Anyone can help, say Canadian Mental Health Association’s Centre for Suicide Prevention. They issue yet another call to arms. People are struggling, thinking of suicide, and you can help, and you, you, and also you. No hesitation, no reflection, just get on with it and help. I don’t like this text at all, this blog explains why. This post might be controversial for some people.

The text is part of the campaign for the World suicide prevention day and it is an appeal to anyone. Here is the fragment I object to. The document says:

Ask and listen

With this in mind, your role is to help the person considering suicide gain back the perspective that they’ve lost, by helping them identify what they have to live for. While this may seem simplistic, its effects are powerful.

Asking someone about suicide, listening to their response, and helping them see the hope in their lives is an extremely effective form of suicide prevention.

I find this fragment highly objectionable, unhelpful, possibly harmful. The key statement is this:

your role is to help the person considering suicide gain back the perspective that they’ve lost, by helping them identify what they have to live for

The sentence is put in the third person singular and the form is to do with linguistically coded certainty. Basically, when you are at your most certain, you simply say things in the third person. So, you say things like this:

• • God exists.
  • Water boils at 100 degrees.
  • This is the treatment for your condition.

No qualifications, no hesitation, no personal perspective. Such sentences simply describe the world as it is. Incidentally, I heard the third sentence a few times from a doctor and every time I was quite taken aback by it. It’s like there is no clinical judgement, no decision to be made. No, this is it, the treatment for you and off you go.

Outside these, language can of course render a spectrum of certainties. From adverbs such as ‘probably’, or ‘certainly’ through ‘I think’, all the way to modal verbs such as ‘may’, ‘might’ etc. We negotiate the certainty with which we can speak/write, deciding which of such phrases to insert, changing what we say or write accordingly. You will probably remember the famous advertisement by Carlsberg, which is ‘probably the best beer in the world’. No, they can’t say it’s the best, but the moment they introduce ‘probably’, they can say just about what they want.

But this not what the Center for Suicide Prevention does. Oh, no. They don’t do qualifications or hesitation, there is no ‘maybe’. They tell us what our role is, as if it were obvious, unproblematic, easy. And before I continue, let me offer a response.

No, it’s bloody not!! It’s not my role, not by a long a way. It’s not the role of anyone who doesn’t want the role, fears it, fears for others. The assumption that we all can take on the role of a counsellor or a psychological helper, or even just a listener, drives me round the bend. Does no one ever think about the possibility that such conversations might not work? That the ‘anyone’ might be left feeling that they failed, that they didn’t say the right things? Conversations are really no miracle buttons that simply make people ‘gain back the perspective’. The simplicity of the CfSP’s assumptions is just staggering.

And then the CfSP continues:

While this may seem simplistic, its effects are powerful.

Again it’s the world as it is, just a simple statement of simple facts. Interestingly, the CfSP offers some references to research along the way in the document, but mysteriously, they stop when they come to the directive bit. So, what exactly are the powerful effects? Are there any at all?

It’s worth stressing that there is surprisingly little evidence the ‘3 minutes can save a life’. It’s likely that closeness or belongingness, as Joiner would put it, is important, but simply saying that by a conversation with a stranger you will quickly ‘regain the perspective’ is nonsense. This is suggesting that suicide prevention is a doddle, and it’s not.

And so, the statement continues:

Asking someone about suicide, listening to their response, and helping them see the hope in their lives is an extremely effective form of suicide prevention.

As I said, there is little evidence that this is true. But what worries me more is the psychologisation of everyday conversations.

Let me re-tell again a story that the suicide prevention field is seems completely uninterested in. The story is about my research which involved interviewing men in depression. One day as many as three men agreed to be interviewed. The interviews were great, all lasted over an hour, the men were talking about extremely difficult things in their lives, all cried during the interview. But they also offloaded all the sadness, misery, unhappiness on me and I was crumbling. I thought I could not cope with the experience and I wanted to disappear. Literally. I needed to talk to someone and fast, as all this sadness was crushing me. I was saved by a wonderful shrink who dropped everything and talked to me.

And that’s why when I see these calls to conversations, I baulk. No, you have no right to tell me or anyone else to engage with the raw misery because it may crush you. As you pressure people to engage, to reach out, you must understand that you may well push people into harm’s way. That the consequences for them might be serious. And, lucky you, you will not be there to pick up the pieces.

Moreover, when you do it in the way that suggests that things are obvious, that this is what things are like, as if there were no other choice, that is unethical. When you suggest that it is clear and unquestionable knowledge that a conversation with people will simply help them, this is unacceptable. And it should never be done.

This is my fourth post about the issue. And I continue to think that every call to reach out should be cushioned in a warning that the person reaching out might not be successful, that they might face significant psychological and social consequences of what they do. And that they themselves might need professional help in the aftermath.

I fully understand that what I am writing about seems harsh. I also know that again I am the awkward sod who is not enthusiastic about things, again I am the one who doesn’t want to help. But I am writing out the experience of ‘helping’, of trying to shoulder the weight of someone’s suffering in a situation way less dramatic than what’s at stake in making small talk save lives. My experience literally almost killed me and I don’t want to go there again. So, stop pressuring me, stop pressuring others.

Instead, tell me you would look out for me when I don’t jump at the ready, when I say nothing. I would like you to (say you) understand that I am scared of saying a word.