By Philip Adkins

Suicide is that horrendous issue that we all know happens in the world, somewhere and to someone, but perhaps, fortunately for most of us, it’s a tragedy that doesn’t affect us directly.

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This year the international theme for Suicide Prevention Day is ‘Creating Hope Through Action’ and in our post pandemic world, it feels as though the theme couldn’t resonate more.

We all have our part to play to spot the signs and take action to help those who are suffering from Suicidal Thoughts. Every life is precious, and each and every one of us can make a difference in the fight against suicide.

It’s time to create hope through action.

The data makes for worrying reading.

Without a doubt, these past two years have been unsettling for all of us. Most of us have felt fear and anxiety at some time and finding a way to pull ourselves through the pandemic has taken a great deal of our emotional energy. This is only to be expected of course, but sadly many people have found the mental strain of the last two years near on impossible.

Sadly, the data makes for very stark and worrying reading. The ONS found that around 1 in 5 (21%) adults experienced some form of depression in early 2021 (27 January to 7 March). This was an increase since November 2020 of 19% and more than double than observed before the coronavirus pandemic (10%).

In addition to this, younger adults and women were found to be more likely to experience some form of depression, with over 4 in 10 (43%) women aged 16 to 29 years experiencing depressive symptoms, compared with 26% of men of the same age.

The ONS also reported that 4,902 suicides were registered in England in 2020, equivalent to a provisional rate of 9.9 suicide deaths per 100,000 people. This actually represents a statistically significant reduction in the rate from 2019 when there were 10.8 suicide deaths per 100,000, but it is paramount that caution is taken in the interpretation of this decrease.

This is because the reduction in the number of suicides registered in 2020 from the previous year most likely reflects delays to coroner inquests, because of the impact of the coronavirus pandemic, as opposed to a genuine decrease in suicide.

Suicide remains a very concerning issue and something that we need to take seriously in light of the growing mental health cases we are seeing across the globe.

Why people have suicidal thoughts and feelings.

People may have Suicidal thoughts or consider taking their own life due to a variety of different – and often very complex – reasons. Risk factors might include:

• Difficult life events, such as a traumatic childhood or due to experiencing physical or emotional abuse;
• As a result of something upsetting or life changing happening, such as a relationship ending or a loved one dying;
• Due to increased anger or fear;
• As a result of misusing drugs or alcohol;
• Due to living alone or in social isolation;
• Because they are suffering from a mental health condition such as depression, schizophrenia or personality disorder;
• As a result of having a physical health condition, especially if this causes pain or serious disability which impacts daily living;
• Due to ongoing problems with work or money;
• As a result of poor social networks or a lack of sense of ‘belonging’;
• Due to a loss of role or status;
• As a result of a recently changed attitude towards death/dying.

The importance of talking as a preventative measure.

We know that suicide can be prevented and giving people the confidence and skills to talk about suicide in the right way to the person suffering can often be an essential component to saving lives longer term. But to get there we have to remove the stigmas associated with suicide.

Many people are afraid to talk about suicide. They don’t know how to ask others about it, they don’t know what to say to someone who has lost a loved one to suicide, and certainly, they do not know how to comfort someone who is affected by it.

The most important point to remember though is that talking to someone suffering with suicidal thoughts does not mean that they are more likely to end their life. Quite the opposite in fact; because it could well help save their life.

10 ways you could talk to someone who is suffering with suicidal thoughts or considering taking their own life:

1. It is essential that you empathise with them. You could say something like, ‘I can’t imagine how painful this is for you, but I would like to try to understand.’ Likewise try to be non-judgemental. Don’t criticise or blame them for how they are feeling.
2. Where possible try to repeat their words back to them in your own words. This shows that you are listening. Repeating information can also make sure that you have understood them properly.
3. Ask about their reasons for living and dying and listen to their answers. Then try to explore and elaborate on their reasons for living in more detail.
4. Ask them if they have felt like this before and if so, ask them how their feelings have changed from the last time they felt like this.
5. Encourage the individual to focus on things they are looking forward to in their future. This can help to foster feelings of hopefulness.
6. Ask them if they have a plan for ending their life and what that might be.
7. Encourage them to seek help that they are comfortable with. Such as help from a doctor or counsellor, or support through a charity. Work with them to put them in touch with that support where possible.  
8. Remember to follow up any commitments that you agree to, so that they feel they can rely on you long term.  
9. Help that individual understand how they could access support if they began to feel worse and what this support would be.
10. Most importantly, make sure someone is with them if they are in immediate danger.

Perhaps most importantly, we would strongly advise anyone working with a suicidal individual to involve their family or friends where possible. Serious case reviews often highlight that friends and family were simply not aware of how that individual was feeling prior to suicide and had they known, they could have helped.

What not to do.

If someone confides in you that they are feeling suicidal, your response may be to tell them to ‘cheer up’ or tell them to ‘pull themselves together’. Perhaps you might try to change the subject to take their minds off it. None of these things are going to help that person – and could actually do far more damage. Likewise, try to avoid telling them that they have no reason to feel like that or that they should be grateful for having a good life. Likewise, never tell them that are being silly. Remember the key is to listen to them and show them that you are there to support them.

It is important to understand that suicidal thoughts are not a form of attention seeking. Rather there are a reality for so many people and the sooner we talk about them, bring them out into the open and remove the stigma, the better.

Author Bio:

Philip Adkins, National IAPT Clinical Lead at Vita Health Group. Philip is a registered Mental Health Nurse and CBT therapist and has worked within NHS services for more than 20 years. He has experience working in community and inpatient settings, and for the last 10 years, has worked in leadership roles within a variety of IAPT settings. Philip is currently Vita Health Group’s National Clinical Lead for NHS Mental Health services and also the organisations Safeguarding Lead for Mental Health.

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