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What could suicide prevention really look like?
With thanks to our Head of Engagement and Development at NCS, Faye Blackwell, for providing this blog post. To mark World Suicide Prevention Day on 10 September, Faye was asked to share her thoughts on suicide prevention and what can be done to improve outcomes by the Professional Standards Authority.
World Health Organisation (WHO) figures from 2019 suggest that the UK has the 9th highest suicide rate in the world.
While a better understanding of risk factors that contribute to suicide exists, improvements are still needed to prevent it happening in such numbers.
So, the important question is; what is missing from current suicide prevention strategy in the UK?
The solution may lie somewhere unexpected; that is, by seeing suicide through a different lens, creating and embedding a shift in perspective and action across society, that could save lives.
The Power of Shame
Let’s normalise the dialogue around suicide, thereby removing associated shame. Positive action has been taken to modify the vocabulary used to move away from historic stigma. This needs to continue and filter into all areas of society. From a familial level, across education, health and mental health sectors and up to Government itself. Professionals across the board need to model a confidence and fearlessness when discussing suicide. Only then might it become normalised and embedded into a national conversation. Then the suicidal can voice their feelings without shame, and those affected by suicide do the same. Comprehensive, community and national leadership in this, can show the way for us all. Understanding the power of shame, the part it plays in suicidal feelings, and how our society feeds into that, is vital for suicide prevention.
The Samaritans report, ‘Dying from Inequality’, similarly recognises that “People living in the most disadvantaged communities face the highest risk of dying by suicide…..financial instability and poverty can increase suicide risk. Suicide is a major inequality issue. Tackling inequality should be central to suicide prevention and support should be targeted to the poorest groups who are likely to need it most.”
In addition to amplifying the national voice as described above, we can help our children and young people (CYP) further, by providing safe spaces, both online and offline, where they can talk about their feelings freely.
Let’s go further and create a societal understanding of how children communicate, to improve our ability to support them. Verbal communication is not always easy for them, so they express feelings through behaviour. When this is punished or shut down, that child’s distress is unheard. We need to understand and explore a child’s behaviour, rather than treating it as ‘naughtiness’. Encourage and normalise the verbalising and expression of emotional narratives.
CYP are encouraged to disclose, however educational establishments are becoming risk averse and, in some circumstances, prefer to decline students a place, or remove them from their studies, as a result of declared mental health issues. This sends a detrimental message about the consequences of disclosing. If we wish children to speak, we need to ensure a safe environment and system for them to do so.
Valuing a child’s wellbeing over academic achievement is another key to suicide prevention, but is unlikely to be actualised soon. However, recognition that educators are not trained mental health workers is achievable and important, for both the sake of pupils and teachers alike. Understanding mental distress in children requires specific training. Therefore, recommendations that all schools, colleges and universities have trained counsellors available, need to be heard and acted upon. Counsellors in every educational establishment should be a statutory requirement and a whole school approach (from early-years) to mental health be adopted.
Kate Day, Child Ambassador for the National Counselling Society and co-author of the Children’s Alliance report on children’s mental health, says, “We must act now to prevent further deaths of our children and young people. Early detection of our child and adolescent suffering with their mental health is crucial to prevent further suicides. The continuing long waiting lists in child mental health services is putting our children at further risk.”
Additional changes that are achievable, include challenging the widespread belief that GDPR is more important than safeguarding, i.e. sharing information with family where appropriate.
All schools, colleges, universities and workplaces need to have clear pathways to, and availability of, crisis support.
Could we risk assess public spaces through the lens of someone wanting to harm themselves - adding in compassionate signage and physical barriers where possible? How about training those who work in public areas? Could they ask someone, ‘Are you ok?’ or, ‘Can I help?’ rather than, ‘What are you doing here?’
Support and Signposting
Despite encouragement for those at risk of suicide to disclose, what happens then? Overstretched services make referrals difficult, or long waits to access help. A reliance on short-term, ‘quick fixes’, is a false economy. Long-term investment could produce longer-term benefits. There could be a case for shifting the emphasis from short-term ‘band-aid’ mental health approaches (Process-Centred), to implementing and valuing longer-term mental health strategies (Autonomy-Centred). Understanding suicide is a not a problem, but the symptom of other problems is necessary.
Support should not be time-restricted, but provided according to need and for as long as necessary. Each suicide affects multiple people affected who are then at increased risk themselves. Ways to actively overcome barriers to engage with peers of people who have died or made a serious attempt on their lives need to be found, and trauma support should be available to all.
Promoting different approaches to mental health care gives people choice and support suitable for each individual.
The Solution to Saving Lives lies in a Societal Shift
In summary, perhaps the key to saving lives is in the fabric of our society, with a discourse of compassion and understanding, asking and listening, and practical measures, woven into every thread.
This is what suicide prevention could look like:
Reduce shame around suicide – turn the volume up, across all of society, on the conversation
Start the conversation from early years. Give children a voice and the space to hear it.
Better funding for state provision and/or the third sector is essential
Available and appropriate support for all, recognise (age/gender/cultural barriers to asking for help.
Emergency intervention meetings when there is an emerging risk with a particular group.
Understand that ongoing support (as opposed to a prescribed amount) may be required and should be needs based.
Training and advice for employers and employees - mental health and welfare being part of health and safety policies as standard - possibly as part of The Health and Safety at Work Act.
Better communication between all groups/agencies involved
Reduce poverty, invest in hard-to-reach groups
Click here to view the blog post on the Professional Standards Authority website.
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