No more silent treatment Society is slowly opening up about suicide — a critical way to prevent it from happening By: Jen Zoratti  Posted: 7:00 PM CDT Tuesday, Jun. 19, 2018 Last Modified: 9:39 AM CDT Friday, Jun. 22, 2018 Updates

Opinion

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This article was published 18/06/2018 (2285 days ago), so information in it may no longer be current.

When a celebrity dies by suicide, it can open necessary conversations about suicide and mental health. 

It also often puts into stark relief how misunderstood suicide and mental illness continues to be. 

“There’s still so much stigma around suicide, but I think that’s changing,” says Janet Smith, the manager of counselling services and a suicide prevention co-ordinator at Klinic Community Health in Brandon. 

“I think our society is talking about it more. I’ve noticed that obituaries in the paper are mentioning death by suicide in addition to where people can go for help and support. Those two things need to come together. People need to know they can talk about it, and that there are resources to help themselves or someone they know who might be struggling.”

Raising awareness about the issue is important but, beyond the statistics and social media campaigns, people want to know what to do. Who do you call if you or someone you love is contemplating suicide? What are the risk factors for suicide? How do you best support a loved one who is struggling? What do you say?

Here, we break that down.

WHEN TO BE CONCERNED

Kim Moffat is a counsellor on the Manitoba Suicide Prevention & Support Line, 1-877-435-7170, a toll-free, confidential 24-hour crisis line staffed by trained crisis counsellors from Klinic. She’s also a facilitator with the Suicide Bereavement Support Group in Brandon. (There are also such groups in Winnipeg and Dauphin, and we’ll get to suicide bereavement later.)

She says the risk factors to watch for, in oneself and others, will vary depending on the person. 

“For some people, you notice their moods become flat,” she says. “They might become weepy or crying often. They may say things like, ‘I wish I wasn’t here,’ or ‘I can’t see the point of living anymore,’ or ‘it doesn’t matter anyway.’ Or they might be more direct and say things like, ‘I can’t take this anymore,’ or, ‘I want to die.’”

You may notice an uptick in someone’s drug or alcohol use, or they might engage in risky behaviour.

“Even showing a marked increase in feeling better could be a sign that something is going on,” Moffat adds. “If they’ve been presenting as lethargic and sad and the fog seems to have lifted and they are presenting more joyful, it could be an indicator that they’ve come to a decision about taking their own life.”

“While suicide is so complicated and so unique for each individual who may be at risk, one of the common things we see in everybody across the board is a sense of hopelessness and helplessness that outweighs their sense of hope,” Smith says.

It’s also important to note that depression and other mental illnesses are not the only risk factors for suicide, and not everyone in crisis will make that choice. 

“People can feel helpless and hopeless for a variety of reasons, but I think one of the things we try to do as human beings is look for a simple answer to a very complex question,” Smith says.

“A lot of times, it’s ‘that person is depressed therefore they died by suicide.’ But we know very well that there are many people who live with depression, anxiety and other mental illnesses who have never contemplated suicide.” 

The good news? Suicide can be prevented. And people can and do get better.

“Some of the things that protect individuals from suicide are family support, being able to recognize that they’ve gone through hard things in the past and can go through them again, a sense of belonging and purpose,” Moffat says.

“Knowing when to reach out and who in your support network you can trust. That’s the message we like to give out when people call the line, that you’re not alone and there are lot of people dealing with similar challenges — and the fact they are calling is a hopeful sign in itself, that they’re willing to get some help.”

WHEN TO CALL A SUPPORT LINE

People can call the Manitoba Suicide Prevention & Support Line if they are struggling with suicidal thoughts, are concerned about someone else who might be at risk, or have been experienced a loss.

They will be met by a trained member of the Crisis Counselling Team, who is there to listen and to provide non-judgmental support and guidance. They will not be shocked by what you have to say, largely because they have heard a variation of it before. Remember: you are not alone.

“While suicide is so complicated and so unique for each individual who may be at risk, one of the common things we see in everybody across the board is a sense of hopelessness and helplessness that outweighs their sense of hope.”

Many people have thoughts of suicide, Smith points out. Not as many people act on them. “We normalize that with folks who call us, and then try to assess how serious and prevalent those thoughts are,” Moffat says.

They will ask if someone has a plan, what their timeline is. If someone is at imminent risk, calling 911 or taking the person to an emergency room is recommended. 

The counsellors who work the line understand that different people have different barriers to further care. Some people don’t have a personal support network, while others cannot afford to pay for psychological services, which are not covered by public health insurance.

Klinic offers free, drop-in sessions, and can help connect people to other counsellors who are free or low cost. 

HOW TO SUPPORT SOMEONE ELSE

Helping others who are being hounded by the black dogs of depression or are contemplating suicide can also be tricky to navigate, especially when it comes to finding the right words.

“I think it’s important to let them know that you care and, that while you can’t take away their pain, you’re prepared to walk alongside them,” Moffat says.

“Letting them know they aren’t alone. If someone is disclosing thoughts of suicide or that they’re struggling, tell them that you’re glad they shared that with you. Letting the person know you’re open to hearing their pain can go a long way.”

Here’s what to avoid: “There are a lot of clichés out there,” Moffat says. “Probably not helpful are things like, ‘Things can’t be that bad,’ or, ‘Don’t worry, things have a way of working out.’ Superficial reassurances. Anytime someone is sharing a message of despair, we want to take it seriously.”

“If someone is disclosing thoughts of suicide or that they’re struggling, tell them that you’re glad they shared that with you. Letting the person know you’re open to hearing their pain can go a long way.”

Moffat says asking someone outright if they are feeling suicidal is helpful in determining next steps.

“It might be scary to ask that question, but we need to be brave enough to be direct,” she says. “Saying something like, ‘Sometimes, when people are struggling, their thoughts might turn to suicide. Is this what you’re experiencing?’”

It’s not just what you say, but how you say it. Be kind and frank. Do not act incredulous.

“‘You’re not thinking of suicide, are you?’ is a very different question than, ‘It’s not unusual when people are going through really hard times to have thoughts of suicide, is that something you’re thinking of?’” Smith says.

Supporting someone is not just about talking, however. It’s also about listening, deeply and compassionately. 

And remember: you are acting as someone’s loved one/friend/co-worker. You are not their therapist. Be mindful of your own boundaries and your own mental health.

“As caregivers, we want to help our friends or loved ones, but it’s important to be aware of the impact that is having on you, the caregiver,” Moffat says. “Caring and loving for people who are struggling does take a toll on us.”

She encourages caregivers to tap into their own support systems, and engage in healthy coping strategies.

Smith adds that under certain circumstances, Crisis Counselling Team counsellors will do call-outs to a person who might be at risk of suicide.

HOW TO SURVIVE A LOSS

“We felt and do feel that survivors of suicide loss often are forgotten in the whole suicide-prevention picture — and we know that people who have lost loved ones to suicide are more at risk themselves,” Smith says. “It’s really important they have a place to call.” 

“It might be scary to ask that question, but we need to be brave enough to be direct.”

That’s why the Manitoba Suicide Prevention and Support Line also offers support to those who have lost someone to suicide, and to help them tease apart the complex knot of grief. Moffat says there are feelings unique to suicide grief, specifically guilt and relief.  

“Relief is a feeling that people are often cautious to acknowledge. Sometimes there is a sense of relief, relief that their loved one is no longer struggling or in pain. It’s a hard one to talk about.”

Those who are grieving can call once or more. They are also invited to attend suicide-bereavement support groups offered in Winnipeg, Brandon and Dauphin.

HOW TO TALK ABOUT SUICIDE AS A SOCIETY

“I feel like suicide is being talked about like never before, in lots of really positive ways,” Smith says.

But it’s not always positive. The coverage of high-profile suicide deaths, such as those of Kate Spade and Anthony Bourdain, can inspire copycat suicides. 

“Those of us who work in suicide prevention have been working for a long time with the media and I think they’re getting better at it, about not talking so much about the means by which they took their life, not to memorialize or romanticize that piece of it,” Smith says.

Avoiding “they had everything going for them”-type statements is also critical. 

“How we talk about it is really important,” Moffat agrees, adding that using appropriate language — ‘died by suicide’ versus ‘committed suicide’, for one example — and being sensitive to families who have lost someone are ways to address suicide respectfully.  

But, she adds, it’s also important not to shy away from the issue. 

“There’s an opportunity whenever a high-profile person chooses to end their life to put information out there so that other people can call and get connected.”

For further resources, visit reasontolive.ca

jen.zoratti@freepress.mb.ca Twitter: @JenZoratti