Every year, on the 10th September, it is World Suicide Prevention Day and it is commemorated each year to raise awareness and commitment to actions to prevent suicide. Sadly 3000 people each day commit suicide. Out of the ten countries with the highest suicide rates South Africa ranks at No. 7.
The most difficult aspect of suicide is the guilt many families feel about not realising how serious the situation was or that their loved one was considering this step. Many families fear that a family member may be suicidal but feel helpless about what to do. So often, in many cultures, suicide is simply not spoken about. Alas, there is no space to educate if you are not allowed to talk about it in the first place. Sadly there is so often no space to grieve either. Suicide can be an endless path of pain.
Why do people commit suicide? The No. 1 reason often cited is depression but the reality is that alcohol and drugs often fuel depression and in turn suicide. The role of alcohol and drugs – especially the extremely toxic drugs available today – cannot be underestimated. This is a whole other subject in itself.
Depressed people have a heightened risk of suicide compared to a non-depressed person. Any family member who is depressed should have access to doctors and professionals. However, many people, particularly in Africa, are depressed and have never been diagnosed and have access to emergency medicine, at best – many certainly don’t have access to the “extras” like mental health care.
Another problem that arises is minimisation of suicidal thoughts. A person will express thoughts of despair and they are told “it’s nothing, get over it”, “just move on”, “you need to man up – life’s tough”. Or the classic: “I had it so much tougher than you, you don’t know how lucky you are!” Minimising shuts the conversation down. Often, these responses are prompted by fear on the other person’s part. They feel uncomfortable.
However, conversely, many young people (and adults) have suicidal thoughts on a daily basis, many people are strangely comforted by these thoughts. They feel “well if it all gets too much there is a way out”. Many people use threats of suicide to manipulate their families. Many people do fake suicide attempts. Its a very confusing place sometimes.
What can we do about all this? The first part to remember is that when anyone expresses any kind of suicidal thoughts or does anything suicidal they must be taken seriously. It does not mean you need to panic but you need to stop what you are doing and start listening and asking “open” questions.
Some examples of open questions are: “tell me more”, “have you felt bad for a while or just recently, I want to hear more”, “can you think of anything that is happening that makes you feel bad”, “are there some particular emotions that you are feeling – can I help you identify them?” Often the urge for suicide is prompted simply because the young person is not being listened to. They literally want to wake up their families – the sad reality is that many of them don’t make it to the other side where they could use more effective techniques.
Another technique is to validate what the person is saying. Saying things like “I am sorry you feel like this, it must be tough to feel like this, please tell me more”. I personally have seen and believe that just spending a moment with another person and giving them your full, unconditional attention can help.
Suicide at it’s heart is the collapsement of the future with the present. Put simply, the person cannot envisage the future at that moment. The tragedy is that this feeling of collapsement does pass – but sometimes the person has already acted with fatal consequences. In this moment the future disappears. That is when we need hope. Even if it is a tiny mustard seed of hope – that needs to happen.
What ways can we add hope? This is all dependent on the situation but it starts with validating the person. Even if they just have the hope that they are worthy can be a start. The easiest way to validate a person is to listen.
If suicide is the collapsement of the future in the perception of that person then we need to train ourselves to watch out for the signs. Things to watch out for can be: stopping pursuing hobbies, giving away prized possessions, stopping studying, losing interest in friends, being alone, not wanting to talk about the future, self-harming, reckless and endangering behaviour, not caring about their body, making comments such as “I’m nothing” or “This world is such a bad place”. None of these are definitive but they can be pointers.
Young people, in particular, don’t envisage the future as clearly as adults. Many suicides are spur of the moment events. Suddenly it seems a good idea. It’s as simple and horrifying as that. Occasionally, young people commit suicide in clusters – it’s quiet incredible. They almost get the idea from others. It’s frightening but being strong enough to talk is crucial in these situations.
I don’t have an answer on the question of suicide. What I have learned in my practice and through many years of volunteering on suicide help lines is that suicide is sometimes an impulse and sometimes carefully thought out. The best prevention seems to be educating people about how to have hope (even tiny drops of hope – hope floats), and also educating ourselves as parents, teachers and members of our community about what to look for.
Community leaders, in particular where it is a taboo subject, need to be brave and open up the conversation. When we bring these subjects into the open they are instantly demystified and lose a lot of their power. Sometimes it’s hard to start these conversations, they can be confronting, bitter, angry, ignorant and defensive at times. If we can stay with the conversation though we can move to places of compassion, understanding and hope. Its from this place that solutions and help start to emerge. Green shoots.
Some helpful numbers:
Lifeline Suicide Line 0861 322 322
South African Depression & Anxiety Group: 0800 567 567
Befrienders South Africa : 039 979 5741
Your pastor, a teacher, a doctor – these are always good places to start but the best start is when communities educate themselves and talk together and persevere.
A shorter version of this article appeared in The Mountain Echo, Southern KZN, South Africa (September ).