Today is World Suicide Prevention Day. This is a day to raise awareness and reflect on the causes of suicide and way that services and support is available or not to those who may be considering suicide.
While it is not difficult to approach the notion that suicide prevention is something that should be promoted, it is hard, at least in my mind, to detach this thought from the need for services to be provided – not just in specific mental health sectors but in broader terms because while it is easy to categorise ‘suicide prevention’ as a specific mental health need, there are those who may choose to take action to end their own lives who do not have what might be categorised as mental health problems.
So what would broader suicide prevention services look like? I think there is clearly a case for formal support (but then, I would say that) through supportive and longer term work through mental health systems. We are struggling in the NHS Community Mental Health Teams at the moment. We aren’t equipped to work with anything except the most acute needs due to decreasing funding. Fancy talk about policy pushes towards prevention mean very little in frontline posts away from Whitehall where these documents are drafted.
Waiting lists for talking therapies can be extensive and the choices between types of therapies (and for that matter, particular therapists) can be limited.
While I would argue (again, I would really) that there are practitioners who want to provide good services, it is becoming more difficult in a climate of cuts and those who pretend otherwise in the government are fooling themselves. Support has to allow time and therapeutic relationships to develop in order to understand what is needed and how. Support has to be provided extensively to family members and friends who support and care for those who have mental health needs in order to reinforce informal support networks. Personal budgets can help but only if they are implemented flexibly and with time and care rather than sped through to meet increasingly harshly imposed local authority and central government ‘targets’ and tick boxes.
My work should always be about people as individuals with wholly different needs, wishes, desires and aspirations but it feels as if it is increasingly turning into a ‘tick box’ culture in mental health services. That is wrong and it only serves to remove an element of humanity from a system that so desperately needs it.
Sometimes, indeed, often, it is not about traditional ‘formal’ services as much as promoting more social interaction and quality networking structures which can thrive (and are often better) as peer based groups. We have greater tools now to create different layers of social interactions now – we can build communities on the basis of interests as well as geography through and combat isolation and loneliness. If a shared interest in Dr Who or football or coffee can create communities around them, we are on the cusp of making it easier to find engaging and accepting communities to be a part of.
Perhaps though, with the greater opportunities come greater pressures to ‘find groups’ or to ‘be a certain way’. I am generally an advocate of the positive power of the internet and new communication forms to promote greater support networks and social interaction but there has been a rise in more public bullying and targeting which is the negative side of living life in the open. I think a greater understanding of the role of those who use these new platforms negatively and to gain a greater platform for negative and unpleasant outlets has to be another focus. Why do people ‘troll’? What are the needs of the bully and what are they missing in terms of their social support in order to use negative outlets to target others?
There are many ways we can and should be looking at suicide prevention but while it remains a very important issue in mental health services, it is not an issue exclusively for mental health services.
We can all take a role in being more open, kinder and more understanding of the needs of others – we, collectively, are not able to prevent all suicide – but there has to be a wider awareness of a different paths to take – whether formal or informal routes, they all need shoring up.