SUICIDE TALK…. YEP, LET’S GO THERE

It has long been thought that by talking about suicide with a possibly suicidal person, that we may be at risk of putting the idea into their head, and thus increase the risk that that person will die by suicide.  We now know that this is most definitely not the case.  Most people who are having thoughts of suicide, don’t actually want to die, they just want their pain to end (Mental Health First Aid Australia, 2017), and having an open, upfront conversation with that person about their thoughts, may be enough to save their life…. But how do we do this?

It’s actually not as complex as it might seem, however, it is really important that our question is not ambiguous, that is, that it could not be interpreted another way, therefore, we simply come out with it…. “are you having thoughts of suicide?”.  It can be difficult to ask this question for the first time, so I recommend you practice beforehand, as it may bring up some strong emotions within you.  If this happens, remind yourself to breathe, slow, deep breaths, you are tackling this topic because you care about the person you are trying to help, and you could very well save a life in the process.

WHY IS IT IMPORTANT TO TALK ABOUT SUICIDE?

In 2007, there were a total of 2,227 deaths recorded as suicide (or intentional self-harm) in Australia.  In 2011, there were a total of 2,393 deaths recorded as suicide in Australia, and in 2016, this figure had increased to 2,862.  Of these 2,862 lives lost to suicide, 75.1% were men, and 24.9% were women, which indicates that suicide occurs at a rate three times greater among males than females (Australian Bureau of Statistics (ABS), 2018).

The median age of people who died by suicide in 2016 was 43, with suicide being the leading cause of death among 15-44 year olds.  Suicide accounted for over one third of deaths (35.4%) among people aged 15-24 years, and over one quarter of deaths (28.6%) among those aged 25-34 years (ABS, 2018).  These figures make suicide very real (and sadly they are probably conservative), think of all these people, their families, their loved ones, even their pets; that is a lot of people who are affected negatively by the ripple effect of suicide.

WHAT FACTORS CONTRIBUTE TO SUICIDE?

There are many factors that can contribute to suicide including:

  • Having a history of mental illness
  • Using substances, such as drugs and alcohol
  • Family history of suicide
  • Socioeconomic disadvantage
  • School/Work stressors
  • Domestic violence
  • Conflict of sexual identity
  • Availability of means
  • Relationship difficulties

It is important to note however, that a person may have many of the contributing factors listed, but not have suicidal ideation, whereas others may have no factors on the list, and still have suicidal thoughts.

SO WHAT MIGHT BE SOME CLUES THAT SOMEONE IS HAVING THOUGHTS OF SUICIDE – WHAT MIGHT THIS LOOK LIKE TO AN OUTSIDER?

There are some signs that may indicate that a person is having thoughts of suicide, such as:

  • Saying goodbye
  • Sudden changes in behaviour, such as withdrawal, loss of interest in usual activities – NOTE that euphoria could also be a warning sign – It could indicate that someone has made the choice to end their life, and this euphoria may be a sign of relief that they have made their decision
  • Loss of humour
  • Apathy about appearance
  • Verbal expressions such as ‘I wish I was dead’, ‘people will be better off without me’
  • Disruptive/Impulsive behaviours
  • Decline in school work
  • Mental illness (such as depression, delusions)

Remember though, just because someone may have one or more of the signs on the list, does not mean that they will be having thoughts of suicide.  Likewise, some individuals may show signs not on this list, or not show any signs at all, and still be having thoughts of suicide.

SO WHO CAN HELP?

There are many people who can help someone who is having thoughts of suicide.  Firstly, you, you have the power to raise concerns with the person you are worried about.  Sometimes just knowing someone cares enough to check in on them, may be a significant turning point in a person’s mental health journey.  You can ask the person you are concerned about, who they would like to talk to.  They may have a certain friend, family member or professional that they feel will be best able to assist them.

A GP is usually the next port of call in getting someone the help that they need – If you suspect that the person you are worried about is having thoughts of suicide, you can tell this to the GP reception staff and they will most likely be able to fit the person in that day.  If not, you can present to the emergency department of your local hospital.

If the person you are concerned about has already engaged with and built a rapport with other professionals, such as a psychologist, psychiatrist, counsellor, paediatrician etc, then they may be able to provide some beneficial assistance.  For us as therapists here at Core Therapy, we provide support to reduce the crisis for that person, and engage in, and instil hope – hope that there are solutions, even if they take some time to find.

In addition, the following organisations are some of many, who can offer phone support and follow up assistance:

  • Lifeline (13 11 14)
  • Suicide Call Back Service (1300 659 467)
  • Kids Helpline (1800 551 800)
  • Rural Link (1800 552 002)
  • Beyond Blue (1300 224 636)

PROTECTIVE FACTORS

There are many protective factors, and these will vary from person to person.  Here are some that are known to act as protective factors:

  • Community and social integration
  • Personal resilience and problem-solving skills
  • Good physical health
  • Good mental health
  • Faith
  • Spirituality
  • Connectedness to family, school, work or club/team
  • Early identification and receiving appropriate help/treatment
  • The presence of a significant other
  • Responsibilities (to children/pets/other loved ones)

If in doubt, ask the person you are worried about directly if they are having thoughts of suicide.  If they say yes, then take steps to aid in their safety and wellbeing, such as some of those mentioned above.  Sadly, we sometimes cannot stop someone from dying by suicide, and if this happens, it is never the fault of a person who has reached out.