Stigma: A major barrier to prevention
Stigma surrounding suicide is the theme of this year’s World Suicide Prevention Day taking place on September 10.
And it isn’t simply the fear patients have in approaching healthcare professionals that needs to be tackled – it’s also the apprehension that nurses and GPs have in exploring their patients’ mental wellbeing. They are usually too scared to ask.
“A lot of people don’t seek help, or if they do, they don’t actually say that they are experiencing thoughts of suicide,” says psychiatrist Dr Alys Cole-King.
Dr Cole-King is the founder of Connecting With People, a not-for-profit organisation that provides suicide awareness and prevention training to professionals acrossa range of disciplines.
“For suicide prevention to work you need to change the culture across all sectors. People need to be inspired to personally make a difference in saving a life,” she explains.
Three quarters of people who die by suicide were not in contact with specialist mental health services in the year before their death but many of them were attended hospital and in particular emergency departments or visited their local surgery for other reasons in the days and weeks prior to their death.
“The first step is to remove the fear and secrecy – tackling the stigma,” she says.
People affected by depression and suicidal thoughts find it hard to approach anyone for help. Research has shown that young people especially do not think their local health professionals will be interested. But people will often seek medical help for other problems in the hope that someone will then approach them, however this doesn’t often happen.
“It may be vague symptoms like tiredness, lethargy or unexplained pain. Sometimes the nurse or GP will find it difficult to then ask about the patient’s general wellbeing. They need to break the barriers and ask questions like, how are you coping at the moment? How is this affecting you? How is life generally?” she says.
Noticing the signs of depression and having the courage to investigate them will improve early intervention with those contemplating suicide.
“People need to be aware of the signs and know how to compassionately respond, and if they can’t deal with the problem themselves they need to know where to find people that can. Our mission is to make sure this happens,” says Doctor Cole-King.
Nurses and GPs providing health services are just as fearful of mental health issues as the public, but many lives are saved when healthcare professionals take a risk and reach out.
“There are some fantastic examples of compassionate care, but some of the research also shows us that healthcare professionals don’t always respond as we would wish because of their own fear and stigma. We need to raise the confidence of healthcare professionals,” she explains.
World Suicide Prevention Day is an internationally recognised event that seeks to raise greater awareness of suicidal thoughts and feelings and their consequences.
“For World Suicide Prevention Day we will be collaborating with all sectors to spread the message that the stigma of suicide is often the biggest enemy. We need healthcare professionals to realise it’s not a ‘them and us’ situation. You never know what life will throw at us. Suicidal thoughts are more common than we realize and it’s important to know that we can get through them and where and how to find support” For more information regarding the Connecting with People World Suicide Prevention Day campaign please see http://connectingwithpeople.org/wspd
How you can help
Do not be frightened to ask your patient if they have suicidal thoughts – this is the first step in reducing their risk of dying by suicide.
Suicidal thoughts are far more common than people realise. Stigma stops us talking about suicide but talking about it helps break down stigma.
All suicidal thoughts, however ‘minor’, require a response that needs to be compassionate, proportionate and timely.
Listen to carers - nurses can gain useful and important information from third parties such as family, friends and colleagues in addition to objective evidence - particularly if someone has self-harmed, or has attempted suicide.
Connecting with People have developed a range of practical and compassionate self-help resources with their collaborators on behalf of the Royal College of Psychiatrists - available to anyone in need of advice and support. They promote appropriate self-help and inform people regarding useful strategies, how to create a ‘safety plan’ and how they can access help and support:
- ‘Feeling on the edge helping you get through it’ - for people in distress attending A&E following self harm or with suicidal thoughts
- ‘Feeling overwhelmed and staying safe’ - for anybody struggling to cope when bad things happen in their life
- ‘U Can Cope’ - originally designed to help younger people develop resilience and cope with any current/future difficulties in their life. Just as helpful for adults of all ages
‘U can Cope’ film and all resources available: http://www.connectingwithpeople.org
Follow World Suicide Prevention Day on twitter: @AlysColeKing
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