The late Jo Cox who is being remembered by the development of the ‘Jo Cox Trust’ to develop strategies to deal with loneliness which is a major cause of suicide
Suicide has been much on my mind lately – not that I am thinking of doing it myself. In a blog last month I shared some thoughts on mental health following the discovery that the daughter of a friend of ours had attempted to take her own life. Fortunately I can now report that the attempt was unsuccessful and that she seems to be recovering well.
By coincidence I have been talking about suicide twice publicly. Last week I was talking about the national ‘Suicide Prevention Strategy’ at the House of Commons Health Select Committee. I met our local MP Luciana Berger there as she sits on the committee and was able to congratulate her on the valuable work she does from the Labour benches on mental health issues. I then spoke yesterday at a major conference which brought together 200+ people from the organisations that most deal with suicide including both its prevention; aftermath where suicide attempts have been unsuccessful and specialist bereavement services where the attempt succeeded.
I was pleased to be able to say at both events that although the development of suicide strategies is a not a mandatory function of councils 95% of upper tier councils have a strategy. Not only do they have a strategy but they are implementing it.
Suicide is a relatively rare event although attempted suicides are much higher. The President of the Royal College of Psychiatry told me that in his professional life he will only deal with 10/12 cases. Many GPs will never deal with a suicide case although they may deal with the aftermath of one. About 6,000 people do take their own lives in any given year. Every one of those deaths, of course, affects dozens more families and friends as they ask, “What did I do wrong?” or “why didn’t I see it coming?”
Research shows that there are a number of starting points for a high proportion of suicides. Loneliness, loss of self-esteem caused by loss of job or other life changes; obesity or other illness being the chief triggers. In this context the idea of a free standing suicide strategy is meaningless. What we do must be part of what we do with the wider needs groups that public health deal with daily. Obesity; sexual illnesses; the unemployed; men; drug users are all ‘constituencies’ where suicide is most likely. In these cases we try and ensure that staff and volunteers are trained to pick up the signs of ‘acuteness’ where there will be a higher propensity to self-harm or take one’s life.
In some ways the more difficult situation is the ‘unexpected suicide’ where people with good jobs; good homes; good families suddenly snap. We cannot train every mum and dad, every brother and sister; every best friend to be able to see the signs. The signs themselves may not be obvious at all even to the trained eye. In these circumstances we must widen awareness of what to look for and where help is available.
The problem is most clearly seen in the biggest constituency of all for suicide – men! 75% of all suicides are of men. It seems that we cannot do the one thing that is most likely to stop us taking our lives and which will help us through any difficulty that we might face in life – talking to someone. Yes that is the most effective defence against suicide; depression and other mental conditions. Talk it over with someone. Men find it very difficult to talk over problems. I know that I do. We are brought up in a culture which values a malemacho, version of strength and find it hard to accept advice and help.
The most important things that a council does to help deal with mental issues are not really health activities at all. If everyone had a decent job; lived in a decent house in a clean, green environment and had a few mates the rates of mental illness and therefore suicide which is the ultimate mental illness would plummet. That’s why I believe that local councils are THE National Health Service and the NHS is really the National Illness Service.
But that is not where society is at now. So we have a full range of services for a variety of needs groups. I was delighted to be able to say yesterday that Liverpool is one of the 90 councils that have a mental health champion. In fact 4 of the 9 councils in the wider City Region and Cheshire have such Champions and as a result of a report from our Directors of Public Health the other 5 are being encouraged to have one as we all review our suicide prevention strategies.
We are also pioneering a new relationship between coroners in the area and public health. Coroners will report suicides to public health directors who will ensure a rapid and follow up visit(s) to families. There are good reasons for doing this. Firstly there is a predilection for those who have been bereaved by suicide to also take their own life. Secondly, they also have a range of specific bereavement and counselling needs to help them develop complex coping strategies.
But there are things we can all do. Is your mate even more reclusive than normal? Are they saying things about life and death that you have not heard before? You can try talking to them and try and get them to seek help either medically or anonymously through the Samaritans or similar organisations.
We can all use the right language. Yesterday I learned that a term, “committing suicide” is actually a term that the bereaved often resent. It’s the language of crime (which suicide used to be). You commit a crime but you take your own life! We need to get mental health issues into the open and discussed more. That is why at the House of Commons I was pleased to mention the pioneering work being done by Mick Coyle at City Talk with his weekly programme about mental health issues.
Most importantly we must all try in our families, networks and communities to make sure that no-one is left along and that everyone has a shoulder to cry. Those who have mental health issues are not from other planets they are from all families and communities. We must all do what we can to talk and listen to those that need us.