This week is suicide prevention week and there’s a lot of discussion and debate about the support appropriate for those in suicidal crisis – how to prevent one killing oneself and, better, how to prevent reaching such a crisis point. However, what often gets missed is the provision available to help those in need – and, indeed, who is deemed suitable to be given that provision which is currently available.
Yesterday, the crisis team manager – who has been very kind to me and tried her best – told me that I am the most suicidal person she’s ever come across. Today, my psychologist parted from me saying she hopes that I’m still here when she’s back from her week off.
So, having had the severity of my ill-health and the extent of the current risk to myself assessed by these two highly trained, experienced professionals in positions of power, what am I left with? An hour with my poor part time care coordinator on Friday and access to a Russian roulette out of hours crisis line. If those at the end of the phone are especially concerned, I might be on the receiving end of a distressing ‘welfare check’ by the police with no additional mental health input. The reason I don’t qualify for more intensive support? Because my illness and crisis are too longstanding and serious- there is neither the capacity nor the knowledge to allow me the help I need to stay alive and to try to enable me to find a safe route out of this pain. My diagnosis closes some doors before certain services will even assess my individual needs. I’m not violent or a risk to anyone but myself, I comply with treatment, I’m quiet and polite, and I show ‘insight’ into my illness and suicidality – so certain measures aren’t taken that might be used to help others. Even when I’m fortunate to have kind, dedicated professionals looking out for me, their hands are tied.
But some don’t get anything.
Some never know that there’s chance to receive support – that’s why we need to raise awareness. But what mustn’t be forgotten is that the overstretched, understaffed, underfunded services that exist for preventing suicide are already beyond bursting point – without an increase in both the volume and remit of such services, raising awareness is no different to trying to prevent pregnancy by teaching the mechanics of conception without contraception or abstinence.
The way I see it, the only way we can effectively work on suicide prevention is to target the beast from all sides:
- Work for much better early identification of mental illness across sectors – primary care, education, social care
- Ensure that there is adequate, specialised provision of suitable treatments available to all upon diagnosis – and certainly prior to crisis
- Ridding the care sector (and society) of the notion that suicidality is attention seeking and/or selfish
- Increasing the availability and resources of more intensive forms of mental health treatment – more staff, wider remits, fewer exclusion criteria, shorter waits, longer treatment periods
- Removal of the notion of being ‘too unwell’ to receive support and treatment – instead expand the resources of current teams, create new teams, improve training, or implement new treatment methods – nobody should be written off as a lost cause and left to take their own life, believing it to be the only remaining option
- Realising that suicidality is about hopelessness and fear of continued pain, not about desiring death – treat the root of the issue, don’t stick a plaster over the ‘crisis’, only for it to rear it’s head again later
- Better training for mental health staff, focussed on empathetic listening, understanding the individual and non-judgemental support – all too often, professionals attempt to write service users’ stories for them, squeeze them into ill-fitting standardised boxes, or place blame where it doesn’t belong – all of which can increase feelings of isolation, invalidation and shame
I’ve lost hope for myself as apparently I’m a particularly complex, troubling and confusing case but I still hold out hope that things can change for others if only research and provision of mental health care is prioritised and increased.
Raising awareness of suicide is admirable and important; making sure that desperately unwell people have access to the support they need to survive is vital and of the utmost urgency.