What do you think on how suicide prevention is handled in the world? What can be done better?
I was inspired to write this after reading this reddit post. It ranted about people who attempt to disuade people from commiting suicide by telling them that they are selfish because of the impact it will have on other people (I do think it is explained better in the post if you are interested).
However I have also been thinking about how suicide prevention is handled by most governments. I am not sure of exactly what process happens in other countries, but in America if you fail a suicide attempt you can be involuntarily put into a mental health asylum for a temporary period of time, and from reading many accounts of what people have experienced in these asylums and from my ongoing experience with suicidal idealation I very much feel i would be 10x more likely to commit suicide if I was put into such a facility once i got out.
But I also wanted to talk about other ways individuals may try to disuade people from suicide which i find problematic. Before i continue, i do want to say that I am not blaming these people, they have very good intentions. But something that has bugged me for a while has been that whenever people discuss suicide/mental health problems the first thing that is done is just recommending suicide hotlines/telling the person in question to seek a therapist/psychologist. While these options can be good for many people, i want to mention that
- Suicide hotlines (mainly 811) are known for reporting people to police and having them put in mental health asylums (often times unnecisarlly). And staff at these suicide hotlines are often uneducated or rude to callers, or will just not answer or even hang up.
- Many people in these circumstances do not have access to trained proffesionals. Even if you live in a country with public healthcare, you may be in a situations (mainly abuse) where you cant get access to one either way.
Anyways sorry for the rambling, my brain is tired and i just wanted to get this out there. But based off of the above points, do you think that suicide prevention in society is flawed, and what could be better? While i do agree that it is flawed and there are ideas related to government on how to handle suicide prevention, i do not know what could be done on the individual level. To me one of my only resources apart from seeing other people experiences online is music (mainly Elliot Smith, Linkin park, Soundgarden and Nirvana) which I deeply relate to. But anhedonia can prevent enjoyment of such things.
Yeah, so the psychiatric care here in the US is pretty bad, but in my opinion it's more a problem of funding then of structure. I've written a bit on this previously here, but it can be productive to think of suicidality as having basically two modes. One, you want to die, you're very depressed or otherwise in dire circumstances, maybe even starting to think about method, but you don't have a specific plan yet. When you're in that mode, which you could maybe call passively suicidal, you can absolutely be reached. Therapy can help, but so can talking through what you're feeling, making an action plan, even just being with a friend. Of course not all of these options are realistic for all people at all times, but the possibility for help, for getting through things without ever actually trying to die, is there. In the second stage, you have a specific plan, the means and intent to carry it out, and you're just so hopeless or in such a spiral that it's not realistically possible to get out of that mindset, build a plan to go on living. So if you're in the first mode, the goal is to get in therapy, get on medication, even just find a purpose or a life philosophy that can help you move out of that headspace. Whereas in the second mode, if you want to prevent suicide, you have to be able to physically stop someone from attempting and at least move them into the first mode.
So here in the US, to be involuntarily hospitalized for suicidal ideation, you have to demonstrate a specific plan to seriously harm yourself and be resistant to attempts to develop an action plan. There are other criteria, depending on the state, but those are the main two. And the goal is to get someone into the hospital, prevent them from attempting (again), get them medicated, get them into the first mode and develop an action plan to help moving forward. In theory, this is kind of what you have to do. Essentially arresting someone (frankly, inpatient psychiatric hospital feels a lot like prison) is maybe the only way to save their life, and the accepted view in society is that life in inherently worth living and so suicide must be prevented (that's not my view, but that's kind of beside the point here).
The devil, as always, is in the details. Okay. So I've been institutionalized twice, in two different states. One stay was voluntary, lasted about a week. I checked myself into the hospital after a suicide attempt. The other was involuntary; I was quite literally taken to the hospital in handcuffs after the police determined during a wellness check that I was about to kill myself (they were correct). Both times, I felt that the stay didn't really help; in the latter case, it actively worsened my suicidal ideation and I probably would have attempted again after being discharged if I hadn't almost died in a blizzard (long, long story).
Here's the biggest problem: money. Inpatient psychiatric facilities are usually quite underfunded and out of date. The first facility I ended up in was actually quite nice; there was a basketball court, a garden, very modern amenities. And yet, it was still noticeably understaffed. To prevent SH and suicide attempts, staff have to be regularly checking in on every patient, which is a pretty big burden in a ward with 20+ people, and when there are like five people there -- one at a desk, the rest juggling therapy sessions and patient meetings and dispensing medications and checking in on everyone and maintaining a pretty strict daily schedule -- they're all pretty rushed. As a patient, it can feel dehumanizing, like you're being treated like a box on a checklist. It's hard to get your concerns heard because everyone is just so busy. And that was at the better funded, better-staffed facility.
At the second one I went to, there were one or two more staff working at a time, but like double the patients (and far worse amenities, older shit, worse food. ugh) I remember literally having one interaction with a nurse during the whole two-week stay that wasn't the routine check-ins or medication dispensing or any of that. I hadn't showered in days (and they do keep track of your personal hygiene; the feeling of being surveilled is pretty oppressive at times) and she saw that and came and actually talked to me, not about the shower but how I was feeling being there, how it had disrupted my routine, etc. And that memory stands out clearly because it was the only time I was there that it felt like someone actually cared; the rest of the time was just a whirlwind of indifference. I could list so many times being in that hospital where I felt very real concerns of mine were ignored or dismissed, or where I felt the palpable disinterest of staff in me, and honestly, I can't even blame them, because they were so fucking short handed all the time. But, like, not always following my dietary restrictions (preventing me from eating a lot of the time, and then chastising me for it (yes, they monitor your food intake)), rooming me, the trans patient, with a capital-n Nazi, not using my preferred name, a psychiatrist getting my paperwork mixed up with someone else's and spending half an hour teaching me coping strategies for illnesses I don't have, these are just pieces of a long list of the failures that were caused by an underfunded system that is forced to churn through patients. Not to mention the days I spent sleeping on the floor of a waiting room before they even let me into the ward, because after they arrested me it was suddenly a problem that I couldn't pay for their subpar treatment.
Sorry, I'm ranting. The point is, I think that inpatient psychiatric facilities are necessary. For people like me, but also for people with serious substance-abuse disorders, who need a lot of help to safely wean off of substances. Even an involuntary hold can be necessary to prevent an attempt (and, if nothing else, these places do take extraordinary measures to prevent self harm and suicide attempts). But they are grossly underfunded and thus underperform for the people who need their services the most. And now my medical debt from a psychiatric stay I didn't consent to is in collections and I have no hope of paying it anytime soon. love that <3.
Okay, but fuck all that though. What can you, as an individual, do to help someone who is struggling? Linking to hotlines can be helpful, yes, but it can also feel deeply impersonal. And I've spent enough time talking to suicide prevention lines where the script really starts to show through and you kind of lose the sense that you're talking to a person who cares (because suicide prevention lifelines are underfunded, and the people who work there are undertrained volunteers, so it wouldn't really be safe to give them discretion about how to engage with callers). Like, don't get me wrong, it can help. Sharing the links and the phone numbers can be invaluable, if the person you're talking too isn't really familiar with them. But that doesn't help much for most people, especially those in the scarier mode, with an active plan. At that point they are frankly probably beyond your help. You can recommend therapy, or checking into a hospital. I had a friend, the one who called the wellness check on me, who called me every couple of days I was in the hospital. It was incredible to know that even at my lowest moment she really cared about me; her attention, even when I was still actively suicidal, did more for me than anyone at the hospital. And most suicidal people can be reached, it's just that what will work is highly specific to the individual and not necessarily something you can provide. So look. Am I saying don't try? Absolutely not. Often, the best thing you can do is just be available emotionally, reach out to friends to start conversations if you notice them struggling (not even about the struggle, just about... life, showing you care), and be kind. But there's no real fix-all for mental illness or suicidality, especially not something that will help random strangers on the internet. And trying to find a solution might alienate them and will probably be deleterious to your own mental health.
I know this is not a good or satisfying answer to your question. I'm really sorry about that, I did my best. It's just, suicide is such a complicated decision, influenced by so many factors (material and psychological alike) that there's no single piece of advice, no word or phrase or strategy, that will work for all or even most suicidal people. And so there's not much that you can do, especially for virtual strangers. Is that disempowering? I guess so. Maybe the best thing you and I can do, apart from being there for friends, reaching out, checking in, being available for strangers online too as much as our mental health will allow... beyond all that, the best thing you can do is be part of a world that is worth living in. Be kind and compassionate, even to people you don't understand. Put positivity into the world. Give what you can, protect yourself and those you love. Join a union? I don't know. But whatever you do, take care of yourself and don't burden yourself with the responsibility of others' mental health.
It's really important to point out that research from the UK shows that safety planning works for people with an active plan.
Interesting, I wasn't aware of that. I couldn't find one specific UK study but I did find this meta-analysis found that safety planning-type interventions (STPIs) led to a >40% decrease in suicidal behavior (i.e. attempts) but no statistically significant change in suicidal ideation. This leads me to believe that STPIs, when they work, do tend to move people from the actively suicidal state to a passive one, although that's just my own speculation. Of course, STPIs don't attempt to reduce suicidal ideation as much as they do prevent suicide by developing coping strategies, suggesting next steps including more structured treatment, and perhaps asking the patient to physically remove dangerous items from around them. I was once asked to give some of my medications to a friend and bring an item I had purchased to facilitate an attempt to my therapist as part of such a plan, for instance.
Do you mean "decrease" here?
yep! thanks for catching that, I can be a bit of a buffoon sometimes
I've actively lived in Stage 1 my entire life and have entered stage 2 a couple of times. Being placed in an underfunded facility that put me in over my head in debt would have been the nail in my coffin.
I go to therapy, I take meds, even switched meds a few times and have a fantastic support system but Stage 1 is just my home I guess.
There is no good answer to this question because I think suicide is a symptom of the current societal structure. There is no support for so many people at every level. As someone that has struggled with ideation before, knows people who went down that hole, and knows people who succeeded, it’s never their fault.
I don’t think an individual really should get involved in any lasting or meaningful way. They need a health professional, as no single person is prepared to handle the level of care required. If I had to give any piece of advice it would be to always be kind to as many people as you possibly can. You have no clue the number of people you bump into on a daily basis that struggle with this. Holding the door, picking up something someone has dropped, complimenting someone’s clothes could all save someone’s life.
On a societal level, we need to combat situations of helplessness as that is where much of this is born from. In the US specifically there are no safety nets, at any given time, you are always a few steps from poverty. We don’t look at mental health as just health and that is part of the problem. In the end, suicide is a symptom of a very very broken system that abuses and abandons millions.
Thanks for pointing this out. And looking at suicide “treatment” it’s always about what must that individual do, “coping” skills, medication, etc. Even when there is clearly a dysfunctional home environment, the focus is always on “treating” the patient. I mean, in many situations, rage or despair are absolutely reasonable responses. At the very we least we need not to gaslight these folks and get them to pretend the problem lies with them.
I’m not sure what the solution is. I’m not sure suicide is not the solution. I think they have suicide stations in Germany. What’s the old adage? Insanity is a rational response in an insane world…
I Sweden, more and more people are put on anxiety medicine and similar every year. Seems like society is wrong and we're just treating the symptoms. I'm not sure how to break the cycle
Universal Basic Income (UBI), robust and obtainable, accessible healthcare, and access to secure, affordable, livable housing options are all suicide prevention measures which would be implemented if we were serious about addressing the origins of hopelessness which inflict so much suffering over people’s lives, but no. No, of course not; instead, let’s figure out a way to prevent people from expressing their clearly abject despair by taking away the means of escape, rather than providing the means to flourish.
Let’s all just bake despondency and self-loathing into the system, whilst also doing our best to trap everyone in it.
A society cannot strip people of their dignity and then profess consternation over so many individuals’ and populations’ desperation to remove themselves from it.
And now I am sitting here, once more seething in impotent rage, staring at this godforsaken wall. Well, back to reading Erich Fromm; his good sense never fails to lift the heart.
Edited to add:
Also, controversial opinion here, but allowing people to openly and freely pursue suicide through well-regulated programs, I believe, in combination with the measures stated above, would do much to alleviate and reduce instances of suicide, overall. Half the reason people die is because they feel they cannot tell anyone exactly how bad their situations have become. So, demonstrating compassion and dignity of choice to such individuals would go a long way in fostering trust to be able to promote people to come forth and speak.
And from there, we could get them to the correct support programs or, if those don’t work for whatever reason, let them die with their heads held high, rather than in darkness and secret agony.
Another edit, because why not:
The current systems we have tend to, in turns, infantilize and demonize people struggling with suicidal thoughts, and our current approach is to take away agency from those who already most lack agency over their own lives. This is ridiculous. One cannot bludgeon suicidal tendencies to death through brute force and belittlement/condescension, nor can one shame such emotions out of existence.
We need a massive overhaul with a goal towards collaboration. Let us collaborate with people suffering to give them the means to reduce their suffering, or to, at the very least, openly acknowledge it.
People don't want to die, they want to kill the suffering. They take their own lives because they don't see any other option. And the fact they may or may not actually have an option is not important, they won't see it. You don't let drunk people make decisions that will harm them, you don't let people with their mental capacity impaired harm themselves.
I agree we are treating the symptoms and are much part of the problem as a society.
This is a prime example of the infantilization of suicidal people, an issue which I briefly touched on in my previous comment. Going off what you’ve said, it would seem you advocate for the rationalizing away of other people’s autonomy based solely on the fact that they want to kill themselves as if the presence of that desire in and of itself must always render or give proof of an individual to be irrational or of poor judgment and limited understanding of the circumstances of their own lives. And frankly, that is a quite prevalent, yet unnecessarily truncated conception of a multifaceted population.
To reject the idea that a person can be clear-headed and meticulous as they reason through and then still proceed to willfully choose suicide from their available options, leads to the question:
Who are you picturing in your mind when we speak about suicide?
And why do you feel so confident that, if given palatable and timely options, they all simply won’t see, *or attempt to pursue, them?
*edited
(What I’m saying here is that it seems as if you are lumping everyone who commits or wants to commit suicide into one neat little pile, but that motivations for suicide vary and that should be taken into account.)
And I was trying to make an argument against infantilization. I get what you're saying, but we got to the point that we are just throwing opinions without any backing in reality.
This is simply not true for a large number of people who die by suicide or who attempt suicide.
While I generally agree that it's less that people desire to die and more to avoid other things, there's nothing about this that inherently means people lose their mental faculties as you compare it to being inebriated.
How is it not important? You're saying it's not important if there are scenarios where someone has no option to escape suffering other than death, and the reason it's not important is because some people would be unable to recognize whether they had options so their viewpoint isn't based in whether the reality of their situation. So what you're saying is even if the reality of their situation was grim, and their perspective of the reality of their situation was grim, it's not because they correctly perceived the reality of their situation, it's because they are mentally maligned to the point where they're capable of perceiving anything whether its based in reality or not. The realities are important whether you perceive the person to be capable of correctly perceiving them is possible or not.
Furthermore, life is not a choice. No one ever got a free choice to begin existing, and from the moment people begin to form thoughts and memories they never actually get a free choice. There's not a single thought you can have that isn't influenced by a bias you cannot control, which is the drive to survive that is ingrained in you beyond what you can consciously override. There is no stronger mental coercion than the survival instinct. You cannot easily reason yourself out of a situation you didn't reason yourself into.
I certainly understand there is a portion, probably a large portion, of people that lose sight of future options because of short term setbacks and that means reduction is helpful towards helping people overcome this. However the more means reduction that occurs, the louder it will get because there are people who aren't part of that possible large portion who actually have a more realistic outlook and rationale for their right to die, and less access to the means to accomplish it safely and peacefully means they have to fight for access. Those restricting access need to be able to acknowledge this rather than infantilize others and actually try to help rather than force people into suffering or dangerous circumstances when there are alternatives. Everyone dies eventually, sometimes sooner, sometimes later, but it always happens, so it's not like you're preventing something that might not otherwise happen. It WILL happen sooner or later, so the only thing you're possibly preventing is what happens between now and later.
I think another large problem can actually come from friends and family influence.
I knew someone who had large bouts of depression all of their childhood, but the family never got them in to see someone. They assumed it was a sign of weakness or something to see a mental health professional or having to take medications to help with depression was somehow seen as being a failure. I’m sure we can all think of someone who thinks this way, it’s pretty common.
Anyways, once this person became an adult and their parents could no longer intervene in their mental health they did end up taking their own life. And it was pretty sad of course.
I think an important step that we can all take is to not disparage people for seeking help, or having to take medications to help balance their emotions. It’s not a character flaw.
Suicide prevention involves a wide range of actions.
You look at reducing access to means and methods. You look at frequently used methods, and you also look at frequently used locations. You focus on high risk groups, but you make sure that your data is accurate, and you also make sure that you're not ignoring everyone else. You then look at common short term antecedents to suicide and see if those are triggers, and if so how they can be reduced or removed or made less harmful. You then look at longer term antecedents and see if those can be reduced. And as you're doing all these you're also trying to make access to support and mental health treatment easier and more meaningful.
Examples of reducing access to means and methods are the UK changing domestic gas supplies from coal gas to natural gas. This reduced deaths by suicide in the UK quite dramatically. (I'm trying to find a link to a talk by Professor Nav Kapur where he talks about this, I'll link it if I find it). I can't find the talk, but here's some research: https://www.cambridge.org/core/journals/bjpsych-bulletin/article/changes-in-risk-factors-for-young-male-suicide-in-newcastle-upon-tyne-19612009/BF8A6466934BF8401CD0379AD7E1F658
Another example might be removing access to high places. Here's an example of a multi storey car park that had the top floor closed to prevent access (Case study 3, page 25). If you're interested in Public Health measures to prevent deaths by suicide in public places this is a good document, although it's very England-centric.
In the UK we have Office for National Statistics that gives us clear and very good quality statistics on suicide, and we have NCISH (previously "national confidential inquiry into suicide and homicide by mental health patients", but they lost the funding for the homicide bit, so now they're "national confidential inquiry into suicide and self harm") who provide excellent research and support. Their annual report is a must read for people involved in suicide prevention in the UK.
That national work gets implemented at a local level by a complicated mix of organisations. Suicide prevention is public health, and so that's the business of Local Authorities. But treatment for people who are suicide is healthcare and so that's the business of the NHS.
Each local authority in England is supposed to have a Suicide Prevention Strategy, and if they don't you can ask your councillors or your local ICS why the heck it hasn't happened. They should also have some kind of forum that members of the public can attend to coproduce local suicide prevention efforts.
NHS Mental Health Trusts in England should also be working towards the "Zero suicide" initiative - eg, here's a collection from the South West of England. (When they say "zero" they mean "zero deaths by inpatients" which is a bit annoying. ) The work happening in hospitals is very strongly around removing ligature points, and also making the ward more therapeutic.
I can speak a lot about the English context of suicide prevention.
Suicidality and loneliness go hand-in-hand. Government sponsored community centers with programs to proactively reach out to high risk populations (the elderly, teenagers, young men, LGBTQ+) might have some effect. Some people just need help to unfuck their lives and don't know how, and can't afford a therapist/life coach/etc. Everybody's situation is different, and you can't accomplish much over a hotline or one-off text chat with a stranger.
Disclosure: I look at it from a professional perspective. If you have suicidal thoughts that are triggered by reading this post, you should reach out to local suicide hotlines, however flawed they may be, or to someone you trust.
Suicidal ideation is something different from ‘not wanting to live’ in my opinion. The latter being a more philosophical discussion about being able to decide when a life lived well should end.
It is a difficult topic because suicidal ideation is not a ‘disease’ and shouldn’t be treated as such. And this is already a statement which conflicts health care professionals of different trades. It makes it difficult to discuss and it means that there isn’t one ‘treatment’ fits all.
Suicidal ideation in a broad sense (thoughts, feelings, planning, actions), could be considered a particular mental state, in which the common factor is the feeling of entrapment; you’ve been trapped in a situation that feels like a tunnel, and there is only one way out. How someone has gotten in this tunnel is relevant, because it gives some pointers for others to help. It’s precisely why opinions differ in this topic, for example about hospitalizations: The topic starter feels like it will hurt their mental state even further, another individual mentions the ‘zero suicide’ campaigns (which involves sometimes a focus on hospitalizations). The one’s suicidal ideation isn’t the same as another one’s.
I will keep the research articles out of this and try to keep it simple and logical. While everyone seems to be scared at the moment that someone ’admits’ suicidal ideation, the options to help aren’t that difficult. Keep in mind that you can’t change the thought content of someone else. Someone else is the one who decides if they get help or end their life (if they don’t reach out to someone else, people wouldn’t have the option to help). More than half of people with completed suicides never saw a mental health professional for their problems. This group is the one that is most interesting for prevention strategies, but difficult to reach.
First, the big one, the distinction between should someone’s suicidal ideation be the responsibility of mental health care or not. It’s why primarily the evaluation of suicidal ideation has been in the hands of psychiatrists and other mental health care professionals. If there’s a psychotic process or clinical depression which fuels the suicidal ideation, this should be treated within a psychiatric care setting. The difficulty in recognizing and diagnosis is probably at least partly the reason for frequent hospitalization of suicidal persons.
The other broad categories could be characterized by either an extreme stress event which would trigger suicidal ideation in someone without prior history (for example seeing your kids drown in the car that you didn’t put in park), or suicidal ideation being an inadequate way to communicate about or deal with difficulties in everyday life. These last two categories don’t respond well to (forced) hospitalizations in mental health care facilities, not in the last place because a hospitalization doesn’t change anything relevant in their situation!
How to prevent suicide in these last two categories? Other than maybe some kind of temporary watchful monitoring outside of the hospital, it’s probably very dependent on the individual, as the cause is more of a societal issue rather than a medical. Ideally prevention takes place with a different stance from society as a whole on what we demand from an individual. Even the goal of zero suicides is in a way a high demand psychologically. The second best thing is that we maybe should try to be kind to each other and to ourselves. For some, therapy might help, but on the other hand I’m unsure if medicalizing this particular problem is the solution. Connection with others, or preventing disconnecting, is an important factor. “But how?” is a key question.
This is a short summary of a very difficult topic. It is no hard science and no assessment method or prevention strategy will be perfect. If you feel like ending your life, please reach out to someone, because in the context of the above, I do not think someone could assess their own mental state adequately in a constructive way, which makes suicide hotlines important in for example lessening the entrapment even a little bit, so that alternative options could become more realistic.
Edit: I thought a lot about wether I should be posting this and if the reader might get something out of this. Who is this for? And it’s just like a page out of a clinical handbook. I’m not too sure if that is really helpful. I might edit this whole comment in the future.
Absolutely one of the best descriptions I've seen, at leaat when describing my experience. I feel like most people's idea of what depression and suicieal ideation are like is just really disconnected from the reality of living with it. Even I didn't recognize a lot of these things in myself at first because the societal image we have of these things is so different from how they manifested in me.
One of the only relatable depictions I've seen of how my flavor of depression felt during these periods is a scene in Bo Burnham's Inside where he attempts to poorly convince the viewer not to kill themselves. That bit at the end where he talks about how he'd kill himself temporarily if he could? That's exactly how I felt whenever I edged into suicidal ideation.
Speaking as an american, suicide here could be reduced by having fewer handguns in the hands of suicidal people. Other methods require planning and preparation. You have to travel to a bridge or cliff, you have to acquire rope and set up a noose, you have to source pills etc. But two minutes of exceptionally dark mood can be enough to allow a handgun owner to complete a suicide. If suicide methods require prep time, then they also provide time for someone to rethink their intended action.
I have read that mostly people have a preferred method, and that if you take that method away they usually will not attempt in another way. This is why removing guns from society can lead to lower suicides. People who would have used a gun generally won’t use pills or hanging instead. Of course, some things can’t be removed from society, but this is why we do things like reduce the number of paracetamol (acetaminophen) you can buy in one go, put barriers on bridges, changed to electric ovens being the norm etc.
As someone who grew up around hunters, I want to distinguish handguns from long guns like rifles and shotguns. It's much trickier to commit suicide with a long gun anyway and it is not as easy for long guns to be fired by extremely young children without warning.
When we were 14 my friends brother, only 16, killed himself with a shotgun. It is certainly not impossible. I agree about accidents being harder though
Oof! I stand corrected. Sorry. It's always so sad.
It's just so quick with a hand gun. So few impediments. The ultimate impulsive act.
Yeah I’ll for sure agree with you there. Very little opportunity to stop and reflect. An instant is all it takes with a handgun. Hunting guns have another use at least, and like you say it’s definitely harder
The goal imo should not be to just reduce the numbers of suicides.
That's similar to china putting suicide nets outside their factory windows, gold star, bravo, the problem is solved. Out of sight, out of mind, I guess.
The goal should be to solve the root cause of what's making people want to kill themselves.
Some people need therapy, medication, etc.
Some people just need the world to be less of a shithole that they don't feel is even worth engaging with.
The right to life must necessarily include the right to end that life if it truly belongs to you.
Speaking from my own subjective experience, suicide prevention depends on providing a suitable answer to the question, “why bother?”
Currently, my answer to that question is “we don’t yet have enough information.” Which is not as posotove as i’d like, but is quite realistic. I interact a lot with a lot of abuse survivors, often extreme childhood and domestic neglect and abuse. A few days when attempting to answer that question together, none of us could come up with any answer, and I have no idea how we survived (and I’m not certain we did, a la Waking Life).
We have lost such little as we had, and were deprived of many basics, and it’s hard to find any reasons for optimism or gratitude. Why bother? It’s a tough sell for many.
I find it interesting that the evidence seems to suggest that means reduction is an effective way to prevent suicide.
Tying their hands doesn't make them any less suicidal, it just keeps their suffering out of your sight.
Sorry I don't mean to suggest that we shouldn't be trying to alleviate people's suffering and tackle the root causes, just that making it harder to access commonly used instruments for suicide can be effective.
Restricting access to means and methods is an internationally recognised part of suicide prevention - recommended by WHO - and it allows time for other support to be provided.
You can help people who are still alive.
You cannot provide support to a corpse.
The world being less of a death spiral where nothing and nobody cares about you as anything other than a disposable part would be nice.
But that's not gonna happen.
I do wonder if the feeling of just being a "cog in the machine" rather than a human being whos full potential is being limited due to oppression and socio-economic class, while seeing the world around you fall apart, can explain a lot of the current mental health crisis. Of course, prescribing people pills and limiting gun access might limit certain things but it doesn't address the root issue, and the mental health industry in general comes across as just trying to make people able to earn their bosses money rather than actually solving their problems.
It's very interesting to me how different people can feel in regards to feeling suicidal/having suicidal ideation.
I think preventing suicide really depends on why someone is feeling this way - is it situational? A tragedy, a stressor? Something in their immediate environment? Is it depression-- or a mental illness? Is it simply due to having an inescapable (terminal) disease? Or perhaps even someone without mental illness that didn't agree to play the game of life and isn't interested? (I don't have better wording)
It's an interesting question, but I think treatment and/or prevention really depends on the reasoning behind the thoughts.