Awkward conversations – our discomfort could save lives

***TRIGGER WARNING*** This post will talk about the impact of mental illness, suicidal thoughts, attempted suicide, and lives lost to suicide. There will also be comments about potentially triggering language and events. Please only read on if you feel able to. For help and support with any of these issues, please visit my mental health and suicide prevention support page. ***TRIGGER WARNING***

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In a recent post about Mental Health Awareness week, I asked questions about how we start managing the flood of mental health patients this country is creating. I also discussed the importance of awkward conversations, and how breaking the common pattern of avoiding them will be critical in managing mental health in the UK at a community level.

The fact is there are many conversations that people routinely put off, side-step, or ignore completely just to prevent awkward moments.

As a woman I can think of many times I’ve avoided verbalising my thoughts in favour of (what I believe will be) an easier existence. These moments have undoubtedly impacted my confidence throughout adult life and if I’d chosen one difficult chat, I’d likely have made ‘future Steph’ less intimidated and anxious.

For example, when was the last time someone said something like ‘I love your outfit today’ or ‘I feel really proud of your achievements’, only for you to respond with something defensive like ‘I’m only wearing this to cover my bloated belly’ or ‘I wish I’d done a better job’?

As females of the 80’s, I know we’re conditioned not to take the compliment and accept it with any grace…of course we can’t. We were trained for years to hear a compliment and throw it back at someone who cares by telling them the things we hate about ourselves. Instead of hearing a comment that should alter how we feel positively, we’re more comfortable reinforcing our existing negative feelings by chucking it back.

This doesn’t just apply to women born in the 80’s, obviously. It applies to EVERYONE, in any demographic, at any time, just in different ways.

Is this level of awkward something we all need to become more comfortable with? Yes, absolutely. Especially if we want to be more resilient, more confident and genuinely empathetic.

But avoidance of these awkward moments isn’t just impacting how we feel about ourselves, it’s also impacting the more dangerous elements of the nations mental health.

Dying not to talk

Earlier this month we marked suicide awareness by talking openly on social media about suicide and, hopefully, normalising the narrative somewhat. However, despite everyone’s work to improve the outlook for those living with poor mental health, the latest statistics remain astonishingly sad.

According to the Office for National Statistics (ONS) 5656 people were registered as having died by suicide in England during 2023. This is more than ever in recorded history, and records began in 1981.

Beneath many of those suicide awareness social media posts I found real people who are still living in silence while trying to manage a dangerous and often frightening internal narrative. Their only safe space is now online, where they usually post anonymously or through a pseudonym. What they probably need is a conversation with someone who cares and understands outside of the online space, rather than existing with these suicidal thoughts on their own. They need a safe space to feel heard, acknowledged and understood while also knowing they can trust the person they’re talking to and that the right help will be found.

What they don’t need, what they fear, is nothing more than judgement, stigma and dismissal at a time when they are literally fighting for their life.

And if you think you’re one of the fortunate people for whom suicide isn’t a life issue, look closely at the world beyond your doorstep and you’ll see people losing the will to carry on exist closer than you think. Life on planet earth is making our mental health more fragile today than it’s ever been. That’s not the fault of a weaker population (despite what some politicians might tell you), it’s a bi-product of the environment we live in.

The general media makes us anxious daily about world events. Other publications shame us for our bodies, life choices and achievements. Society pressures us all to always be better than the next person. Finance worries from bills, groceries and education are challenging us all every day…and so much more. On top of all that, there are our individual pains, our life experiences, that never seem to be resolved and now act as the soil for these other anxieties and pressures to grow.

Suicide and suicidal thoughts are not linear concepts. They can exist in many forms in anyones life. Those that seem successful, happy and content can succumb to poor mental health just as easily as anyone else. Whether it’s a fleeting thought that leaves as fast as it arrived, or a constant narrative that seems to be in control of your existence, it’s almost always something that needs addressing for long term recovery.

To be clear – anyone attempting to have conversations about their mental health and/or suicide is not just crying for attention. Whatever the reason for their worries, it has to be addressed.

I’ve experienced this problem from many angles – having attempted to end my own life twice, living with a permanent ebb and flow of suicidal thoughts alongside my mental illnesses, and hearing stories from people I know about those who’ve lost their lives to suicide. Every time suicide is in my brain I inevitably wonder why more conversations about it aren’t happening. It’s still so common to hear that a death by suicide is met with shock because those closest to the victim had ‘no idea’ there were problems.

As I said in my post about mental health awareness week, we have to get comfortable with the uncomfortable, normalise the abnormal, and find hope in each others empathy. Poor mental health is an epidemic that can’t be solved quickly by the NHS right now, so thinking about how we support our nearest and dearest closer to home is going to be critical. It sounds complicated, but it starts with a simple conversation.

How to talk about suicide and mental health

Noticing that someone you care about doesn’t seem themselves can be a daunting situation. I understand that approaching them about their mental health could create an underlying fear that, somehow, even by trying your best, you might only make the situation worse.

However, when you’re talking about ‘brain pain’ as part of daily life, you’ll start to actively normalise the conversation and therefore make it easier for your loved one to manage effectively and know they can trust you (if needed) without anxiety. You’re opening the doors for you and those around you to reveal their innermost concerns without fear or judgement – this is a priceless gift, not a burden.

So where do you start?

Think about the ‘6 P’s’ – Proper Planning Prevents Piss Poor Performance. I know this is usually a comical term used by business wankers, but the idea of being prepared for these chats is very important. Before you approach your friend, you might find it helpful to research some information. Helplines, local community groups, charities that support their issues, and information on relaxation and mindfulness are some ideas to start with. Having this information to hand before the conversation might help you to start your friend on road to recovery as quickly as possible. The sooner they start getting help, the better.

Next, how do you approach a conversation like this with care? The national suicide prevention charity Papyrus says there are some simple questions to use to break the ice.

“How are you?” is the most obvious opener, but expect to ask again “How are you, really?” because they might tell you they’re fine in an attempt to shut it down.

Also, it’s ok to be specific if you’ve noticed something specific, but let them open up by asking about it. “Is everything ok at work?”, “How are things at home?”, “Is your pain getting worse?”, “You haven’t been yourself recently, is there something you want to talk about?”. Although it’s sometimes difficult to become more personal, these non-invasive questions only show that you’re paying attention and care about your friend.

However, if being direct seems too hard, try using your own struggles to open the dialogue. “I’m finding work really stressful lately. How’ve you been doing?”. Again, be prepared to ask in different ways in case they try to shut the conversation down the first time. Papyrus say that showing everyone has ups and downs can help the other person feel validated and more open to discussing their problems.

And if you get to a point where your friend does have the courage to open up, it’s so important to actively show you’re listening, show you understand, refrain from any stigma-centered comments, and use the resources you’ve already researched to start helping them.

Papyrus has more detailed information on their website covering how to have difficult conversations about suicide and mental health – if you need more support with this then please take a look.

Getting suicide language right

I also want to mention something important – the language we use.

The term ‘committed suicide’, which is still commonly used socially and in the media, implies that the victim is a criminal, and it’s dialogue we need to eradicate. This is language used many years ago when a life lost to suicide was considered selfish and a sin, both of which are obviously wrong. Although I’ve tried to use different words myself for some time, I didn’t know the origins of the phrase, and I hope that understanding the implications of labelling a victim this way helps to change the way we communicate, and therefore reduces the unintentional impact of such labels.

So, when we’re talking about the subject it’s important to say things like ‘attempted suicide’ or ‘ended their life’ rather than ‘commited suicide’.

In conclusion – this isn’t too awkard to save a life, is it?

I’ve obviously simplified things here, and I’m fully aware that every individual situation is exactly that; individual. However, most of the time people are anxious to approach the subject, and that’s because of the stigma and misinformation that remains. But remember that every pro-active conversation we have about this will help to reduce such stigma and normalise the thoughts and feelings that can happen to anyone.

According to UK Government suicide statistics in May 2024 241 men and 83 women died by suicide. That’s an approximate average of 10 people per day whose lives might have been saved through a trusted, caring, and concerned friend who took that awkward first step.

I believe our discomfort is a small price to pay to save these people and their loved ones from absolute tragedy.

There will be more on this difficult subject in the coming weeks as I launch The COPE Campaign website and companion MOSAIC app, both of which are aimed at mental well-being and suicide prevention.

For help and support with any of these issues, please visit my mental health and suicide prevention support page.

In the meantime, look after yourselves and those around you. Thank you for visiting 💜