Below I cover strategies for dealing with a suicidal crisis and strategies for early intervention and prevention of suicide.
The Scale of the Problem
Suicidality includes thinking about suicide (suicidal ideation), planning suicide and attempting suicide.
There was a 6.5% increase in suicide numbers in England in 2023. More people under 35 die from suicide than anything else in the UK and about three-quarters of these young people are male. However, men between 45 and 49 years old have the highest rate rate of suicide in the UK.
While men are four times more likely to take their lives, women are three times more likely to engage in suicide ideation and attempts.
On a global scale, suicide is the fourth highest cause of death in young people and immigrants have a higher rate of suicide than native populations.
There was a 6.5% increase in suicide numbers in England in 2023. More people under 35 die from suicide than anything else in the UK and about three-quarters of these young people are male. However, men between 45 and 49 years old have the highest rate rate of suicide in the UK.
While men are four times more likely to take their lives, women are three times more likely to engage in suicide ideation and attempts.
On a global scale, suicide is the fourth highest cause of death in young people and immigrants have a higher rate of suicide than native populations.
The Stigma of Suicidality
One of the challenges with suicide prevention is the stigma associated with suicidality. Many of us don’t like to talk about it, making suicidality difficult to spot, and if we can’t spot it we can’t change it.
Suicide Ideation vs. Suicide Attempts
Suicide ideation is comparatively common and in the majority of cases, does not result in a suicide attempt. The percentage of the population who have engaged in significant suicidal ideation during their lifetimes is 9% and two-thirds of those have never attempted suicide. This is not to minimise the issue of ideation, attempting, or planning suicide. All sufferers need help. Suicidal ideation and attempts frequently occur with people who have underlying mental health problems, such as anxiety, depression.
Suicide Crisis Intervention Strategies
In case of a suicidal emergency, here are some guidelines for managing suicidality and being ok in the moment:
- Get expert help. You can access expert support 24/7, for free!
- Call the emergency services on 999
- Samaritans Phone: 116 123; Email: jo@samaritans.org (available 24/7)
- Shout 85258 Text ‘SHOUT’ to 85258 (available 24/7)
- HOPELINE247 (Papyrus UK) Phone: 0800 068 4141; Text: 07860 039967; Email: pat@papyrus-uk.org (available 24/7)
- Campaign Against Living Miserably (CALM) Phone: 0800 58 58 58; chat via website (5 pm to midnight daily)
- Childline (for under 19s) Phone: 0800 1111 (available 24/7)
- Talk to someone, a friend, or family member, someone who is available now
- Just be with others. You are not obliged to talk to them and you don’t even need to know them. You could hang out somewhere there are other members of public, for example
- Feelings associated with suicidality can be overwhelming, but remember, they do pass, in the same way that all feelings do
- Steer clear of alcohol and drugs that could ultimately make you feel worse, or that could make you more impulsive
- You may worry that you could feel like this again, but focus on the passing of your feelings. They come and they go
- Use your hope box, or your hope book if you have one
- Bring your awareness into the present moment:
- Pay attention to what you can see (colours, shapes, patterns, depth, light/dark etc.), hear (volume, pitch, location, rhythm etc.), feel (texture, temperature, moisture/dryness etc.), taste (sweet, sour, spicy, umami, salty etc.) and smell (floral, earthy, fresh, sweet, herbal etc.)
- Identify 5 things you can see, 4 things you can hear, 3 things you can touch, 2 things you can smell, 1 thing you can taste
- Practise the “Physiological Sigh” breathing technique
- Be in a place you like and that feels safe – a place of nature, your bedroom, the gym, a place of worship
- Do something simple. Walk, cook something, wash-up, exercise. This will alter your state of mind
- Why do today what you can put off until tomorrow? Don’t make any big decisions – decide later
- Engage in activities, or media, or be with people that make you feel good
- Keep this information nearby and have it available to access should you need it
Suicidality Early Intervention and Prevention Strategies
Here are some guidelines for preventing and intervening on suicidality more deeply and ahead of time:
- Find an NHS talking therapy service. This kind of service is free, but the wait time may be weeks to months. The number of sessions may be limited, you may not be able to choose which therapist you work with and the treatment may be homogenised, firmly structured and lacking in terms of client-centred care
- Tell your GP
- Access private therapy
- Create a crisis plan, so you are really clear about how to respond in case of a crisis. I converted these simple templates (link) from some made by Rethink Mental Illness, so you can download them and use them immediately
- Create a hope box. This is a box that you can fill with things that connect with a good feeling. You can focus on items that are a delight to each of the five senses – make it your own! For example:
- Look – Photos of loved ones, images of places you feel safe, something with soothing patterns, Your crisis plan
- Smell – Scented candles, aromatherapy oils, jars of spices, scented lotions, a comforting perfume, scratch and sniff stickers
- Taste – Chocolate, hard sweets, mints, sour sweets, flavoured tea bag, popping candy
- Listen – A USB filled with relaxing noises, your favourite CD or playlist, a musical instrument, audio books, clickers, phone apps with soothing sounds
- Touch – Stress balls, nail file, a soft piece of clothing, hand lotion to massage hands with, tactile beads, rubber bands to snap on wrist or stretch, clay, PVA
- Create a hope book. Much like a hope box, you can fill a hope book with things, and/or writing that connects with good feelings. You could even put it in your hope box. For example:
- Photographs of loved ones
- Favourite quotes
- Letters from friends
- Poetry
- Places to see
- Song lyrics
- Colouring in pages
- Achievements
- Upcoming Events
- Photographs of pets
- Hobbies
- Resources
- Your crisis plan
- Build and interact with a trusted support network of friends and/or family
- Optimise your social media feed for positivity and uplifting messages and away from conflict, outrage, politics and other media that can negatively hijack your emotions
- Integrate a daily practise of meditation, or other forms of mindfulness
- Listen to self-hypnosis, or guided meditation audio tracks
- Practise breathing exercises regularly, such as the “physiological sigh”, or Wim Hof breathing (with optional cold exposure)
- Learn to sleep well
- Exercise regularly
- Eat a healthy diet
In Conclusion
If I were to recommend one action to take in an emergency strategy, it would be to call the emergency services.
If I were to recommend three actions to take in terms of intervention ahead of time and prevention, it would be to access therapy, lead a healthy lifestyle and practise meditation and mindfulness regularly.
Whatever your situation, help is available and taking the step to access help is in itself a positive manifestation of autonomy, agency and self-control.
