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The Role of Friends and Family of Suicidal People Print E-mail
Living - Relationships
TS-Si News Service   
Sunday, 30 October 2011 15:00
Suicide Clue.Bristol, United Kingdom. Relatives and friends of people who were suicidal did not always receive clear and unambiguous warning signals from the suicidal individual; even when it was obvious that something was seriously wrong, they could not always summon the courage to take action.

A preliminary study highlights the family and friends of suicidal persons, focusing on a persistent – and as yet unsolved – problem: how should they judge whether a person is in danger and decide what should be done about it.


The research team asked relatives and friends of the deceased what they had witnessed in the period leading up to the suicide and how they had interpreted what they saw. Family members and friends of those who may be contemplating suicide are confronted by powerful emotional blocks, particularly fear. They may be afraid of intruding into another person's emotional life or afraid of damaging a cherished relationship by saying the wrong thing.

The research, carried out by Dr. Christabel Owens from the Peninsula College of Medicine and Dentistry, and her colleagues, is reported in BMJ (the British Medical Journal).

The Owens team investigated 14 suicides aged 18-34 in London, the South West and South Wales, none of whom were receiving specialist mental health care.

In all, 31 lay informants (parents, partners, siblings, friends and colleagues) took part.
The whole situation is emotionally charged, and that affects the way in which people respond. Unlike conditions such as stroke, where national awareness campaigns have been built around the very obvious signals to look for, this study emphasises that for suicide there is no clear if you see this, then do that message – despite research literature suggesting that warning signs for suicide do exist.

Said Dr. Owens: "Even doctors with many years' training and experience find it very difficult to assess whether or not a person is at imminent risk of suicide." Family members and friends find themselves in uncharted territory, with no training and little public information to guide them. They may know that a relative or friend is troubled but have absolutely no idea that suicide is a possibility. "The person may give very indirect hints, possibly when disinhibited by alcohol, that they are thinking of killing themselves, but it is difficult for others to know how seriously to take these messages and how to respond to them."

The study indicates that, where emotional or psychological pain is involved, people do not seek medical help lightly. For a person who is feeling overwhelmed and suicidal, consulting a doctor and confessing those feelings requires immense courage and is often a last resort.

"It is sad that, in the course of our research, we have repeatedly come across examples of people who did go to their GP, were given a cursory risk assessment and sent home with little or no support, and subsequently killed themselves. In other cases, a relative has taken their concerns to a GP and asked for advice, and has been told that the case cannot be discussed with them for reasons of patient confidentiality and that the person must visit the GP themselves," said Owens.

Having identified the challenges facing family and friends of the suicidal, the authors of this study will, in partnership with statutory and voluntary organisations, work on developing solutions.

Said Dr. Owens: "There are some suicide prevention skills training courses available, but they are not ideal for members of the general public, and we don't know how to get them to the people who need them. We still need to identify the key messages that we have to get across to people, and work out how to deliver them to relatives and friends of those who are at risk of suicide."

FundingThis research was supported by the Devon Partnership NHS Trust and funded by the UK Medical Research Council.
CitationRecognising and responding to suicidal crisis within family and social networks: qualitative study. Christabel Owens, Gareth Owen, Judith Belam, Keith Lloyd, Frances Rapport, Jenny Donovan, Helen Lambert. BMJ 2011; 343: d5801. doi:10.1136/bmj.d5801
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Abstract

Objective. To shed light on the difficulties faced by relatives, friends, and colleagues in interpreting signs of suicidality and deciding whether and how to intervene.

Design. Qualitative study of completed suicides, based on in-depth interviews with multiple informants.

Setting. London, southwest England, and south Wales.

Participants. 31 lay informants (one to five for each case), including parents, partners, siblings, friends, and colleagues of 14 cases of suicide in which the deceased was aged 18-34 and was not in contact with secondary mental health services.

Results. Informants described both intellectual and emotional barriers to awareness and intervention within the family and social network. They reported that signs and communications of distress were often oblique and difficult to interpret, that they may have disregarded warning signals and focused instead on positive signs, and that, even when they were aware that something was seriously wrong, taking any action at all involved considerable personal risks.

Conclusions. As the suicidal process unfolds, significant others are faced with a highly complex task. Their proximity to the suicidal person and their emotional investment in the relationship make it difficult for them to see what is happening, to say anything to the person or to other members of the network, or to seek help outside the network. Efforts to strengthen the capacity of lay people to play a role in preventing suicide are urgently needed and should be informed by a thorough understanding of these difficulties. They should highlight the ambiguous nature of warning signs and should focus on helping people to acknowledge and overcome their fears about intervening.

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Last Updated on Sunday, 30 October 2011 12:28