This post deals with suicide and might be triggering for some readers.
As I write this, it has been four years to the day since my boy, Josh made his final visit to the emergency department in crisis.
Three days later, he took actions to end his own life. After 11 days in ICU, we lost Josh at the age of just 17.
We had been through two years of crises off and on. At the time I did everything I could with what knowledge and skills I had. But I will forever harbour a poignant wish that I had been better prepared.
In the hope of helping others who are now where I have been, here are five key things I’ve since learned that I wish I had known at the time.
1. You have to talk about it.
One of the biggest unspoken myths is that if we ignore suicide, it will go away. It doesn’t. The thoughts grow. They grow in the dark of silence and secrecy, unchecked.
I froze with fear at some of the thoughts my son revealed.
He saw this and resolved not to trouble me with his darkest thoughts. I was still there for him in the emergencies of suicidal crisis, but what I lost was the chance to help Josh in between the surges; to hold space for him to work through his underlying thoughts and feelings.
2. Suicide hides in plain sight.
What I now know is that one in eight Australians will think about taking their own life at some point in their lives*. These people are going about their everyday lives alongside you and I, usually unnoticed. This is where we have to trust our gut instinct and open up the conversation.
I didn’t ask, 'Are you thinking about suicide?' many times when I should have.
I was afraid. Afraid the answer was yes. Afraid I would be faced with suicide and wouldn’t know what to do. Afraid I’d make it worse.
As it turns out, the opposite is true: opening up the conversation is actually the first step to safety.
3. The only person who can save someone from suicide is the person themself.
We forcibly stopped Josh from taking his life in crisis moments maybe five times.
Keeping him away from the means of suicide momentarily was clearly necessary but having him locked up for two weeks was a more of a complicated decision. The lock up wasn’t helping him. But it was keeping him alive.
I have painfully learned that there are limits to what we can do to save someone from suicide.
We can’t lock people up indefinitely and take away every possible deadly means. Ultimately, it is the person themselves who must choose life and our key role is to support them in that process.
4. You can’t rely on the mental health system alone.
Our society’s capacity for physical medicine is so remarkable that you would assume our mental health system is comparable. But it is not.
If I had to draw an analogy, I’d liken it to the pre-disinfectant era of the 1800s.
Treatment for my boy included: being left in severe distress in the emergency department for up to several hours, being told that if he really wanted to, he would have already taken his life, and being told that if they hadn’t been able to help him up until now, they wouldn’t be able to help him that night. That was the final visit.