The challenge

Every year in Wales nearly twice as many people die by suicide as are killed in road traffic accidents.

In any year, an estimated five per cent of the population have serious thoughts of suicide. (Samaritans)

For every suicide, there may be up to 100 times more who are injured by non-fatal suicidal behaviours. Suicide is the leading cause of death in young people living in Wales. But this is just the tip of the iceberg:

This year as many as 150,000 people in Wales will have thoughts of suicide. Many of these will never go on to attempt suicide, but having thoughts of suicide results in acute emotional and mental distress. 

The opportunity

Most people considering suicide share their distress and their intent. Training can help us see and respond to these invitations to help. It can give you the confidence to ask about suicide if you are concerned about someone's safety. It can provide you with the tools to help prevent the immediate risk of suicide.

The National Suicide and Self Harm Reduction Action Plan for Wales emphasises the importance of early intervention, and the role that all front-line services should play in responding to individuals in need, at the point at which they request help. This early response helps to reduce the isolation of the person at risk, relieves distress and improves the chances of services working together effectively to support the individual.

Principles of effective action

Underpinning the delivery of the action plan is the need to change the behaviour of the public and the agencies that are responsible for positively engaging with the public. It highlights the need to raise awareness of suicide and self harm; deliver training to those agencies that engage with the public and improve the immediate response to individuals in distress at the point at which that distress is recognised.

Early intervention means services responding to individuals in need at the point at which they request help. This early response helps to reduce the isolation of the person at risk, relieves distress and improves the chances of services working together effectively to support the individual. While a referral to mental health services will often be an integral part of this response, individuals with thoughts of suicide will usually need a range of interventions, including help with issues relating to housing, debt, use of alcohol/drugs etc and support from family, friends and community groups. The service where the individual has first asked for help is usually the best-placed to help them access this range of help and support.

Barriers such as stigma, fear and pessimism can get in the way, leading to suicide being seen as something only a specialist mental professional can deal with, and can translate into inertia in front line services and the general public. As long as suicide is seen as the preserve of specialist mental health services, opportunities for early intervention will be missed. While only 25 per cent of those who die by suicide are known to specialist mental health services, the majority of the remaining 75 per cent will be in contact with front-line services.

"Can I help this person stay safe?"

There is evidence that even people with intensely suicidal thoughts are ambivalent about dying but are so distressed that they cannot think of an alternative to dying. By giving them the opportunity to talk, this distress can be reduced enough for them to want to keep themselves safe and increase their ability to engage with available support. The chances of someone who is thinking about suicide finding someone to talk to, and relieving that distress increases if there are trained people in the community who are ready, willing and able to intervene.