THE FIRST COUNTRY TO ELIMINATE SUICIDE?
It’s a question that was posed to me by Green MP Chloe Swarbrick while I was rattling around Parliament talking with various Ministers from all Parties that stuck to me like a piece of chewing gum in my hair ‘what would make a difference for someone suicidal, what can we do?’. Mildly dumbstruck, I sat there like a stuffed chicken pondering her question. After talking to others and families of those who have taken their lives, I think we need to approach the issue completely differently than how we are currently dealing with it.
My own story involves six suicide attempts landing me in hospital, usually in a coma, I have come to the decision that I am terrible at trying to take my life and the New Zealand healthcare system is struggling to help people like me.
I went to a friend’s funeral recently, she was twenty two. I saw the signs but acted too late. The odd social media post about her feeling vulnerable, not coping. Like her devastated family and partner, I keep thinking I could have done more. I wear that guilt every day.
As a survivor, and someone who has recently tried to turn my life around, live and thrive, I have also tried to understand my own suicidal ideation and if it is possible to help someone who is suicidal. What would make a difference? I know I’m a little different due having an impairment but in one sense, that makes me more vulnerable because an obvious impairment is easy to blame, when the underlying causes can be completely unrelated.
Counselling alone, while great for some, is a one size fits all approach and it’s not for everybody. I think we need to look at the Maori Te Whare Tapa Wha model where the person is treated on a holistic level. Physical, spiritual, family and mental health are all interlinked. With one pillar broken, the rest will fall.
What did I need? For me, it’s a downward spiral, maybe losing a partner, a baby, not sleeping due to the pressure of work, financial issues. One by one, they build up and although on the outside I appear fine, inside, I’m drowning in a complicated mess that grows. In the end, suicide becomes a solution to those problems. And it’s not fun, it’s horrible. It’s lonely and scary. For me personally, talking to people at this point is often too late. But there will still be signs.
Always smiling, I’d start wrapping up the small things, who would look after my dogs ‘if something were to happen’, I’ll mention I love people to their face sometimes, little quirks that might be out of character. I may even appear happy but that’s a weird mix of thinking the problems are about to disappear while trying not to think about potential complications. Losing cognitive abilities terrifies me during each attempt.
So how to deal with a suicidal person in a perfect world? First, the intervention needs to be free. Often suicide is a result of financial concerns. Someone would need to visit me – for many, going out can be very difficult or even too expensive. The part I am still researching is whether this needs to come from the suicidal person or someone else. Doctors can be eliminated, mine and many others appear overworked and just fill me with ‘deliciously happy’ antidepressants like a stuffed pig. A friend? Family? Ultimately, my ideal is that it would be the suicidal person, but for that to happen, there needs to be trust in the process, the programme and the place. Giving up everyday life, kids, pets, isn’t a decision to be taken likely (although when suicidal, that happens anyway). Catch 22.
Someone with buckets of empathy will gently assess me, but not in a clinical sense. The medical model is not welcome in this approach. Judging on how serious the suicidal client is (this is where honesty and extremely perceptive people need to be on the frontline), I’d be given a ‘goodie bag’ of survival tools. Distractions, advice, elements catered to that person and their physical abilities. I’ve had counsellors tell me going for a walk – the beach is especially cathartic apparently - is the ‘panacea’ for all depressive symptoms… except I can’t walk or access a beach due to my wheelchair, but hey, thanks for letting me know something else I can’t do, that will go into my ‘suicide trigger’ box.
If the person is critical and beyond ‘goodie bag’ status, with consent, I’d be taken to an accessible facility, much like a warm home, somewhere comfortable, not clinical, but safe. Kindness, respect and caring will be the motto. I’d be assigned my own ‘case manager’ who talks about all the issues. Probing into which ones are triggering the suicidal thoughts. Financial concerns will be handled by someone and any outcomes must be signed off by the suicidal client. I say client as ‘patient’ has medical connotations and there is a negative hierarchy involved. Clients need autonomy and autonomy is a vital ingredient for those who feel they have little control over their lives.
For a period of time, the client will stay at the facility. It won’t be like the mental health wards with their sterile, suicide inducing gloom, inhumane treatments and exhausted workers (it’s New Zealand, we are still in the dark with how to deal with the ‘MENTALLY ILL’). In this facility, the client will be encouraged to stay, sleep, and healthy food given freely and there will be no expectations on the client.
Various therapies will be offered and technical help, fixing a cold home, issues that might be too much to deal with will be sensitively dealt with, all while making sure the client has autonomy over every decision. Where possible, volunteers could help with an unmanaged garden, a cold home, a broken car and the volunteers will also become integral in working with the client.
It takes a lot of digging sometimes to get to the guts of why someone wants to die, but asking the right questions is a start. No assumptions will be made about the client, their ethnicity, disability, sexuality. Too many times has my suicide been blamed on my disability – even if a miscarriage is also in my medical records. Yes, it will take someone special, someone who can listen, not judge and be ok with sharing their own experiences if appropriate.
When leaving the facility, a mentor will be assigned to the client, like with Alcoholics Anonymous. Many who have attempted suicide ironically want to help others, and purpose is a vital ingredient for life. Friendships will be encouraged and the person will leave knowing they have the scaffolding for a new community of support.
I have never liked the fact that with health, it is a one-sided conversation. I’ve volunteered at Youthline, counselling our vulnerable youth, and when I did take calls where thoughts of suicide are mentioned, I would do my best to create rapport with them. It’s not that I want my two seconds of ‘me time’, it’s about them knowing they are not alone. It also has to be genuine, fake rapport smells like rotten fish down the phone line. Ironically, my own trauma came in handy during these times.
So, it will be a collective approach. Admittedly, it might need to change depending on the person, their age and location, I’m still pondering how best to deal with this and our burgeoning elderly population who will also need the intervention. Recently I was a guest speaker at the Waipuna Hospice and loved the vibe there. Obviously quite different being a Hospice, but hope and love emanates within the walls of that facility.
People need to feel safe, secure, loved, valued and part of a community. In the mean time as we wait to gain a better understanding of suicide, and incorporate the Te Whare Tapa Wha model into suicide support, we can all help each other by reaching out, being kind, and giving back when we can. I also highly recommend sleep and good food if possible. Happiness isn’t what we might think, more money, stuff.. it comes from connections we make, purpose, autonomy and feeling valued.