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When was the last time you really talked about suicide?

Posted by:

18 August, 2014

If anyone ever needed irrefutable evidence that depression doesn’t discriminate, the death of Robin Williams is surely it.

When the news broke last week, you couldn’t move on twitter for people offering their condolences and the hashtag #depression littered every other tweet. Depression stopped being a hidden illness to be swept under the carpet and became something peoplecould feel confident talking about.

But this hasn’t always been the case. The word “depression” in itself is not a scary word- how many times have you heard someone, or even said yourself, “Oh I’m so depressed!” when what you really mean is “I’m disappointed that I forgot Tesco closes at 4pm on a Sunday”?

Depression has become an everyday word. Pre-fix it with the word “clinical”, however, or add suicide into the equation and you’ve got a whole different story.

I’m a registered mental health nurse and volunteer on a mental health helpline. At least once a week I ask a stranger “When you say you ‘feel like ending it’, do you mean suicide?” And yet, on a personal level it feels uncouth saying the ‘S’-word out loud.

In fact most people I know would be surprised to hear that my life was changed by suicide when I was 18. Just writing that sentence makes me feel like I’ve over-shared, I’ve been back over it again and again, trying to somehow make it more comfortable to write – and more comfortable for you to read.

Yet, if I told you I’d lost someone from cancer, would that be more palatable?

In our open society, with all the doors social media has opened and every topic under the sun being blogged about on a daily basis, suicide remains one of the last taboos. A subject that feels uncomfortable to bring up.

But open discussion is important. It makes it ok for people to ask for help, to express how they’re feeling and recognise that others feel the same.

By openly talking about his illness, Robin Williams has helped us take a huge step towards changing how society views depression and suicide. Even, perhaps, towards depression being recognised for the debilitating, involuntary, and sometimes terminal, illness that it is.

Readers' comments (6)

  • I worked for several years in a CAMHS overdose assessment team, so talking about suicide was the bulk of what I did.

    This service was closed down for non-clinical reasons (management politics, commissioners thinking we were too expensive).

    In my next job I was involved in preparing a multi-agency care pathway around adolescent self-harm and devising related training. I had to do much of this "under the radar", fiddling my diary to create time, as my manager (not a mental health nurse, nor indeed anything MH, by background) didn't think it was good use of my time nor that of anyone else in the service. The care pathway won awards, as did the training package, which is still in use today.

    Draw your own conclusions about how important services directed at the suicidal were seen as by our management and their paymasters...

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  • Whilst yes, I have talked about suicide to people, both as a nurse, and as a volunteer, I have also seen the fear engendered in fellow (not just less-experienced) nurses when the word is mentioned - fleeing from the patient rather than engaging.

    Having subsequently been suicidal myself, the response from services has been frighteningly bad (apart from the police who seem the most compassionate of the emergency services, certainly locally, even if their hands sometimes tied over what they can do).
    If the distress leading you to be suicidal is not deemed to be due to a mental illness, but psychosocial/situational issues mental health services aren't interested. Is that distress somehow less real, less valid, or less indicative of unmet need?!

    Even 2 suicide attempts (both requiring hospitalisation) and 6 adult concern reports from police apparently don't make a person deemed 'at risk' by social services. Maybe a 'fatal accident inquiry' will?

    There is a 3rd sector 24/7 service in my area, but it is increasingly struggling to keep up with demand.

    Meanwhile, the 2 staff previously responsible for organising all/providing some of the suicide awareness training in the region have left and not been replaced, train-the-trainers funding is apparently no longer available (but I know of at least 3 trainers who have retired so situation is going to become increasingly unsustainable) etc etc.

    So yes, despite rhetoric/official policy, it isn't prioritised/seen as important - well, maybe it will when the statistics start going up again (shutting the stable door etc etc).

    Having said all that, I know v senior people in the area who would love to be providing more, but they're being told to cut funding.

    Suicide prevention week is coming up in September. Please let people take notice.

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  • many mental health staff, both medical and nursing, simply do not wish to get involved with patients expressing suicide ideation which is sometimes met with punishment or telling them it is their problem, or that if they make an attempt there is nothing they can do to stop them. Maybe these staff are on secondment to psychiatric services as part of their training and really do not wish to be there. It is very hard when in despair to meet with such reactions and nobody else to turn to for help other than organisations run by lay members of the public without any mental health/psychiatric training which, although not always needed often is for more complex underlying problems. It is also difficult speaking to these people as they usually have other incoming calls or in hospitals other more urgent cases awaiting them which means a patient may have to break off in the middle of relating their story and can be made to feel insignificant and another has a greater or more urgent need. As with everything now in this life and all services whether public or private and at a cost, demand outstrips supply and those on the front line often do not have the authority to direct their own work or use their own discretion and initiative to meet the needs of their patients/clients, etc. leaving the other very frustrated or down and desperate. Anger may arise which can be confronted with raising barriers, the 'them and us' syndrome or even 'zero tolerance' which whilst staff need to protect themselves against potential aggression, this is very often not the case and simply escalates the situation perpetuating a situation of increasing frustration and anger, etc.

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  • Anonymous | 21-Aug-2014 10:14 pm

    Sadly what you say is often true: in my last job (community CAMHS) I tended to be the "go to guy" for self-harming and/or suicidal patients, as it was the area of the job I liked (if that is the right word) most, while many colleagues, nursing, medical, OT, would run the proverbial mile from this sort of work.

    When I did over-dose assessment we often described a large part of our job as being an anxiety sponge for MAU and paediatric ward staff, as we took away all that side of the decision-making from them and they knew that Little Johnny or Little Joanne would be seen and assessed promptly.

    I have never been quite sure why people feel this way. The over-dose assessment job was the best job I had in 30 years in MH nursing.

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  • Having recently had a daughter with severe clinical depression during pregnancy and the post natal period I am in a unique place to understand how complete and overwhelming clinical depression can be. Watching how she suffered and how this highly intelligent young woman felt life was not worth living, when she had so much to look forward to, was horrific. Watching how it affected her husband and other two children was somehow even worse. It is a terrible thing to admit, but I thought many times it would have been so much 'better' for everyone if she had been diagnosed with cancer. The NHS must wake up and realise that depression is a terrible disease that requires many more resources made available to be able to cope adequately and help patients to recover and re-join life.

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  • Further indication of how seriously the powers that be take these issues:

    http://www.theguardian.com/society/2014/aug/27/self-harm-suicide-mental-health-patients-nhs-rises-56-per-cent

    One of the trusts with the highest rise is my old employer, who I know was hacking nursing budgets to ribbons...

    Safe in whose hands?

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