World Suicide Prevention Day

10th September is World Suicide Prevention Day, a day that should absolutely be acknowledged and nonetheless something that I feel almost apologetic for writing about.

It would be easy to do a cursory nod in acknowledgement of the day and swiftly move on to other things, yet that feels disrespectful to anyone with personal experience of suicide whether that be as someone attempting to end their life, or the families, friends and communities that are affected.

Suicide has long been hidden; a taboo that can’t really be spoken of. However, the World Health Organisation estimates that worldwide, at least 800,000 deaths each year are as a result of suicide. The actual number is almost certainly far higher because of issues with recording cause of deaths; many suicides are absorbed into “misadventure” or a coroner’s narrative verdict because unless there is certainty over intent a verdict of suicide won’t be recorded. But this is not about technical definitions, but about human experiences.

Say the word “suicide” and I suspect that the thoughts that spring to mind are almost universally “negative”; this is an observation not a criticism. It’s a historical, socially constructed idea that suicide is somehow shameful and this pervades modern society. Let’s not forget that it was a criminal offence until the Suicide Act of 1951, and there are still moral and religious judgements made on such a cause of death.

More recent debates have perhaps made conversations about suicide easier, as long as we wrap those up in the more palatable language of euthanasia and consider it to be a release from suffering. Just as long as that suffering is something noble and by that I mean that it is somehow more acceptable to consider suicide to be “ok” if someone has an enduring, terminal physical condition.

Suicide as a means of escaping psychological and emotional suffering is somehow more challenging to us. Much emphasis is put on whether the individual was in sound enough mind to make that a genuine choice. Suicidal behaviours can be the result of a “suicidal psychosis” where thinking is so altered as to cause a person to perceive or interpret things differently to others.

Some suicidal thoughts may be “delusions” – believing things that when examined rationally are obviously untrue, or may be as a result of “hallucinations” such as hearing voices that no one else can hear, perhaps telling them that suicide is the only answer. I am by no means qualified to even guess what proportion of completed or attempted suicides are as a result of suicidal psychosis, but it does make a lot of sense of some of the experiences of suicidal thoughts.

Once again, I feel apologetic about this – I’m a HR consultant, not a psychiatrist so who am I to dare an opinion? My interest in mental health issues goes back a long way and I’ve spent a long time on the academic study of mental health and mental disorder over the past few years. It’s an issue close to my heart and one that crops up regularly in my line of work.

I have learned a lot in the ten years since I called an ambulance for a suicidal member of staff. I had sat with him for almost two hours trying to access adequate support, first encouraging him towards professional help, then the frustration that his GP was unwilling to see him outside of a pre-booked appointment.

With the benefit of hindsight, telling ambulance control that I was only 95% certain that he was of no risk to anyone but himself was perhaps a mistake, but at that point I had only just persuaded him to hand me the pen knife he was fiddling with. That decision however resulted in a police escort for the ambulance and I now cringe at how little I understood and how clumsily I handled that situation.

I have always hoped that he understood that my intentions were good, but sadly he resigned not long after that and I have no idea whether long term he recovered from the depression that fuelled his experience. I still feel in some way honoured that he sought me out with a “have you got five minutes?” and shared his thoughts. It takes a lot of courage to be that vulnerable with someone. I’d like to think that I’d be much better at that conversation now.  

I had my inadequacies at that time underlined by a research conference I attended a couple of years ago with SANE who presented qualitative research into the experience of suicidal feelings. The descriptions of the process of suicide, of both the distress that leads to that dark cavern and the sense of calm and acceptance that can immediately precede an attempt were harrowing, yet demonstrate the change in thought processes that people can experience.

I’ve been party to conversations that epitomise the “suicidal psychosis” where a person argued black was white that they were right in their thinking that ending their life was the right thing to do. Through those, I’ve also learned that as much as studying mental health in its abstract helps, being a witness to someone’s distress is a life-lesson all on its own.

If you want to read more about Mental Health, and ways you can help inspire a conversation about it in your classroom, have a look at our blog on Teaching Resources for Young People's Mental Health.

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