Today is World Mental Health Day (the 27th annual), and this year’s focus is on mental health promotion and suicide prevention.
The message from the president of the World Federation for Mental Health, which organizes World Mental Health Day, states:
“The object of making suicide prevention the theme of World Mental Health Day in 2019 is to attract the attention of governments so that the issue might be given priority in public health agendas around the world.”
The WFMH’s campaign materials for this year’s World Mental Health Day notes several key goals in order to reduce suicides:
- “prevention of mental illness
- promotion of good health
- reduction in the stigma associated with mental illness
- improved access to evidence based mental health care.”
The document also lists the following recommendations:
- “To improve mental health literacy in the community so that people can identify mental distress and mental illness earlier ensuring people get more effective help.
- To improve the skills of community and primary care health professionals in the recognition of signs of mental illness and suicidality at first contact.
- To ensure that general hospital and secondary mental health care staff have enough training and manpower to identify those people at increased risk of suicide so that an appropriate prevention plan can be put in place, particularly during the first two weeks of admission and the first two weeks following discharge when suicide risk is at its highest.
- Governments to increase their funding into suicide research and public health measures to improve prevention.
- Policy makers, WHO and international professional colleges to work collaboratively to develop better tools for rating suicide risk and for developing effective management plans for suicide prevention.
- Psychological first aid to be included in all first aid training courses in order to raise awareness of mental health problems and provide the general public with increased confidence and skills to identify mental health crisis and problems and obtain early help.
- Collaborative working between those involved in developing and influencing mental health classification systems in order to consider suicide more explicitly in mental health diagnosis to enabling early identification of those at increased risk and the development of treatment plans to support preventive action.
- Regulators to include suicide prevention indicators and suicide rates as part of mental health key performance indicators.
- Develop a global agenda and consensus on tackling mental health stigma in suicide prevention strategies.
- Brief intervention and contact (BIC) works.”
Sounds good, doesn’t it? None of it helps me, though.
Why do I say that?
Well, for one, it really doesn’t address the reasons why I’d rather slice my hand off with a rusty spoon than go into hospital. You want to make sure people won’t seek treatment again? Give them a couple bad ER/inpatient experiences, and that should be enough to do it. These recommendations also don’t change the fact that I have a mental illness that causes suicidal thinking, and there is no available treatment that fully controls my illness.
All the prevention talk is great, but when you’re dealing with chronic mental illness, unless there’s treatment available, people can talk their fancy talk all they want and there are still going to be people dying.
So now that I’ve got that little rant out of the way, this is what’s on my top 3 wish list for suicide prevention:
- the availability of better treatments – too many people are not responding well enough to their current treatment regimens
- improved access to treatment – long waiting lists can cost lives
- treatment needs to be acceptable, which at least in part requires a serious attitude adjustment in emergency departments and inpatient psych units – stigma is alive and well in the places where people really should be going when in suicidal crisis, and that keeps people from seeking help
Crisis lines are essential, but for people with serious mental illness they can only do so much. So often the message that gets shared the loudest is that people should be willing to talk about it, and crisis lines are the right place to turn. Sure, for some people, they are the right place to turn. For others, they’re a temporary bandaid solution, and for some people they don’t do much of anything. That’s okay, but it means that suicide prevention efforts can’t just be a one-trick pony.
Speaking to World Mental Health Day in more general terms, I think there’s been progressing in opening up dialogue around mental illness. And the more we speak to others about mental illness, the more real we become – more “us” and less “them”. There’s still a long way to go, but I’m optimistic that we’re moving in the right direction.