We need to do more to further suicide awareness. According to the latest data from the Samaritans, 6,221 suicides were registered in 2020 in the UK. [1]. Many more experience suicidal thoughts and seriously contemplate or attempt suicide. Males account for three-quarters of all suicides in England and Wales [2], a proportion which has been steadily rising over the past decade.
The causes are complex and for many who lose a family member, friend or colleague, the shock often comes with bewilderment and the regret of wishing they had known how to recognise the signs and offer support. This article seeks to explore the issues and identify what we can do, with particular reference to prevention and the workplace.
The signs are so often hard to spot
Sometimes there has been a long history of mental health issues, previous attempts, and a discernible pattern. Some people are known to be “high risk”. Equally for the family and friends of others, a suicide attempt is a shock, a complete bolt out of the blue. Yet there may be few outward signs, at least initially. It is perhaps only in hindsight that people begin to piece together fragments of conversations, slight observations or uneasy feelings and wish they had read them more closely. So often such conversations begin with “if only I had realised…”
A powerful exhibition running on the Southbank esplanade in London and organised by CALMS (Campaign against living miserably)[3] is of billboard poster sized photographs of people who have committed suicide. Entitled The Last Photo, it sounds gruesome, but the impact is that each of these photographs is the last known picture taken of the person who a few hours, days, or weeks later committed suicide. Those photographs often show smiling faces, snapshots at the zoo, out with friends, posing with family, holding babies or little children. The kind of photographs that could be of any one of us taken in similar situations.
But beyond the ordinary, the mundane, the unexceptional snaps of normally everyday events there are very often persistent signs that people are struggling – despite the smiles and thumbs up for the camera.
Telling others – we have a long way to go
A survey of 1,000 people by YouGov this month revealed that 61 per cent of those polled would struggle to tell someone if they felt suicidal, while over half (51 per cent) said they didn’t feel confident to help someone who is at risk. We have a long way to go in terms of raising awareness of suicide when our starting point is a frank admission that a high proportion of us would not tell others, and half of us would feel totally unable to know what to do if faced with a family member or friend who was feeling suicidal.
The early warning signs
We must learn to spot the early warning signs so that we can identify and provide support to someone experiencing suicidal thoughts and feelings. According to Mental Health First Aid England[4] eight out of ten people who take their own lives give definite warning signs of their suicidal intensions. Those warning signs may be a full and frank conversation, or they may be a throw-away side comment. Equally, those signs may not be words at all. Someone close to us who seems to be cut off, withdrawn into themselves, simply not connecting with others. There may be fluctuations of mood, sudden outbursts of tears. But remember that exhibition “The Last Photo”… for very often those we think we know well are masking their feelings and putting on a brave face, perhaps to avoid causing any pain to us, and to all intents and purposes going about their everyday lives.
What can we do?
Accept that providing support and help may be difficult. Do not take it personally if someone is evasive or avoids any response to your well-meaning comments. Try not to push too hard, as if rising to a challenge to “break through”. More than anything, if you suspect someone is struggling, seek ways to spend more time with them, and enlist the support of others to do the same.
We can find it hard to simply “be there” and may want to launch into offering our listening ear or well-intended comments. But sometimes all that we can do is be alongside someone, doggedly there. This may cause us to feel anxious, frustrated that we cannot do more, and even somewhat useless. But it is sometimes in that stillness, whilst someone is in the depths of despair, that simply being there may mean so much. So find out what support is available and being accessed by the person concerned. Offer to accompany them if it is helpful and provide gentle nudges to them to seek help. But avoid being too intrusive, too pushy, and be prepared for this to be a slower process than you would like. At all costs keep open a channel of communication.
The support of the Samaritans
If you are at all concerned about someone then call the Samaritans on 116 123 for free, 24 hours a day to discuss that situation. Ask for their advice on what you can do, and seek help for yourself to know how to manage what can be a long-haul and difficult situation.
At the same time respect the privacy and dignity of the person concerned. Avoid widespread gossip with all and sundry, focus instead on talking to a few people who are closest to the person concerned and to professional advisors. Let the person know what you are doing and why, even at the risk of causing offence.
If there is an imminent risk of suicide, then be prepared to act. You may well not know what to do, and that is perfectly understandable, so try to get the person to professional help as quickly as possible. Ring the Samaritans with them present and put them on the call to each other. Offer to take the person concerned to their GP Practice or to an A&E Department. In exceptional circumstances call 999 and explain the situation seeking their advice.
You may well not know what to do, but you can act as the means for ensuring that the person concerned gets the help they need. You can be the person who makes the connection.
Good Practice in the Workplace
We are seeing increased awareness and support in the workplace over a wide range of well-being issues including mental health concerns. Rightly much of this is focused on creating a workplace environment which seeks to reduce stress, offers support from line-managers and from peers, and seeks to be inclusive.
A workplace culture can certainly be focused on high performance and meeting challenging targets, but at the same time, the best places to work demonstrate concern for staff as their priority, ensuring that everyone feels supported and that access to help is simple and encouraged.
There is a huge opportunity for employers and managers to be part of the solution in understanding and addressing mental health concerns, including suicide, through helping to prevent issues from occurring, detecting any problems early on, providing rapid interventions, and supporting employees who are experiencing difficulties.
Awareness at work – the steps we can take
- Promote health & wellbeing benefits – specifically confidential helplines, Employee Assistance Programmes, Occupational Health, and Mental Health Champions and First Aiders.
- Communicate and engage everyone – foster open cultures that are inclusive and supportive.
- Enable people to feel able to talk freely about their mental health.
- Provide comprehensive training for managers to look for early-warning signs, to observe how their team are interacting the workplace. And to encourage regular conversations about health and wellbeing.
- Put in place some external support for employees to feel they can access confidential and private help. This could be through a comprehensive EAP programme (Employee Assistance Programme) offering on-line and telephone-support or it could be through an Occupational Health Provision where skilled, professional help is provided both on and off-site.
In conclusion
As the numbers show, suicide is a desperately sad and frequent occurrence. There will always be those who hide the signs or make them very hard to spot. But, with greater awareness, and hopefully a little more confidence to take those crucial steps that may prevent the worst, we can all be more equipped to make that vital difference.
[2] https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/bulletins/suicidesintheunitedkingdom/2020registrations#suicides-in-england-and-wales
[3] https://www.thecalmzone.net/thelastphoto
[4] MHFA England: Adult MHFA Manual
Photo by Becca Tapert on Unsplash
