Suicide: Five minutes between now and forever

Suicide may be an uncomfortable topic – but talking about it is very necessary, as it can help prevent tragic, untimely deaths.

“Suicide is complex and there is rarely a single deciding factor; however, depression, anxiety and substance abuse, as well as interpersonal conflicts or a crisis, are often underlying risk factors,” says Megan Gonsalves, Netcare Akeso’s crisis line and marketing manager.

“While some suicides are planned carefully months in advance, many appear to be impulsive and may be acted on within hours or minutes of being conceived. A study by the Harvard School of Public Health found that one in four survivors of almost lethal suicide attempts deliberated for less than five minutes before acting on the impulse, and a mere 13% of those interviewed had thought about suicide for more than a day.

“Other studies suggest almost half of people attempt suicide within just 10 minutes of the thought entering their minds, while Australian research indicates 40% acted on suicidal thoughts within the first five minutes,” she reveals.

“It is deeply disturbing that in a mere five minutes, a person can decide to end their life forever. Netcare Akeso is creating awareness with a campaign, One call – the difference between now and forever, to intervene in these crucial minutes when a person may be contemplating suicide.”

This campaign aims to help suicidal individuals break free from the ‘fog’ in which they may feel trapped and move into a clearer and brighter space where hope can be found beyond the immediate crisis they are experiencing.

“One call to check on a friend, colleague or family member who is going through a difficult time, or placing one call to a mental health resource for help can make the difference between life and death for someone who’s suicidal,” Gonsalves says.

Five steps to help a person at risk

“It can be challenging to know how best to approach someone who may be having suicidal thoughts; however, bear in mind that this conversation needs to be direct to ascertain the risks and to determine what can be done to help the person,” she says.

Five practical steps when you are concerned someone may be at risk:

• Ask: Be direct in asking the person whether they are thinking about suicide or have plans to harm themselves.
• Be there: Listening without judgment is key to understanding more about what the person is thinking and feeling. Remember, this is not an easy conversation for them, either. You don’t need to give advice; just listen and be there for them.
• Help them keep safe: Don’t leave the person alone. Where possible, reduce access to any harmful items or areas where suicide could be attempted. Asking the person if they have a plan can help identify these factors and help keep them safe if suicidal thoughts occur.
• Connect with professional help: There are many resources and suicide helplines that can be contacted, including the Netcare Akeso 24-hour crisis line on 0861 435 787 and the South African Anxiety and Depression Group 24-hour suicide crisis helpline on 0800 567 567. Help guide the person to a safe place for support and, if possible, help them reach out to these resources.
• Follow up: Stay in touch with the person after the crisis or after they have contacted a professional. Ongoing support is important to mental health and well-being.

“Tragically, stigma remains the main barrier to people seeking help when they are at potential risk of developing suicidal ideation. This could be influenced by the taboo many feel when it comes to discussing mental health and a misplaced – though widespread – societal belief that suicide shouldn’t be spoken of. This only perpetuates feelings of shame or failure that stand in the way of people reaching out when they need support and treatment.

“The more people who speak up to encourage suicide prevention strategies and know how to offer support to someone who could be at risk, the greater our chance of dismantling the stigma and reducing the unquantifiable burden of tragedy the suicide rate represents.”

Addressing myths about suicide

Myth 1: Talking about suicide will encourage suicidal attempts

“Talking about suicide can help reduce suicidal ideation. Talking about these difficult topics increases the likelihood of someone seeking help. Having a conversation around suicide can help provide alternative views for someone struggling to see beyond their specific existing circumstances,” says Gonsalves. “Asking someone in crisis if they are thinking about suicide can help open a conversation they otherwise may not know how to begin.”

Myth 2: Suicides happen without warning

“While people do not always share their thoughts, some studies have found that almost 50% of people do tell someone about their suicidal thoughts or behaviours. This is not always obvious or direct, but could be through non-verbal gestures or subtle comments.”

Even if someone doesn’t directly say they may be experiencing suicidal thoughts, there are often warning signs to look out for:

• Talking about suicide – statements such as “I wish I were dead”, “I wish I hadn’t been born”, or preoccupation with death or dying.
• Having access to weapons or means to take their own life, or engaging in risky or self-destructive behaviour.
• Withdrawing from social contact and isolating from others.
• Feeling trapped, hopeless, or helpless about a situation.
• Increased use of alcohol or drugs.
• Giving away belongings or getting their affairs ‘in order’ and saying goodbye to people as though they won’t see them again.
• Personality changes, severe anxiety or agitation.
• Extreme changes in normal routine, such as sleeping patterns.
• Previous history of suicide attempts.
• Experiencing trauma or crisis.

Myth 3: Once a person is intent on suicide, you cannot stop them

“Suicide can be unpredictable, but in many cases, it can be preventable. A person thinking about suicide is often experiencing hopelessness or extreme emotional pain, and helping them address those feelings and seek support can make a lifesaving difference,” Gonsalves says.

Myth 4: People who threaten suicide are seeking attention

“Any threat or talk of suicidality should be taken seriously. Some people open up to those around them about how they are feeling, which can be a way of asking for help. If someone talks about feeling suicidal, it is important to be kind and sensitive, avoid blame or judgement, and ask direct questions to understand the risks. Connecting with professional mental health or medical support should be encouraged and facilitated if necessary.”

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