Columnist Nicki Gemmell recently wrote about her mother’s death in The Weekend Australian Magazine. Her mother had had a foot operation 10 months earlier but the outcome was less than satisfactory leaving her crippled and despondent. She experienced chronic unrelenting pain and the thought of further restorative surgery was too much to contemplate. Her quality of life was diminished and she feared becoming dependent on others and being a burden. She took an overdose while sitting in front of the telly.
Nicki Gemmell finds the term suicide awkward and prefers to say, “My mother euthanised herself.” Like Gemmell we are forced to ask ourselves, “Was it empowerment, or despair?”
The Living Is For Everyone (LIFE) Framework (2007) makes the following observations about life events.
The extent to which a specific negative life event is a triggering factor for a suicide attempt is unknown. Everyone at some time experiences adverse life events and difficult circumstances. Stress, sadness and anxiety are all normal human responses during such times. Most people can cope with changing and challenging circumstances and continue to function in their personal, professional and social lives. However the same life event can have a very different impact on different people, depending on the context and the person’s capacities.
Negative life events that may trigger suicide attempts or suicide include financial difficulties, family disturbances, onset of mental illness, deterioration in quality of life, imprisonment, child custody disputes, interpersonal conflicts, legal problems, loss of social status, public humiliation, victimisation, unemployment, abuse, self harm, loss of cultural identity and natural disasters.
There is a growing body of evidence suggesting that one or more adverse life events often precede suicide attempts. A research review found that many case-control studies have shown that people who take their own lives are likely to have experienced more recent adverse life events than people who do not. (Kolves et al. 2006)
Brian Draper, Conjoint Professor of Psychiatry at UNSW Australia suggests that if we are to prevent suicide, we must understand the nuances of these journeys – what they mean to the individuals who are on them, what is sought as an alternative to death.
He says there are age-related reasons for mental disorders. In old age, common reasons include pain and discomfort associated with physical illnesses, loss of independence, social isolation and loneliness, and a diminishing circle of family and friends. Any of the above may cause an older person to consider suicide.
He concludes by saying that just because the suicidal preoccupation of an older person is understandable does not mean that it is rational or immutable.
Very few late-life suicides occur in circumstances that could be interpreted as rational but most are understandable and amenable to change providing the underlying issues are adequately addressed.
An effective treatment regime is only part of the equation. We must give people hope and bolster their desire to live. But whatever the support we provide there is an emotional cost. It requires a willingness to listen to another’s disillusionment and despair; an openness to feel their pain and sadness; and the courage to offer a way forward that may involve us personally. It is incumbent on all of us to offer our loved ones who are feeling suicidal a better option than death.