R U OK?

September 15 is RUOK Day.   RUOK day aims to help reduce the numbers of people who take their own lives.

A little while ago Gemma invited me and other bloggers to join her in posting on this important day.  And it is a topic that is very close to my heart.

There have been times (and will be again) when I have been decidedly not OK either mentally or emotionally.  Once during a very bad patch, knowing I had the house to myself for a week or so, I spent days sitting on the floor ripping paper into ever smaller pieces, neither eating nor sleeping while the piles of confetti built up around me.  I was lost, could not see any future, and certainly thought it would be much easier for me (and for others) if I was dead.  I had a plan and the means to kill myself.  In the end apathy saved me.  I didn't want to live, but dying required action which took more energy than I had at that time.  So I lived. Mostly I am glad, but still sometimes in the throes of what I call the 3am horrors I wonder.

It always appalls me how easy (and fast) the descent into the depths of despair is, and how agonisingly slow and hard it is to climb back to something approaching sanity.  When I have hit the bottom I have always felt both that I was alone, and that it was up to me to get myself out again.   A feeling which was and is almost certainly wrong. True, no-one had asked me if I was OK but it was equally true that I had not said that I was having trouble coping.  Not sensible of me, but I have learnt (the hard way) that I am not sensible at these times and that I am prepared to go to some pains to conceal just how bad I am feeling.  It appears that this subterfuge is a skill of mine, so the people around me cannot be blamed for not noticing that I need help.

It is much, much easier (and still not easy) for me to admit that I am having physical problems than it is to make the same admission about my mental or emotional health.  On those issues, if (and it is a big if), I admit that I am struggling I really mean I am teetering very close to the edge.  I have known for some time that this is dishonest and hypocritical and preparing this post has led me to make a promise to myself that I will ask for help when I need it next.  A promise I hope I can keep. 

My second reason for participating in RU OK? Day is less directly personal but no less heartfelt.  I have been a telephone counsellor with Lifeline for nearly fourteen years.  And I have learnt some horrifying things.

Suicide numbers in Australia are currently falling slightly.  However, according to the latest Australian Bureau of Statistic Causes of Death report, 2130 Australians took their own lives in 2009, and:
suicide is the leading cause of death for women aged 15-34;
suicide is the leading cause of death for males aged 15-44;
and more Australians die from suicide than on the roads.

Frightening isn't it?  And I assume that suicide is under rather than over reported.  These are Australian statistics only, but I would be surprised if the percentages were very different in any of the westernised countries.  Every suicide impacts on so many people - family members, friends, peers, co-workers and the community at large. 

There are circumstances (particularly given our euthanasia laws) where I can both understand and accept people choosing to end their lives.  However, even when a person has a terminal or an incurable illness which is degrading their quality of life, I hope that palliative care options are looked at before suicide is identified as the only option.

Other reasons for suicide, including struggling with mental illness, lack of acceptance of a person's sexuality, relationship break downs, loneliness, financial issues and the like worry me more.  A lot more.  And I firmly believe that there are alternatives to suicide available for most people.

In Australia there is on average a suicide attempt every fifteen minutes and a death from suicide every four hours.  In my time at Lifeline I have talked with many, many people who have attempted to kill themselves, and about the same number who were actively considering it.  More rarely I have talked with people who were in the process of committing suicide.  I have also talked to people who have lost friends and family through suicide.  I have wept with and for these callers.  Heartbreaking calls, some of which will haunt me forever.

A common thread has run through my conversations about suicide with callers.  Almost without exception the callers did not want to die, but could see no other way to make their pain stop, regardless of whether that pain was physical, mental, emotional or a mixture of some or all of those things.  Pain, teemed with desperation and a loss of hope is truly dangerous.  And, rightly or wrongly, the callers often consider themselves to be alone.  Which is why it is so important to reach out to people we think may be struggling.

Of course we will never be able to eliminate suicide.  Nonetheless, talking, and much more importantly listening to people who are in pain is hugely important. So, a simple question to someone you are worried about could be the start of a lifesaving journey.

Listen to their pain.  Allow them to express their fears.  The first step, of acknowledging just how bad things have got, is the hardest.  And takes a lot of courage (which should be acknowledged and affirmed).  And it is only when their pain has been heard, and perhaps shared that the first small glimmers of hope can creep in.

Hard as it can be, don't try and solve their problems for them.  Accept that they are doing the best they can, in very difficult and frightening circumstances. 

You could summarise what you have heard, and ask them what they plan to do. It may be that they are not ready to do anything just yet.  Nonetheless, being able to express their pain and their fears without being judged can be a very powerful healer.   If they don't know where to start getting help for themselves but feel ready to take action you could suggest a few places which might provide a resource for them.

The appropriate resources are obviously going to be as individual as the person but some which may be of assistance include family, friends, school and other counsellors, doctors, religious groups, mental health crisis services, hospitals, relevant support groups, and/or

Lifeline (131114), 

Kids Helpline (1800551800),

Beyond Blue, 

Sane Australia.

Encourage them to take one step at a time.  And follow up.  Let them know that you will contact them, later today, tomorrow, or next week to see how they are going.  Nothing can change till someone acts - and you could be the catalyst for lifesaving action.

Who are you going to ask RU OK today?  And not just today, but each and every day.