Preventing suicides is about much more than just talking

THE first time my friend expressed a desire to kill himself, I did not miss a beat. “You better bloody not,” I told him. “Who am I going to sit here and drink coffee with?” It was a bullish response to mask how uneasy I was.

In the months that followed, we talked candidly about death; everything that made life worth living and the deep-seated depression which enjoyed telling him that it wasn’t. Joking made it more bearable, he said, so sometimes we did that. My friend reached out for professional support and life went on. It stayed like that for a while.

When my friend died, years after our first conversation, I felt more guilt than grief. I had intimate knowledge of his struggles. He had been told to talk – men, we know, are particularly bad for being honest about their mental health – and he had. I was angry it hadn’t stopped him.

But, when you are trying to understand what would drive someone to take their own life, the only obvious takeaway is that there is no obvious takeaway.

A new report has found that nearly half of Scots who take their own lives contact a GP, NHS 24 or the ambulance service in the year before their death. An inability to reach out for help is a major problem, but it is not the only issue – and perhaps not the most prevalent one anymore.

There is no black and white action plan but a better understanding of how and when to introduce support must be sought. Too many people are still dying.

Most of the conversation of focused on reducing the stigma attached to mental health and suicidal thoughts. We should talk – nay, we must. There is no question that bottling up struggles has cost lives. We must talk, while also demanding action.

We must have better emergency psychological care available and clinical treatment for severe depression beyond 10mg of an SSRI accompanied with a sheepish explanation about a four-month waiting list for counselling referrals.

We must also think about what makes a person want to end their own life. Because it rarely comes out of nowhere. What are the root causes of a depression so deep that suicide presents itself as the only course of action? Poverty, homelessness, addiction, trauma are all major causes.

Suicide prevention cannot be solely focused on leading someone back from a dark place. Wherever possible, it must be about blocking off routes that lead to there in the first place.

Of course, when are you struggling, coffee with a friend is a fine place to start. l Samaritans (116 123) operates a 24-hour service available every day of the year