations or groups would be enhanced by further outreach to involve and upskill whole communities to be willing, able and responsive for supporting the health and wellbeing of all people. There is an increasing drive towards co-production, community and assets-based approaches in health and social care. As such, this is a good time to encourage health and social care professionals, the voluntary sector and communities to work together to come up with solutions that are geared to support everyone. And everyone – of course – includes those same health and social care professionals – we are all part of the communities we live and work in.
In my previous role as a health improvement specialist within the NHS, I underwent the train the trainers Applied Suicide Intervention Skills Training (ASIST), as well as training to deliver safeTALK. These two programmes of learning, combined with my own experience in emergency services and community development within the NHS, have given me an insight into some of the key things we can be doing to raise awareness, decrease stigma, and enable people to support each other in practice:
- Talk about it – if we can have a proper conversation, we can start to make changes. If we have the courage to ask the questions about suicide, we can address the taboo and stigma that surrounds suicide ideation. If we can better understand the complexity of the issues, we can then use our collective wisdom to support people, and everyone (not only those working directly in health and social care) can be empowered and enabled to make changes and save lives. This website: https://www.talkaboutsuicide.com, shares videos and real life experiences to give an insight and encourage people to talk about the issues.
- Education and training – community-based suicide awareness and intervention programs can help people to identify and respond to provide support to people at risk of suicide, and work together to create and sustain suicide-safer communities.
- Make time – if we can make the time to listen and learn how to support people, then this is where the difference will be made.
- Appreciate and work with diversity – effective support relies on hearing a person’s individual story, validating the person’s internal world, allowing them to own their own experiences, and appreciating how they may be different to your own.
- Understand your own attitudes and beliefs around suicide – and how these may either hinder or support intervention and prevention.
- Don’t project your own framework onto people. An awareness of how to adopt a mentalising approach in conversations is helpful to do this.
- Active listening – really hear the person at risk and be with them in order to reflect back what you have heard with empathy not sympathy.
- Unlearn what you think you know – be open and curious, don’t ‘expect’ people to say certain things or act in certain ways, rather allow them to have their own unique and individual experiences, thoughts and feelings.
About the author
Chukumeka Maxwell is the Founding Director of Orchid Community & Associates Ltd, an organisation co-ordinating specialist training in suicide prevention, intervention and postvention. They are affiliated and part of the Devon and Torbay Suicide Prevention Alliance (DTSPA). He is also the Founding Director of Suicide Safer Communities CIC and a Mental Health Mentor.
Sowcroft E (2017) Suicide statistics report 2017. London: Samaritans. Available online: https://www.samaritans.org/sites/default/files/kcfinder/files/Suicide_statistics_report_2017_Final.pdf
LivingWorks Research and Evaluation: https://www.livingworks.net/resources-and-support/research-and-evaluation/
Department for Transport (2015) Reported road casualties in Great Britain, provisional estimates: January to March 2015 report. London: Department for Transport. Available online: https://www.gov.uk/government/statistics/reported-road-casualties-in-great-britain-provisional-estimates-january-to-march-2015