Psychology
Some thoughts on the right and wrong way to advocate for suicide prevention.
Some thoughts on the right and wrong way to advocate for suicide prevention.
his column will include discussion about suicide, but first let me introduce you to the “sh*t sandwich” – the pet name university tutors give to sandwiching feedback on students’ assignments. It goes like this: “I really like what you wrote about A, but I thought that B, C and D needed a lot of work. But I really liked A.”
So, I really like that Mike King has shone a public light on important mental-health issues. I agree we should talk a bit more about these issues than perhaps we have. That’s one piece of sandwich filling.
I also think that there’s a right way and a wrong way to encourage these conversations. Encouraging people to seek help while criticising the helpers probably undermines confidence in those services. It puts people in the confusing position of wanting help but not knowing how to get it and is depressing for therapists.
I feel it’s deeply unfair, ill-informed and disingenuous to suggest psychologists and other people working in public mental health aren’t doing their absolute best to change people’s lives for the better with, in King’s words, their “evaluated and evidence-based rubbish that doesn’t work”.
Some of these clinicians, psychologists, are on one of the quietest strikes you’ll not hear about. It’s been going on since July and has mainly involved working to their role descriptions – not withdrawing their work, but things like working only within set hours.
There aren’t enough psychologists employed to meet demand. Estimates of the shortfall vary between 500 and almost 1000 psychologists needed to provide minimum effective support. It’s been reported that psychologists working in Corrections earn up to $20,000 more than psychologists working in district health boards. One psychologist I work with hasn’t had a pay rise in six years. You do not turn up to spend your days talking people out of suicide unless you believe it is important and that you can make a difference.
It’s not just unfair to slag off these people but also vaguely hypocritical. The Gumboot Fund that King set up allowed people to apply for money to see a therapist they might already have contact with, or one from a list provided by King’s organisation.
The irony is that some, perhaps many, of them are the people peddling the “rubbish” that King is concerned about, yet the fund will apparently pay them.
Another well-meaning misstep concerns the call for “1000 letters” – suicide notes – to be analysed to counter what King says is a lack of understanding of why people end their own lives. The idea made sense in the 1990s, and earlier, when people started doing exactly this. Ironically, that research showed the same themes King says are apparent to him: a sense of feeling like a burden or feeling overwhelming pain. Dealing with these are part of our theoretical and therapeutic approaches to suicide.
Setting aside that such a project mightn’t tell us anything we don’t already know, there’s a right way and a wrong way to do this. I think King’s wrong to ignore the concerns that have been raised, which now include a call from the Ministry of Health ethics committee for the notes to be destroyed.
Some of the people who’ve fronted for King’s organisation are themselves signatories to codes of conduct that require them to seek ethical approval. That helps to protect participants (they know what the risks of being involved are) and the researchers – it shows they’ve thought about participant safety, and that they can look after their own safety in working on something that could be very confronting.
That’s a couple of sandwich filling layers, so let’s top it off. I really like that King is passionately advocating for what he thinks is right. Grade B-, needs work.
There aren’t enough psychologists. Estimates of the shortfall vary between 500 and almost 1000.