There were 6,188 deaths by suicide in the UK in 2017. Men are three times more likely to suicide than women; but suicide rates among women are at their highest rate for a decade. These are the facts of suicide. Each incidence of suicide represents a massive emotional upheaval : for the person who suicides; for the people who are left behind; for the emergency services and other support networks that are brought into play in the aftermath of a suicide. And yet most of us still find it incredibly difficult to talk about suicide; and the idea of raising the possibility that somebody is suicidal and may need our help, is a terrifying prospect.
ASIST – Applied Suicide Intervention Skills Training – is a programme developed in Canada which is now being rolled out across England with support from the NHS and organisations including Samaritans and local authorities. I was lucky enough to complete the course on Thursday and Friday of this week, alongside colleagues from the residences pastoral care team at the University of Bristol. The programme starts by challenging individual assumptions and attitudes towards suicide, and reflecting on how those assumptions and attitudes may impact on our approach to somebody contemplating suicide.
The aim of the training is to equip people with a framework for providing ‘first aid’ to somebody contemplating suicide, with the overall aim of keeping that person safe for now. The emphasis is very much on building the confidence to identify and respond to the invitations to talk about suicide that people with suicidal thoughts will typically send out. These invitations may not be obvious – and may not even be deliberate. Changes in behaviour – becoming withdrawn and cutting themselves off from friends and family; behaving erratically; a sudden and unexplained fall of in academic or workplace performance – all can be signs that somebody is struggling to live. One of the key points of the training is the fact that asking somebody if they are feeling suicidal won’t put the idea into their head if they aren’t already contemplating it. And actually asking somebody if they are suicidal can be an enormous relief to somebody who may have been waiting for that one person to accept their invitations to talk about it.
The training is inevitably emotionally charged. An early session which invites participants to talk about their experiences of suicide revealed the extent of suicide and the impact that it has on family, friends and colleagues. In our group of 14 trainees, everyone had had some direct experience of somebody close to them who had suicided. In my own case, talking about those experiences exposed a part of me that had been suppressed for a long time, and the feelings were as raw as they had been at the time. That in itself is reason enough to increase awareness of suicide, and increasing the confidence and competence of all of us to speak openly with somebody who is struggling to live, and to support them to stay safe for now; and to put in place a plan to keep them safe in the longer term.
I hope that I will never have to use the skills that I’ve learned in the past two days. But I know that if I am in a position where somebody is struggling to live, I now have a framework to respond positively and in a supportive way to the invitations to talk about suicide; and hopefully to help somebody keep safe for now.
If you get the chance to attend an ASIST course, please consider it very carefully. I doubt that you’ll regret it.