Suicide and Stigma
I have recently been catching up on some archived episodes of the
SBS program Insight. One of the
episodes I saw the other night was about how to reduce the stigma and
spread awareness regarding suicide. It is still for most people a
taboo issue when it comes to discussion. One of the main problems
with this is that when it comes to suicidal people, there are as many
different types of suicidal people as there are viewpoints on
Insight. If you've ever watched an episode, you will see that
different people all have different takes on any particular issue.
It's similar for the suicidal on suicide.
Speaking as a person who has been depressed for most of her life, and
who has felt for more than half of her life that killing herself is
the only realistic way to deal with her particular problems, the
problem with creating ads or programs to increase suicide awareness
seems to be that those who want to make the ads have a vague idea
that suicide is bad and must be stopped, but they don't truly
understand the causes of suicide, or how to help, or that enough
resources to help don't exist. Aside from suicide specific resources,
and referrals to various therapies and services, it's a holistic
issue that involves many social issues and quality of life issues.
The current state of modern life might itself be part of the problem.
It's one thing to offer immediate crisis support, but what about
after? What if people are realistic to fear for their
futures?
Lifeline
Lifeline is an
organization dedicated to helping those in crisis, whether by phone
or through their website.
My first impression of the Lifeline website was that it wasn't very
warm and welcoming, or rather that there was so much attention to the
corporate or brand aspect that it's offputting. I realize they need
donations, but one of the problems people might have in feeling
suicidal, that they might not even consciously realize they have, is
that they're feeling alienated by the way the modern world works. And
meanwhile, at the same time 'help' is offered, the site itself is a
brand and a career opportunity or a nice addition to a resumé
for go-getters.
For me, it sort of emphasizes the pressure of having to speak up or
advertise oneself in 10 seconds or less..
The live chat is probably a good idea, because there are people very
comfortable with that kind of format. I would probably be better with
email, and the possibility of IM if I felt comfortable after email,
but at the same time I'm not in a 'crisis' situation in the sense
that I will kill myself while waiting for a response.
As for the Lifeline website, it might be good for a person who sees a
phone number to call, or wants to chat immediately, although the chat
is only from 8pm-4am? But anyone who looks around a little before
committing to a call, to find out the philosophies, might find
themselves discouraged.
On second viewing, I still find the website offputting. There's a lot
about the organization itself which sort of might make a person feel
guilty if they already feel like a wuss for calling a suicide
hotline. 'Oh no, I should be making a donation, I should be
volunteering and giving back to my community, look at all these
people who can handle jobs, school and volunteering..'
For those who just want to talk to someone, as long as
they aren't on hold too long or at all, they'll probably find it
easy enough to navigate, and those who like chat will probably find
it helpful.
Again, I think the Lifeline live chat is probably a good idea,
because there are people very comfortable with that kind of format -
but it would probably be even better if it were possible to provide
it 24 hours.
What's missing is maybe a section or link to 'alternative' types of
approaches, in addition to links to more mainstreamish things.
Social Inequalities
If we know that individuals from certain groups, for instance,
Indigenous individuals and LGBTI individuals, are more likely to
attempt suicide, then surely we should recognize that part of the
solution to the suicide crisis is that we must push for social
changes? And if we can't do that, then we should increase awareness
of the extra difficulties such individuals face trying to get a
'fair go' in life.
What if rather than complain or question some of these human rights
issues and risk being perceived as a whinger, some people just kill
themselves? If more people felt free to speak up about their
experience and to question the setup, could this possibly lead to
social changes that will benefit everyone? Maybe platforms for
speaking out need to be established.
Communication Breakdown
Keeping a person safe for a night or a few nights, and locking away
all potential suicide objects or methods does not address the
underlying issues that led to a person becoming overwhelmed. In many
cases, the crisis will pass, but a person may never really be feeling
they are coping well and some might live with a certain level of
misery, and not be able to participate in life fully, or share
whatever it is they could potentially share, partly because people
still believe that suicidal feelings sometimes come out of nowhere,
or that depression has no real reason. Just because people with a
certain mindset can't see the reasons for depression doesn't mean
that there aren't any.
There's a lot of pressure, from families, peers and society as a
whole, to accept 'the way things are', without question. You don't
have a right to question why housing is so expensive, why there are
so many crappy jobs and crappy products, why to participate in
almost every level of life you have to disregard some laws and
rules, while pretending you don't, and constantly have it reinforced
that to walk away from all this means that you're the lowest of the
low rather than a conscientious objector, or at least a sign that
the system is corrupt, rotten.
People take in the brainwashing, and override their own personal
perceptions and experience and say: I'm bad, I have no reason to be
depressed, I have people who care about me, it would be so selfish
and cause them so much pain if I did this to them, so many people
have it so much worse. And so they don't really connect with what's
really going on with them, burdened by all of these shoulds, and then
one day it's too much, they kill themselves and everyone is
scratching their heads saying 'she would never do this, it came out
of nowhere'.
Sometimes when people think they are communicating in ways that allow
open conversation, they don't understand that they might
unconsciously be imposing acceptable limits that the other person
picks up on.
If you take a look around xesce.net, you will see the things that I
was not allowed to discuss with family, and that even psychiatrists
and other mental health professionals either didn't want to know
about, or didn't have the time for. I'm not saying that all depressed
or suicidal people are like me or have anything in common with me -
refer back to the beginning where I mentioned that there are as many
different viewpoints in the suicidal community as in any Insight
audience - but there are probably things within my website that
represent that some things aren't
really acceptable, even when
family and friends say 'we accept you'.
I tried to talk to family and friends, I tried to talk to the
professionals, and in the end, I ended up here, because there was
nowhere else I felt I could go.
On the Insight episode I referenced, there was a proposed ad campaign
that included: Thinking of suicide? We'll help you write the note
writethenotenow.org.. I think there's a sort of dark humour that's
ashlike [I am referring to a newsgroup called alt.suicide.holiday
where I hung out years ago, and where GK and I met] to that billboard
ad. But underneath it, it's not a bad idea for people who are more
comfortable with writing rather than speaking to someone. And so you
have a suicidal person who goes to a website, checks things out, and
maybe decides to write to some people in their life, not to say good-
bye, but maybe to think about what they would say to a person. Or, to
write an email to discuss with the people there, as long as it didn't
feel like cops were going to knock down your door and drag you away.
I think this option actually isn't bad. I do also think that it's not
bad to write to people a letter that might even be 'shocking' - what
would you say if you weren't shy, or if there's nothing else to lose?
But I've done all this. I've written those emails, I have put up tons
of stuff on my site expressing everything, what else can I
write?
Some people said the ad was confusing, some said they didn't believe
it would drive people to services.. but my perspective is that I'd be
more likely to contact these people than Lifeline. If it is 'too
much' to risk that dark humour might harm the majority, then at least
it might be a good idea to have an 'offshoot' from the Lifeline site
which focuses on writing and communicating, and phone options for
those who would prefer that - and the link to this offshoot could
say: if our site seems too corporate and unfriendly or mainstream for
you, try
this. And that way, it is possible that some who
might otherwise fall through the cracks could find a place.
Compatibility Issues
The problem with suicide hotlines is partly that however well-trained
the volunteers are, it is hit-or-miss that the 'right' volunteer
will match up with a certain indivual - this is again about the
varying viewpoints issue. I know that volunteers would be specially
selected, and trained to be without judgment, but it is not a human
specialty that most can be objective, insightful and compassionate
to the extent that might be required.
Just as not many people could do Jenny Brockie's job, not many people
could be trained to respond to the entire range of suicidal
mindsets.
There are also certain jobs which carry increased suicide risk, and
this should also be addressed.
The Media and Copycat Suicide
Apparently media laws or guidelines include that you are not allowed
to broadcast details of methods or locations, because this increases
copycats. What was not mentioned in the Insight program was that if
methods are mentioned, but also the gruesome possibilities of what
could happen when such methods go wrong are also mentioned might
deter some suicides.. this was one of the reasons the newsgroup a.s.h
was a 'positive' resource. Through talking about all aspects of
suicide, from discussing pros and cons of suicide methods, emotional
and practical problems, as well as being a social atmosphere where
people could share opinions about what's happening in the world, or
jokes, or poetry, or personal stories, all of this probably prevented
many suicides rather than encouraging them.
Besides that, at present, aside from the 'regular media', social
media is pretty difficult to police.
While there might be some link established between reporting suicides
and methods, there is as far as I know no data concerning communities
like a.s.h.
Resources and Reality
One of the ways to decrease suicide would be to make life
seem more attractive. The way it is set up is very rigid and
competitive, and it's pretty limited in a lot of ways if you don't
want a 'normal' life. This would include talking openly about
realistic options for life, what a person can realistically expect,
what is expected of them, etc, and it should be posed that a person
maybe has a right to decide if the terms of life are acceptable to
them.
OK, this whole thing is pretty scary, because you have all these
panicked people who want to stop suicide, but don't actually
understand suicide. They might see that resources are needed, and
awareness of how to connect with resources, but if there aren't many
people who are actually trained and understand enough, what are the
resources going to do even if they could provide enough of
them?
SBS and Insight already address many of the social and political
issues in the world that contribute to extra obstacles for certain
groups of people. It's like there needs to be a way to link what
combinations of risk factors are, and potential ways of addressing
these. Link and process all different layers? Or like a supercomputer
that can do this? Or, therapists who can adapt and provide
'integrative' approaches or adaptable approaches to therapy.
Ripple Effects
Ripple effects for decades after a suicide.. what about ripple
effects from parenting techniques, or deciding to have kids when you
probably shouldn't? Suicide might have 'worse' effects than other
forms of death for those left behind in large part because of the
stigma that surrounds it, making it impossible to talk about.
Altruistic Aspects of Suicide
When people discuss the aftereffects of suicide, something many don't
see is that some people's deaths really might not be
noticed by their families, and we already know that depression and
isolation might result in suicidal feelings, so there's a big
disconnect here, or a lack of connecting dots. Some cultures and
individual families might actually think suicide is 'right' when one
member has brought shame upon them. With all the focus on people
being productive, caring members of society who will one day 'give
back' - what if some people have disabilities or conditions that will
result in them always being something of a 'liability'?
One man on the Insight program about suicide said that he felt he had
brought so much shame to his family he thought they'd be better off
without him.. when it comes to my website, I actually get the
impression my family wish I hadn't posted it and that this has caused
more shame and problems for them than if I had just shut the fuck up
and killed myself.
With all the focus on 'giving back', what about people who realize
they have some condition or situation that means they can never
contribute as much as others, or make up for all the expense they
have caused? How do you realistically convince them it's not as
important as preventing their suicide if you yourself believe in the
importance of pulling one's own weight and giving back to the
community?
Come On, Admit It, in a Lot of Ways, Life Sucks
Many people are depressed because life sucks. They may not be
consciously in touch with this, but when they try to follow what
everyone is telling them they should do and feel, they can't. They
might even echo the things people say, in an attempt to get it all to
sink in, or not to worry others, or cause a fuss or problem, but what
if the reality for some people's depression is that the realistic
life options available to some people are not especially appealing?
There are plenty of messages saying: you can achieve anything if you
set your mind to it, and if you don't you have no one to blame but
yourself, but these messages aren't strictly the truth. Perhaps if
more people truly understood this, there'd be a hell of a lot more
suicides.
There are some people who could potentially be helped by going right
to the edge, confronting the harsh realities of life, having someone
acknowledge that their perceptions of the realities of life aren't
insane, trying to sort through it all, to find out if there is
something in life they still want, something that it is realistic to
achieve, and then perhaps to have help in formulating a plan toward
achieving that.
But many people are so affected by the shoulds that they are not
really in touch with what they want to do. They have ideas about what
would fit well in their families, or earn respect, etc, or what seems
cool, or what has status, and many people as a result do not really
know how to assess their real interests, and cross-reference these
with their real abilities and available resources and
spots/positions.
Substance use as a symptom, not cause
People aren't aware of the prejudices they have about alcohol and
drug use, and when discussing these issues, people tend to assume the
addiction is causing the depression, I know I'm doing something bad,
I know I should stop, and stopping in itself is the biggest step.
While I think substance abuse can exacerbate depression or a
preexisting problem, I think it's rarely the primary problem.
Whatever it is Might Not Pass
People who have been depressed for long periods, or off and on
throughout life might be put off by the assurances that there is
help, that this will pass. Also, when you realize how many different
volunteers there are, and you know you have a complex problem, you
realize that finding someone who can understand your particular
issues is very random or unlikely, especially when the training for
the site seems like a onesizefitsall approach, and reflects the
values of mainstream society.
Through my reading of the site, I wasn't sure about some things..
When it came to positions at the organization, they seemed to be
saying they wanted to investigate if you had a criminal past, or
anything else that might disqualify you from being a good
counsellor.. meanwhile, people who have experienced alternate lives
from mainstream society might actually have very important imput to
offer.
More on Lifeline Services
Lifeline securely stores transcripts of chat sessions. De-
identified transcripts may be used for the purposes of clinical
supervision and evaluation.
er.. clinical supervision of a person who has not been identified?
In other words, a person is discussed, and if found to be at risk,
they'll look up the IP address and various other things? They might
show up at your door?
Prospective employees, volunteers at Lifeline:
will not engage in conduct that might damage the reputation of
Lifeline and the services it provides
will provide and update Lifeline with relevant information about
their background, criminal history and personal circumstances that
could affect actual or perceived ability to deliver Crisis Support
Services
-These two above are perhaps open to interpretation.. but does
the first mean a person can't be a good counsellor if found in
possession of pot, or something?
-Does the second mean that they do accept some people with
criminal histories, as long as these aren't seen as potentially
tarnishing Lifeline's name or likely to affect the ability to provide
the service? [On another part of the site, they spoke of
volunteers from 'all walks of life', and presumably former criminals,
recovering addicts, and anyone who knows what it's like to be
socially excluded could possibly help others in a similar position?
Or would they not be allowed?]
-What about relapses into addiction, which are actually considered to
be expected on the road to recovery.. does this mean that as soon as
you have a relapse, you have to tell someone, or does it mean you
immediately must step down and go away?
will not use any information (de-identified or otherwise) obtained
while undertaking their role within Lifeline, outside the
organisation unless permission is sought and received from Lifeline
National Office
-does this mean that if you want to use some of the info in a school
paper or thesis, you have to ask for permission? what about talking
to your friends? relating 'unusual' or 'entertaining' stories about
some of the 'characters'? While you are not allowed to judge the ones
who call to their face, perhaps when discussing them with friends
it's ok?
In Summary
When it comes to resources and places to go for help, some practical
life problems might not have good solutions, and preventing someone
from killing themselves in the short term does not necessarily solve
the problem.
23.05.14
->exile on meme st: a diary
->xesce.net