In January 2024, I will have been working with psychotherapy and counselling clients for three years. The majority of clients I have worked with have been challenged by suicide. From thoughts of suicide, known as suicidal ideation, to actively planning a suicide or to having been bereaved by suicide. Although my work is commonly immersed in suicide it is wise to acknowledge that society can still attach a stigma or a taboo to the topic.
Suicide is not commonly spoken of in society even though mental health is being spoken about more openly. This is at odds with the fact that most people in the country have been impacted by suicide, whether in their family, friend group or their community at large. So, how can we talk about suicide in a way that is respectful, compassionate, supportive and informative all at once? The topic is certainly one that can elicit a multitude of thoughts and emotions and deserves respect.
The World Health Organisation (WHO) states suicide is a global public health issue by which 703,000 people die every year, with more than one in every 100 deaths globally in 2019 the result of suicide. Closer to home, in Ireland in 2019, 524 deaths by suicide were reported, fourteen more than in 2018: 408 of those deaths were males and 116 were female. However, figures of reported deaths alone do not paint the picture of how suicide impacts us in Ireland. As an example, in 2019, Pieta delivered more than 50,000 client sessions across their nationwide network of support. These figures show that there are many more people thinking about suicide than people who take ideation into action and end their life.
Therefore, if suicide is such a common mental health challenge in Ireland, I can’t help but wonder, why don’t we talk about this? It is prudent to recognise that there are a few reasons why. Anyone who has lost someone to suicide will know how painful it is; it can result in unanswered questions and can leave a person feeling guilty – not light feelings or topics that we might share when going to the shop for a pint of milk! Furthermore, suicide can still hold a sense of shame or being wrong, some might even think of it as a crime. Suicide was decriminalised only 30 years ago in Ireland in 1993. The use of language such as “committed suicide”, although still used by some, can be stigmatising and implies the act is a crime. Outside of Ireland, there are at least 20 countries in the world where suicide is considered a crime punishable by law, which leads me to wonder who can be punished when a person has ended their life? Wouldn’t compassion, prevention and conversation be more appropriate?
It is also helpful to understand what leads to suicide. What is it that might make a person thinking of suicide, which is quite common, end their life? This is harder to define, as there are many reasons and experiences that could lead a person to suicide. What can be defined is that it has been found time and time again that a person wanting to end their life does not want to die. Rather, they can no longer cope with the immense mental anguish and pain they are experiencing in which no longer living seems like the permanent solution to ending that pain. More often than not, mental health challenges or common life stressors can become unmanageable to the point when a person loses touch with their ability to reach out for support leading to a constricted view of their world and their future.
This can happen over time or in a moment. It could be the loss of a loved one, financial strain, depression, relationship issues, addiction, losing a job, experiencing trauma, changes in health, overwhelming anxiety or another significant life change, to name a few reasons, but this list is not exhaustive. It is noteworthy for our West Cork community that research in 2016 found living in more rural areas of Ireland can increase the likelihood of suicide due to experiencing isolation.
In 2022, research by academics from Maynooth University, National College of Ireland, and Trinity College Dublin found that 42 per cent of Irish adults have a mental health challenge and more than one in 10 have attempted suicide. This paints the picture of how addressing mental health in general can support suicide prevention. Research has proven that the main way to prevent suicide is to talk about it. Talking to friends, partners, family and whoever might listen sounds simple but can be quite a challenge for the person thinking of ending their life due to the perceived shame and stigma and lack of hope they experience.
So what can we do about this? Charity fundraisers, mental health week and suicide prevention days are all steps in the right direction. Yet, in our own communities we can all also take individual actions to foster change. The most helpful thing any person might do if feeling concerned about someone is to ask directly “are you thinking of suicide and ending your life?”. It has been proven that this question can be more than enough to support someone feeling suicidal. Communicating acceptance, compassion, understanding and connecting to the person from a place of concern can make all the difference. Asking this can save a life.
The next step would be to support that person in seeking further help whether it be ringing a helpline, visiting a doctor or seeking out a psychotherapist and counsellor. Lastly, if the person feels like they cannot keep themselves safe, then ringing emergency services is always the best option. It is important to remember also that we can be responsible ‘to’ a person but not ‘for’ a person and if someone wants to end their life they can do so without warning. The ability to predict suicide is no better than chance, no more accurate than the toss of a coin; this can be one of the hardest truths to accept about suicide.
With that said, it must be recognised that this topic is a difficult one and can be painful to acknowledge. It does take compassion, understanding and intention to talk about suicide yet it can only lead to better conversations and hopefully lives saved. If, after reading this, you feel that you need support, please do take care of yourself and reach out to someone close to you, to a helpline or to a mental health professional. I hope that this information can be useful for you and, with courage, we can all contribute to destigmatising and talking more openly about suicide. As the stoic Roman philosopher Seneca said, “Sometimes even to live is an act of courage”.
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