*Content warning: suicide*
It is likely that you are attuned to the startling reality of suicide in the UK. The often reported and commented upon data is stark, with 2019's figures revealing a year-on-year rise in the number of people who took their own life. (2020 data, so far, shows a decrease, though the Office of National Statistics has stated that this is likely due to delays to coroner inquests, as a result of the pandemic, rather than numbers truly being lower. For an accurate reflection, we'll need to wait as figures are updated.) To take this lens wider, globally, one person dies by suicide every 40 seconds, according to the World Health Organisation. That totals 700, 000 people with each passing year.
If you are struggling with suicidal thoughts, there is a list of resources at the end of this feature which might help. If you need urgent help, find your local NHS urgent mental health helpline. If you have seriously harmed yourself, or you don’t feel that you can keep yourself safe right now, call 999 or go straight to A&E.
While the reality of the problem is firmly sketched into public consciousness, a lot of misinformation around suicide persists, says Joy Hibbins, founder and chief executive of the Gloucestershire-based charity, Suicide Crisis. This, she notes, can influence how you think about the problem and, in turn, can make it harder to dispense the best possible help to someone who is at risk.
This World Suicide Prevention Day, WH is sharing an extract from her book, The Suicide Prevention Pocket Guidebook (Welbeck Balance, £10.99). Here, Hibbins dispels some unhelpful – and potentially dangerous – myths. Addressing these, she hopes, will help, by creating a wider understanding of suicidal feelings.
MYTH 1: A genuinely suicidal person won’t ask for help
This myth feeds into the idea that if someone has genuine strong suicidal intent, they will go and take their own life without telling anyone, so that there is no opportunity for anyone to help.
It gives the impression that there isn’t much (or anything)that you can do to help someone who is 'genuinely suicidal'. In reality, many people who go on to end their lives ask for help for their suicidal thoughts at some point, or they tell someone or give other indications that they are at risk of suicide. When someone asks for help, you may only have a short window of opportunity in which to do so. Their willingness to seek help may fluctuate.
If they are depressed, their depression may deepen as the days pass – and their suicide risk may increase, too. As they become more depressed, they may withdraw from the world and stop seeking help. So it is vital that we try to help them while we can, because they might withdraw and stop asking in a few days’ or a few weeks’ time.
Sometimes, there is only a very small part of them that is trying to survive. You sometimes hear counselors explaining to to their client that they are trying to 'work with that small part of them which is trying to stay alive'. In 2017-18, Suicide Crisis undertook research into deaths by suicide in Gloucestershire, UK.
This research found that most people who took their own life revealed their suicidal thoughts to someone in the weeks before their death, whether it was their doctor, a psychiatric professional, a friend or a family member.
The fact that someone tells you they are feeling suicidal does not mean that they are less at risk of taking their own life, as explain below. It is so important to recognise their risk and respond.
MYTH 2: People who talk about suicide don’t do it
This is similar to the previous myth. In fact, someone who is at risk of suicide may well 'talk about it', and draw your attention to their risk. Within days, their willingness to talk and reach out for help may have evaporated, and they may end their life. That is why it is so important to hear them and recognise their risk of suicide, so that you can make sure that they get help and support.
MYTH 3: People who make casual remarks about feeling suicidal are not genuine
Sometimes a person may make quite casual remarks about wanting to die. It would be easy to miss the significance of these, because of the way in which they are expressed. As part of our research into deaths by suicide in 2017-18, we attended inquests over a six-month period. Two of the individuals who died had made casual remarks about suicide in the days before they died. One of them said: 'I don’t know why I don’t just kill myself.
The other said: 'I might as well kill myself.' Both of them referred to a particular method of suicide. Understandably, friends and family members might not immediately recognise these remarks as a sign of increased risk. The casual nature of the remarks can give a false sense of security. Our research shows how important it is to take notice of every expression of suicidal intent, however it is expressed.
MYTH 4: Asking about suicide may give someone the idea to do it
Research shows that asking direct questions about suicide helps to protect someone’s life, and that it does not put the idea into their head. In a research study carried out in London among 443 adults in a primary care clinical setting, the findings showed no evidence that asking about suicidal thoughts increased hopelessness made the participants think that life was not worth living.
In other research in the USA, it was found that asking young people about suicidal thoughts did not increase distress or suicidality afterwards, and that there were beneficial effects for people who were showing signs of depression or had previously attempted suicide.
Asking questions about suicidal thoughts gives someone the opportunity to disclose their risk. It can be very difficult for them to tell someone that they are feeling suicidal. They may want to, but they may not know how.
MYTH 5: Suicide is a selfish act
Sadly, a depressed person is likely to think that they are a burden to their family and that they are being kind to their family by removing themselves from the world. This is how depression can distort the way someone is thinking. It can lead people to feel that they have no worth. It can mean that they no longer see themselves as they really are.
Describing it as 'selfish' adds to the pain which they are feeling, and adds to the negative things they are probably already feeling about themselves in their depressed state, so it is really important to dispel this myth. I have been supporting people in suicidal crisis for many years, and I know how often they think about and consider other people and worry about their loved ones.
But they can reach a point where they descend deeper into crisis and lose sight of them, particularly if they go deeper into the 'tunnel' of depression. Many of them are unwell at this point, or unable to think clearly and rationally anymore because their intense suffering or emotional distress is preventing rational thought.
MYTH 6: It’s weak to be suicidal
In reality, a suicidal crisis can happen to people who have been extremely self-reliant throughout their life. During a family crisis, they may bury their own feelings and care for everyone else. They're often described as the rock of the family or 'the strong one'.
Crucially, they may never learn to ask for help or support – and this is the key part. The pain of major life events can accumulate over the years. It stays buried inside because they never talk about it. Eventually, a final trigger may occur – one too many painful life events. This can 'unlock' painful or traumatic events, which they have filed away in a compartment of their mind. The years of pain that have built up inside them may be released at this point. It can be overwhelming and may trigger a suicidal crisis.
MYTH 7: It’s attention-seeking
This is suggesting that someone is telling people that they are feeling suicidal in order to get attention. It implies that they are trying to gain attention for negative reasons. It may also give the impression that we should not take what they are saying seriously. You can frame this differently by saying: 'They are drawing my attention to the fact that they are feeling suicidal.'
They are letting you know that they are in crisis and that they need help. It’s important to always take this seriously. I remember going out to see a young woman at her home and hearing a neighbour comment: 'There’s an ambulance outside her house every other week because she’s harmed herself, or she says she’s going to harm herself. Either that or the police are out looking for her because she is saying she is suicidal. It’s just attention-seeking.'
The neighbour did not know the reasons for the young woman's crises, though. The young woman was experiencing deep emotional pain. She was trying to cope with severe post-traumatic symptoms. We often find that people who have multiple crises have been through something very traumatic. This can be extremely destabilising. Often, they have not yet had the right kind of help or treatment. They may not have had psychological therapy, either because it is too soon for them, or because there is some other reason why there is difficulty accessing it.
MYTH 8: Only certain types of people become suicidal
In reality, a suicidal crisis can happen to any one of us. It is usually a complex interplay of different factors which leads someone to feel suicidal. We all have a limit to what we can take before we become psychologically vulnerable. None of us is psychologically invincible. It is so complex that it can be hard even for the person in crisis to see what has led to their own suicidal crisis.
If they are asked, they may say that they don’t know. We are complex beings, and our minds are complicated. Sometimes it is only months or years after a suicidal crisis that someone can see all the different factors that may have led to it. Depression can happen to any one of us. Depression can change and distort the way we think. It can make us vulnerable to a suicidal crisis.
When someone says that they cannot imagine ever becoming suicidal, I think it is that they have not encountered the unique set of circumstances that might push them into a suicidal crisis.
MYTH 9: If someone is really determined to end their life, there is nothing that anyone can do about it
If someone experiences a suicidal crisis, they may develop a strong intent to end their life at some point during the crisis. However, it is often a short-term feeling, because things have suddenly escalated. Sometimes this strong suicidal intent has been triggered by something that has just happened, which has felt overwhelming.
When someone experiences this very strong intent, it can feel like they have developed a kind of tunnel vision. All they can see is the goal of ending their life. It is as if everything they care about and everyone they love disappears into some far distant horizon. People who have experienced this often say that they could no longer hold their loved ones in their mind, at this point.
MYTH 10: Someone who dies by suicide will leave a note
In reality, a high proportion of people who end their lives don't leave a note, because they are so highly distressed or mentally unwell at that point that they are unable to do so. Some people do leave a note, because it is important to them to leave an explanation, or because they want to leave practical instructions for arrangements after their death such as funeral arrangements.
In some cases, they may have written the note several days before ending their life as part of 'final acts'. When there is no note, bereaved families who are desperately seeking to understand what may have led their loved one to end their life may be left with the question 'why?'
This can be a source of unbearable anguish and distress, as families try to find answers. Even when someone has left a note, it may be very short and may provide little information about what led them to end their life.
If you are struggling with suicidal feelings:
The Mental Health Foundation provides the following advice.
If you have seriously harmed yourself, or you don’t feel that you can keep yourself safe right now, call 999 or go straight to A&E.
If you are experiencing suicidal thoughts and need support, you can:
call your GP and ask for an emergency appointment
call NHS 111 for out-of-hours help
contact your mental health crisis team if you have one.
This crisis care page has more information on who can help.
There are many free helplines available.
CALM (Campaign Against Living Miserably) has a helpline (5pm – midnight) and webchat for anyone who’s having a tough time and needs to talk.
Papyrus supports people under 35 who have thoughts of suicide and others who are concerned about them. You can call their HOPELINEUK on 0800 068 4141, text 07860 039967 or email email@example.com. They’re open every day from 9am to midnight.
Samaritans has practical tips on dealing with suicidal feelings.
The Suicide Prevention Pocket Guidebook by Joy Hibbins is on sale now (Welbeck Balance, £10.99)
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