Prior to 1946, technical references to mental health as an explicit field or discipline are rare, although mentions of mental hygiene exist.  Over the subsequent 75 years, understanding of mental health has progressed rapidly, going from an unknown, stigmatised phenomenon to a much better-understood subject.  It is now often considered to be of equal importance to physical health – with ‘parity of esteem’, a term which describes the need to value mental health equally to physical health, being noted by institutions including the Royal College of Nursing, NHS England, and the House of Commons.

In spite of this progress, suicide has remained riddled with misconceptions, poor understanding and taboos, resulting in a limited ability to recognise and support those at risk.  Suicide accounts for 10 in every 100,000 deaths in the UK and increases to as high as 20 in every 100,000 for males aged 45-65.    It is rightly considered an incredibly sensitive subject.  For both those at risk of suicide and their friends and family, it is a complex, personal, and difficult topic to approach.  However, unfortunately, a reluctance to talk about suicide on a personal level has resulted in a wider issue of poor public understanding.

The Campaign Against Living Miserably’s recent ‘the Last Photo’ exhibition served to highlight some of the misconceptions around suicide by displaying photos of people taken within 50 days of them taking their own life – often happy, laughing, or with loved ones.  The exhibition was complemented by a YouGov poll which found that only 24 per cent and 22 per cent of people respectively think that someone experiencing suicidal thoughts would smile and joke, or would share happy photos on social media.  Whilst there can be signs or situations to look out for, these do not apply to all who are struggling.  Sensitively opening dialogue can therefore often be the only way to gain a true understanding of what someone is going through.

The same YouGov poll found that over half of people said they would not feel confident helping someone who is at risk.  In a representative poll conducted in Australia, 31 per cent of people believed that ‘asking about suicide might start them thinking about it’.  This view is associated with a reduction in the intention to ask risk assessment questions.  However, evidence shows that asking someone if they are suicidal enables the person to feel listened to, validates their feelings and helps let them know someone cares.  Talking to someone, whether that be a loved one or a healthcare professional, can often be the first step to getting help (more information can be found on Samaritans’ website As illustrated by Samaritans here, many myths surrounding suicide have been debunked yet continue to contribute to a reluctance to discuss the topic – when in reality, talking about the subject is a crucial first step in helping those at risk.

The portrayal of suicide in the media also complicates the discourse.   Online searches for the corresponding method increased sixfold on the day when details of Caroline Flack’s death were released, highlighting the impact that reporting can have, and also shining a light on the ease with which anyone can access information about suicide online.  This impact can be even more substantial when the media sensationalise the story and give a detailed account of the method.  This issue has led for calls to formally regulate how the media represent suicide. The Samaritans provide clear guidelines on how to best portray suicide in the media and, whilst open dialogue is encouraged, it must be done in a sensitive and constructive manner.  One of the more common examples, not just in the media but in society as a whole, is to move away from the use of the phrase ‘committed suicide’ which harks back to an era in which suicide was a sin or crime.

On the other hand, media can be used as a productive tool in suicide prevention.  One example is the song “1-800-273-8255” by American rapper Logic in collaboration with the US National Suicide Prevention Lifeline (NSPL).  The song details the beneficial role of crisis counselling from personal experience and the three weeks following the release of the song saw a reported rise of 27 per cent in calls to the NSPL.  Charities across the UK are similarly seeking to open the dialogue about suicide in a sensitive manner, and campaigns such as the annual Talk to Us by Samaritans remind people that, should they need it, there is always someone there to listen.

Mental health has undergone a seismic shift in recent decades – from highly stigmatised to slowly becoming embedded in mainstream health services.  However, it is vital that the issue of suicide is not left behind.  Reducing misconceptions, encouraging wider discussion, and handling the topic in a sensitive manner will hopefully empower people to recognise, understand and support those at risk, overcoming the final taboo.

Photo by Aarón Blanco Tejedor on Unsplash