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We Need To Start Talking About Suicide, and We Need To Keep Talking About It

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The coronavirus brought swift public health and economic damages, but the mental toll from thousands of deaths, hundreds of newly unemployed people and forced isolation could have serious effects on mental health and loss of life to suicide.

Suicide has long been a severe public health problem, but the ongoing uncertainty over the economy and forced isolation contribute to anxiety and depression, culminating in increased risk for post-traumatic stress disorder or at worst; suicide. That’s on top of large groups of vulnerable people who were already struggling to survive the changes of the ever-changing world.

They are our colleagues, family members, friends, and they are scared.

Become more aware of risks and warning signs

Preventing suicide begins with observing our own internal experience and behaviour and that of loved ones and people we encounter informally every day. It then relies on pivoting into a conversation within ourselves, or with the people we care and worry about.

What should we be on the lookout for – both in ourselves and others? Here is a list of warning signs that could suggest an elevated risk for suicide:

  • Depressed mood
  • Mood swings
  • Intense anger
  • Recklessness and/or impulsivity
  • Substance abuse
  • Significant or chronic medical problems, including pain and chronic insomnia
  • Increasing incapacitation in elderly
  • Social withdrawal, isolation
  • Shame and / or Guilt
  • Feelings of detachment or disconnection
  • Feeling like a burden
  • Comments (including “jokes” or offhand comments) about death or suicide
  • Sudden behavioural changes, including a sudden shift from depression and despair to feeling euphoria
  • Significant loss (death of a loved one or patient, especially by suicide, job loss, debt, retirement, divorce)

Also be aware that there are some groups who can often be at especially elevated risk for suicide:

  • People going through a tough life experience such as a divorce, or relationship breakdown
  • Veterans
  • People with trauma histories
  • People with substance use disorders
  • LGBTQ+ people
  • Elderly people
  • People who live alone
  • People in debt, or with complicated financial situations
  • People who have attempted suicide or have a family member who has died by suicide

Please don’t wait to start the conversation

Starting the dialogue in the event of concerns is probably the best way to try and help. But what words to use? A lot of people think talking about the subject of suicide might plant a seed in another person’s mind or give them ideas.

What is really important to understand, is that bringing up the subject of suicide does not increase the chances that a person will become suicidal or be more apt to act on such thoughts or impulses. In fact, it is just the opposite, and talking about suicide can be a relief for someone who doesn’t know how to translate his or her pain into a plea for assistance.

Being direct is the best approach, as opposed to hinting. Dancing around the subject might make us feel more comfortable, but it is less likely to elicit an honest answer.

For instance, if we ask someone if they have thoughts of hurting themselves or having any “dark” thoughts, the answer may not tell us what we need to know. People who consider suicide don’t necessarily consider dying by suicide to “hurt” (maybe quite the contrary), and “dark” thoughts are so vague as to be unhelpful.

The best way is to talk directly about it, but sincerely:

“I’ve noticed ______, and I am worried about you. Have you had the feeling that you would be better off dead, or have you had any thoughts that people would be better off without you around, or that you might be a burden?”

As uncomfortable as it might be for you to say the words. Honest, sincere, direct and to the point is often the best way of helping someone.

How we talk about suicide matters

Starting a conversation with someone about suicide is already a very tricky one, but it is made ten-times worse by the way suicide is generally discussed in society. For instance, if someone hears a person mention that suicide is synonymous with weakness, cowardice, or selfishness, they may be reluctant or unwilling to speak to that person if they are suicidal.

This also applies to our word choice when someone attempts or dies by suicide. There is no such thing as an “unsuccessful” or “failed” suicide attempt (since there’s no success or achievement with dying by suicide). Similarly, referring to “committing” suicide or suicide “completion” also can unwittingly suggest something shameful (i.e. “committing a crime or sin”) or achievement where there is none.

So be mindful of how you discuss it in your day-to-day life. It might stop someone feeling brave enough to talk about their feelings in the future.

Keep the dialogue going

If someone you know indicates they have considered suicide or that they feel like they might have no purpose anymore, more questions are necessary. This is why some people shy away from starting this line of questioning in the first place.

After asking the question about considering being dead or having thoughts of killing oneself, the next questions could follow:

  • Have you identified any ways you might use to kill yourself?
  • Are you preparing in any way to kill yourself (online searches, writing a note, buying or hiding items)?
  • Do you have a specific plan to kill yourself?
  • Have you decided that you are going to attempt suicide? If so, when?
  • Have you ever attempted suicide without telling me or anyone else?

Suppose you or someone else has answered “yes” to the first question. In that case, it is essential to follow up with the remaining questions, start talking about it often, and try to schedule an appointment with a mental health professional. A “yes” to any of the remaining questions merits the need to speak with a mental health professional immediately, and possibly even staying with the person in visual proximity until help can be obtained by contacting a doctor, a therapist, a physician, or a suicide prevention hotline.

Suicide Prevention Resources

How to make the home safer

The last facet of suicide prevention involves the restriction of harmful materials. We can make our homes and our loved ones exponentially safer, without too much modification, by doing the following:

Medications

Many people attempt suicide using what we usually regard as benign household items in our medicine cabinets. To help prevent a tragedy, remove unused, expired, or unnecessary medications from home – especially opioid medicines. Secure any remaining household medications in an inaccessible lockbox. This may seem impractical, but remember we’re talking about slowing down (if not wholly preventing) the steps that can lead to suicide.

Alcohol and drugs

Remove or secure within the home all alcohol and drugs. These substances represent an added risk because they reduce our capacity to think clearly, and in combination with medication, can be deadly. Autopsies reveal that in over 50 per cent of suicide deaths, there is evidence of alcohol or drugs in the deceased’s system.

We need to talk about the issue of Men

According to recent research, just 23% of men would see a GP if they felt low for more than two weeks, compared with 33% of women. One of the more common ways men deal with it is self-medicating with alcohol and drugs. They start going to the pub, block feelings, hide feelings, drink, then do it more, and it becomes a cycle. Pubs have often been used as sort of informal community groups for a lot of people, so having them shut over the last year has also forced the issue back into the home, and behind closed doors.

Other research has suggested that men are twice as likely as women to develop alcoholism, leading to severe issues with violent or inappropriate behaviour, late-night gambling, other addictions and ultimately suicidal ideation if left untreated.

Drugs and alcohol can end up as big a problem as the mental distress in the first place —It’s a truly vicious cycle, and something we need to keep a close eye on with our friends, family and colleagues.

Many people consider suicide at some point in their lives

By looking out for one another, matching people with the help they need, and helping those who are hurting feel more connected, people who are contemplating suicide have an opportunity to recover.

People who feel marginalised, bullied and alone often live with the stark emptiness that leads them to decide that they may want to die by suicide.

What’s important is realising that it is not a taboo to discuss it. It’s also not shameful to ask for an expert to support you if you are supporting someone who is having suicidal feelings.

Please get in touch with Vala or one of the experts listed below if you or someone you know is feeling suicidal.

Suicide Prevention Resources

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