Welcome etc. Suicide evokes strong emotions. Almost everybody has experience of it, some have very close experience. I want to acknowledge that. If you have any difficulty during this presentation, take a moment out if you need to. I will be available afterwards if people have private questions as is (name other support people present if possible).
(Don’t leave this slide open while you are setting up) This image came from ‘21 GRAMS’ an art installation by artist Seamus McGuinness in collaboration with the 3T’s, Turning The Tide of Suicide “ 21 Grams” the perceived weight of the human soul was depicted in over 90 suspended white shirt collars. Each shirt weighs 21 grams, symbolising the aftermath of suicide, the reverence of life and living, the life lost, and the void left behind. To find out more contact the 3T’s.
1. General look at some of the facts and myths about suicide in Ireland today. 2. Look at suicide prevention: Ways of helping people not become suicidal in the first place - ways of coping with the mess of life. 3. Suicide intervention: This presentation has a strong focus on this. This is about one-on-one contact with people who may be thinking of suicide. It will include how to recognise signs that some on might be suicidal, what you can do and where you can get further help. 4. Quick look at supports for those bereaved by suicide. 5. Some suggested actions after today.
First we’ll look at Suicide Prevention. This aimed at ensuring people in crisis get the support they need around them and don’t become suicidal.
What do think attitudes are like to mental health in Ireland? Would you agree that in general this is the attitude to mental health including suicide - “I don’t want to hear about it / see it / talk about it”. Would you agree?
Cultural change is needed so that as a society we move from these...
...to these. Change can only happen when the majority of people make that shift. It starts with us, our communities and each of us here. It might be a little scary in practice because it’s a new way of being, different to what most of us have been taught. This is all about positive mental health which helps prevent suicide. So lets look closer at suicide in Ireland now.
Attitudes to Suicide - lets start with YOU. (Allow a moment of silence, time to think, in between each question).
How does the word suicide make you feel? Think about these and silently identify where you are at... (Read bubbles aloud, dispelling each as you go) 1.False - People who die by suicide almost always give warning signs. We’ll look at some of these in a moment. 2.False - Although young males make up about 40% of suicides in Ireland, older people do die by suicide and this number is increasing. Although more men than women die by suicide, many more women than men attempt suicide. 3.False - People contemplating suicide CAN be helped. More about this in a moment. 4.False - Research shows this is not true. Asking someone about suicide allows them to talk about it - it brings relief and lets them know you are open to talking about it. The Samaritans have a policy of asking every caller if they are thinking of suicide. Roughly 25% say yes. Would they ask this if it would make the other 75% suicidal? 5. False - Anybody talking about suicide should be taken seriously. Someone thinking of suicide and talking about it is looking for help. Don’t dismiss that cry for help, even if it sounds like attention-seeking to you.
Emphasise: -In 2009, 527 people died by suicide, an increase of 24% on 2008 and the highest on record. -Although the number of young male deaths is high, about 40% of all suicides, note the high number of male deaths aged over 34. -For every male who dies, it is estimated that between 10-20 females attempt suicide. -In the three months of January, February and March 2010, 104 people took their own lives in Ireland. This compares with 42 from road accidents. Consider how much media coverage road accidents get as opposed to suicide. -Suicide is the biggest cause of death among people under 35 in Ireland. -Statistics only reflect deaths officially recorded as suicide. Some road accidents, drownings and overdoses are likely be suicides also. It is estimated that two funerals due to suicide take place each day in Ireland - thats 730 per year. (Figures from CSO, Gardai & SOSAD. Estimates from Joan Friedman, Chief Executive of Pieta House)
Well research shows people from these groups all frequently die by suicide... (read through them). It seems like a lot of people...
So... Who is at risk of dying by suicide? The real answer is....
If you were to only think in ‘risk’ groups, what could happen? (You could miss a cry for help/sign from someone not in a ‘high risk’ group). For example, if you were to only think of people who are depressed or only young males, you could miss a sign from a older female who appears to be in fine mental health. Suicide is a community issue. Not just for families to deal with by themselves. To impact positively on our suicide figures, Ireland as a community has to act.
Ask each question 1st - 3 questions. Long pause after each one. I’m guessing for some of you, its about as comfortable as sitting in this chair...
... or maybe its closer to this one? There’s quite a difference but thats what we’re talking about. On a personal level, family level, community level, national level and international level we all need to become more comfortable talking about suicide. But each of us can only do our own bit; ‘Be the change you want to see in the world’ (Gandhi)
I’m now going to run through the steps involved in suicide intervention. These steps have been adapted from the ASIST model (explain ASIST - see blog for more details: http://topicsuicide.blogspot.com )
These are signs to look out for that might mean someone is thinking of suicide. Look at how people are coping after stressful events, especially those with feelings of loss. Any life event can be stressful, depending on our reaction to it. It may not seem huge to you but it's how the person themselves feel about it and how it's affecting them that you need to be aware of. For example, a pet dying may not seem that massive to you but it may be devastating to their owner. Likewise, some people cope pretty well with unemployment, but many take it as a huge blow.
Physical signs include...
Thoughts are sometimes expressed verbally. Listen out for....
These images were anonymous contributions to the ‘art from the heart’ section of www.headsup.ie , a youth mental health promotion website. They may or may not be related to suicide. Invitations will often not be verbal and the list of possibilities is endless. The message they are all trying to give you is on the clock face (read it).
Another one (pause a moment)
After recognising the signs, enquire; how are you? Listen. If the answer doesn’t put your mind at ease....
Ask directly. Here’s some examples of how. It is vital you use the word “suicide” or “suicidal”. A direct question is more likely to receive a direct answer. You asking calmly and without judgement will show them that you are someone they can talk to about suicide. Do not ask by saying something like “I hope you’re not thinking of doing something stupid” - This gives me the impression you think its a stupid idea; that’s a judgement. It will not encourage an honest and direct answer.
This approach doesn’t work! Be prepared for a ‘yes’ answer. Try not to react with shock or anger. If you do, catch yourself, apologise and get back to listening without judgement. Try to focus on what they are trying to tell you, not on your reaction. Don’t lecture, judge or reject them. Be quiet and listen. If they say no? You can still help them if they are in bit of turmoil by pointing out resources. Also, they now know you are open to the subject - you are not afraid to discuss things like this.
Here’s a 1 minute clip of how it can be done. This is an excerpt from a Living Works video (from their website), which they use during ASIST training.
Listen to their reasons for wanting to die. Then and only then listen for ambivilence - there is usually a part of them that is unsure, a part of them that wants to live. Re-inforce this when it comes. Just listen and be there.
For the majority of people, just talking about it will have been a huge relief and made the pain they are feeling more bearable. You now need to work together to get further help. Ask the person this question - How long can you keep yourself safe? Help them identify who might help them and agree the steps you will take together. If you cannot physically stay with the person, these steps may include that they call you if they feel they cannot keep themselves safe. Ask if they will agree not to use alcohol or drugs while they are at risk. Alcohol is a factor in more than half of all suicides in Ireland and in 93% of cases where someone under the age of 30 has taken their own life. If you are struggling with figuring out what steps to take, call the Samaritans or 1Life helpline there and then (numbers on next slide) You are not alone - neither of you. Steps could also include talking to a doctor, meeting a counsellor or other support person. Offer to go with them. Stay committed to the plan until you can hand over the primary care role to some one else who can help
These are supports for the person at risk and also for you. You can call the Samaritans or 1Life (suicide prevention helpline set up by 3T’s and Console), they will help you. The person’s doctor is the first port of call in the HSE - he/she can refer you on to other services Counselling - arranged through doctor / privately - call the Irish Association for Counselling and Psychotherapy for details of local counsellors. Some community & voluntary groups offer subsidised counselling e.g. Pieta house in Dublin, Family Resource Centres nationwide etc.
There are very likely support services near you. You will be able to find these by calling the National Office for Suicide Prevention, by asking your doctor or by asking in local community centres.
Have you got fears about asking directly about suicide? Some people are afraid that by asking about suicide, they may be ‘suggesting’ it to someone, putting the idea in their head’. But this has been extensively researched with people who have attempted suicide and it is one thing all the experts agree on. It works. If you ask someone, they say yes and you panic - call the Samaritans there and then. They will talk you through what to do next.
There are support services available nationwide for people bereaved by suicide including counselling and support groups. Contact Console or your local Suicide Prevention Officer to find out about groups in your area. You get their details from www.nosp.ie (National Office for Suicide Prevention) - 01-6352139
If you’ve found this presentation worthwhile, other than taking the steps to be ‘suicide alert’, you may be wondering what else can you do next? How can you learn more? Here’s some suggestions. Personally - take a step towards de-stigmatising mental health issues. Talk about mental health. Practice asking the question - are you thinking of suicide? Let it be known that you are someone who the people around can talk to when they are in turmoil. If anyone here needs personal info - stay back after/ talk to (assigned person where possible)
Suggestion for your community / organisation / college / workplace/ school to become a ‘suicide-safer’ community: Poster & leaflet campaign. Start with National Office for Suicide Prevention / Mental Health Ireland / Seechange.ie Further training - Safe Talk / ASIST / Other. Local research - what local supports are out there? Research and feed back. Invite them in. If you’re involved in a school/ college; could further exploration be worked into any subject e.g. SPHE Refresher courses down the line.
Campaign led by Irish Mental Health Coalition & Amnesty International. This website contains e-mails to send to government to urge them to protect funding and change policy on mental health services (more info on blog).
Attitudes to Suicide How does the word ‘ suicide ’ make you feel? Do any of these attitudes apply to you?
People serious about suicide can’t be helped so what’s the point? People who talk about suicide are just attention -seekers People who die by suicide don’t give warning signs It’s mostly young men who die by suicide Talking about suicide might give someone the idea to do it
Signs / Invitations to talk Stressful events especially with feelings of loss Any major change e.g. school / work etc. Bereavement Unemployment Money worries Move / Any loss of social support End of relationship Including
THOUGHTS “ I won’t be needing these things anymore” “ I can’t do anything right” “ I can’t think straight anymore” “ I can’t take it anymore” “ I wish I was dead” “ Everyone will be better off without me” “ All my problems will end soon” “ No one can help me now” “ Now I know what they were going through”
“ Are you thinking of suicide?” “ Have you been contemplating suicide?” “ Sometimes people who say things like that are thinking of suicide. Are you thinking of suicide?” Be calm and matter-of-fact “ Are you suicidal?” “ I’m worried about you and I need to ask; are you thinking of suicide?” Ask About Suicide
<ul><li>Slide 2: From ‘21 GRAMS’ by Seamus McGuinness / 3Ts Arts Programme taken by David Stephenson http://www.3ts.ie/about.htm </li></ul><ul><li>Slide 4: 3 people chatting by Chris P, Flickr http://www.flickr.com/photos/chr1sp/3585292512/sizes/l/in/photostream/ </li></ul><ul><li>Slide 5: See/Hear/Speak photo - Leo Reynolds, Flickr, http://www.flickr.com/photos/lwr/4975889/ </li></ul><ul><li>Slide 9: http://www.flickr.com/photos/uk_parliament/4748525073/sizes/l/in/photostream/ </li></ul><ul><li>Slide 12: Created in www.wordle.net </li></ul><ul><li>Slide 15: Uncomfortable Chair - Rob Flickenger ‘Hackerfriendly’ Flickr http://www.flickr.com/photos/hackerfriendly/2746453753/ </li></ul><ul><li>Slide 16: Comfortable Chair Katybecks- http://www.flickr.com/photos/katy/3607364712/ </li></ul><ul><li>Slide 17: Close up eyes - http://www.flickr.com/photos/rutthenut/3390529932/sizes/l/in/photostream/ </li></ul><ul><li>Slide 23/24: Images from Art from the Heart, anonymous contributors www.headsup.ie/heart </li></ul>Photo Credits:
<ul><li>Slide 25: Connect 4 - Vasta’s photostream, Flickr, Sameer Vasta, http://www.flickr.com/photos/vasta/167104294/ </li></ul><ul><li>Slide 28: http://www.flickr.com/photos/pigatto/374735869/ </li></ul><ul><li>Slide 30: http://www.flickr.com/photos/billselak/2330291800/sizes/l/in/photostream/ </li></ul><ul><li>Slide 31: Lifebuoy - Jensjeppe Flickr http://www.flickr.com/photos/jensjeppe/2647550534/ </li></ul><ul><li>Slide 33: Google Maps </li></ul><ul><li>Slide 34: Fear - http://www.flickr.com/photos/stumayhew/3747070194/ Stu mayhew, flickr (licenced under creative commons) </li></ul><ul><li>Slide 35: Ian Horner - Hard calll to make http://www.flickr.com/photos/ihorner/3863496221/in/photostream/ </li></ul><ul><li>Slide 36: Woman’s back - http://www.flickr.com/photos/fchouse/2897490267/sizes/l/in/photostream/ </li></ul><ul><li>Slide 37: Same as Slide 4 </li></ul><ul><li>Slide 38: Image from Amnesty International Mental Health Campaign - http://www.amnesty.ie/our-work/mental-health </li></ul><ul><li>All Flickr photos licenced under creative commons </li></ul>Photo Credits: