Let’s Talk about Suicide
Talking about suicide and suicide prevention is at the heart of preventing suicides, and yet so many people shy away from this (potentially life-saving) conversation. So let’s not shy away, let’s talk!
In the UK, more than 6,000 people die by suicide each year. Anyone who has even the most basic knowledge of suicide prevention will tell you that opening up the conversation is a key part of the solution to reducing these numbers.
This means appropriate one-to-one conversations with those who are at risk or in danger, and an open conversation in society at large about suicide and suicide prevention without stigma, with intent to prevent suicides (and move towards a ‘zero suicide society’), and around practical actions people can take to help save lives.
In suicide prevention, a valuable practical action is talking about suicide — learning how to have that conversation, and then having that conversation — so, in that sense, talk is action!
But many if not most people don’t feel confident or comfortable talking about suicide. How can we help encourage potentially life-saving conversations?
The Jordan Legacy/MEL Research Survey Spring 2022
In the Spring of 2022, The Jordan Legacy CIC partnered with MEL Research to carry out a survey among a representative sample of 1531 UK adults (aged 18+) to make sure we had some up-to-date figures which could inform conversations around mental health, suicide and suicide prevention.
Many thanks to MEL Research for their generous support and professional service in partnering with The Jordan Legacy to make this survey happen.
Two notes before reporting on the survey results.
First, if you do quote any of the results from this survey, please give your source as The Jordan Legacy/MEL Research Survey Spring 2022, and link to this published summary to ensure accuracy and avoid misrepresentation.
Secondly, given the subject matter, all those taking part in the survey were directed to sources of support. If you or anyone you know needs support, there are many options (and it’s important to know there are many options!), including via the Resources page on The Jordan Legacy website:
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Those involved in suicide prevention would argue that “As a society, we should discuss suicide and suicide prevention much more openly”. When we put this to the population as a whole, four in five agreed (79%, including 41% strongly agreeing and only 4% disagreeing). This endorses the decision to carry out this survey and talk openly about the results, which are highlighted below.
How many people consider taking their own life?
One of the problems with not having a society where there is open conversation about suicide is that its prevalence and impact can be underestimated.
As the chart below shows, two in five UK adults (42%) say they have at some point had thoughts about taking their own life; one in five (20%) have ‘seriously considered’ suicide (that’s the sum of the 7% + 5% + 8% in the right-hand column); one in eight (12%) have gone a stage further and planned how they would end their life; and one in fourteen (7%) say they have made a suicide attempt.
As is usually the case in research on suicidal thoughts and behaviour, these figures are all higher in the youngest age group, 18–24.
Among the population as a whole, 9% say they have had thoughts about taking their own life in the past month, and 4% in the past week.
How many people are exposed to suicide in some form?
Because suicide is often not talked about openly, some people mistakenly assume that it only affects a small minority of the population. This is not true. The National Suicide Bereavement Survey has estimated that for every death by suicide there are around 135 people affected — family, friends, work colleagues, neighbours, those who were trying to support that person with clinical care, counselling, etc.
With more than 6,000 deaths by suicide in the UK each year, that means more than 800,000 people each year are affected by suicide each year, aggregating and compounding each and every year.
The Jordan Legacy/MEL Research Survey Spring 2022 shows how this translates into the population-wide picture for the UK. Two in three UK adults (67%) have had some form of exposure to suicide:
One in three (32%) say they have known someone who died by suicide. One in eight (12%) say they have lost a close friend or family member to suicide.
This is not ‘niche’! It’s just that the conversation about suicide is so limited.
We know that it can often be hard to talk about for those who have lost someone close to them, and it’s a different kind of hard for those with no past exposure to suicide joining this conversation.
Some people and groups are being brought into the conversation more, and getting more support. Some less so, including those who witness a suicide or suicide attempt who are often left alone to process what they’ve witnessed.
How many people experience mental health issues?
The Jordan Legacy/MEL Research Survey Spring 2022 asked about mental health as well as suicide and suicide prevention. The two are closely related of course, as someone with untreated or unsupported mental health issues is at a higher risk of suicide and those having suicidal thoughts are experiencing a form of mental distress (although the suicidal crisis can be triggered by other factors, eg a financial crisis, loss of job, relationship breakdown).
Among the UK adult population as a whole, two in five (43%) say they have ever experienced “mental health issues that needed treatment or support”. One in six (17%) have experienced this in the past 12 months.
One in five of those surveyed in Spring 2022 (21%) described their current state of mental health as fairly poor or very poor (the same proportion as described their physical health as poor — there is an overlap in these two groups, but they are not the same people).
Among those aged 18–24, one in three (32%) said their mental health was poor. It was also especially high among those who identified themselves as having a disability (37%). This is consistent with other research which often shows especially high suicide risk and high suicide rates among people with disabilities or living with chronic physical pain.
Among all adults aged 18+, two in three (66%) have known someone with mental health issues that needed treatment or support — 35% knowing a close family member in this situation, 31% a friend, and 12% a work colleague.
Again, this emphasises how widespread the experience is of being exposed to mental health issues and mental illness, as well as suicide. Most people’s lives are touched by these issues, but most people don’t talk openly about them, which perpetuates the problems, and continues the stigma, fear, etc.
The Jordan Legacy/MEL Research Survey Spring 2022 also included some questions around knowledge the general population has around suicide and suicide prevention, and their attitudes on some key issues. These were designed to provide insights and data to help fuel the conversation around suicide and suicide prevention — in our networks, communities, workplaces, at public events, in our campaigning and advocacy, etc.
Knowledge about suicide and suicide prevention (facts and myths)
It is a fact that “suicide is the biggest killer of UK adults aged under 35”. Indeed, knowing this is one of the key drivers for many of those who are active in trying to reduce the numbers of deaths by suicide.
As the chart below shows, in The Jordan Legacy/MEL Research Survey Spring 2022, a majority of the UK population (58%) said they thought this was true, but only one in six (16%) thought it was ‘definitely’ true, one in ten (10%) thought it was false, and three in ten (30%) answered ‘don’t know’. The two in five UK adults answering either ‘don’t know’ or ‘false’ illustrates the level of awareness-raising and education that is needed.
National charities such as Papyrus, with its focus on children and young people, campaign and advocate around what are often regarded as startling statistics such as “200 schoolchildren per year take their own lives”. Half of those in our cross-sectional sample of UK adults (50%) think this is true but two in five (39%) answer ‘don’t know’.
Several studies have shown that, sadly, another fact is that “those who lose a loved one to suicide become at greater risk of suicide themselves”. The trauma of suicide loss and grief makes many people highly vulnerable. However, among the population as a whole, only two in five (39%) think this is true, only one in fourteen (7%) think it is ‘definitely’ true, one in three (34%) answer ‘don’t know’, and one in four (26%) think it is false.
Thankfully, the increased risk to those bereaved by suicide has been acknowledged much more in recent years, and there have been huge developments in support for those experiencing suicide loss (still with much more scope for improvement). But of course without greater awareness of this being an issue and without greater knowledge of how to provide support (ranging from clinical services to peer support groups to family and friends at least talking about it rather than shutting down), the risk remains high.
In this true/false survey format, we included a mix of key facts, common myths, and sweeping statements that mask much nuance and complexity. Given the proposition “suicide occurs without warning”, 43% think this is true, 36% think it is false, and 19% answer ‘don’t know’.
It’s not surprising that many people think suicide occurs ‘without warning’ because they often hear about deaths by suicide where it appears to be a shock to even close friends or family members. And there are cases where there has been a very short time between an event triggering suicide (such as loss of a job, breakdown of a relationship, life-altering trauma) and someone taking their own life. There are also many cases where the person taking their own life has had no history of mental illness or mental health issues.
However, in many cases, there were ‘warnings’ or certainly noticeable signs or symptoms, clearly visible prior to a suicide attempt or with hindsight. And many cases where people taking their own lives had a (long) history of mental illness, where they had recently been having treatment, and — perhaps most tragically of all — where they had sought help but not been provided with the support they needed. So, in all these contexts, deaths by suicide were clearly not ‘without warning’.
Another proposition put to those taking part in the survey was “suicide cannot be prevented”. Two in three (67%) said this was false, including 44% answering ‘definitely’ false, although one in six (17%) thought it was true.
‘False’ is the ‘correct’ answer in the sense that most of those working in the field of suicide prevention would say that ‘most suicides are preventable’ and some would argue that almost all deaths by suicide are potentially preventable with the right prevention and intervention measures, including crisis interventions right up to the very moment a suicide attempt is made.
There is an important qualification though which is that not all suicides are preventable. Sometimes, despite the very best efforts to provide support to those in known danger — support from family and friends, support from clinicians, support from peer groups, charities, workplaces, etc — some people do take their own lives. This includes instances of mental illness and psychotic episodes where it has appeared impossible to prevent a death by suicide.
Anyone saying ‘all suicides are preventable’ can upset those who have done their utmost to support someone in danger or who has lost a loved one despite feeling they have done all they can. And public debates around ‘all suicides are preventable’ as an absolute tends to raise other issues such as an individual’s human rights, including the right to take their life if they choose.
But, as a general rule, it is healthy to open up and have the conversation and, it is healthy to think and act on the basis that most suicides are preventable (when developing suicide prevention strategies, plans, policies, campaigns, etc) and ‘suicides are never inevitable’ (when providing one-to-one or group support focused on individuals at risk or in danger).
In another question on the survey, more than two in three (70%) also rejected the proposition “If someone has decided to kill themselves, there’s nothing we can do to stop them”, although one in six (16%) agreed. Whether or not we should ‘stop them’ can be a highly complex ethical question. But the evidence suggests that, in most cases, we can do more to ‘stop them’ and help them through a temporary crisis and on to a future quality of life which means they don’t again see suicide as their ‘best’ option or ‘only’ option.
The chart below summarises the other survey responses on the true/false question format. In each case, these are generally regarded as ‘myths’, ie statements that are often made by those who are not well informed about the issues or evidence base. It makes them unhelpful comments and, in some cases, such statements can actually be harmful.
In The Jordan Legacy/MEL Research Survey Spring 2022, we (thankfully) have a majority answering ‘false’ for each of these myths but we have between 13% to 30% answering ‘don’t know’ and 11% to 19% saying ‘true’, so this emphasises the need for more wider and deeper education to raise levels of awareness, knowledge, and understanding:
For those who are not well informed about each of these issues, here’s a summary of what the evidence base tells us.
Thinking about suicide is not ‘rare’. In this very same survey, we have found that two in five UK adults (42%) have had thoughts about taking their own life at some point, including one in eight (12%) who have got as far as planning how they would end their life. This is clearly not ‘rare’.
Many studies have included interviews with people who have been in suicidal distress or who have made suicide attempts and survived, to try and get a better insight into their lived experience and what can be done to help prevent suicides. A common theme from these studies is that ‘suicidal people don’t want to die, they just can no longer live with the pain they are living with’. Many of those who have survived suicide attempts report feelings of wanting to live moments after attempting to take their lives. Again, it’s important to emphasise that this is not all cases, and some who survive suicide attempts are distressed to find they did not die. But the sweeping statement “suicidal people clearly want to die” is not evidence-based and potentially harmful.
“Only people who are mentally ill take their own lives” is a particularly complex ‘myth’ to address. We can clearly state that it is factually incorrect in the sense that not all people who take their own lives have diagnosed or even diagnosable mental illnesses, and many suicides are triggered by a life crisis which did not appear to be a mental health crisis (eg a financial crisis). However, it clearly requires some form of ‘mental distress’ for someone to try to take their own life.
What is most important is recognising that each individual has their own set of circumstances that is causing them to consider suicide or try to take their own life, and to provide the tailored support each individual needs. If, with appropriate clinical input, they are openly acknowledging that they have a mental illness, that is part of facilitating the treatment and support they need. If they are seeing themselves as not being mentally ill but experiencing a crisis that is the result of other factors, it is likely they will be focused on addressing the underlying problems that have brought them to crisis (eg losing their home or job) than discussing whether they are ‘mentally ill’.
Again, it’s heartening to see in The Jordan Legacy/MEL Research Survey Spring 2022 that so many people reject potentially harmful myths such as “suicidal behaviour is motivated by attention-seeking” — two in three (67%) say this is false, including almost half of the population (47%) saying ‘definitely false’ — but, sadly, one in seven (15%) think this is true.
First of all, there is a fundamental difference between a ‘cry for help’ and ‘attention-seeking’. The latter terminology is loaded with stigma, implying the primary motivation is just to attract attention rather than someone being in crisis and not knowing where to turn.
Secondly, suicidal behaviour is often the exact opposite of ‘attention seeking’. People suffer in silence, and take steps to conceal their distress from others.
If ever suicidal behaviour is visible, we should see it as a positive opportunity to help someone through their crisis, not criticise them for seeking attention! And because it’s often not obviously visible, we need to get better at spotting the more subtle signs and get better at asking questions.
One of the most dangerous myths of all is “asking people about suicide increases their risk of suicide”. Thankfully, there have been many research studies carried out over the past 20 years that have concluded there is little or no risk from talking openly about suicide, and much benefit. Asking someone who is not suicidal if they are thinking of ending their lives does not make that person suicidal. Asking someone who is suicidal if they are thinking of ending their life can save their life.
As with all of these complex matters, we cannot say there is absolutely no risk from talking about suicide but we can pinpoint those circumstances where there may be a risk. In particular, it can be harmful for someone who is suicidal to be exposed to conversations about ways of ending their lives, so we shouldn’t talk about means of suicide with someone at risk, except where we are trying to support someone in immediate danger by talking through the plan they have made in order to keep them safe.
Also, talking about suicide in any context can be triggering for those with lived experience of suicide, so we need to be sensitive, give appropriate warnings, and provide appropriate support for those who might be adversely affected by being exposed to conversations about suicide.
However, these specific instances aside, what the evidence tells us is that opening up the conversation about suicide among the population as a whole (and in families, communities, groups, schools, workplaces, etc) has a huge benefit with a negligible risk (and a risk that can be managed); and asking direct questions about suicide to those we think might be concerned about is an opportunity to help them without harming them.
Another myth which is problematic is “once someone becomes suicidal, they will always remain suicidal”. In most cases, suicide attempts occur when someone is experiencing a crisis and set of circumstances that makes them feel their ‘best’ option or ‘only’ option is to take their own life. It is situation-specific and, if they get through this temporary crisis, they may go on to live a long life without ever again (seriously) contemplating suicide.
This doesn’t mean that we should not continue checking in with them. We should, because they may have suicidal thoughts in the future. And we know that those who have made a suicide attempt are at a particularly high risk of making a future suicide attempt if their mental health continues to be poor or the underlying issues that brought them to crisis are not addressed.
What it does mean is that we should not ‘give up on people’ or think that suicide is ‘inevitable’ in any individual case.
Attitudes around Suicide and Suicide Prevention
In The Jordan Legacy/MEL Research Survey Spring 2022, we put a series of proposition statements to our representative sample of the UK population and asked them to what extent they agreed or disagreed. The results are shown in the charts below.
The vast majority agree that “The Government should allocate more money to mental health services” (80% agree, including 50% strongly agreeing) and “The Government should allocate more money to suicide prevention” (72% agree, including 38% strongly agreeing).
Four in five (81%) agree that “We should aspire to a society where deaths by suicide are rare events”. This means investing resources where it can help bring the suicide numbers down of course, along with more people, groups and organisations opening up the conversation and learning how to support.
The vast majority of UK adults also agree that “Mental health and wellbeing should be taught in schools” (83% agree, including 49% strongly agreeing) and that “Suicide awareness and prevention should be taught in schools” (74% agree). This is a topic discussed at one of The Jordan Legacy’s online events in 2022, with the recording available on the website.
Given the proposition “We can all do more to help prevent suicides”, more than two in three agree (72%), including one in three (32%) strongly agreeing. Everyone ‘doing more’ is of course the way we can move towards a ‘zero suicide society’ or a ‘society where deaths by suicide are (very) rare events’. However, this does mean there are significant numbers disagreeing (9%) or answering ‘no opinion either way’ (19%) so part of the conversation we need to have is around how ‘we can all do more’, eg by taking basic training and learning how to spot signs or ask direct questions to those at risk or in danger.
In response to the statement “I would know how to help someone who was struggling”, fewer than half the population agree (43%). Around one in four (23%) answer ‘no opinion either way’ and around one in three (31%) disagree, ie admit they would not know how to help someone who is struggling. Given how many people are struggling — as evidenced by this survey — we need to raise our capacity to help.
The Jordan Legacy/MEL Research Survey Spring 2022 highlights that two in three UK adults are exposed to suicide in some way and to mental health issues, with one in six (17%) experiencing mental health issues needing treatment or support in the past 12 months and around one in ten (9%) having thoughts about ending their life within the past month.
The vast majority of the population want to see more support and more funding for support, they think we can all do more to help save lives (although most do not currently think they would know how to help someone who is struggling), they think we should aspire high in suicide prevention, and they think that, as a society, we should be discussing suicide and suicide prevention much more openly.
So we end this piece as we began…Let’s Talk about Suicide!
This piece is being published following an online event entitled “Let’s Talk About Suicide” hosted by The Jordan Legacy which included a presentation of The Jordan Legacy/MEL Research Survey Spring 2022 and facilitated discussion with Mental Health First Aid and Suicide First Aid trainers, Tara Powell and Steve Carr. A link to the recording of the event can be accessed here via YouTube:
or via The Jordan Legacy website’s store of recordings from all events:
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Paul Vittles is a researcher, consultant, coach and counsellor who specialises in mental health and suicide prevention. Paul works with Steve Phillip and The Jordan Legacy team to develop and implement strategies for transformational change in suicide prevention; to raise awareness and knowledge; to prompt actions (talking about suicide being a key action!); to highlight practical actions that we all can take; and to support people and organisations wanting to make a life-saving difference.
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