In November 2020, a friend exited. I cannot say I was close to him, we have met several times – he had dinner with us when he came to town, and once he joined us to watch my son at a karate lesson. I was introduced to him through my good friend. They have been close friends for many years.
When my friend broke the news about Laurent, I was sad; I was shocked. Only two months prior to his departure I was looking forward to see him; he had planned to come to Geneva to spend some time here. But that trip did not materialise. He was also supposed to meet my friend in another city in October, alas, that too did not happen.
Many questions came to mind upon hearing the news, and each time I kept asking “why”.
It was very devastating for my friend who had known Laurent for more than 20 years. It was really difficult he said. They had been in touch several days before Laurent’s passing, but only through WhatsApp. Had he spoken to Laurent, maybe he could have sensed what was going on, he confided saying the toughest time was when was he was alone.
According to WHO’s report, Suicide worldwide in 2019, every year, more people die as a result of suicide than HIV, malaria or breast cancer or war and homicide. In 2019, more than 700,000 people died by suicide: one in every 100 deaths.
“We can be speaking to a close friend and not be aware that they are struggling, that could be depression with suicidal thoughts or some other kinds of mental health. And sometimes it needs a little bit of time and thought and follow up conversation in order to find out when somebody is really feeling very low. It is hard to have these kinds of conversations,”the World Health Organisation (WHO) Communications Officer Alison Brunier.
Brunier was moderating the panel discussion at the launch WHO’s LIVE LIFE guide on suicide prevention.
DJ Nash, one of the panellists, concurred with Brunier adding that asking someone about hurting themselves does not make them more likely to hurt themselves.
“I think we are sometimes afraid to have that conversation because what if they say yes, but as that incredible video demonstrates someone stopping and saying what’s going on, are you ok, sometimes feeling cared about and have someone think about you is enough to get you out of the nosedive ” he said referring to the video that was played at the beginning of the panel discussion.
Nash is a creator and producer of A Million Little Things a family drama series about a group of friends who became motivated to living fuller lives after the unexpected death of a close friend.
Nash’s involvement in suicide prevention originated from losing an old friend a few years ago. He had ran into his friend on the street and making plans to have lunch the next week. But before they could meet up again, he learned that his friend had killed himself. “I don’t feel for a second like my lunch, our lunch, could’ve saved him. But I do feel a lot of seconds, like, we could have had one more lunch,” he said.
Panellist Jonny Benjamin, author and founder of youth mental health charity Beyond, who is a suicide survivor, underlined the importance of having conversations about suicide, saying it does not get any easier for him but the difference when comparing now and the time when he was growing up is that he could talk about it.
Benjamin began having mental health problems at a young age and his parents first took him to see a psychologist at the age of five. He later developed depression at 16 and was eventually diagnosed with schizoaffective disorder, a combination of schizophrenia and bipolar disorder, in his early 20s. He intended to exit by jumping off a bridge but a passerby found him and talked him out of it, which lasted long enough for the emergency services to arrive.
Benjamin, 34, said when growing up, mental health was not talked about at all and he wished someone would come to his school and talk about it, and say it is ok not to be ok.
His work through Beyond promotes mental health among young people including in schools in the United Kingdom. At schools, his organisation has a 30-minute slot to speak about mental health. Benjamin though wished more time should be allotted.
“We have to give proper time to this. This really needs to come from the top, the head teachers, senior leaders and government. We have to put real valuable time into the curriculum for this, otherwise things are not going to change,” he opined.
Benjamin’s argument makes sense as global statistics show that half of all mental health conditions start by 14 years of age but most cases are undetected and untreated. Suicide is the fourth leading cause of death in 15-19-year-olds.
When to talk about suicide?
What are the causes of suicide? Panellist, the WHO suicide prevention expert, Dr Alexandra Fleischmann outlined several risk factors associated with the topic. These includes mental health issues, depression and alcohol use.
But there are other issues to be considered too, she added. These include experiences of loss of a loved one, breakup of a relationship, experience of violence or trauma, loneliness and lost of employment especially as the economy plummets due to Covid-19.
“Different risk factors should be taken into consideration and the important thing is if there is one risk factor at play, one should already ask about suicidal thoughts and follow up with that, and if there are many or several risks factors together, of course the risk increases,” she said.
Benjamin highlighted the importance of listening when talking about suicide prevention. “Listening is so key, we don’t learn to listen very much, we learn to quickly respond especially now with meetings being online, everything is going at a fast pace, we don’t take the time to pause. We don’t talk to each other,” he stressed.
He cited some examples of good practices. One example is at work places where before going right into meetings, the people involved would they take a pause, and they actually ask each other how they are doing. Another example was starting a meeting by going for a walk with a colleague and asking about how the other person was doing; this can be a good technique when it is hard to look into someone in the eyes and open up.
When a nation talks about mental health
Jazz Thornton, mental health activist and co-founder of Voices of Hope, also a suicide survivor spoke about her work in advocacy and mental health activism in her country New Zealand where youth suicide rate is one of the highest in the developed countries.
“We made noise, we keep talking about it, and eventually made it to the front page, and the radio and TV stations in the country talked about it so much, and when the elections came everyone was looking at how much attention was given to mental health,” she said.
Thorton and fellow activists’ work paid off as eventually the government listened, and allocated an overwhelming budget to mental health. “It started from the ground and still continues. We need to get them to listen,” Thornton added.
The WHO’s comprehensive guidance for implementing its LIVE LIFE approach to suicide prevention outlines four strategies of this approach to support countries in their efforts:
- limiting access to the means of suicide, such as highly hazardous pesticides and firearms;
- educating the media on responsible reporting of suicide;
- fostering socio-emotional life skills in adolescents; and
- early identification, assessment, management and follow-up of anyone affected by suicidal thoughts and behaviour.
Dr Fleischmann said the strategies are applicable to all countries but some adaptation to country context should be applied. “For example with access to means of suicide, a country would need to know what are the main means used and then intervene and restrict of possible access to the means. With pesticides, these are found in lower and middle income countries in agricultural areas where in the households they are right there readily accessible, in other countries maybe different means are more important,” she said.
Do no harm approach
Thornton when responding to a question about how advocates can post in social media without triggering somebody from attempting suicide, said she is always very careful when posting on social media as it can be very dangerous and one must always be careful in one’s messaging.
“Especially on advocacy point, at all times no matter what the story is that you are telling you always have to add hope into it, that you can be raw, you can be real, but you must provide hope, you must be able to say that change is possible, even if the thing you are directly talking about is very raw,” Thornton said.
She added she would often made sure that she was not impulsively posting, and she was actually thinking things through before she put it out because, “as soon it is out in the world people are seeing it, and we are responsible for what we put online,” she emphasised.
The role of the media
Media reports of suicide can lead to a rise in suicide due to imitation, especially if the report is about a celebrity or describes the method of suicide. The WHO LIVE LIFE guide highlights the role the media plays in relation to suicide and how national media (including social media) bodies at local level can work with local media outlets. Below is an extract from the guide outlining tips for implementation at country level.
- Change is possible
- There is hope
- If you are struggling, reach out for help, that’s so important
To those interested in resources of this article, please refer to the following links:
https://bit.ly/3zZxaWn (panel discussion)
https://bit.ly/3ttlGbb (video on preventing suicide and coping with loss)
For me personally, I was especially moved and encouraged by the testimonies by the suicide survivors. I have also gained valuable insights into a topic which I have always been afraid to approach. Now, I understand a little better.