Archive-name: suicide-aus-faq Version: $Revision: 1.2 $ Posting-Frequency: monthly [ Contributions and feedback on this article are more than welcome. ] Suicide is the most common external cause of death in Australia, claiming 2294 lives in 1992[1]. For young people aged 15 to 24, suicide is the second most common of all causes of death, exceeded only by motor vehicle accidents. Estimates of unsuccessful suicide attempts vary from 20 to 100 times as many; in even the most conservative estimates, around 40,000 Australians attempt suicide annually. About four times as many men successfully complete suicide each year as women. By comparison, Motor vehicle accidents claimed 2066 Australian lives in 1992. Our society spends literally billions of dollars on safer roads, but very little on suicide awareness and prevention. Over the past decade, the rate of motor vehicle accident deaths has reduced, while the suicide rate has continued to increase, from 1726 deaths in 1983. Here are a number of frequently asked questions to help raise awareness and dispel some of the common myths about suicide: 1. Why do people attempt suicide? People usually attempt suicide to block unbearable emotional pain, which is caused by a wide variety of problems. It is often a cry for help. A person attempting suicide is often so distressed that they are unable to see that they have other options: we can help prevent a tragedy by endeavouring to understand how they feel and helping them to see that there are other choices they could make. Suicidal people often feel terribly isolated; because of their distress, they may not think of anyone they can turn to, furthering this isolation. 2. But isn't it illegal? Doesn't that stop people? Suicide is not illegal in Australia, but in the vast majority of cases a suicide attemptor would choose differently if they were not in great distress and were able to evaluate their options objectively. The majority of suicidal people give warning signs in the hope that they will be rescued, because they are intent on stopping their emotional pain, not on dying. 3. If it's not illegal, aren't people free to kill themselves if they want to? What about their rights? Helping people to deal with their problems better, see their options more clearly, make better choices for themselves and avoid choices that they would regret empowers people with their rights; it does not take their rights away. Ultimately, it is the person's own responsibility what they choose to do. 4. Aren't all suicidal people crazy? No, being suicidal does not imply that you are crazy. Acutely distressed perhaps, but not crazy. As Appleby and Condonis[2] write: The majority of individuals who commit suicide do not have a diag- nosable mental illness. They are people just like you and I who at a particular time are feeling isolated, desperately unhappy and alone. Suicidal thoughts and actions may be the result of life's stresses and losses that the individual feels they just can't cope with. The idea that suicide is usually due to mental illness is a myth which unfortunately tends to perpetuate the problem: as if the suicide attemptor didn't have enough pain in their lives, they are now lumbered with the stigma of the label "mentally ill" to boot. Whilst it is true that people with a mental illness, particularly schizophrenia, have much higher suicide rates, they are still in the minority of attemptors. 5. Doesn't talking about suicide encourage it? No, talking about the feelings surrounding suicide promotes understanding and can greatly reduce the immediate distress of a suicidal person. In particular, it is OK to ask someone if they are feeling suicidal, if you suspect that they are not coping. If they are feeling suicidal, it can come as a great relief to see that someone else has some idea how they feel. Talking exclusively about how to commit suicide can give ideas to people who feel suicidal, but haven't thought about how they'd do it yet. Media reports that concentrate solely on the method used and ignore the emotional backdrop behind it can tend to encourage copycat suicides. 6. How would I know if someone I care about was contemplating suicide? Often suicidal people will give warning signs, consciously or unconsciously, indicating that they need help and often in the hope that they will be rescued. These usually occur in clusters, so often several warning signs will be apparent. The presence of one or more warning signs is not meant to guarantee that the person is suicidal: the only way to know for sure is to ask them. Typical warning signs which are often exhibited by people who are feeling suicidal include: - Withdrawing from friends and family. - Depression[3]: - Loss of interest in usual activities. - Showing signs of sadness, hopelessness, irritability. - Changes in appetite, weight, behavior, level of activity or sleep patterns. - Loss of energy. - Making negative comments about self. - Recurring suicidal thoughts or fantasies. - Sudden change from extreme depression to being `at peace' (may indicate that they have decided to attempt suicide). - Talking, Writing or Hinting about suicide. - Previous attempts. - Feelings of hopelessness and helplessness. - Giving away possessions. This list is not definitive: some people may show no signs yet still feel suicidal, others may show many signs yet be coping OK; the only way to know for sure is to ask. Nor is it a list of risk factors which lead to suicide: it is intended to help people identify others who may be in need of love, help and support. 7. I'm a bit uncomfortable about the topic; can't it just go away? Suicide has traditionally been a taboo topic in our society, which has led to further alienation and only made the problem worse. Even after their deaths, suicide victims have often been alienated by not being buried near other people in the cemetery, as though they had committed some utterly unforgivable sin. We could go a long way to reducing our suicide rate by accepting people as they are, removing the social taboo on talking about feeling suicidal, and telling people that it _is_ OK to feel so bad that you'd think about suicide. A person simply talking about how they feel greatly reduces their distress; they also begin to see other options, and are much less likely to attempt suicide. 8. So what can I do about it? There usually are people to whom a suicidal person can turn for help; if you ever know someone is feeling suicidal, or feel suicidal yourself, seek out people who could help, and keep seeking until you find someone who will listen. Once again, the only way to know for sure if someone is feeling suicidal is to ask them. If you really don't know where to turn, chances are there are a number of 24 Hour telephone counselling services in your area that you can call; if you can't get through on one, keep trying several until you do. Many people that feel suicidal don't realise that help can be so close, or don't think to call at the time. You don't have to be in a crisis before you call either, and they can also be of help if you're concerned about someone else who may feel suicidal or isn't coping well. In Australia, check the Community Health & Welfare page in the front of the phone book. Lifeline now has a national number (131114) for the cost of a local call anywhere in Australia; but remember, if for some reason you can't get on, don't give up: keep trying. Suicidal people, like all of us, need love, understanding and care. People usually don't ask "are you feeling so bad that you're thinking about suicide?" directly. Locking themselves away increases the isolation they feel and the risk of suicide. Asking if they are feeling suicidal has the effect of giving them permission to feel the way they do, which reduces their isolation; if they are feeling suicidal, they may see that someone else is beginning to understand how they feel. If someone you know tells you that they feel suicidal, above all, listen to them. Then listen some more. Try to make yourself available to hear about how they feel, and try to form a "no-suicide contract": ask them to promise you that they won't suicide, and that if they feel that they want to hurt themselves again, they won't do anything until they can contact you. Take them seriously, and refer them to someone equipped to help them most effectively, such as a Counsellor, Psychologist, Minister, etc etc. Get yourself some support, as you try to get support for them; that Community Health & Welfare page in the phone book also makes a useful list of resources you can access. Don't try to "rescue" them or to take their responsibilities on board yourself, or be a hero and try to handle the situation on your own. You can be the most help by referring them to someone equipped to offer them the help they need, while you continue to support them and remember that what happens is ultimately their responsibility. 9. Talk, talk, talk. It's all just talk. How's that going to help? While it's not a long-term solution in itself, asking a person and having them talk about how they feel greatly reduces their feelings of isolation and distress, which in turn significantly reduces the immediate risk of suicide. People that do care may be reluctant to be direct in talking about suicide because it's something of a taboo subject. In the medium and longer term, it's important to seek help to resolve the problems as soon as possible; be they emotional or psychological. Previous attemptors are more likely to attempt suicide again, so it's very important to get unresolved issues sorted out with professional help or counselling as necessary. 10. Help? Counselling? But isn't counselling just a waste of time? Certainly it is true that counselling is not a magic cure-all. It will be effective only if it empowers a person to build the sort of relationships they need for long-term support. It is not a "solution" in itself, but it can be a vital, effective and helpful step along the way. 11. I know I'm not at risk. Am I? It's quite likely that some people that read this will one day attempt suicide, so here's a quick suicide prevention exercise: think of a list of 5 people that you might talk to if you had nowhere to turn, in order. Form a "no-suicide contract" with yourself so that if you ever felt suicidal, you'd go to each person on the list in turn and simply tell them how you feel; and that if someone didn't listen, you'd just keep going until you found someone that would. Many suicide attemptors can't see anywhere to turn to at the time, so having thought beforehand of a few people to approach would help. 12. Finally, what about survivors? Suicide is often extremely traumatic for the friends and family members that remain. In addition to the feelings of grief normally associated with a person's death, there may be guilt, anger, resentment, remorse, confusion and great distress over unresolved issues. Anyone burdened with unresolved feelings and issues because someone they were close to has suicided should seek some form of counselling or other appropriate help to ease the burden and help resolve their feelings. The stigma surrounding suicide can make it extremely difficult for survivors to deal with their grief and can cause them also to feel terribly isolated. Footnotes: 1. From "Causes of Death, Australia", Australian Bureau of Statistics, 1992. Cat. No. 3303.0 2. "Hearing the cry: Suicide Prevention", Appleby and Condonis, 1990. ISBN 0-646-02395-0 3. Not usually or necessarily clinical depression, which is a diagnosable mental illness; however, people suffering clinical depression are more likely to attempt suicide than the general population. This article is Copyright 1994 by Graham Stoney, but may be freely redistributed so long as this copyright message remains intact.