A few things I learnt at a recent meeting on Suicide Prevention:

Only 25-40% of people who end their own lives have been  in contact with Mental Health services in the year before their death. So, it is everyone’s problem. It is important to educate everyone about recognising ‘at risk’ people; symptoms typically include dramatic withdrawal, reduced self-esteem, restlessness and agitation, severe hopelessness, acting recklessly, threatening to harm themselves and talking or writing about death.

A patient went to her GP with many of the above features and he said to her,” Why don’t you go shopping?” Not surprising at all. Is it? GPs are not trained adequately to deal with these situations.

Taking time to care and pay attention to everyone, no matter who we are or where we live and work, makes them feel valued. Each one of us can make a difference. It is our responsibility to:

1. Ask.
2. Listen.
3. Give hope.

Very often the professionals will say that a particular suicide was ‘unavoidable”. Really? How do we know? Did we anticipate it? If yes, then did we do our best to prevent it? If not, then why not?

What is an acceptable suicide rate?

There needs to be a change in mindset. A cultural shift needs to take place. We need to believe that we can achieve a Zero Suicide Rate as some places in America have done.

As a society we need to:

1. Talk openly about suicide as our problem.
2. Remove access to means of suicide by tackling the hotspots such as multi-storey car parks.
3. Improve access to Secondary (Specialist) care.
4. Offer training to all professionals, especially GPs, police, airport and railway staff.
5. Have a safety plan for patients with a known illness be it mental or physical, such as chronic pain and stroke, that might make them prone to suicide.
6. Forget about the ‘risk assessment’ approach which is essentially a form of rationing. Do the same thing for everyone – have a safety plan.

Apparently each suicide costs the government £1.4 million. Police and coroners cost plus lost employment for the deceased person and the damaging impact on the people affected by the event. On an average 60 people are deeply affected by each suicide. So, even the treasury is interested in reducing the suicide rate.

Ask. Listen. Offer hope.

Self-harmers are commonly looked down upon. They are considered by many as wasters : wasting their own time (seeking sympathy and attention), other people’s time and precious resources.

They are much misunderstood. Self-harm is a coping mechanism. It is a way of expressing very deep distress that cannot be put into words or even thoughts. It is an ‘inner scream’ that helps release emotional pain and show someone else how they feel.

Young women are most likely to self-harm, although the number of young men who do so is on the rise. Mental health problems, stressful circumstances (being homeless, being a single parent, being in financial difficulty), using drugs and alcohol are the commonest causes.

Myth 1: People who self harm don’t feel pain and therefore do not need painkillers to stitch wounds.

Of course they feel pain. They should be offered full assessment of their physical, psychological and social needs by a professional who has been trained in their treatment in an atmosphere of respect and understanding.

Myth 2: Young people who self-harm always have mental health problems.

Not always. Sometimes that is the only way they can cope with traumatic experiences from the past, for example, bullying or abuse.

Myth 3: Young people who self-harm want to commit suicide.

They often don’t. In extreme circumstances though, life can get too much for a young person and that is why it is important to seek help.

Myth 4: People who self-harm are just seeking attention or being manipulative.

Sometimes it is the only way they can express their pain, even though this can be very upsetting for those around them.

How can we help?

1. Don’t ignore what’s happening.
2. Tell them that you want to understand how they are feeling and want to help.
3. Be honest about your feelings while not being critical of or blaming the young person.
4. Emphasise the positive aspects of the young person’s life.
5. Be realistic. They may not stop self-harming just because you want them to.
6. Don’t take over but show you care.

Whether you are a patient or a carer, please seek professional help from GPs, psychiatrists, emergency departments, councellors, psychologists or psychotherapists.

(Source: http://www.bernardos.org.uk)