Are we in the middle of a female suicide crisis?

·13-min read
Photo credit: Getty Images
Photo credit: Getty Images
Photo credit: Hearst Owned
Photo credit: Hearst Owned

Rat-a-tat-tat, ping, rat-a-tat-tat, ping. The noise infiltrates the air, becoming louder and more loaded with significance as the evening stretches into night. Six women are on the screen in front of me, one in her kitchen, an expanse of green grass just visible behind her, while another sits cross- legged in her bedroom, a halo of fairy lights strung on her lilac walls. They frown as they type, cock their heads, breathe deeply.

They’re all currently speaking to strangers. Each ping signifies someone waiting for them, someone in distress. The keyboards rattling are their words flying into the night, lighting up pockets across the UK. The women will never meet those they’re speaking to, they won’t be in contact again. But these one-off conversations, conducted through text messages, are vital. They’re saving lives.

I'm sitting in on an evening shift at Shout 85258 – the free, 24-hour mental health text support service. The majority of those reaching out to the service are under the age of
25, with 79% of Shout texters identifying as female, and 35% as LGBTQ+. It’s completely anonymous, and while I can’t see the exact conversations the volunteers are having, they are talking me through what’s being said (changing any identifying characteristics as they go). Through this, I’m hoping I can gain some insight into what’s really going on with our generation’s mental health.

Photo credit: Stephen Zeigler - Hearst Owned
Photo credit: Stephen Zeigler - Hearst Owned

What I find is scary stuff. Since the coronavirus pandemic broke out, there’s been talk of a second, “hidden” mental health pandemic: the toll this period will have on our psyche is predicted and feared, but as yet unknown. But these women are on the frontline.

Before the virus struck in early 2020, Shout saw an average of around 750 conversations per day. This rose to an average of 1,400 in early 2021 – with the peak happening around major news events. “It’s quite drastic. You watch the news and then you come on the platform and see how busy it is,” says Imogen Wade, 23, who has been volunteering with Shout since September 2020. “You’re seeing the impact play out in real time.”

The platform’s busiest period was 20th December 2020, just after the Christmas plans of Tier 4 areas were sent into chaos. The number of conversations shot up to 5,174 over 24 hours. And the topics discussed? They vary widely, but within the first 15 minutes of the evening, three of the volunteers I’m shadowing are speaking to people experiencing suicidal thoughts.

In statistics recorded over the platform’s first 500,000 conversations (held between May 2018 and November 2020), suicide was the most common issue among texters, with 18-24-year-olds the most likely to discuss it. There were also 57,246 conversations involving self-harm, 84% of which were with women.

This worrying pattern was emerging even before the country was sent into disarray. Data collated by Samaritans shows the suicide rate for females under 25 has increased by 93.8% since 2012, reaching its highest level in 2019. But with suicide being associated more with men (something that is still a huge problem – it’s the single biggest killer of young men under the age of 45), when it comes to women it is rarely discussed. So what’s happening? And is there anything we can do to slow it down or – even better – halt it in its tracks?

SAFE SPACES

As I stand on the doorstep, I can feel the energy of those who have been here before me. People who have rapped on this mint-green front door and waited for the beginning of their salvation. I’m visiting Maytree, a residential respite centre for those who feel suicidal. It’s a homely place, set over four floors in north London (though they are set to open a new residence in Manchester).

There are patchwork quilts on the beds and colourful paintings hung lovingly on the walls.“Most of the art is from former residents,” says Elisa Booker, an operations co-ordinator for the centre, who is showing me around, with her colleague Sadia Ahmad. There are lots of butterflies, rainbows and messages in handwriting proclaiming how we are all loved.

Photo credit: Getty Images
Photo credit: Getty Images

Pre-COVID, this house welcomed four people for free five-day stays. “If we think of suicidal ideation as a spectrum, then Maytree is for those who are in the middle,” says Sadia, as we settle around a table in the garden. “Someone who needs more than a one-off conversation with a helpline but perhaps isn’t at the medical intervention stage just yet.” Through a series of phone calls, the team assesses whether Maytree can help and, if not, they signpost them to other services. The pair estimate that around 70% of those who come to stay with them are women.

The programme involves a “lot of talking”, with guests having multiple conversations with different trained volunteers each day. The guests also speak to each other, with everyone dining together – during which, Sadia and Elisa tell me, there’s also a lot of laughter. “The hope is that [the stay] will reconnect them to who they are beyond their suicidal thoughts. They don’t have to worry about bills, cooking, cleaning... they can just focus on themselves.” The programme is guest-led, meaning those staying choose what they want to explore. “There’s nothing off-limits, no judgement.”

When I first started researching this piece, there were a couple of moments where I felt I was perhaps the wrong person to take on this subject. I found it incredibly hard
in early interviews to even say the word “suicide”. I worried that I’d be allowing the darkness in somehow. This, I soon learned, is a common misconception.

Alongside the Shout volunteers, I also interviewed Samaritans phoneline operators and multiple experts, who all told me the same thing: speaking about suicide does not increase the likelihood of it happening. If anything, it’s the opposite.

“It allows it to be out in the open, alongside the possibility of exploring the root of those feelings,” Sadia tells me. “I think we tend to think of suicide outside of the realm of other feelings, but if you’ve had a lifetime of distressing events, it may actually be appropriate to feel like you can’t go on. That doesn’t mean you should act on that feeling. It’s just about accepting [suicidal thoughts] as part of the realm of human emotion. That makes it less scary. It takes away the shame. If the feelings stay inside, then they’ll just grow and grow.”

OPENING UP

The television was on, blasting out a show that Addy was barely watching. Blurry-eyed, she was messaging Samaritans, telling them she was suicidal. “Everything was spiralling,” Addy, 30, says, reflecting on the time three years ago before she went to rehab for depression and an eating disorder. “I was going above and beyond to act like everything was fine. It had become so mentally exhausting that I felt I couldn’t go on – and that was when I reached out to Samaritans.”

Messaging meant Addy could open up in a way she hadn’t felt able to before. “The person was just asking warm questions,” she says. “There was no judgement, more ‘Why do you feel that way?’ They allowed me to empty my brain.” Being able to speak to a stranger helped.

“Before all this, I wasn’t able to express myself,” Addy says, as we discuss how there’s often a misconception that one reason behind the suicide gap (men are, on average, three times more likely to die by suicide than women) is that women talk about their problems more. But how often do we tell our friends how we are really feeling? And do we want to portray ourselves as “superwomen” who can handle everything? “Women put on a mask. We can feel weak if we come across something that we can’t handle,” Addy muses.

One common question Shout volunteers are trained to ask those texting in is “what support looks like for them”, as many feel they have no one to turn to. “I think it’s more the fear of the reaction,” says Lorraine Roper, a volunteer who also works in the mental health sector. “[Women tend to] say,‘Everyone’s got their own problems to deal with.’”

“I’ve found a lot of teenage girls who text in say, ‘I told someone and they say I’m causing drama,’” adds Imogen. “It’s a stereotype and then their feelings aren’t validated. We all have internalised attitudes in society that play out in our relationships with others, [but] the starting point should always be ‘I believe you and it’s OK to feel this way.’”

LIFE AFTER LOSS

From September to December, there’s always been one guarantee in the Marshall family: that they’d all be watching Strictly Come Dancing. So when Clara Amfo scooped two 10s for her Charleston in November last year, the first thing Sara Marshall did was pick up her phone. She had to message her big sister, Rebecca. Then she remembered. “It’s something that comes in waves,” she tells me over a video call, her sister Esther (the eldest) beside her, nodding. “During lockdown, I kept thinking this hasn’t happened,” she adds. “Because we weren’t seeing each other face-to-face, there was no empty seat at the dinner table...”

In February 2020, aged 28, Rebecca died by suicide. Both sisters are keen to stress that particular wording. “She didn’t ‘commit’ anything,” Esther says. “You say that about crimes, about murder. If we’re being specific, she died from an illness called bipolar. When someone dies from cancer, you say that.”

Rebecca first began showing signs of her illness in high school. She was diagnosed eight months before her death, after six years in and out of hospital, and given medication that seemed to help. “She wrote in her note that she felt like pieces of her had been chipped away,” says Sara. “But we could see she was getting better.”

The family feel the diagnosis came too late; that those six years had a lasting impact on Rebecca, who – like her parents – was an NHS doctor. “I think the system she gave her life to, ultimately, she lost her life to,” says Esther. “She gave all she could to every patient she had. But the stigma and the lack of funding in the NHS ultimately meant she couldn’t get the care she needed.”

Both sisters remember one occasion when Rebecca was admitted to hospital during a psychotic episode, then sent home to Esther’s. “They called and said,‘She’s having suicidal thoughts, so we need you to prepare your flat [to prevent that happening].’ It was five days before they found her a bed. I always wonder what would have happened if they could have got her one earlier. We will never know. It’s not fair that we have to sit with that question.”

Photo credit: Peter Griffith - Hearst Owned
Photo credit: Peter Griffith - Hearst Owned

When Annie Arkwright suggested to her daughter she come home for a few days, in October last year, to “recharge her batteries”, Annie knew something was wrong. “There wasn’t a massive change [in her],” Annie tells me over the phone. “Her light just shone a little less brightly.” In her second year studying history at Cardiff University, Lily was enjoying her course. Then lockdown hit.

“Everything moved online. Lily was living in a shared house, but struggled to acclimatise to the restricted conditions.” Annie says her daughter “felt trapped, seeing the same four walls days after day”.

During her visit home, Lily took her own life. Understandably, Annie is not able to talk about the grey days and nights that followed. “Lily and I were close,” she tells me. “I felt that if she needed me, she would reach out. But I was unaware that so often we don’t see signs.” She is now spreading the message that “no one is immune. Don’t think suicide is something that wouldn’t happen to you. Reach in. Don’t wait until someone reaches out to you.”

CIRCLING ROUND

The top floor of Maytree has views that stretch past terraced houses, a maze of overgrown gardens that lead to a skyline peppered with tower blocks. On my visit, I looked out and thought about how suicide might live in those homes. How it will live in the minds of the people I passed in the street. Yet it is rarely spoken about in tones that are not ones of hushed horror.

Suicide is cloaked in shame, causing those who feel its pull to keep that to themselves. But if those thoughts are muffled up inside, they become deafening. Everyone I spoke to agreed that the normalisation of the conversation around suicide was desperately needed – to save those who feel that they’re lost and have nowhere to turn. They do. There is so much help out there. Everyone I spoke to was testament to that. But, unfortunately, there still isn’t enough.

When I set about writing this, I wanted to find out what specifically could be behind the rise in women’s suicide. Are our attempts to reach out for help dismissed as “attention- seeking”? Could a year of isolation have hit us harder? Yes, it’s likely on both counts. But, truthfully, suicide is way too complex to ever get to the bottom of why the people behind those statistics took their lives. It’s often a cocktail of factors – factors that they then take with them. Yet there was one thing that came up again and again: a lack of funding.

Over the five years I’ve worked on this magazine, it’s an issue I’ve seen crop up constantly across the breadth of subjects that we cover. It’s a frustrating conclusion to come to, so out comes the red pen as I try to find something more tangible that you, our readers, can perhaps recognise and have control over. Because, other than donating what we can to the many organisations doing incredible work across the board, funding is not something your average person can influence.

But it seems impossible to ignore this time, as all roads lead here – that a lack of funding impacts lives in a devastating way. Not just in mental health services (the number of mental health beds has dropped 25% since 2010, despite an increase in demand for treatment), but other sectors, such as housing (one in five adults in the UK suffer from mental health problems due to their living situation) or when someone can’t get the help that they need to leave an abusive relationship (Women’s Aid have said they are facing a “funding crisis” and there have long been links between suicide and domestic abuse) or the lack of support LGBTQ+ people receive when reaching out for healthcare services.

It’s hard not to feel drawn down by that thought, as if I have no control or way to help those suffering. But I do. We all do. We can support those around us as best we can, we can listen, and we can open a dialogue. We can bring suicide out of darkened corners
and into the daylight, safe in the knowledge that we won’t cause any harm by voicing our feelings and concerns. And we can remember that help is just a text message away.

If you’re struggling, text Shout on 85258, or call Samaritans on 116 123, any time, day or night. If your life is at imminent risk, please call 999 for immediate help.

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