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**Trigger Warning –this blog mentions suicide**
Nicky Lambert
Director of Teaching and Learning and Associate Professor, Department of Mental Health and Social Work, Middlesex University

The 10th of October is World Mental Health Day and the theme for 2019 is  MENTAL HEALTH PROMOTION AND SUICIDE PREVENTION.

It is an opportunity for people to come together to speak out, celebrate awareness, take action and help push good practice forward. The day is organised by the World Federation for Mental Health and this year it’s supported by the World Health Organization (WHO), the International Association for Suicide Prevention and United for Global Mental Health.

‘Suicide is preventable and can therefore be avoided, which is why all of our efforts and public policies should focus on prevention’.

Dr. Alberto Trimboli – President WFMH

The WHO state that more than 800,000 people die by suicide a year globally, it is the main cause of death among people who are fifteen to twenty-nine years old. We also know that the number of suicides rose in the UK last year

  • There are 4,500 suicides each year in England.
  • Around 13 people end their life every day.
  • Men are 3 times more likely to die by suicide than women.
  • Suicide is the leading cause of death in men under 50 and a leading cause of death in young people. 

It’s possible that a recent change in the law reducing the burden of proof needed to register a death as a suicide (rather than accidental death) has impacted the figures, but it is important that we have a clear understanding of the scale of the issue.  Looking at the statistics it is easy to be overwhelmed by the numbers and forget that each instance of death by suicide leaves behind a trail of loss and grief. Two years ago I was one of the many people bereaved by suicide and that pain changed me in a fundamental way – something that 20 years of working as a professional in mental health services hadn’t. I am profoundly grateful for the compassion and support I received from others in the mental health community and I can’t imagine how people cope in the countries where suicide is still illegal or where religious law can leave people who attempt suicide at risk of prison (Mishara & Weisstub, 2016). The stigma of mental distress and suicide still hinders suicide prevention efforts and can discourage people from seeking help. 


We can all take steps to move towards communities which are more mentally healthy  and we work together to make a difference. Speaking up about this issue gives it a higher priority in public health agendas around the world and having public conversations breaks the taboo so that communities can learn to identify risk factors and address them. 


We know that poverty, unemployment, ill-health and trauma, alongside societal ills like inequality, loneliness and discrimination combine together to increase the likelihood of suicide. We know the importance of promoting hope about this issue thanks to work by Prof. Rory O’Conner who notes that feelings of being overwhelmed, trapped or defeated can lead to suicide.

However change is in the air! This year saw the first ever cross government suicide prevention plan which has a focus on how social media and  technology can flag people at risk of suicide. Other parts of the plan include:

  • Local authorities and government developing local suicide prevention plans to ensure that very practical steps are taken to keep people safe. 
  • Ensuring every mental health trust has a zero-suicide ambition plan for mental health inpatients by the end of 2019 and every prison putting actions in place to reduce suicides and self-harm and improve staff awareness and training.
  • More community and therapeutic support for higher risk individuals including middle-aged men, care leavers, veterans or survivors of abuse and bereaved families (because we know that experiencing loss from suicide increases suicide risk). 
  • Improving research on triggers to suicide, such as debt and gambling addiction. 

Research also highlights some types of media coverage – which can glamorise suicide and increase risky behaviour. The Samaritans have a range of resources on this, including comprehensive Media Guidelines for Reporting Suicide which describe how to cover suicide and self-harm more safely.


It can be hard to know what to say when we see another person suffering and thinking about ending their life. It can be shocking and we can feel overwhelmed or frightened of saying the ‘wrong thing’. The most important thing you can do is be non-judgemental and listen. The heart of supportive communication is empathy and listening well – there aren’t any ‘magic’ words to change the situation but SHUSH  – from the Samaritans is a way to remember how to use active listening to support people in distress.

S  – Show you care – Focus on the other person, make eye contact.

H – Have patience – It can take time for someone to be ready to speak, if you are not sure what to do .. just wait for a moment you don’t have to fill the spaces in a conversation with noise.

U Use open questions – An open-ended question might be ‘Tell me more’, don’t just jump in with your own ideas about how the other person may be feeling

S Say it back – Repeating something back can show you’re listening and can check you’ve understood. Remember not to interrupt or try and fix the problem by offering a solution without listening to the emotions and giving the person space.

H – Have courage – Don’t be scared to try and reach out if someone is reluctant to get help you could try: 

‘Have you talked to anyone else about this?’

‘Would you like to get some help?’

‘Would you like me to come with you?’

‘Do you have someone you trust you can go to?’

‘If it helps, you can talk to me any time.’


If you are feeling like ending your life, please call 999 or go to A&E and ask for the contact of the nearest crisis resolution team. 

  • Samaritans offer a 24-hours a day, 7 days a week support service. Call them FREE on 116 123. You can also email jo@samaritans.org.
  • Papyrus is a dedicated service for people up to the age of 35 who are worried about how they are feeling or anyone concerned about a young person. You can call the HOPElineUK number on 0800 068 4141, text 07786 209697 or email pat@papyrus-uk.org.
  • NHS Choices: 24-hour national helpline providing health advice and information. Call them free on 111. 
  • Childline – for children and young people under 19  Call 0800 1111 – the number won’t show up on your phone bill.

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