SUICIDE PREVENTION

Suicide is a concern for each of us. Whether in our family or our community we may have someone contemplating suicide - a suicide we can prevent if we take the right steps.

On Wednesday 1st February 2012 a friend wrote me the following:

My nephew committed suicide last October. He left work early, drove to the ferry, took a boat ride to his family's holiday cottage, went into the back garden and cut his throat.

It took the police two full days to clean the site up sufficiently for the family to come and see it.

When a suicide cuts his throat, there can be no doubt of his intention. At the same time, there is no doubt in my mind that  ignorant, malicious and bigoted attitudes  towards mental illness, sexuality and tolerance formed a part, however small, of his motivation...


General information about suicide and suicide prevention

(Note: I added a Suicide Prevention page to save a life. Suicide prevention is everybody’s business. Educate our community that suicide is a preventable public health problem. Suicide should no longer be considered a taboo topic, and that through raising awareness and educating the public, we can SAVE lives. )

Suicide is a significant cause of death in many western countries, in some cases exceeding deaths by motor vehicle accidents annually. Many countries spend vast amounts of money on safer roads, but very little on suicide awareness and prevention, or on educating people about how to make good life choices.
Attempts at suicide, and suicidal thoughts or feelings are usually a symptom indicating that a person isn’t coping, often as a result of some event or series of events that they personally find overwhelmingly traumatic or distressing. In many cases, the events in question will pass, their impact can be mitigated, or their overwhelming nature will gradually fade if the person is able to make constructive choices about dealing with the crisis when it is at its worst. Since this can be extremely difficult, this article is an attempt to raise awareness about suicide, so that we may be better able to recognize and help other people in crisis, and also to find how to seek help or
make better choices ourselves.
Help and resource information:
This posting is accompanied by a companion posting containing information primarily about crisis and suicide prevention resources available on the Internet, and other national resources available in various countries. It should be available in the same newsgroup, but is also available from:
ftp://rtfm.mit.edu/pub/usenet/news.answers/suicide/
The information here is updated periodically, and is intended to be informative rather than authoritative. Readers are encouraged to offer feedback, suggestions, criticisms and any comments on ways you may have found it helpful. The latest version is also archived at: ftp://rtfm.mit.edu/pub/usenet/news.answers/suicide/
Here are a number of frequently asked questions to help raise awareness and dispel some of the common myths about suicide:



1. Why do people attempt suicide?
People usually attempt suicide to block unbearable emotional pain, which is caused by a wide variety of problems. It is often a cry for help. A person attempting suicide is often so distressed that they are unable to see that they have other options: we can help prevent a tragedy by endeavoring to understand how they feel and helping them to look for better choices that they could make. Suicidal people often feel terribly isolated; because of their distress, they may not think of anyone they can turn to, furthering this isolation.
In the vast majority of cases a suicide attemptor would choose differently if they were not in great distress and were able to evaluate their options objectively. Most suicidal people give warning signs in the hope that they will be rescued, because they are intent on stopping their emotional pain, not on dying.

2. Aren’t all suicidal people crazy?
No, having suicidal thoughts does not imply that you are crazy, or necessarily mentally ill. People who attempt suicide are often acutely distressed and the vast majority are depressed to some extent. This depression may be either a reactive depression which is an entirely normal reaction to difficult circumstances, or may be an endogenous depression which is the result of a diagnosable mental illness with other underlying causes. It may also be a combination of the two.
The question of mental illness is a difficult one because both these kinds of depression may have similar symptoms and effects. Furthermore, the exact definition of depression as a diagnosable mental illnesses (i.e. clinical depression) tends to be somewhat fluid and inexact, so whether a person who is distressed enough to attempt suicide would be diagnosed as suffering from clinical depression may vary in different peoples opinions, and may also vary between cultures.
It’s probably more helpful to distinguish between these two types of depression and treat each accordingly than to simply diagnose all such depression as being a form of mental illness, even though a person suffering from a reactive depression might match the diagnostic criteria typically used to diagnose clinical depression. For example, Appleby and Condonis[1] write:

The majority of individuals who commit suicide do not have a diagnosable mental illness. They are people just like you and I who at a particular time are feeling isolated, desperately unhappy and alone. Suicidal thoughts and actions may be the result of life’s stresses and losses that the individual feels they just can’t cope with.

In a society where there is much stigma and ignorance regarding mental illness,a person who feels suicidal may fear that other people will think they are “crazy” if they tell them how they feel, and so may be reluctant to reach out for help in a crisis. In any case, describing someone as “crazy”, which has strong negative connotations, probably isn’t helpful and is more likely to dissuade someone from seeking help which may be very beneficial, whether they have a diagnosable mental illness or not.
People who are suffering from a mental illness such as schizophrenia or clinical depression do have significantly higher suicide rates than average, although they are still in the minority of attemptors. For these people, having their illness correctly diagnosed can mean that an appropriatetreatment can begin.

Suicide Warning Signs
Talking about suicide	Any talk about suicide, dying, or self-harm, such as "I wish I hadn't been born," "If I see you again...," and "I'd be better off dead."
Seeking out lethal means	Seeking access to guns, pills, knives, or other objects that could be used in a suicide attempt.
Preoccupation with death	Unusual focus on death, dying, or violence. Writing poems or stories about death.
No hope for the future	Feelings of helplessness, hopelessness, and being trapped ("There's no way out"). Belief that things will never get better or change.
Self-loathing, self-hatred	Feelings of worthlessness, guilt, shame, and self-hatred. Feeling like a burden ("Everyone would be better off without me").
Getting affairs in order	Making out a will. Giving away prized possessions. Making arrangements for family members.
Saying goodbye	Unusual or unexpected visits or calls to family and friends. Saying goodbye to people as if they won't be seen again.
Withdrawing from others	Withdrawing from friends and family. Increasing social isolation. Desire to be left alone.
Self-destructive behavior	Increased alcohol or drug use, reckless driving, unsafe sex. Taking unnecessary risks as if they have a "death wish."
Sudden sense of calm	A sudden sense of calm and happiness after being extremely depressed can mean that the person has made a decision to commit suicide.

Suicide prevention tip #1: Speak up if you’re worried

If you spot the warning signs of suicide in someone you care about, you may wonder if it’s a good idea to say anything. What if you’re wrong? What if the person gets angry? In such situations, it's natural to feel uncomfortable or afraid. But anyone who talks about suicide or shows other warning signs needs immediate help—the sooner the better.

Talking to a person about suicide

Talking to a friend or family member about their suicidal thoughts and feelings can be extremely difficult for anyone. But if you're unsure whether someone is suicidal, the best way to find out is to ask. You can't make a person suicidal by showing that you care. In fact, giving a suicidal person the opportunity to express his or her feelings can provide relief from loneliness and pent-up negative feelings, and may prevent a suicide attempt.
Ways to start a conversation about suicide:

• I have been feeling concerned about you lately.
• Recently, I have noticed some differences in you and wondered how you are doing.
• I wanted to check in with you because you haven’t seemed yourself lately.

Questions you can ask:

• When did you begin feeling like this?
• Did something happen that made you start feeling this way?
• How can I best support you right now?
• Have you thought about getting help?

What you can say that helps:

• You are not alone in this. I’m here for you.
• You may not believe it now, but the way you’re feeling will change.
• I may not be able to understand exactly how you feel, but I care about you and want to help.
• When you want to give up, tell yourself you will hold off for just one more day, hour, minute — whatever you can manage.

When talking to a suicidal person

Do:

• Be yourself. Let the person know you care, that he/she is not alone. The right words are often unimportant. If you are concerned, your voice and manner will show it.
• Listen. Let the suicidal person unload despair, ventilate anger. No matter how negative the conversation seems, the fact that it exists is a positive sign.
• Be sympathetic, non-judgmental, patient, calm, accepting. Your friend or family member is doing the right thing by talking about his/her feelings.
• Offer hope. Reassure the person that help is available and that the suicidal feelings are temporary. Let the person know that his or her life is important to you.
• If the person says things like, “I’m so depressed, I can’t go on,” ask the question: “Are you having thoughts of suicide?” You are not putting ideas in their head, you are showing that you are concerned, that you take them seriously, and that it’s OK for them to share their pain with you.

But don’t:

• Argue with the suicidal person. Avoid saying things like: "You have so much to live for," "Your suicide will hurt your family," or “Look on the bright side.”
• Act shocked, lecture on the value of life, or say that suicide is wrong.
• Promise confidentiality. Refuse to be sworn to secrecy. A life is at stake and you may need to speak to a mental health professional in order to keep the suicidal person safe. If you promise to keep your discussions secret, you may have to break your word.
• Offer ways to fix their problems, or give advice, or make them feel like they have to justify their suicidal feelings. It is not about how bad the problem is, but how badly it’s hurting your friend or loved one.
• Blame yourself. You can’t “fix” someone’s depression. Your loved one’s happiness, or lack thereof, is not your responsibility. 

Adapted from: Metanoia.org