As we join forces to express our ongoing support on World Suicide Prevention Day on September 10th, we asked three ambassadors of mental health and suicide awareness how they try to help and improve the lives of those touched by suicidality and mental illness through the work that they do in their field of expertise.
According to the World Health Organization, in 2012, suicide was the sole cause of 1.4% of deaths worldwide. Every year, approximately 800 000 will people die by suicide. Up to 25-fold will re-attempt suicide and many more people still, will be affected by it.
As a significant public health issue ‘pushed under the rug’ for so long, what are we doing to decrease these numbers? What can we do? How are we working to better understand the complex biological and socio-psychological elements behind such a global phenomenon? In order to help us target critical questions such as these, CAN-BIND‘s public outreach team asked three individuals to share their thoughts on current research, effective interventions and working to break down the big barrier of stigma.
Yvonne Bergmans, Suicide Intervention Consultant, St. Michael’s Hospital
Q: In your 16 years of establishing and delivering the 20- week Skills for Safer Living (SfSL) program at St.Michael’s Hospital, what impact do you feel this intervention has had on those affected by suicide?
A: For some, it has been the beginning of the journey toward living life more safely, others will say it was ‘life-saving’ and still others will identify that it wasn’t enough to stop the person from thinking of, attempting or dying by suicide.
We repeatedly hear from participants that it is the first place or intervention they have come across where suicide is not a secret, and it is not seen as shameful. Participants also speak of it being a place where they learn they are not alone; that others experience the same shame, stigma, fears, thoughts, feelings and behaviours as they do.
Q: There is still stigma surrounding the topic of suicide. How can we help the community break down this stigma to better understand why a person may be led to suicidal thoughts and behaviours?
A: We need to understand that suicide arises out of great emotional or ‘psychological’ pain. I think that as long as we continue to view it as ‘manipulative’, ‘shameful’, and/or directly attributable to mental illness, the point is being missed, which leads to people who experience suicidal thoughts and behaviours feeling unbelieved, misunderstood and alone.
I have learned most from my clients and the graduates/peer facilitators. They are capable of being the best ambassadors and communicators. They are able to reflect upon and articulate their past experiences and current lives to help the rest of us appreciate the amount of courage, persistence and willpower it takes to consciously choose to live.
I think their voices need to be mandatory in professional training and in also active collaboration with front workers. Sharing their stories and wisdom will help unlock the doors to open conversation between those who suffer with suicidality and those who care about the person who is struggling. The secret of suicidality is a burden no one should have to bear on their own.
Q: What advice would you give an individual, family and/ or friend in a time of crisis when someone they know is at a difficult point in their life and may be considering suicide?
A: Often the person who is feeling at risk can’t articulate what they are feeling, so listen, show compassion and have patience. By trying to understand together, a shared understanding can grow.
If you know someone who has experienced suicidality, plan for the crisis when the iron is cold. Starting conversations with questions like ‘In the event of another episode, how can I be more helpful?’ or ‘What would you like me to do?’ can help provide direction in the crisis moment.
When all else fails and you’re scared, call a care provider and ask for direction or go to your nearest hospital. Be clear about your concerns and how you understand the current crisis the person you care about is experiencing. Know your limits and when you too, need to ask for help. Remember, you can only give from your surplus not your core.
Dr. Sakina Rizvi, Scientist, CAN-BIND-5, Arthur Sommer Rotenberg (ASR) Suicide and Depression Studies Unit, St. Michael’s Hospital
Q: Through the CAN-BIND-5 research study, your team hopes to identify measurable biological characteristics, or ‘biomarkers,’ that will help determine predictors of suicide. How do you think this will influence those suffering from suicidal thoughts and behaviours?
A: We are still trying to understand what can predict suicidal behaviour and how biological and environmental factors interact with each other to contribute to this risk. So a biological marker or ‘biomarker’ has its advantages. It can help us characterize the biology of suicide risk and as a result, this could lead to treatment development that is targeted to that biology.
Furthermore, knowing that suicide risk has a biological basis could help communities be more understanding and empathic. We don’t blame people for getting cancer or Alzheimer’s disease in the same way that we shouldn’t blame someone for being suicidal.
Q: Your research proposes that suicide attempters are characterised by psychological pain that places a burden on brain resources. Can you expand on this hypothesis?
A: We are humans and not robots. As such, we can’t load more memory into our systems and are stuck with the limitations of our brains. If we follow this logic, we only have a certain amount of ‘space’ for tasks like paying attention to things or remembering things.
I propose that psychological pain experienced with suicidality takes up most of the ‘attention space’, so that there isn’t enough room to pay attention to other attention-grabbing things like physical pain or potentially rewarding things (e.g., ice cream on a hot day).
There is some early evidence to support that those at risk for suicide do not feel physical pain as intensely or learn when a reward is present as much as those who are not at risk. As a result, brain capacity for attention, and how we experience physical pain and reward could be a potential biomarker for suicide risk.
Q: What inspired you to partner up with James Ince to showcase the play, The Ties That Bind?
A: We need to change the conversation in psychiatry. As researchers we have the power to do this. James (Ince) is an incredible example of the amazing things that the lived experience community is doing. The stigma is that people suffering from psychiatric illness are not capable people, when this is so far from the truth. At the ASR, we want to focus on function—not dysfunction—and give people with lived experience a platform to share their strong voices.
James Ince, Writer and Performer, Our Souls
Q: What inspired you to create and share The Ties That Bind?
A: Well, it really, REALLY was out of necessity. There was a very deep and very real need, a pain almost, to get this story out. Not that it was particularly ‘painful’ to write, though there were moments.
I really needed to say something about mental illness, also as an artist, I felt the need as well to do something that actually touched people, that said and meant something – something more than an Andrew Lloyd Webber musical.
Q: If you could pick three key messages for the audience to take away from your show, what would they be and why?
A: Well, the first would be to keep the conversation about mental illness and mental health going. How can we help those who need help, and how can we recognize when help is needed when someone is living with a mental illness? I wish that it could get to the point in society when someone asks ‘How are you?’ that we are able to answer openly and without fear; whether the answer is ‘I am really well’ or ‘I haven’t felt this bad in years.’
The second thought to pass along would be to be kind to ourselves, to be gentle and take care of ourselves first. It may sound selfish, but it isn’t. If we don’t or can’t take care of ourselves, it may take a long time for anyone to take notice, and that may well be too late.
The final message I’d like The Ties That Bind to pass along is… Be Yourself. ‘Normal’ is a myth. Besides, normal means common, and there is nothing more boring than that! Your perfection lies in your imperfect uniqueness.
Q:What advice would you give an individual or set of people, to help someone they know who may be at a difficult point in their life?
A: By all means and any means, reach out. Whether you or someone you know is going through a difficult time, do reach out and do not let go! Be gentle, though, with yourself and with those in need.
Talk to someone, a therapist, a friend, a doctor, a social worker or a stranger with a kind ear. For far too long we suffer in silence, whether it be depression, a mental illness, a mood disorder, an undiagnosed darkness or the concern for a loved one. Talk about it. Far too often we wait for too long and then we are left with ‘what ifs’ and the worst pain that no one should have to bear.
“Life can be more than livable, it can be incredible and beautiful. Life has been very dark for me too, but there is light, there is hope; and it’s right here.” – James Ince