If I mention suicide prevention, it’s a fair bet that the first thing you think of is some sort of telephone hotline. The first call to an official suicide helpline was made in November 1953 to the Samaritans. The first US Samaritans branch was established in Boston in 1974. Helplines run by charities and other bodies around the world are a vital part of the safety net for people in crisis or thinking of suicide, as well as offering support to friends and family members.
As vital as they are, hotlines are not enough. World Suicide Prevention Day reminds us of the need to raise awareness about suicide and suicidal thinking. It also challenges us to think how we can do more, individually and collectively, to help people stay safe. In this blog post, we’ll explore a range of approaches to suicide prevention. We’ll see how modern technology, community initiatives, and wider policy changes all play a role in developing more holistic strategies for saving lives. Technological approaches in particular are not without potential issues and we’ll look at those too.
The Role of Technology
Modern technology impacts almost every aspect of our lives, and health and mental health are no exceptions. Information, help, and support are now widely available, often with just a few taps on our phones. It’s important to acknowledge the risks of relying too much on online resources and services, but they can offer significant benefits if used wisely.
Mobile Apps for Mental Health Support
“There’s an app for that” was launched as an advertising slogan by Apple in 2010. It’s been widely parodied, but there’s a truth behind the joke. It would be wrong to imagine any and all aspects of human live can be coded to run our mobile devices, but apps can make information, help, and support available to people living with a wide range of mental health conditions. Text and chat lines offer alternatives to traditional telephone hotlines. These are more accessible for anyone living with speech or hearing difficulties, and allow people to reach out in ways they may be more familiar with, or which feel less intimidating. Text-based services also mean it’s possible to access support without the risk of conversations being overheard.
Despite their convenience, services such as these have some potential drawbacks. The relative anonymity they offer can be a barrier to providing more personalised care and offer appropriately targeted support and guidance. There’s also a risk that we may come to rely too much on such tools, rather than seeking support from professional mental health services.
There’s a growing range of apps which offer a broader support to people at risk of suicide or self-harm. Funded by teenage mental health charity stem4, the Calm Harm app aims to help people manage urges to self-harm by offering coping strategies developed from Dialectical Behaviour Therapy (DBT). Apps such as Better Help act as a front door to licenced therapists who offer online counselling sessions. These technologies are part of a growing trend focused on preventative care to manage mental health symptoms, rather than relying solely on crisis management. Potential issues include the quality and regulation of apps and the coping strategies and support they offer.
The Role of Artificial Intelligence
Artificial intelligence (A.I.) and machine learning are likely to play an increasing role in suicide prevention. Social media providers and search engines are already developing tools to identify people who may be struggling or at risk, based on their online activity. As valuable as such approaches may be, they raise legitimate questions about privacy and the potential for malicious or discriminatory misuse of the information gathered. Setting aside the uncertain distinction between monitoring and surveillance, there are risks of bias and misinterpretation by the A.I. engines themselves. These could lead to people being incorrectly referred to crisis services, or someone at genuine risk being missed. The latter might appear more serious, but the former is no less important. Someone who has been incorrectly subjected to a mental health intervention might avoid accessing information or support in the future, in case the same thing happens again. Not everyone experiencing thoughts of suicide or self-harm, or seeking information about such topics online, is at immediate risk or in need of intervention.
Similar technologies underpin chatbots such as Woebot and Wysa, in which people can engage in chat conversations about how they’re feeling. These apps us A.I. to provide respond in real-time depending on what the person has shared about their situation. These tools are no substitute for talking to a real person — a friend, family member, or professional — but they can offer an outside perspective, especially if the person feels unable to discuss what they’re going through with family or friends. In addition to the risks and limitations already mentioned, these services can only be considered a partial solution. No matter the sophistication of the machine learning involved, a chatbot is unlikely to be capable of responding appropriately in highly complex or emotional situations. This limitation applies to humans too, of course. No matter how much we care and want to support our friends and loved ones, we may not always pick up on the clues or respond in the most helpful or appropriate way. Human professionals are not infallible either.
It Takes a Community
Technology has an important role to play, but human connection will always be at the heart of effective strategies to keep people safe.
Peer Support
Whether online or in person, peer support networks offer space for people to share their experiences and support one another. Groups are often led by professionals or trained volunteers, and counter the isolation many people feel concerning their situation, experiences, thoughts, and feelings. Community initiatives often offer social activities such as local walks or other events, building a sense of belonging in addition to providing emotional support, advice, and guidance.
The Role of Education
There’s an increasing acknowledgment that mental health education needs to start early. Integrating mental health awareness into our schools, colleges, and universities helps combat the stigma and discrimination that still surround mental ill health. It also helps equip young people with the information and tools they need to recognise when they, or their friends and loved ones, may be struggling and need additional help and support. A generation of people brought up aware of and educated about mental health is the best strategy for suicide prevention in the long-term.
Courses such as the internationally recognised Mental Health First Aid (MHFA) certification, Applied Suicide Intervention Skills Training (ASIST), and many other mental health and suicide prevention courses are now widely available. These are often provided free or with costs subsidised by employers or other organisations. It’s never been easier to learn more about how to recognise the signs that someone might be struggling, and offer meaningful help and support.
Policy Changes
As important as these approaches are, they do not and cannot operate in a vacuum. Policy changes and advocacy are needed to create and maintain a culture in which mental health is prioritised, with appropriate resources available and accessible to everyone who needs them.
National and Global Initiatives
National governments and international organisations such as the World Health Organisation (WHO) are increasingly focusing on mental health. In many countries, recent policy changes have aimed at improving mental health services by expanding access to care, increasing research funding, and incorporating mental health into their broader public health policies. It remains to be see how effective these changes will be, but it’s encouraging to see initiatives such as the WHO’s Mental Health Action Plan and the United Nations’ Sustainable Development Goals highlight how crucial mental health is to humanity’s overall health and well-being.
Advocacy and Awareness Campaigns
Awareness events such as Time to Talk Day (February), Mental Health Awareness Month (May), World Suicide Prevention Day (September 10), and World Mental Health Day (October 10) play an important role in changing how we think and talk about mental health and suicide. Social media campaigns like #StopSuicide and #ItsOkayToTalk help reduce stigma and encourage open conversations about what have for too long been taboo subjects. These campaigns often go viral, reaching millions of people and spreading messages of hope and support. Grassroots movements are driving change at the local level. Organizations like To Write Love on Her Arms (TWLOHA) and Project Semicolon have built strong and committed communities around the message that suicide is preventable and help is available.
Drawing it all Together
Preventing suicide needs a broad approach that goes beyond the provision of traditional mental health hotlines. While these will always remain a vital resource for people in crisis or needing immediate support, building a robust and effective safety net for everyone at risk requires us to think and act creatively and on a wider scale. On this World Suicide Prevention Day, let’s recognise the importance of both innovation and caution in developing effective strategies. By supporting comprehensive suicide prevention efforts that include both traditional and modern methods, we can work towards a world where everyone has access to the support they need when they need it most.
Further Reading
You can find details of World Suicide Prevention Day at the International Association for Suicide Prevention. Our resources page includes links to crisis lines, support organisations, training resources, and books. UK mental health charity Mind offers a range of help and information if you need support or are concerned for someone else.
Photo by Jenna Anderson at Unsplash.
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