Suicide and Suicidal Ideation

Today is World Suicide Prevention Day – an internationally recognised day to prevent suicide. I don’t like days like this, because it suggests that we should only focus on it for one day – but nonetheless, it is important to do so. I have personal experience with suicide and suicidal ideation. I will only discuss my own story in this post, out of respect of the survivors that I know and their right to privacy.

The Office for National Statistics (ONS) found that in 2019 5,691 suicides were registered in the UK, of which men accounted for nearly 75% of them (Brown, 2020). The male suicide rate stands at 16.9 deaths per 100,000 – the highest since 2000 (Ibid.). We won’t know until late this year or next year how the coronavirus will impact on these statistics, but it could be estimated that we will see an even more dire picture.

I want to also mention that whilst the number of women who complete suicide is lower than men, their figure of 5.3 deaths per 100,000 is at the highest since 2004, with the age group 10 to 24 seeing the biggest rise (Ibid.). This is incredibly important.

It’s important to also recognise the importance of raising awareness around ideation and nonfatal suicide attempts. At the moment of researching this article, I found that the majority of data is around completed suicide attempts, but that doesn’t give the full picture. Ideation and attempts are arguably “strongly predictive of suicide deaths” which can result in injury, hospitalization and disability (Klonsky, May & Saffer, 2016: 308).

Klonsky & May (2015) developed a 3 step theory which describes how a person can move from non-suicidal feelings, to ideation and finally to an attempt. This is a continuum that people can move up and down based on various factors. It’s important to note that “most individuals with ideation do not make a suicide attempt” Klonsky, May & Saffer, 2016: 322), which is normally based on whether someone has the capacity to do so.

I have experienced both active and passive suicidal ideation over the space of 20 years. Marcia Purse (2020) defines these as follows:

• Passive: “occurs when you wish you were dead or that you could die, but you don’t actually have any plans“
• Active: “not only thinking about it but having the intent to commit suicide, including planning how to do it“

This has been brought about by a variety of situations in my life, such as trauma. My capacity to complete suicide has changed over the years, but generally I have been held at bay due to my support network. From not wanting to cause harm to others, to needing to support those around me, all the way through to receiving appropriate medical intervention and therapeutic support when I have needed it.

Something I wanted to make clear though, is that just because someone has suicidal ideation, doesn’t mean they definitely want to die. It may be that life is just too hard, or there doesn’t seem a way to change their situation. In my case, I’d often wondered if things would be better if I just didn’t wake up, or was in an accident on the way to work. I wasn’t necessarily making any plans, but I just wanted the pain or sorrow to end.

I’m a fairly open book (cliche, I know), so I’m open to questions, as long as they are not too invasive. I feel that it is so important for mental health professionals to discuss their lived experiences, and I don’t feel any shame anymore for my experiences with this challenging aspect of my mental health. I value my own safety plan and use of boundaries to protect myself and others.

So on World Suicide Prevention Day 2020, remember, suicide is preventable.

References and Further Reading

• Brown, F., (2020), “Male Suicide at Highest Rate in 20 Years“, Metro, 1 Sept 2020
• Klonsky & May (2015) “The Three-Step Theory (3ST): a new theory of suicide rooted in “ideation-to-action” framework”, International Journal of Cognitive Therapy, 8
• Klonsky, May & Saffer (2016) “Suicide, Suicide Attempts, and Suicidal Ideation”, The Annual Review of Clinical Psychology, 12
• Purse, M., (2020), “What is Suicidal Ideation? A Look at Dangerous Thought Patterns“, Very Well Mind, 25 Mar 2020