Well I’m in Nottingham at the moment delivering a course on Suicide & Self-harm – Razor’s Edge! Coincidentally as I was about to start the group I received an e-mail (see www.dangerousbehaviour.wordpress.com) about the threefold increase in young people contacting ChlidLine feeling suicidal. Obviously this may be a reflection of ChildLine’s success in connecting with some of our most disenfranchised and desperate young people – but you can’t help feeling that things aren’t getting better. Yet all the other statistics tell us that suicide rates are declining across all age groups (only exception being women over 75) in the UK. So what’s going on?

Well, I think the first thing is not to be blinded by figures and to understand what they mean. Probably both Childline and the official statistics are roughly right even though they seem contradictory. Suicide rates are about death rates/fatalities. Feeling suicidal is not the same as being suicidal. So we are looking at two different things.

Blimey! As I’m writing this, in my hotel room, with the TV news in the background – I’m hearing the same thing – that ChildLine (East Midlands) is reporting a “two-fold” increase in young suicidal callers and that four out of five callers are female! Synchronicity! Well the pieces are beginning to fall into place. The suicide rate among young people 15-24 is 5:1 male:female in England and Wales, yet all indicators suggest that young women in this age group attempt rather than complete suicide acts twice as often as young men.

Now clearly people who eventually kill themselves have usually made multiple attempts before they die – so all signs have to be taken seriously. However, at any one moment in time, feeling suicidal is not the same as having decided to die. Youth suicides are exceptionally tragic, but they are not the most at risk groups in the UK. For women the suicide rates go up with age and accelerate in the over 75s – sorry if your a woman reading this, it’s just bad news! For men, there are peaks and troughs – despite the publicly held view that adolescents are most at risk the figures tell us something else – it’s the 25-34 years olds, then if you survive that, the over 85s. Well all that’s a bit debatable – but interestingly women are least likely to die following a suicide attempt between the ages of 15-24, but most likely to make a suicide attempt at that same time. It comes back to what I was trying to say – they are not the same thing.

Obviously, one can and often does lead to the other. One could interpret the Childline figures as hopeful rather than despairing. These young people know where to go with their problems, they have some hope that someone could help them, they have not given up, they realise that their situation is desperate. Obviously if all that is thwarted they could cross from feeling suicidal to being suicidal. This group, however, tend not to call Childline, the Samaritans or anyone else – they feel alienated and hopeless (can’t conceive of anything ever getting better). They may have had multiple run-ins with the mental health system and lost faith with it – they are further down the line.

Well I could go on, but what am I saying? Clearly young people need to be listened to and many are having a real hard time. Things are likely to get worse in the near future as the recession hits leading to fewer prospects and potentially greater parental discord. Childline is clearly an essential service, but don’t let that deflect us from the fact that it is the children who don’t contact Childline that are most at risk, and that there are virtually no services for the adult suicidal population. It’s the tragedy of our times that the suicide death rate doubles that of deaths on the road (RTAs).

And I’m worrying about bricks hitting my car – sorry I haven’t told you about that – but pales into insignificance!

Filed under: Self-Harm, Suicide, helplines, Suicide, suicide rates, young people

Violence or Suicide Training?

Tomorrow, in Southampton, and then on Monday and Tuesday next week in Nottingham I am delivering “Razor’s Edge: Responding to Suicide and Self-harm.” That’s fine – but actually almost 75% of the training I deliver is on Violence.

I’m still in my hotel room so I’ll have to recheck this later, but I am sure that you are far more likely to be killed by yourself than by someone else. Indeed, although I have worked in, and visited some very violent places – actually the more everyday and persistent encounter is suicidal ideation. So you would think that mostly I’d be providing “suicide/self-harm” related training – but that’s not the case.

Suicide is probably (to many) more emotionally evocative than violence and my guess is that most organisations would rather be seen as negligent following an assault on a staff member than for the self-inflicted death of a service-user. Furthermore, in my experience, most people feel far more out of their depth in dealing with suicidal and self-destructive behaviour than they do with violent behaviour.

Well, you could say (this is me answering and refuting my own questions – because I know there is no one out there listening anyway) that this is because I am better known for my work on violence that suicide. This may be truse but if you google a bit, you will realise that there is much more information (I mean of a helpful kind) on suicide than violence, but when you look for training the picture reverses.

I don’t know. My first thought was that organisations believe that “if a person wants to kill themself they will do it” – no blame. But actually in my experience there is a lot more blame all around after a suicide (self, colleagues, family, organisation and even the person who died) – and it persists (you can’t ask the dead person “why”). A team can bond together after a colleague has been attacked, but can fall apart after a suicide – it’s the same with families.

That’s clearly the wrong track. Right now I do still think it has to do with culpability – but in a different way. I think organisations are wary of Suicide Prevention Training for a number of reason – all understandable:

• If you train a care-worker to deal with a suicidal crisis – will that give the message that they are expected and equipped to deal with a suicidal crisis (pay and responsibility implications)?
• If you provide suicide awareness training (for example in schools – best place for it)  what happens if a suicide happens afterwards?  Who will point the finger and who will take the blame? I’m sure if one of my sons killed themselves and I found out that there had been a suicide awareness class the week before, I’d want to point the finger – but the truth may be that many young people kill themselves because they couldn’t talk to anyone. And their best friend didn’t know what to say or do either

Now I was reaching some kind of conclussion, but that would be like suicide. Thankfully with all the interuptions, I lost the thread. May be I’ll return to it, or you can turn this into a debate?

Filed under: Suicide, Training, Violence, risk, Suicide, Training, Violence