Will we see increased suicide rates during this recession?
There’s no doubt about it, we’re in a global economic recession. And historically, increased suicide rates have been observed following a depression. Dr Adrian James, Royal College of Psychiatrists, 2020 said: “Recessions are terrible news for the nation’s mental health. Debt, unemployment and poverty are linked to higher rates of anxiety disorders, alcohol use, depression, and even suicide.
Trigger Warning: Talk of Suicide
The looming economic crisis will widen existing health and social inequalities and worsen the mental health problems they bring. Those already unemployed, young people, single-parent families Black, Asian and minority ethnic communities will be hit the hardest.”
Death by suicide cuts across all ages, and can run through generations in some families. My lovely blogging pal, Nathan at My Brain’s not Broken posted this informative and insightful article Suicide Prevention Awareness Month 2020 only today.
Nathan’s article was a timely reminder that it’s World Suicide Prevention Day (WSPD) on 10th September. WSPD aims to promote worldwide action to prevent suicides. Various events and activities are held during this occasion to raise awareness that suicide is a major preventable cause of premature death.
This is my nod to WSPD 2020, and I’ll be looking to post more on Suicide Prevention in the run up to 10th September.
Past recessions and increased suicide rate
Again in 2014, we saw The BMJ‘s startling headline “Economic recession may have caused 10 000 extra suicides.” It read that the 2008/2010 increased rates of suicide were “highly likely to be related to the recent economic recession.”
The Guardian, 2015 wrote “Austerity a factor in rising suicide rate among UK men. Academics from the universities of Bristol, Manchester and Oxford estimate an extra 1,000 deaths and an additional 30-40,000 suicide attempts may have occurred after the economic downturn.
While the report shows a correlation between economic turmoil and increased suicide rates, it can’t prove a causal relationship, the researchers note. It can’t prove that the people who lost their jobs or homes were the ones who died by suicide.
Can we predict and prepare for increased suicide rates
Yes, research shows that the best predictor of future behaviour or risk is past behaviour. That said, we can expect to see another dramatic increase in the suicide rates. So now we know this, we can prepare for it, prevent it even, right?
An article in The Lancet, 2020 said that mental health services need to prepare for a rise in suicides due to covid 19. The paper called for mental health services to develop clear remote assessment and care pathways, and staff training to support new ways of working.
It states that:
- Helplines that are already established should receive additional support to maintain or increase their volunteer workforce, and offer more flexible methods of working.
- Digital training resources would enable those who have not previously worked with people who are suicidal to take active roles in mental health services and helplines.
- Evidence-based online interventions and applications should be made available to support people who are suicidal.
- Governments should provide ongoing support for those who have lost employment and have financial issues as a result.
- Mental health consequences are likely to be present for longer and peak later than the actual pandemic.
- However, research evidence and the experience of national strategies provide a strong basis for suicide prevention.
Helplines and Crisis Centres are going to be critical in providing immediate support to everyone who needs it or to signpost individuals to local services.
Can we prevent suicide?
Yes, while the ‘powers that be’ discuss and implement policies and procedures at the top end, we can all take action to prevent suicide. Talking about suicide and staying connected with loved ones are just some of the actions we can all take to help.
Suicide prevention starts with recognizing the warning signs and taking them seriously. If you think a friend or family member is considering suicide, there’s plenty you can do to help save a life.
Know the warning signs
If you believe that a friend or family member is suicidal, you can play a role in suicide prevention.
The best way to prevent suicide is to recognize the warning signs and know how to respond if you spot them. Especially if their behavior is new, has increased, or seems related to a painful event, loss, or change. Watch out for the following warning signs:
- Saying they want to die or to kill themselves
- Drawing or writing a lot about suicide and dying
- Seeking out ways to kill themselves, like searching online or buying a gun
- Talking about feeling hopeless or having no reason to live
- Talking about feeling trapped or in unbearable pain and being a burden to others
- Expressing feelings of worthlessness, self-loathing, self-hatred
- Increased use of alcohol or drugs
- Withdrawing or isolating themselves
- Appearing anxious or agitated, or behaving recklessly
- Sleeping too little or too much and staying bed all day
- Displaying exceptionable rage or talking about seeking revenge
- Extreme mood swings
If you spot warning signs of suicide in someone you care about, it’s natural to feel uncomfortable or afraid to mention suicide. Of course they might get angry with you for even suggesting it, but what’s the alternative? Anyone who talks about suicide or shows other warning signs needs immediate professional help
Know the risk factors
Risk factors are characteristics that make it more likely that someone will consider, attempt, or die by suicide. They can’t cause or predict a suicide attempt, but they’re important to be aware of.
- Mental disorders, particularly mood disorders, schizophrenia, anxiety disorders, and certain personality disorders
- Family history of suicide, or exposure to others who have died by suicide (like in the media)
- Previous suicide attempt(s)
- Lack of mental and physical health care, and substance abuse treatment
- Hopelessness. Studies have found that hopelessness is a strong predictor of suicide. People who feel hopeless might talk of “unbearable” feelings, predict a bleak future, and say that they have nothing to look forward to.
- Lack of social support and sense of isolation
- Impulsive and/or aggressive tendencies
- History of trauma or abuse
- History of, or increase in alcohol use and other substance use disorders
- Major physical illnesses
- Job or financial loss
- Loss of relationship(s)
- Easy access to lethal means
- Stigma associated with asking for help
The above lists are by no means exhaustive. If you are concerned either about yourself, or someone you know, you must seek professional support.
How to help someone who is suicidal
If they have a plan and are ready to carry out that plan, call 999 immediately. It’s better to be safe! Tell them you’re concerned and ask if they’re having thoughts of suicide. However, your first concern must be your immediate safety. If you fear for yourself or the person who’s suicidal — call 999. If you feel safe:
- Assess the immediate risk, like do they have a gun or other lethal weapon?
- Ask if they have a plan, when will they do it, and do they have the means i.e. stockpiled tablets, knife. Ask the person to hand over their weapon/medication. You’d be surprised — this often works!
- Let them know that you care, that they’re safe with you, but if you become more concerned, you’ll have to call for support i.e. their GP, or emergency services.
- Reassurance is crucial, as people having suicidal ideation may not have much hope. Clearly state to them that suicidal thoughts are often associated with a treatable mental illness, and if you feel comfortable, you can also offer to help them get the appropriate treatment. You can also tell them that thoughts of suicide are common, and that you don’t have to act on them (MHFA).
- Tell them that you’ll listen and do so, actively, without judgment, but with compassion. Showing that you’re listening might help them feel less alone.
- Try not to interrupt or give them reasons why they shouldn’t take their own life i.e. their kids, their partner etc. They often think they’re a burden and feel bad enough, they don’t need further guilt-trips.
- Ask if there’s someone you can call for them, such as a particular family member.
When someone is suicidal
Take it seriously but try not to act super shocked, take a deep breath and be yourself.
Try not say:
- “I understand how you feel” then go off on a tangent with something like “My brother’s best friend’s mum killed herself.” It’s not helpful, and you’re supposed to be listening! You could try “I can’t possibly imagine what you’re going through. Do you want to tell me a bit more?”
- “You should tell your mum, partner, teacher.” However, you could say “Have you thought about telling ………?”
- “Call me if you need me.” It’s a bit vague and they actually need you — like now!
And don’t lecture or argue with them, or tell them to “Snap out of it.” It’s how they feel and they’ll clam up if you continue in this way. Try open ended conversation, rather than getting a “yes” or “no” answer, like:
- What can I do to help?
- Tell me what’s been going on for you? I’m listening.
- I’ll call “………..” for you, what do you want me to say?
Well, I could go on forever. Suicide and suicide prevention are such huge topics, and something that many people just don’t understand. I’ll stop here and continue my research, with the aim to put out another post in the run up to 10th September.
Over to you
How do you feel about people who chose to die by suicide? Do you think suicide is selfish, something I wrote about a while ago? Would you feel comfortable asking the question — “Are you having suicidal thoughts?” I’ve had to ask my sons in the past, and the response was devastating, despite all my knowledge and nurse training. I’d love to hear your thoughts, so I look forward to any comments or questions, and constructive criticism.