In this blog for World Suicide Prevention Day Dr Jon Van Niekerk, Cygnet Group Clinical Director and Interim Suicide Prevention Lead, provides tips for supporting someone with suicidal thoughts.
Official figures show suicide rates are the highest they have been in 25 years. In the UK, mental ill health is the largest single cause of disability, with suicide levels so high it is considered a public health emergency.
According to the ONS, there were 6,069 suicides registered in England and Wales in 2023, compared with 5,642 the previous year.
Pre-election, Labour’s Health mission set out a pledge to reverse the rising trend of lives lost to suicide, so we anticipate, and fully support that this should be a national priority for the new government.
Days like World Suicide Prevention Day, hosted on September 10th each year by the International Association for Suicide Prevention, are so important in providing the opportunity to raise awareness of suicide and suicide prevention. Suicide does not just touch all of us…it can happen to any of us.
The figures released by ONS equates to 11.4 deaths per 100,000 people up from 10.7 deaths per 100,000 in 2022.
Suicide rates are highest among men, increasing from 16.4 deaths per 100,000 people to 17.4 last year, the figures show. But rates among females also increased to 5.7 deaths per 100,000 which is the highest figure since 1994.
The date also highlighted a stark north-south divide with the lowest rates in London at 7.3 deaths per 100,000 compared with the North-West which reported 14.7 per 100,000.
A recent poll by the Samaritans found that only 45% of people feel comfortable talking to family and friends about suicidal thoughts, compared to 74% who said they feel comfortable talking about mental health.*
More than 700,000 people die worldwide due to suicide every year, which is one person every 40 seconds. The triennial theme for World Suicide Prevention Day for 2024-2026 is “Changing the Narrative on Suicide” with the call to action “Start the Conversation”.
This theme aims to raise awareness about the importance of reducing stigma and encouraging open conversations to prevent suicides. Changing the narrative on suicide is about transforming how we perceive this complex issue and shifting from a culture of silence and stigma to one of openness, understanding, and support.
Supporting Someone with Suicidal Thoughts
1. Warning Signs
It is important to familiarise yourself with the signs that a loved one or friend may be considering suicide. These include:
• A change in normal routine, including eating or sleeping patterns.
• Expressing thoughts of suicide — for example, making statements such as “I am going to kill myself,” “I wish I were dead”, saying goodbye to people as if they won’t be seeing them again.
• Looking for ways to end their life such as stockpiling medication.
• Withdrawing from others and wanting to be left alone.
• Expressing feelings of helplessness and hopelessness about the future.
• Being preoccupied with death, dying or violence.
• Feeling trapped or hopeless about a situation.
• Increasing use of alcohol or drugs.
• Self-destructive behaviour, such as drugs, taking unnecessary risks or driving recklessly.
• Giving away belongings or getting affairs in order when there is no other logical explanation for doing this.
2. Difficult Situations
Perhaps your loved one is going through a difficult, challenging period in their life which may prompt mental health difficulties. These might be:
• Financial worries
• Relationship issues
• Work related stress
• Loss including loss of a job or a family member or loved one through bereavement
• Loneliness and isolation
• Mental illness
• Physical illness
3. Effective Communication
It is important to be non-judgemental and empathetic and allow the person to express their distress. Asking simple, open questions can encourage them to be honest about how they are feeling.
• Ask open questions which require more than a ‘yes’ or ‘no’ answer. Some good examples include “Tell me how you are feeling”, “What is life like for you right now”. Give them time.
• Take them seriously. It is a common myth to believe that someone who talks about suicide doesn’t intend to act upon those feelings. Always assume they are telling the truth.
• Do not judge, no matter how shocked, scary or upsetting it is to hear their feelings.
• Direct questions about suicide like ‘Do you feel like life is not worth living?’ or ‘Do you feel like ending your life?’ can help someone talk about how they are feeling. Asking someone if they feel suicidal may not feel like the right thing to do but it is the recommended approach. Some people worry that this might indirectly encourage the person who is feeling suicidal to act on their feelings, but in reality research has shown that speaking openly about suicide decreases the likelihood of the person acting on their feelings.
• It can sometimes be difficult to find the right words to talk about difficult feelings, including suicidal thoughts. Please see this useful resource from the Samaritans through their campaign What Should People Do #WSPD : https://media.samaritans.org/documents/WSPD_Finding_a_way_to_say_it_FINAL.pdf
4. Encourage them to seek medical help
Sometimes people do not seek help for many reasons, including due to a fear of stigma, fear of being admitted to hospital or being started on medication. Let them know that it is okay to receive help from trained professionals and assure them that you will be there to support them on their journey.
5. Offer practical help
There are lots of practical things you can do to support someone who is ready to seek help. For example:
• Ask them if there are any tasks you could help with. This may include supporting with household chores, arranging childcare for them, offering a lift, etc.
• Help to write down lists of questions that the person you’re supporting wants to ask their doctor or nurse.
• Help them to organise paperwork, for example making sure that they have somewhere safe to keep their prescriptions and records of appointments.
• Go to appointments with them, if they want you to – even just being there in the waiting room can help someone feel reassured.
6. Encourage them to continue to take their treatment
It is important that they continue to take medication or any other forms of treatment. Sudden discontinuation of medication sometimes can increase the risk of suicide. If they would like to come off their medication, it is important that they first discuss this with their GP.
7. Discourage illicit drugs or alcohol
People often tend to turn to illicit drugs or alcohol to cope with distress. This is counterproductive as drugs and alcohol often acts to depress mood and worsen suicidal feelings.
8. Intervene if there is a serious risk to someone’s life
If there is an immediate danger to someone’s life, call 999 for an ambulance immediately or go to the nearest accident and emergency department.
Do not leave the person alone, remove any means of suicide available, including potential weapons, medications, alcohol and other drugs and even access to a vehicle. Give as much information as possible to the 999 operator and be as clear as you can when giving your address and telephone number.
Looking after yourself
Supporting someone else who is really struggling with their mental health and having suicidal thoughts can be difficult and emotionally draining. Making sure that you look after your own wellbeing can mean that you have the energy, time and distance to help them.
Below are some things to consider to help look after your own wellbeing:
• Ensure that you eat, drink and sleep well
• Take regular breaks
• Set small goals and celebrate them together
• Continue to do the things that you enjoy
• Talk to someone you trust about how you’re feeling
• Seek help as required. Find someone to talk to, maybe friends, family, GP or professionals
Further Advice
I would encourage you all to watch, Moving America’s Soul on Suicide | The Official Film , a powerful film, a story of hope and inspiration. It shows that “Anyone Can Get Broken”, but also that “Anyone Can Come Back”. It powerfully shows the moments where relationships, compassion and real human connection can save lives.
The national helpline NHS 111 will now respond to mental health crisis, giving people with mental health problems another way to get urgent help. This puts much of the UK ahead of other international health services, offering mental health support alongside that for physical problems. The number connects to a local team of call handlers with mental health training, alongside nurses and clinicians who are available around the clock. It was launched one year after our colleagues in the US introduced the 988 Suicide and Crisis Lifeline. Latest reports reveal there have been nearly 5 million calls, texts and online chat messages answered through 988 in the year since its launch.
