It's World Mental Health Day 2019. This year's theme? Suicide prevention.
Over 6,000 people die by suicide annually in the UK, with men three times as likely as women to take their own life.
That leaves thousands more with grief made all the more devastating by the stigma of suicide. And yet, we rarely hear their voices. Here, writer Cecilia Knapp, 27, shares what it’s been like for her.
What happened when my brother took his own life
The text on my phone read, ‘I’ll love you forever.’ It was from my 21-year-old brother Leo back home in Brighton and, when I read it, on a Sunday afternoon in May 2012, I was at a venue in East London, about to go on stage to perform my poetry before doing a shift behind the bar.
If you need someone to talk to the Samaritans are always there to help and listen. Call 116 123 free, 24/7.
I assumed he was drunk, high or just being his affectionate self and decided I’d check in later. I forgot. Later, a neighbour called to tell me that my brother had made an attempt on his own life, and that he’d succeeded.
I went into shock and ran out of the bar, and a couple of friends ran after me. They drove me down to Brighton, all the while trying to get hold of my dad, who was on his way back from work. I desperately didn’t want him to get home and see it all happening outside our house.
‘Listen, you have to know that Leo’s dead,’ I said, when I eventually got through to him. ‘Just so you’re prepared for when you come home.’
My brother, Leo
Leo’s death was a visceral, destabilising shock, but it wasn’t a surprise. He was an eccentric, intense and dramatic person. As children, we loved inventing worlds and adventures, but as we grew older it was like he didn’t know where to put this energy.
Before he died, he’d struggled with coming to terms with his sexuality and was entrenched in dangerous patterns of addiction with alcohol, Valium, ketamine... all ‘downers’ that would provide him with an escape from the depression he’d battled from the age of 10, which – as per societal norms at the time – he didn’t have the language to talk about.
Even when he was coming round following his three previous suicide attempts, and we were talking, I’d get the sense that he was confused and trapped and that this violent outburst seemed to him to be his only option.
Each time, he’d be discharged from hospital the day after, with a prescription for heavy-duty tranquillisers and sleeping aids, which, as an addict, he’d abuse.
My brother's suicide: the aftermath
I was no stranger to grief. After losing my mother to cancer at eight years old, it was just my dad, my two older brothers and me. I’d grown up my whole life with men and I didn’t want to sob in front of them, so my default was to organise: Leo’s funeral service, the flowers, food and invitations.
In many ways, what happens immediately after you lose someone to suicide is much like the process that follows a more palatable, straight-down-the-line tragic death.
Everyone just naturally falls into a role in this weird limbo period when life seems to stop. When it doesn’t matter what day of the week it is or that you’ve had 75 cups of tea and you’re living off scones and freeze-dried noodles; when you don’t have to go to work or even change your trousers if you don’t want to.
Dealing with the stigma of suicide
But the stigma around suicide makes grieving for someone who has died this way all the more complicated.
Once the practicalities were sorted, the grief hit – hard. Speaking to anyone about Leo’s death triggered a flood of questions in my mind. Do they think it’s my fault? Do they think that I think it’s my fault? Am I making them feel uncomfortable?
I felt a sense of shame, anchored by the fact that I blamed myself: for leaving home to go to university in London just a few months earlier, knowing Leo wanted me to stay; for not reading between the lines of that text message; for allowing this to happen.
This shame was reinforced by people’s distance. It had happened in my home town; it was a neighbour who had found Leo; it was all out there and everyone knew what had happened.
Why saying something is always better than nothing
Yet, people would cross the road to avoid talking to me. Part of me understands. There was no script to help you talk about something as uncomfortable as suicide.
But please know that whatever you say, even if you feel like you’ve put your foot in your mouth, it’s better than nothing. Grieving suicide is a lonely experience, made worse by every wide berth. As for the impact on me, I never had one big breakdown.
Instead, as months morphed into years, my self-worth plummeted. I tried to justify all the bad things that had happened by ascribing all the blame to myself and assassinating my own character in the process.
I wanted to make sense of what had occurred, so I could stop it happening again, and if I became the villain?
So be it. I began to accommodate people who treated me badly because I didn’t want to lose anyone again, returning repeatedly to a relationship that was ruinous for my self-esteem – and still impacts me negatively today.
‘I’m robust,’ I thought. ‘I can take it, and then at least they won’t leave me.’ But, inevitably, they ended up leaving anyway.
With Leo, I spent my whole life compromising and making small sacrifices to ensure he was safe no matter what, and it’s only in the last couple of years that I’ve been learning how to undo that. I still go back to that day: what would have happened if I’d called him back straight away? Could I have made it back to Brighton in time to stop him? (Answer: no – I’ve done the numbers countless times.)
The support that saved me
What saved me, I think, was the unwavering support I’ve had from the few people I’ve been able to confide in since that night; people who can provide evidence to counter my brain’s repeated accusations – even almost seven years later – that I was useless, selfish, and did nothing for my brother.
With them in my corner, I’ve come to understand that I wasn’t to blame – no one is. It was an understanding that emboldened me to start writing about what happened. I started by journalling and writing poetry about losing Leo, then I wrote a play about the experience, called Finding Home, the final performance of which took place in December.
I began working with male suicide charity CALM (Campaign Against Living Miserably)
I was looking at the men on the Tube in the morning, imagining 84 of them (how many men kill themselves in the UK each week), enough to fill several carriages, just ceasing to be there.
The numbers are disproportionately skewed towards men who are gay, like Leo, or trans, or from working class backgrounds.
Suicide prevention and the policy that needs to change
That’s an intractable part of this conversation. Mental wellbeing doesn’t exist in a vacuum.
And when people are routinely using food banks, long-standing communities are being eroded and schools are operating without adequate provision to support children (like my brother) with complex additional needs, what kind of an impact is this going to have on the health of those in our society?
That said, you can’t just march up to Whitehall, rewrite NHS policy and ensure it’s rolled out adequately. You can lobby and write to your MP, sure. You can use your words and actions carefully to chip away at the toxic assumptions that men can’t vocalise their feelings.
But if you’ve lost someone to suicide, you absolutely need to be gentle with yourself. It’s only in the past couple of years that I’ve accepted that my mind and body have taken an intense battering over the past seven years, and this emotional recovery is going to be a lifelong journey.
I’m learning not to beat myself up if, every now and then, I just need to go for a swim, read and have a sit.
I’ve not sought therapy yet, but I look forward to seeking it out one day. I think it’s partly because I write every single day and keep diaries and interrogate my experiences that way.
Creativity is both a cathartic and empowering way to take responsibility for your mental health. Even if you have no intention of sharing your mind’s inner workings in print or on stage, it’s a powerful tool for helping you understand what’s really going on in there.
My brother's death and rebuilding my life
Almost seven years on from the day my brother chose to leave the world, I’m doing pretty well. I’ve become happier and more confident in myself and, when I feel a pang of guilt about enjoying my life, I remind myself that it’s exactly what my adoring big brother would have wanted.
Integral to this is the fact that I’ve managed to find peace with his decision to cut short a very painful existence – and with myself, for not being productive and positive all the time.
I’m accepting that, as I move on with my life, the shock and pain of this peculiar type of grief will live with me forever.
Suicide prevention: how to talk to someone you think may be at risk
1/ Mark out time
Don’t wait for the ‘right’ moment; there’s never going to be one. ‘But make sure you won’t be interrupted,’ says Mental Health First Aid England director of communities and content development Caroline Hounsell. Choose a quiet place, where you won't be interrupted or on looked.
2/ Say the word
If they talk about feeling low, don’t be afraid to ask them if they’ve thought about killing themselves. ‘Discussing someone’s suicidal thoughts doesn’t make them more likely to act on them,’ says Hounsell. ‘Keep your voice steady and try to create a sense of calm.’
3/ Let them talk
Ask how certain events make them feel, and what they need. Your role here is to listen and reassure the person that they’re valued and cared for, so tell them so. While you shouldn’t dismiss someone’s feelings or experiences, it’s okay to remind them that these feelings won’t last forever.
4/ Make a plan
Once you’ve got an idea of their emotional state, it’s time to take action. If they’re not suicidal, help them make plans for life activities over the coming weeks and arrange an appointment with a doctor.
If they are suicidal, stay with them until they are seen by medical professionals.
5/ Keep showing up
Suicide prevention is never about one conversation; if a loved one is vulnerable, they need sustained support. Face-to-face meet-ups are ideal. Let’s be clear: this is far from a one-person job.
As soon as you know someone is suicidal, reach out to their other friends and family.
Now that you know about suicide prevention, read up on what happens when you go for CBT.
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