On the 10th September every year, we celebrate the World Suicide Prevention Day (WSPD). ‘Working Together to Prevent Suicide’ is the theme for this year’s WSPD. This theme was chosen internationally as it highlights the most essential ingredient for effective global suicide prevention and collaboration. We all have a role to play and together we can collectively address the challenges presented by suicidal behavior in society today.
It is estimated by the World Health Organization that over 800,000 people die by suicide each year – that’s one person every 40 seconds. In Australia according to the Australian Bureau of Statistics (ABS) over a five year period from 2012 to 2016, the average number of suicide deaths per year was 2,795. In 2016, preliminary data showed a total of 2,866 deaths by suicide (age-specific suicide rate 11.8 per 100,000), 2,151 males (17.9 per 100,000) and 715 females (5.9 per 100,000). There were 3,027 deaths in 2015 (12.7 per 100,000). In 2016, preliminary data showed an average of 7.85 deaths by suicide in Australia each day.
Although most Australians live healthy and happy lives, among the LGBTI community, a disproportionate number experience worse health outcomes than their non-LGBTI peers in a range of areas, in particular mental health and suicidality. Available research continues to demonstrate that the prevalence and rates of self-harm and attempted suicide are significantly higher amongst LGBTI people than among non-LGBTI populations, though the prevalence of completed suicide statistics remains unknown.
According to Gabi Rosenstreich in LGBTI Mental Health and Suicide:
- LGBTI people have the highest rates of suicidality of any population in Australia.
- 20% of transgender Australians and 15.7% of lesbian, gay and bisexual Australians report current suicidal ideation (thoughts). A UK study reported 84% of transgender participants having thought about ending their lives at some point.
- Up to 50% of transgender people have actually attempted suicide at least once in their lives.
- Same-sex attracted Australians have up to 14x higher rates of suicide attempts than their heterosexual peers. Rates are 6x higher for same-sex attracted young people. The average age of a first suicide attempt is 16 years, often before ‘coming out’.
- There is a lack of data on intersex people but overseas research and anecdotal evidence in Australia indicate that intersex adults have rates of suicidal tendencies and self-harming behavior well above those of the general population.
- Indigenous LGBTI Australians, LGBTI migrants and refugees, LGBTI young people and LGBTI people residing in rural and remote areas are likely to be at particularly high risk of suicide, in line with tendencies of high risk identified in the population as a whole.
- There is increasing concern that older LGBTI Australians may also have a particularly high risk of suicide, with many having endured persecution, including legal condemnation and ostracism and fearing dependency on potentially discriminatory mainstream aged care services, especially as they are less likely to have children to care for them.
- Many LGBTI people who attempt suicide have not disclosed their sexual orientation, gender identity or intersex status to others, or to only very few people.
Given the evidence for this heightened vulnerability, it’s important for prevention campaigns to target lesbian, gay, bisexual, and transsexual, and intersex people by being culturally relevant, accessible, and focused on the specific factors that increase the risk for suicidality. This is particularly the case during adolescence when young people are especially vulnerable while coming to terms with their sexuality or gender-identification.
Encouragingly, in 2007 the National LGBTI Health Alliance was the national peak health organization launched in Australia specifically to provide health-related programs, services and research focused on LGBTI people and other sexuality, gender, and bodily diverse people and communities.
Their core mission states: “As the national NGO peak body for LGBTI health in Australia, our particular mission is to provide a national focus to improve health outcomes for LGBTI people through policy, advocacy, representation, research evidence, and capacity building.“
Many suicides are preventable. When risk groups are identified, as is the case with LGBTI individuals, it is incumbent on us to use our knowledge about how to help people to the greatest possible extent.
Here’s some useful information on identifying the warning signs of suicide as well as helping a suicidal person:
- Talking about suicide – Any talk about suicide, dying, or self-harm, such as "I wish I hadn't been born," "If I see you again..." and "I'd be better off dead."
- Seeking out lethal means – Seeking access to guns, pills, knives, or other objects that could be used in a suicide attempt.
- Preoccupation with death – Unusual focus on death, dying, or violence. Writing poems or stories about death.
- No hope for the future – Feelings of helplessness, hopelessness, and being trapped ("There's no way out"). Belief that things will never get better or change.
- Self-loathing, self-hatred– Feelings of worthlessness, guilt, shame, and self-hatred. Feeling like a burden ("Everyone would be better off without me").
- Getting affairs in order – Making out a will. Giving away prized possessions. Making arrangements for family members.
- Saying goodbye – Unusual or unexpected visits or calls to family and friends. Saying goodbye to people as if they won't be seen again.
- Withdrawing from others – Withdrawing from friends and family. Increasing social isolation. Desire to be left alone.
- Self-destructive behavior – Increased alcohol or drug use, reckless driving, unsafe sex. Taking unnecessary risks as if they have a "death wish."
- Sudden sense of calm – A sudden sense of calm and happiness after being extremely depressed can mean that the person has made a decision to attempt suicide.
If a friend or family member is suicidal, the best way to help is by offering an empathetic, listening ear. Let your loved one know that he or she is not alone and that you care. Don't take responsibility, however, for making your loved one well. You can offer support, but you can't get better for a suicidal person. He or she has to make a personal commitment to recovery.
It takes a lot of courage to help someone who is suicidal. Witnessing a loved one dealing with thoughts about ending his or her own life can stir up many difficult emotions. As you're helping a suicidal person, don't forget to take care of yourself. Find someone that you trust—a friend, family member, clergyman, or counselor—to talk to about your feelings and get support of your own.
Here are some ways to help a suicidal person:
- Get professional help. Do everything in your power to get a suicidal person the help he or she needs. Call a crisis line for advice and referrals. Encourage the person to see a mental health professional, help locate a treatment facility, or take them to a doctor's appointment.
- Follow-up on treatment. If the doctor prescribes medication, make sure your friend or loved one takes it as directed. Be aware of possible side effects and be sure to notify the physician if the person seems to be getting worse. It often takes time and persistence to find the medication or therapy that’s right for a particular person.
- Be proactive. Those contemplating suicide often don't believe they can be helped, so you may have to be more proactive at offering assistance. Saying, “Call me if you need anything” is too vague. Don’t wait for the person to call you or even to return your calls. Drop by, call again, invite the person out.
- Encourage positive lifestyle changes, such as a healthy diet, plenty of sleep, and getting out in the sun or into nature for at least 30 minutes each day. Exercise is also extremely important as it releases endorphins, relieves stress, and promotes emotional well-being.
- Make a safety plan. Help the person develop a set of steps he or she promises to follow during a suicidal crisis. It should identify any triggers that may lead to a suicidal crisis, such as an anniversary of a loss, alcohol, or stress from relationships. Also include contact numbers for the person's doctor or therapist, as well as friends and family members who will help in an emergency.
- Remove potential means of suicide, such as pills, knives, razors, or firearms. If the person is likely to take an overdose, keep medications locked away or give out only as the person needs them.
- Continue your support over the long haul. Even after the immediate suicidal crisis has passed, stay in touch with the person, periodically checking in or dropping by. Your support is vital to ensure your friend or loved one remains on the recovery track.
Crisis support lines (Australian services)
- Emergency Support 000
- Lifeline 13 11 14
- Qlife (3pm - Midnight) 1800 184 527
- Kids Helpline 1800 55 1800
- Beyond Blue 1300 22 4636