- Psychological Issues
In Britain there is a suicide every 85 minutes and research suggests that the rate could be in fact three times higher than this, as coroners often return verdicts of misadventure or open verdicts. To lose someone you love through suicide is indescribably awful. It has been referred to as a personal holocaust. People torture themselves with a million questions of ‘Why?’ There is a whole kaleidoscope of emotions and feelings stirring around in a pit of despair. The sense of rejection can be crushing too. How can he have loved me to do what he did? Then there is the searing guilt – if only I’d done this or that. The replaying in the mind of countless permutations of possible scenarios of what may have been.
Over 30 years ago, I was bereaved through my father’s suicide. At that time there was no support available to my sister and I, other than ourselves. It was incredibly hard. My sister became depressed and I went with her to see a psychiatrist who basically told her to take tablets. There was no referral to a counsellor for her to whom she could ventilate her feelings. I was only 19 at the time and knew nothing about mental health problems and distress. However, common sense and intuition told me she needed someone to talk to but this wasn’t on offer. The tablets had all sorts of nasty side effects and my sister gave up taking them. As a consequence, she became more depressed and suffered with depression for many more years. It is a fact that people bereaved through suicide are more likely to have mental health problems and be at increased risk of suicide themselves.
In 1993, I saw a letter on a notice board in the social services department where I worked as a psychiatric social worker about the proposed formation of a group to help support people bereaved through suicide. The words seemed to leap off the paper at me. I thought, “what a great idea”! What a pity it had not been thought of before, as it could have really helped my sister and I. I then got involved with the group and have been very active with the work ever since. The group came about because other bereavement groups were telling its founder, a mental health chaplain, that there was a need for something specific for people bereaved through suicide because of their unique needs and problems. I think the group does an excellent job and it is made up of people who have themselves been bereaved through suicide, so they know first hand what it is like and that is very important to the people who come to the group. Often one of the first things they ask is, “Have you lost someone through suicide?” Some Facilitators of the group have come from people who have a professional role in mental health work and counselling skills and they have developed a lot of expertise over the years in this specialised area. Ideally, we would like to see people initially on a one-to-one basis and then when appropriate, to introduce them to the group, which meets twice per month. The group is entirely voluntary and it gets a small grant from social services.
We believe, however, that there is an urgent need for a suicide bereavement/prevention worker to take forward and develop other areas of work. For example, there is the need to establish a group for men, who presently don’t tend to come to the group, or if they do, only for a short time. In general terms, men have a lot more difficulties than women discussing their emotional issues and problems. The male macho culture, which has developed, and the concept that ‘big boys don’t cry’ is still very much around and accounts for the fact that many more men than women take their own lives. There is also a strong need to develop culturally sensitive suicide bereavement/prevention services to people from ethnic minorities as the present group has had very little contact with people from ethnic minorities. There is also a strong need to develop a suicide bereavement service for children and young people and by its very nature this will demand a skillful sensitive specialised response. The worker would also be involved with gay and lesbian people, due to their higher suicide rate.
Another area of concern is mental health workers who lose service users through suicide. These workers need help and support in the distress that they are experiencing and often with the guilt around their perceived professional failure toward the person they have lost. There is also a need to build links with other bereavement groups that can meet other related losses like compassionate friends in the case of parents who have lost a son or daughter or the Widows Advisory Service for people who have lost a wife or husband. There is also much to be done under standards 1, 4, 6 and 7 of the National Service Framework and by the recently launched National suicide prevention Strategy.
A priority area must be mental health promotion and the teaching of coping strategies to deal with psychosocial problems and difficulties and to facilitate the means of access to appropriate counselling, and mental health supportive services, particularly for young men, where the suicide rate is at its highest. A worker would also be able to work collectively with health, social services and the voluntary sector in determining how strategies could be implemented to reduce the rate of suicide as far as possible. The worker would also link into the Bereavement Forum to liaise with other appropriate bereavement groups. The worker would also develop working relationships with the coroner, police, prison service, Samaritans, colleges, universities, and also with the school educational service to support suicide bereavement work, and help implement mental health promotion and anti-suicide strategies. The worker would also facilitate the setting up of a special interest group relating to suicide bereavement and prevention with a view to holding workshops, seminars and other educational profile raising events.
The need for this service is clear, as every day more and more people are being bereaved through suicide. They are an overlooked, badly neglected group of people, whose acute needs and problems are very considerable and warrant a compassionate, well organised systematic response. We also need the same approach to prevent suicide occurring in the first place. Health and social welfare agencies need to adopt a common policy as one worker could not provide all the help that is needed. The worker’s task would be to facilitate all the networking and developmental tasks to ensure that the agencies were on track in the implementation of the policy and that it was clearly understood and focused If we live in a civilised society is the price of a single worker too much to pay? It would, in fact, prove to be a very cost-effective service because of its scope and effect, leaving aside humanitarian considerations and the ‘milk of human kindness’. We need a service model such as this throughout the Country as soon as possible.