Suicidal thoughts do not mean death is inevitable

With the news that Anthony Bourdain, celebrity chef has died today, just three days after the death of designer, Kate Spade, death by suicide has understandably been thrust into news headlines on both sides of the Atlantic, and beyond.

My condolences to their families, friends, colleagues and acquaintances, on their tragic deaths, especially as they navigate mourning in the glare of the media.

Both Antony Bourdain and Kate Space leave extraordinary legacies in their respective professional fields. For them, as with all the 45,000 people who have died by suicide over the last 12 months in the USA, and the 6,000 in the UK, we must all help to ensure that they are defined by the life that they have lived, and are not reduced to the manner of their death.

And yet, it would be irresponsible to not recognise, and take steps to mitigate the fact, that deaths by well-known figures present a very real public health risk as there is documented evidence of contagion effect. After the death of Robin Williams suicides in the USA rose by 10%. We therefore urge the media, health professionals and each and every one of us to make it clear that suicide is not inevitable for anyone.

When high profile suicides happen let’s seize the moment, to open up our minds to each of us having more conversations in our homes, our workplaces and communities about mental health. Talking is the way in which we can help break down taboos which do stop people in need from seeking help when they need it. Speak to everyone and anyone you meet about mental health – you need only watch Lady Gaga and Prince William’s tête-à-tête to realise that you can talk about mental health with the most unlikely of friends:

Share with each other the fact that mental health problems are incredibly common – one in four of us will experience mental ill health at some point in our lives. And mental health does not discriminate – it affects men, women, young, old, rich and poor. You are not weak, a failure, or pathetic if you have a mental health problem.

Talk also about the fact that suicidal ideation is much more common than we think, and dare to admit. It is estimated that for every one death by suicide there are 300 people thinking of suicide. Yes, it is a difficult fact to accept, but if we lock talk of suicidal thoughts away, and shroud it in shame and secrecy, then people become too fearful to share their darkest thoughts, and that’s when suicidal ideation can turn to death by suicide. Talking openly about suicide is NOT more likely to make it happen. On the contrary, all the evidence shows that when we are prepared and brave enough to ‘call out’ suicide and give a name to what people may be thinking, that it reduces their risk of death. The word suicide should not be avoided in favour of one of many unhelpful euphemisms (remember Lord Voldemort, and the sinister power he was given by being called ‘He who must not be named’).

We need to recognise as a society that suicidal thoughts can be a part of people’s lives, and a mechanism to navigate difficult painful times. By doing so people who are thinking of suicide will feel less shame, and feel better able to talk openly about how they are feeling, and turn to family and friends and health professionals for help and support.

Let’s make sure that Anthony Bourdain and Kate Spade’s deaths don’t drive up the number of suicides, but that instead compel each and every one of us to help lives that are threatened by suicidal thoughts.

Finding the words to support someone bereaved by suicide

Few people like to talk about death, and many of us feel awkward around someone who has been bereaved. Alongside our uncertainty over how we should react to a bereavement, is the fact that people bereaved by suicide have significantly less chance of receiving support from friends and family, and there are limited suicide bereavement support services across the country. To help to address this we have recently completed the editing, design and production of ‘Finding the words’, a booklet to support anyone bereaved or affected by suicide. The advice is based on the research of Dr Alexandra Pitman from UCL and it was written by Maxine Roper.

New guidance on bereavement by suicide support services

As part of yesterday Prime Minister’s speech on mental health and suicide prevention, PHE and NSPA have launched new resources developed by us here at Meadows Communications to encourage the development of services for people bereaved by suicide. It is a key ambition of the Government to see that everyone affected by suicide should receive timely and appropriate support and it has been recognised as a key area of action in the national strategy since 2012 but to date support services are very patchy across England and too many people receive no help in the wake of a suicide. To help commissioners provide appropriate local services a Guide to providing local services is now available from Public Health England. We hope that as part of local authority and health services’ wider suicide prevention work that they will provide more and better postvention services.  In addition, NSPA, have launched Developing and delivering local suicide postvention support and Evaluating local suicide postvention support. These resources outline a suggested pathway of support for people affected by suicide and a step-by-step framework for delivery. All three resources were produced by Meadows Communications during 2016 with input from a wide range of valued practitioners.

Health Select Committee report on suicide prevention

We have spent much of 2016 working on producing suicide prevention resources for Public Health England and the NSPA. So it was with interest that we read the House of Commons Health Select Committee interim report on suicide prevention. They have provided a strongly worded conclusion and clear recommendations that more needs to be done. In particular they believe that the forthcoming refreshed suicide prevention strategy must be underpinned by a clear implementation strategy, with strong national leadership, clear accountability, and regular and transparent external scrutiny. We agree that this will provide much needed additional impetus for genuine and comprehensive action.
Interim report on suicide prevention (PDF)

New suicide prevention guidance for local authorities

Today sees the publication of the Public Health England local suicide prevention planning guidance to support local authorities develop and deliver effective suicide prevention interventions. Amy and her team are proud to have led the development of this important guidance over the last six months. The project has involved a comprehensive review of the evidence and extensive consultation with practitioners. It has been shaped with regular input from Public Health England, Department of Health, NSPA, academics and our specially formed Expert Reference Group. A letter from the Secretary of State, Jeremy Hunt is being sent out to every local authority encouraging them to use the guidance. We are grateful to everyone who has contributed to the guidance and we hope that with this support that there will be more local action across England in 2017 and beyond.

Local suicide prevention planning guidance (PDF)

Suicide Bereavement Conference

We were delighted to have been invited to speak in Manchester for the fifth annual national suicide bereavement conference. Speaking with Hamish Elvidge of the Matthew Elvidge Trust, Amy gave the final plenary session of the event, outlining an ambitious vision for a national pathway and framework for bereavement support services. We are currently developing forthcoming Public Health England and NSPA bereavement resources to help people with an interest in developing, delivering and evaluation postvention support services for people affected by suicide.

Help is at Hand

It has been a privilege for Meadows Communications to work closely with Public Health England and National Suicide Prevention Alliance on producing a revised guide for people bereaved by suicide. Amy led a group of people who have been bereaved by suicide in deciding how the guide should offer practical information and emotional support to others affected. We think Public Health England should be commended for handing over control and hope that other government departments will give beneficiaries the same responsibilities when producing future products. Amy launched the guide today at the Manchester Suicide Bereavement Conference and spoke about the issue on BBC Breakfast.

Get Help is at Hand

New Help is at Hand launches today at the Manchester Suicide Bereavement Conference

We’re delighted that Amy has led producing Help is at Hand, a guide offering practical and emotional support for bereaved by suicide. Amy has spent the last six months working with others who been bereaved by suicide, along with experts from Public Health England and the National Suicide Prevention Alliance, to produce a guide with stories, advice and sources of help. The guide launches today at the Manchester Suicide Bereavement Conference and Amy will be giving a speech about the project and bereavement by suicide.

Get Help is at Hand

Further information is available at www.supportaftersuicide.org.uk.

Inside Out

Huge congratulations to If You Care Share for their successful Inside Out campaign. Launched just last year they have really captured the public’ imagination this year with simple but brilliant call to action to wear your clothes inside. By turning your clothes inside out the campaign encourages people to bring what’s on the inside out into the open. Having conversations with people is a fundamental key to survival when you are experiencing suicidal thoughts.

http://www.ifucareshare.co.uk/inside-out-campaign

Male suicide highest for 10 years

Bleak news today that more men are taking their own lives that at any time in last decade. There’s been a 4% rise to 6,233 suicides a year – equating to 19 deaths by suicide for every 100,000 men in 2013 (compared to 15.6 deaths per 100,000 in 1981 to 10.6 per 100,000 in 2007). 78% of all suicides are amongst men and the most vulnerable age group are men aged between 45 and 59, however, the rates have been increasing in all age groups except in the under thirties. It’s critical that more is done to encourage men to seek help early. The full ONS report can be read here.

Zero suicide ambition for NHS

Deputy Prime Minister Nick Clegg has today set out a new ambition for ‘zero suicides’ in the NHS in order to dramatically reduce the number of suicides happening in the health service. Recognising the significant stigma and taboo that surrounds suicide Nick Clegg’s spotlight on the issue is most welcome and we hope that it will bring new interest and commitment in the NHS to tackling this preventable cause of death. We hope other public services, schools, universities and employers will also rise to the challenge so the future quickly brings zero suicide communities across the UK.

We need to talk about it suicide. But we also need to research it.

Robin Williams’ death is a tragedy. He was undoubtedly a comic genius who has brought so much laughter and joy to millions of people around the world in his memorable (and at times immortal) roles. So many of his films and prophetic musings have been powerful way markers for my childhood and early adulthood.

Many health professionals and mental health charities have taken to the airwaves and social media to encourage people who are experiencing depression and have had suicidal thoughts to talk about how they are feeling and seek help.  This is really important advice that I hope people in distress will heed.

Yet, sadly, we have to recognise that sometimes it’s not enough. As it is being widely reported, Robin Williams was talking about how he felt, and he had sought help over many years. It also seems he was surrounded by a loving supportive family, another critical safety net. But he still made the fateful decision to end his own life.

My mum also died by suicide. She talked about how she felt before she died. She went, repeatedly, to see her GP, and just two days before she killed herself she sat talking to her psychiatrist. She had a doting husband, adoring children and a wide circle of caring friends who she shared how she was feeling with. But still she died.

In fact, almost 50% of people who take their own lives in the UK have seen their GP in the preceding month, and many in the fortnight before they die.

That’s why it’s not always easy for me to have confidence that the advice to share your worries and get professional help will be enough.

I don’t believe that suicide is inevitable. It doesn’t have to happen. But to really protect people who are thinking about suicide we have to do more than put the onus on them to talk and seek help. We have a duty to also ensure that those to whom they turn in times of distress are much better at recognising risk and spotting and acting on the danger signs. Every week thousands of people with mental distress go and see their GP, and prescriptions for drugs to effect mood and feelings are rising all the time. It’s understandably therefore a real challenge to spot those 6,000 people who each year take their own life.

For years, stigma and shame have prevented people from talking about deaths by suicide. And that’s stopped us from learning from their deaths – the factors that contributed to the risk, the build up to the day the tormenting demons got their own way, and how those bereaved by suicide think their loved one could have been saved.

Now, fortunately times are changing, thanks to the sterling work of organisations like Time to Change and occasions like the sad death of public figures like Robin Williams, are a chance to debate the issues. So please now let’s galvanise support and interest in suicide prevention.

And for me, that has to include recognition that suicide is a legitimate topic for medical and academic investigation. We have to invest in research that helps to equip us with the knowledge and tools to spot risk, to interpret warning signs, to train professionals and to educate the public. We need research that talks to families about their loss, to the professionals who have held conversations with them, and also to people battling their own suicidal thoughts. Then we need to organise this information and share it. And then use it to help to shape the delivery of effective services and to motivate and educate everyone in society to ensure that we’re all equipped to make a difference when someone does ask for help. From every suicide, each of which is a tragedy, we should be looking for the information that can help us to prevent another death. That’s what I, and every other bereaved family I know, feel is the least we can do for our loved ones.

And that’s why I commit my own time and energy to the Judi Meadows Memorial Fund to raise funds and awareness of the importance of suicide research. To date we have supported the University of Oxford Centre for Suicide Research and the GRiST safety and risk management tool. But we need many more people, clinicians, academics and policy makers to have an interest in, and willingness to, understand suicide to truly stand a chance to help save threatened lives.

We have to take every suicide, each of which is a tragedy, and use it to derive knowledge to help prevent another one.

Brighton strives to become the first suicide safer city

Today is World Suicide Prevention Day, and a broad range of mental health and other well-being organisations unite to use the opportunity to shine the spotlight on suicide and to tackle the stigma that surrounds the issue. I was emboldened and intrigued to read of Brighton and Hove’s ambitions to become the world’s first suicide safer city by September 2015. They report that they are already on their way to delivering their three year plan to significantly improve access to suicide intervention services and suicide bereavement services; train staff in suicide alertness and intervention skills and bring the community together to mark World Suicide Prevention Day. This is laudable as suicide prevention is sadly rarely seen to the public health priority that it should be, given the lives lost and impact on health that suicide has. I’m disappointed that it’s a year since the National Suicide Prevention Strategy was launched by Government, and as yet there has been pitifully little that Public Health Departments across the country have done to seek to embed prevention activity, and support for those bereaved. I will find out more about this inspiring Brighton and Hove vision and hope it inspires others to follow their lead.

Suicide requires sensitive handling

The car manufacturer Hyundai and their advertising company,  Innocean Europe, have made a gross error of judgment in producing an online video commercial featuring a man seeking to take his own life in a Hyundai car.  In an effort to illustrate the car’s environmental credentials of zero emissions, the middle-aged man is shown connecting a hose to the car exhaust. His efforts are prevented as the car emits only water vapour.

The advert has thankfully now been pulled, following the very personal plea of Londoner Holly Brockwell who wrote a devastatingly powerful letter about the profound impact the advert had on her given her father’s suicide using the same method when she was five years old.

Understanding the impact that a commercial can have on its viewers, both desired and inadvertent, must surely be a critical element of the creative process? Advertising companies know, and capitalise on the power they hold. But given this, they need to also exercise the responsibility that comes with it.

Suicide is a valid subject for discussion, and in fact, it is essential that conversations about suicide take place publicly, in order to tackle the surrounding stigma and enable people experiencing suicidal thoughts to feel able to come forward and seek help.

Yet it must be done with caution, as rigorous and extensive research has demonstrated an indisputable link that the inappropriate portrayal of suicide can lead to imitative behaviour. This includes providing details of the mechanisms and procedures used to carry out a suicide given that the descriptions of suicide methods can lead to other deaths that imitate the same method. Hence, the fury of protestors to this advert, as it clearly demonstrates the ‘how’.

We hope this case, played out in the world-wide high stakes arena of corporate reputation management, will demonstrate the urgent need for advertising agencies, and their clients, to follow the lead of newspapers and broadcasters in implementing the suicide media reporting guidelines from the Samaritans and other leading mental health organisations.

 In 2003, Amy was involved in producing the media reporting guidelines for Mind Out for Mental Health, the Department of Health’s campaign to target stigma and discrimination in mental health. This programme was the precussor to the excellent high impact Time to Change programme, in which Amy was also involved producing the brand and undertaking audience insights research. 

Suicide happens. We need to talk about it.

I want to applaud the personal story of Andrea Sutcliffe, Chief Executive at SCIE (Remembering Adrian) for her courage in sharing her story today, the day the Office of National Statistics published the worrying news that suicide numbers increased 8% in 2011 across the UK (and shockingly 30% in Wales).

My mum took her own life in 2009. Like Andrea Sutcliffe though, I refuse to allow this to be our family’s dirty secret. Instead, I believe that in order to positively influence the work of care and support services, that it is vital to be able to talk about suicides such that we can learn lessons and look to improve. It is also absolutely critical that suicide is spoken about more openly in order to challenge public opinions. People need to recognise that suicides do happen. And that they will continue to happen, often in the most tragic and preventable of ways, if people aren’t willing to talk about mental health problems, suicide ideation and even death. So I wish to thank Andrea, and the others who are willing to bring a name and human dimension to the statistics and the word ‘suicide’.

I hope that given these new suicide statistics from the ONS that Clinical Commissioning Boards will seek to prioritise suicide prevention work and help to ensure that the National Suicide Prevention Strategy moves beyond policy. I hope too that the care providers SCIE works with will never underestimate the devasting impact that every suicide has.

The value of a celebrity’s story

This week, comedian, actor and children’s author, David Walliams is the latest celebrity to publish his autobiography and to reveal his long-standing battle with depression. Simon Cowell recently spoke out about feeling unable to cope with juggling the demands of his US and UK show commitments. And since the tragic suicide of Gary Speed the Football Association are encouraging footballers to seek help early, recognising the potentially damaging impact of top-flight competition.

The cynical and uptight are all too quick to dismiss celebrity discussions about emotional well-being as a part of an increasingly tired arsenal to achieve column inches and raise book sales.

But for me, and others I know working in mental health promotion and suicide prevention, we welcome their honest accounts of facing emotional distress. I recognise their lives, laced as they are with the trappings of fame and wealth bear little relation to the lifestyle of ordinary Britons, but as role models (even when earned with dubious measures of talent or success), they can help to shine the light on an issue, that despite affecting 1 in 4 of us, continues all to often to be closeted away.

So today, World Mental Health Day, I renew my call for people from all walks of life to talk about mental health. By talking, listening, sharing, comparing and learning from each other’s experiences we are better equipped to manage our own well-being and improve the lives of others.

Talking openly applies to suicide too. 5,500 people take their own lives in the UK every year. And we need to face up to the fact that suicide happens and talk about it. How else can we possibly hope to help others who may be feeling suicidal if we don’t learn from the suicides of loved ones. Making society face up to suicide is an important step in suicide prevention. And, importantly, the evidence shows that if someone has feelings of wanting to take their own life that, contrary to popular opinion, if you explore those emotions with that person, they are less, not more likely to go through with the act. My mum experienced three episodes of depression, and went on took her own life in 2009.

For us as a family we always talked openly about her illness and since her death about her suicide. In so doing, we have avoided one of the biggest burdens associated with mental health problems, the pressure of having to watch what you say, and hide what you’re doing. Being frank requires strength and confidence that it is the right thing to do. And it requires society to accept the people that do speak out, and not turn away, shun or discriminate against them.

It’s a risk I’m willing to take. My legacy to my mum is to refuse to accept the mantle of public stigma and talk openly in order that it may encourage others to both seek the help they need and learn how to better support others. I hope World Mental Health Day will encourage others to do the same.