A survivor shares how we can help prevent suicide

Allowing people to voice their despair makes space for hope to grow.

Rachael Newham

Rachael is an author and theology of mental health specialist.

yard signs read: Don't give up. You are not alone. You matter.

Yard signs, Salem, Oregon.

Dan Meyers on Unsplash.

Were there signs I missed?

Why couldn’t they stay for me?

Could I have done something?

These and a million other questions fill the minds of those who lose a loved one to suicide - and there are no easy answers.

Suicide evokes a particular loss which can torment those left behind with grief and guilt. With suicide rates reaching a twenty-five-year high, too many people are living with these unanswerable questions.

At the heart of many of these questions is the stigma which still surrounds suicide; it was only eighty years ago that suicide was still a crime and much of the condemnatory thinking remains.

People still believe that suicide is somehow selfish, that it’s the reserve of only those most severely affected by mental illness or that nothing can stop someone from taking their own life if they’re considering it.

The truth is far more complex and, thankfully, far more hopeful because whilst suicide is complex - it can be prevented.

A heartbreaking 1 in 15 people will attempt to take their own life - and most will survive, with trauma, yes but also with the opportunity to build a life that they can bear.

Suicide prevention involves the whole of society. From government, charities, families and friends, it has to begin with shattering the myths that perpetuate the stigma. And, we need to begin by changing the language we use: Suicide is not a crime that is committed so people don’t commit suicide, they die by suicide and by moving away from the language of committing we can begin to accept that suicide is no-one’s fault - it’s a tragedy.

Suicide is not selfish; for many people in the depths of suicidality, they believe that they are relieving their loved ones from a burden, and it can affect anyone - including those with no history of mental ill-health.

Many have believed in the past that once someone has decided to take their own life, there is nothing that can be done to stop them, but suicide is preventable with openness and honesty.

A heartbreaking 1 in 15 people will attempt to take their own life - and most will survive, with trauma, yes but also with the opportunity to build a life that they can bear, but they need help to do so.

We each have a role by reaching out with kindness and creating sanctuaries.

As a teenager, I twice attempted to take my own life and I’ve lived with thoughts of suicide for almost twenty years, but I am still here - in large part due to the kindness of others as they held hope for me when I could not manage it alone.

Perhaps strangely, the place I wanted to be the most in the wake of my attempt was church; it was the place I felt the safest and I wanted to be in a place where I could cry and let out my conflicted and confused feelings to God because I felt there was no-one that could understand what I was going through. I remembered the character of Elijah in the Bible who begged God for death and was met with God encouraging rest, nourishment and the opportunity to pour his heart out. It was what he needed in his darkest hour, and it was what I needed in mine.

We cannot take on the role of mental health professionals - and neither should we - but we can be prepared to hear the hardest words and to listen to someone’s thoughts of suicide because research shows us that allowing people to give voice to their despair makes space for hope to grow.

When people are struggling with thoughts of suicide or trying to navigate the aftermath of a suicide attempt, we each have a role by reaching out with kindness and creating sanctuaries; safe spaces for those who are struggling to express their despair and receive compassion. It might look like dropping around a meal, listening to them pour their heart out, advocating for them with mental health professionals or offering childcare or running errands.

We can all play our part in changing the culture around suicide with language, care and holding hope for those who feel that all hope is lost.

Article

Assisted dying

Comment

29 October 2024

4 min read

Assisted Dying logic makes perfect sense but imposes a dreadful dilemma

The case for assisted dying appeals to choice and autonomy, yet not all choices are good. It means vast numbers of people will face a terrible choice as their life nears its end.

Graham Tomlin

Graham is the Director of the Centre for Cultural Witness and a former Bishop of Kensington.

A black and white picture shows a woman head and shoulders, she is looking up and to the side in an unsure way.

Anastasiya Badun on Unsplash.

Two broad cultural trends have led us to our current debate over assisted suicide.

One is the way consumer choice has come to be seen as the engine of successful economies. Emerging from Adam Smith’s theories of rational choice based on self-interest, given a boost by Reaganomics and Thatcherite thinking in the 1990s, the provision of a range of choice to the consumer is usually argued, with some logic, as key to the growth of western economies and the expansion of freedom.

The other is the notion of individual autonomy. Articulated especially in the past by figures such as John Locke and John Stuart Mill, the idea that individuals should be free to choose to dispose of their property, their time and their talents as they choose, as long as they don’t harm anyone else, has become standard moral fare in the modern world.

Put these two together, and the logic of assisted dying makes perfect sense. What can be wrong with offering someone a choice? Why should the state restrict individual freedom to end your life in the way you might decide to do so?

Yet expanding choice is not always good. Forcing an employee to choose between betraying a colleague or losing their job is not a fair choice. There are some choices that are unfair to impose upon people.

Assisted dying will lead us to this kind of choice. Imagine a woman in her eighties, living in a home which is her main financial asset, and which she hopes to leave to her children when she dies. She contracts Parkinson’s or dementia, which will not kill her for some time, but will severely limit her ability to live independently (and remember about of third of the UK population will need some kind of longer-term care assistance as we get older). At present, her only options are to be cared for by her children, or to sell her house to pay for professional care.

With the assisted suicide bill, a third option comes into play – to end it all early and save the family the hassle - and the money. If the bill passes, numerous elderly people will be faced with an awful dilemma. Do I stay alive, watch the kids’ inheritance disappear in care costs, or land myself on them for years, restricting their freedom by needing to care for me? Or do I call up the man with the tablets to finish it soon? Do I have a moral duty to end it all? At present, that is not a choice any old person has to make. If the bill passes, it will be one faced by numerous elderly, or disabled people across the country.

Even though the idea may have Christian roots, you don’t have to be religious to believe the vulnerable need to be protected.

Of course, supporters of the bill will say that the proposed plan only covers those who will die within six months, suffering from an “inevitably progressive condition which cannot be reversed by treatment.” Yet do we really think it will stay this way? Evidence from most other countries that have taken this route suggests that once the train leaves the station, the journey doesn’t end at the first stop - it usually carries on to the next. And the next. So, in Canada, a bill that initially allowed for something similar was changed within five years to simply requiring the patient to state they lived with an intolerable condition. From this year, there is a proposal on the table that says a doctor’s note saying you have a mental illness is enough. In the same time frame, 1,000 deaths by assisted dying in the first year has become 10,000 within five years, accounting for around 1 in 20 of all deaths in Canada right now. Some MPs in the UK are already arguing for a bill based on ‘unbearable suffering’ as the criterion. Once the train starts, there is no stopping it. The logic of individual choice and personal autonomy leads inexorably in that direction.

Of course, some people face severe pain and distress as they die, and everything within us cries out to relieve their suffering. Yet the question is what kind of society do we want to become? One where we deem some lives worth living and others not? Where we make numerous elderly people feel a burden to their families and feel a responsibility to die? In Oregon, where Assisted Dying is legal, almost half of those who opted for assisted dying cited fear of being a burden as a factor in their decision. Or would we prefer one where the common good is ultimately more important than individual choice, and where to protect the vulnerable, we find other ways to manage end of life pain, putting resources into developing palliative care and supporting families with dependent members – none of which will happen if the option of assisted dying is available.

Even though the idea may have Christian roots, you don’t have to be religious to believe the vulnerable need to be protected. Changing the law might seem a small step. After all, doctors routinely administer higher doses of morphine which alleviate pain and allow a natural death to take its course. Yet that is a humane and compassionate step to take. To confront numerous people, elderly, disabled and sick with a dreadful dilemma is one we should not impose upon them.