Death by suicide means lost life, lost talent, a lost mother or father, brother or sister, son

or daughter, and a wound that does not easily heal in families and communities.

In England, a person dies every two hours by suicide. There are over 4,000 deaths by
suicide each year. More lives are lost to suicide than to road traffic accidents.

Suicide is usually the result of a complex set of issues in someone’s life. Most people
who attempt suicide do not want to die; they want to end the pain they are suffering.

A wide range of factors contribute to suicidal behaviour. These include traumatic events,
family difficulties, social isolation, socio-economic deprivation, financial problems,
unemployment and mental health issues.

Aspects of the context or environment someone is in can influence whether the

experience of such difficulties results in suicidal behaviour. For example, the way places
like schools, universities, workplaces, hospitals and prisons are run; the way suicide is
represented in the media; or the availability of methods of suicide.

The majority of suicides in England occur in men. Suicide occurs more among people
from lower or deprived socio-economic backgrounds. This means suicide is an issue
that is related to poverty, inequality and social justice. But suicide does also affect all
ages, genders, cultures and social groups.

1. Samaritans Call to Action

Show your commitment to preventing suicide and to support those bereaved by suicide.
Join a range of national agencies and organisations in the Call to Action for Suicide
Prevention in England.

Call to Action for Suicide Prevention

Download the Samaritans Call to Action

Talk confidentially to Samaritans any time of the day or night

Whatever you're going through, whether it's big or small, don't bottle it up. We are here
for you if you're worried about something, feel upset or confused, or just want to talk to
someone.

About Samaritans and suicide

Myths about suicide
2. Bereaved by Suicide
3. Have you been bereaved by suicide?
4. Responses and emotions
Losing someone close to you brings about intense grief and mourning. The loss of
someone through suicide often results in different responses and emotions.
Bereavement by suicide is prolonged. Shock, social isolation and guilt are normal
emotional responses, and you need the chance to talk them through with someone you
are comfortable with and whom you trust.

Make sure you share how you are feeling and use the support that’s out there.

You may experience some or all of the following:

5. Intense Shock

The sense of shock and disbelief following a death of this kind may be very intense. A
common aspect of grief is recurring images of the death, even if this was not witnessed.
Finding the body may be another traumatic and indelible event. It is a natural need to go
over and over the very frightening and painful images of the death and the feelings
these create.

6. Questioning - Why?

Bereavement through suicide often involves a prolonged search for an explanation of

the tragedy. Many people eventually come to accept that will never really know why.
During the search for explanations, different members of the same family may have
very different ideas as to why a death happened. This can be a strain on family
relationships, particularly where an element of blame is involved.

It is very often the case that we will simply never know what that person was feeling or
thinking when they chose to end their life. This can make bereavement by suicide even
more difficult as people struggle to try and understand why such a thing could happen.

7. Questioning - Could it have been prevented?

It is common to go over and over how the death might have been prevented and how
the loved one could have been saved. Everything can seem painfully obvious in
retrospect. The 'what-ifs' may seem endless. Rewinding events is a natural and
necessary way of coping with what has happened. Research suggests that some
people bereaved by suicide feel more guilt, self-blame and self-questioning than those
bereaved in some other way.

8. Abandonment/rejection

You may experience a sense of rejection. It is common to feel abandoned by someone

who 'chose' to die.
"I was upset that he hadn't come to talk to us. I think we all went through anger at some
point. You think: 'How could you do this to us?' "

A sister whose brother took his life.

9. Suicidal fears and feelings

Despair is a natural part of the grieving process, but after the suicide of a loved one
hopelessness may be combined with fear for one's own safety. Identification with
someone who has taken their life can be deeply threatening to one's own sense of
security. You may suffer more anxiety than those bereaved in other ways and be more
vulnerable to suicidal feelings.

10. Media Attention

When someone dies by suicide or other unexpected causes, it may attract public
interest. The inquest that is demanded by law draws attention to the person who has
died and to close relatives and friends. Attention from the media can be very stressful
for bereaved relatives and friends, particularly where a death is reported in an
insensitive or inaccurate manner.

11. Stigma and Isolation

Social attitudes to suicide are changing, but they may still limit the support that is
available. The silence of others may reinforce feelings of stigma, shame and 'being
different'. If others are embarrassed, uneasy or evasive about suicide, you may be left
feeling intensely isolated. Opportunities to talk, remember and celebrate all aspects of a
loved one's life and personality may be denied. A strong need to protect a loved one,
and oneself, from the judgement of others may also be felt.

A mother writing about her son's death pointed out that we have never been told what to
say to someone who has had a suicide in the family. She needed to hear the same
thing that might be said to anyone else who had experienced the death of someone
close: "I'm truly sorry for your pain and is there anything I can do? If you need to talk
about it, I am a good listener. I've got a shoulder to cry on."

© The Royal College of Psychiatrists 1997

12. Who else can help?

Help is at Hand
A resource for people bereaved by suicide and other sudden, traumatic death from the
 Department of Health in the UK.
www.dh.gov.uk

Please see our list of other UK and Ireland-based agencies that can offer specific
advice.
13. Helping others at risk
14. What are the symptoms of someone at risk of suicide and
depression?
Suicidal behaviour differs from person to person. Some people show very positive
behaviour such as happiness or relief once their decision to take their own life and end
the pain has been made.

Unusual behaviour, such as being very withdrawn or excessively animated can also be
a sign that there is something wrong. If someone is going through an emotional distress
they can feel very isolated and will sometimes show anger or impatience towards the
people close to them. Low self-esteem, being close to tears and not being able to cope
with small every day events are also signs that someone is struggling to cope with
overwhelming feelings.

Physical symptoms of depression and distress also include sleeplessness, loss of

appetite or irregular eating, stomach aches, panic attacks, low energy and loss of
concentration. Signs that someone is suicidal can include talking of tidying up their
affairs or expressing feelings of despair and failure.

Some factors can indicate suicide risk and these are outlined below.

Has your friend:

 experienced the recent loss (a loved one, pet, job)?

 experienced a major disappointment (failed exams, missed job promotions)?

 experienced a change in circumstances (retirement, redundancy, children leaving

home)?

 experienced physical/mental illness?

 made a recent suicide attempt?

 a history of suicide in the family?

 begun tidying up their affairs (making a will, taking out insurance)?

Behaviour:
 Taking less care of themselves

 Finding it difficult to relate to others

 Being very withdrawn

 Acting noticeably different in some way, for example being unusually cheerful

 Being tearful, or trying hard not to cry

 Finding it hard to concentrate

 Being less energetic, and/or seeming particularly tired

 Eating less (or more) than usual

 Sleeping badly and/or waking early

 Losing appetite or eating more than usual

Thoughts:

 Seeing no hope in the future

 Believing that things will never change

 Seeing no point in life

 Feeling worthless or a failure

Feelings:

 Feeling low-spirited

 Feeling more irritable

 Feeling suicidal

 Feeling very isolated and alone

Things to listen for - does your friend talk about:

 feeling suicidal (it's a myth that people who talk about it don't do it)?

 seeing no hope in the future, no point in life?

 feeling worthless, a failure?

 feeling very isolated and alone?

 sleeping badly, especially waking early?

 losing their appetite, or eating more than usual?

15.
16. How can I help someone at risk of suicide?
If you are worried about a friend, colleague or family member they may really appreciate
you asking how they are. You don't have to be able to solve their problem, or even to
completely understand it, but listening to what they have to say will at least let them
know you care.

Remember to act quickly. When someone is distressed, it may be a seemingly small

thing or something which only affects them indirectly which acts as the trigger to them
becoming suicidal or acting out suicidal thoughts. Letting someone know that you are
there whenever they want to talk is the first step in offering help.

17. Talking about feelings

If you feel able to, offer support and encourage your friend, colleague or family member
to talk about how they are feeling. Ask direct questions and don't be afraid of frank
discussions. If someone is talking about suicide always take it seriously. It is a myth that
talking about suicide is attention seeking.

It is vital not to pressurise the person into talking if they don’t want to, but giving them
the time and space to talk openly without interrupting or offering solutions or judging
them can provide the first step in helping them cope. Sometimes people want to talk to
someone outside their situation and suggesting they talk to Samaritans or visit their GP
can help them widen their options.

Find out more about how to start a conversation and the sorts of questions to ask

Find out about a way of listening which helps people talk through their problems

18. Still concerned

If you are seriously concerned about a friend or relative, Samaritans volunteers can
discreetly approach the person in distress to offer emotional support, if the permission
of the person in distress has been given.

Contact Samaritans

19. Points to remember

 Ask the person how they are feeling and listen to the answer.
 Ask if they are feeling suicidal: giving permission to be honest is important

 Encourage your friend to seek help and talk to someone they trust.

 Keep the conversation going with open questions

 Remember that it is difficult to support someone who is suicidal on your own-

encourage your friend to seek emotional support and talk to someone they trust-
maybe friends, family, medical services, Samaritans.

 Contact Samaritans yourself. We may be able to contact the person you are worried
about.

20. Look after yourself

Remember that it is difficult to support someone who is suicidal on your own.
Samaritans volunteers often talk through a conversation that they found upsetting with
another volunteer, in order to get support themselves. Take care not to take on so much
of other people’s problems that you yourself start feeling depressed.

 Encourage your friend to seek emotional support and talk to someone they trust -
maybe friends, family, medical services, Samaritans.

 Talk to another friend about the problems you've been listening to or, if you have
promised not to tell anyone else, you can call Samaritans who will keep the
information confidential. Contact Samaritans

21. Difficult Conversations

22. Starting the conversation

Every situation is different but here are some suggestions to

help you start a difficult conversation. Often, starting a conversation is half the battle.
Once someone knows they can talk, they will. You could try and go straight to the heart
of the problem:

‘You seem really stressed out. What’s the matter, are you coping OK?’

This direct approach could put people on the defensive. They may think you're accusing
them of not dealing with the problem. So you could try a more gentle approach:
 ‘It must be difficult having your first baby. Is there anything you want to talk
about?’

or

‘It’s difficult starting a new job. How are things going?’

By coming across as understanding, tactful and gentle, there's a better chance that the
other person will respond. Some useful phrases include 'what can I do?', 'Why don't we
have a coffee and talk about it?', 'I've been a bit worried about you', 'How are things
going?', 'I'd like to help'. It’s also useful to ask ‘open questions’ as this means the
person cannot respond with a simple ‘yes’ or ‘no’ answer.

Think about where and when to have the conversation before you start. Choose
somewhere where the other person feels comfortable and has time to talk.

23.
24. Asking the right questions
You might feel that you don't know how to help someone, because you don't know what
to tell them or how to solve their problems. You don’t need to be an expert to support
someone. In fact, sometimes people who think they have the answers to a problem are
less helpful. This is because they forget that every person is different, so that what
worked for one will not always work for another.

You might feel that you don't know how to help someone, because you don't know what
to tell them. But you shouldn't tell them anything. Telling doesn't help. The best way to
help is to ask questions. That way you leave the other person in control. By asking
questions, the person you are talking with finds his or her own answers.

Active listening is a way of listening which helps people talk through their problems,
however difficult to put into words they find it. Find out more about active listening

Here are some questions which can lead conversations into useful areas:

 When – 'When did you realise?'

 Where – 'Where did that happen?'

 What – 'What else happened?'

 How – 'How did that feel?'

 Why - Be more careful when asking a person 'why' – it can sound challenging, and
put the other person on the defensive. ‘What made you choose that’ or ‘What were
you thinking about at the time’ could be more effective.
All of these questions effectively ask the person you're talking with to examine, honestly,
the problems they're experiencing. All you need to do is start the conversation. Nobody
expects you to know the answers. But that doesn't mean you're not helping.

25. Find out how they are feeling

Don’t forget to ask how this person is feeling. Sometimes people will talk you though all
the facts of what happened and why it happened and what actions they are thinking of
taking, but never say how they actually feel.

Revealing your inner most emotions- anger, sadness, fear, hope, jealously, despair and
so forth – can be a huge relief. It sometimes also give clues about what the person is
really most worried about.

26. Checking they know where to get help

If someone has been feeling low for some time it is probably a good idea that they get
some support, whether it is through talking to someone like a counsellor or getting some
practical support for the problems they are experiencing.

Useful questions might be:

Have you talked to anyone else about this? Would you like to get some help?
Would you like me to come with you?

Or, for someone who is reluctant to get help:

In an ideal world what would you like to happen next? Do you have someone you
trust you can go to? If it helps you can talk to me any time.

27. I think I said the wrong thing

There is no perfect way to handle a difficult conversation, so don’t be too hard on
yourself if it didn’t go as well as you had hoped.

If you feel able to, put things right. “Last week I said … and I realise now that was
insensitive so I’m sorry. What I meant to say was … “

Sometimes the person is not ready to talk. Being there for them in other ways, like
through socialising or helping with practical things, can also be a great source of
support.
Find out about a way of listening that helps people talk about their problems

28. Looking after yourself

Hearing someone else’s worries or problems can be distressing for you too. Samaritans
volunteers often talk through a conversation that they found upsetting with another
volunteer, in order to get some support themselves. We would encourage you to do the
same. Talk to another friend about it or, if you have promised not to tell anyone else,
you can call Samaritans who will keep the information confidential. Take care not to
take on so much of other people’s problems that you yourself start feeling depressed.

29. Useful information

More information about Active Listening

Personal Stories

Other sources of support

30. Active Listening
31. We can all think of situations where we found it hard to talk about
something that was troubling us. Difficult, painful or just embarrassing
situations, which we found almost impossible to speak to someone about.

Imagine you've got a colleague or friend who needs to get something difficult off their
chest. How do you get them to open up?

Active listening is a way of listening which helps people talk through their problems,
however difficult to put into words they find it. It sounds a strange idea. Listening
actively? Surely, when you listen, you don't actually do anything?

With active listening, although you actually do some talking, you're really acting as a
sounding board. Whatever you say doesn't influence what the other person has to say.
It just helps them talk.

32. Active listening to keep them talking

All too often, we say things which lead conversations down dead ends. 'I know just how
you feel', 'Try not to worry about it'. Although they're meant well, they don't encourage
the person you're speaking with to go on. Rather, they tend to wrap up what the other
person was saying. With active listening, you avoid this. Here are some suggestions to
help you actively listen in a conversation:
33. 1. Open questions

Rather than asking questions which only require a yes or no answer, try and ask
open questions. For example, instead of saying: 'Has this been going on a long
time?', ask 'How long has this been going on?'. That way, instead of closing the
conversation down into a yes or no response, you open it out and encourage the
other person to keep talking. Another good example to remember is instead of
saying “is everything ok?” you can ask “how are things going?”.

34. 2. Summarising

This helps to show that you've listened to, and understood, what's been said. For
example, 'So you're feeling very stressed by your work, but you still love your job.'

35. 3. Reflecting

Repeating back a word or phrase can encourage people to go on. If someone says,
'So it's been really difficult recently,' you can keep the conversation going simply by
repeating 'Difficult…'.

36. 4. Clarifying

We all skirt around or gloss over the most difficult things. If we can avoid saying
them, we will. If the person you're speaking with glosses over an important point,
saying 'Tell me more about…', or '…sounds a difficult area for you' can help them
clarify the points, not only for you, but for themselves. It sounds obvious, but a 'Yes',
'Go on', or 'I see' can really give some much needed encouragement.

37. 5. Reacting

You don't have to be completely neutral. If whoever you're talking with has been
having an absolutely dreadful time of it, some sympathy and understanding is vital.
'That must have been difficult', 'You've had an awful time' – this really helps.

All of this sounds quite simple. And it is. All you're doing is listening, and from time to
time giving responses which encourage the other person to keep on talking. That's
often the key – get them to keep on talking.

38. Looking after yourself

Hearing someone else’s worries or problems can be distressing for you too. Samaritans
volunteers often talk through a conversation that they found upsetting with another
volunteer to get some support themselves.
 Talk to another friend about the conversation or, if you have promised not to tell anyone
else, you can call Samaritans, who will keep the information confidential. Take care not
to take on so much of other people’s problems that you yourself start feeling depressed.

39. Useful Information

Feeling Low?

40. Do you recognise some of these in yourself? Or in a friend?

 Lacking energy or feeling particularly tired

 Feeling more tearful

 Not wanting to talk or be with people

 Not wanting to do things you usually enjoy

 Eating, drinking or sleeping more or less than usual

 Using alcohol or drugs to cope with feelings

 Finding it hard to cope with everyday things

 Feeling restless and agitated

 Not liking or taking care of yourself or feeling you don’t matter

If several of the things listed above describe you or a friend then now is the time to get
some help and support.

41. Getting help

Different people find different things can help. Lots of people in your own workplace,
school, university or community can help and there are also many services and
helplines ready to listen and help you.

Many people find talking to someone else is the best way to get help. It doesn’t have to
be the same person who could actually help. It just needs to be someone you can trust.
It could be a friend, partner, family member, colleague, tutor, supervisor, counsellor,
practice nurse, doctor or a helpline.

Samaritans volunteers have heard many people’s stories, and you can discuss anything
you want with them in complete confidence. Samaritans often work with those who feel
they cannot talk to anyone else – either because they don’t have someone they trust, or
 because they do not want to worry those around them. Remember that our phone,
email and face to face support services are available 24/7.

42. Starting a conversation

Talking with friends, family, colleagues or someone like Samaritans about a problem is
never easy. If a problem is really bad, what can you say?

Every situation is different, and there are no absolute answers. But here are some
suggestions to help you start talking in difficult, challenging situations. Often, starting a
conversation's half the battle.

Some of these tips might be useful:

 Think of where you will have the conversation. Choose somewhere you feel safe and
where you’re not likely to be disturbed. This could be somewhere private or
somewhere really busy where you won’t be overheard

 If you’re worried you won’t know what to say, perhaps write it down beforehand.
Could you tell them how you feel? If you know – what’s making you feel like this?

 Remember that they will almost certainly want to offer you support but you need to
help them understand what you want from them. What help would you like?

 Most people find it helps to tell someone. Most people who contact Samaritans said
talking or emailing helped them cope and feel less anxious, less isolated and more
understood

Remember that the hardest part is starting a conversation. Once you have done this, it
will get easier.

43. What should I do if someone I know has died by suicide?

The death of anyone close can cause immense sadness and grief but a death by
suicide is one of the most painful and complicated types of bereavement. It can raise
many emotions like disbelief, anger, guilt and sadness. All of these are normal reactions
and you need the chance to talk them through with someone you are comfortable with
and whom you trust.

A death through suicide delivers a double blow to families – not only do they have to
cope with a sudden, often unexpected death, but they also have to deal with the way
their relative has died and the fact that there may be media attention surrounding it.

Make sure you share how you are feeling and use the support that’s out there.
 Personal Stories

Everyone goes through difficult times in their lives and everyone has different ways of
dealing with them. Sometimes though, things get really tough. Especially when they are
problems you’ve never dealt with before, or situations which go on and on and are
unlikely to change.

Are you the only one going through this? The answer is probably not. Only you know
your exact situation, but someone else will have been something similar. These people
wanted to share their stories, hoping to help others going through the same thing.

 Emma's Story

The story of 24 year old Emma, who was bullied at 13 and tried to kill herself.

 Tony's Story

Tony rang Samaritans when he was at his lowest point, and doesn't know what he'd
have done if he hadn't talked to Samaritans.

 Cassie's Story

Cassie describes how Samaritans has been an invaluable lifeline and support.

 Sophie's Story

Sophie was abused as a child and visited Samaritans for ongoing support.

 Mary's Story

Since the first time she called, Mary uses Samaritans fairly regularly when her mental
health isn't so good.

 Alex's story

Alex called Samaritans for support when she was a teenager after she was bullied at
school.

 Janet's Story

Janet uses Samaritans regularly to support and help her cope with obsessive-
compulsive disorder.
 44. Could your story inspire others?
Case studies are also immensely valuable to Samaritans as they help us learn how to
develop our services and understand the impact we have on people.

We always seek permission from people before publishing their stories, and names and
some details are changed to protect people’s anonymity.

If you have used Samaritans services and would be willing to tell us about your
experience please contact Samaritans Press team on +44 (0)208 394 8300 .

About Emotional health

45. About Emotional Health
46. What is emotional health?
47. Is emotional health the same as happiness?

Not exactly. Happiness is an emotion which people feel for a short period of time, often
alongside many other emotions. Emotional health is about more than this, it is the ability
to cope with difficult times in life, and this depends on a person’s knowledge, skills,
experience, social and environmental circumstances. If someone has good emotional
health they are more likely to cope with difficult times, and hence they may be happier in
life.

48. Emotional skills

The ability to cope with difficult times in your life is not something we are born with, it is
something we learn. We learn from our own experiences and from copying, or avoiding,
the experiences of the people around us.

For example, if you have grown up in a family where people do not talk about their
feelings or what is worrying them, then it is likely you will find it very difficult to do so.

Skills considered to be important for emotional health are:

 Self awareness

 Empathy

 Social skills like listening and relationship skills

 Managing difficult feelings

 Motivation

These skills can be taught for example in schools or work place training, or learnt
through life experience. For information on Samaritans schools and workplace
programmes click here.

49. Emotional awareness, attitudes & stigma

People generally have a far better understanding of physical health than of emotional
health. Whereas people feel comfortable talking about most physical health problems
and illness, they don’t like to talk about emotional problems or mental illness.

Talking about feelings is sometimes seen as taboo or a weakness. When people suffer
emotional or mental health problems, like depression, a phobia, a eating disorder, or
dementia, this is often not openly talked about. People suffering mental health problems
say the stigma they experience is sometimes more stressful than the illness itself.
Inaccurate media reporting which makes people with mental health problems sound
dangerous or unstable is also unhelpful. The result of this is that people feel excluded
from society and in some cases don’t get jobs, or housing they are entitled to.

The more people know about emotional issues and talk about them, the more accepted
these become and the more included people feel. To find out more about emotional
health problems visit our Feeling Low section.

Other sources of support

Help and support

British Association for Counselling and Psychotherapy

Through the BACP you can find information about counsellors in your area. If you want
to be referred to a counsellor you may want to discuss this with your GP.
BACP House, 35-37 Albert Street, Rugby, CV21 2SG
Tel: 0870 443 5252
http://www.bacp.co.uk

Breathing Space
A free and confidential phoneline service for any individual, particularly young
men, experiencing low mood or depression, or who are unusually worried and in need
of someone to talk to
www.breathingspacescotland.co.uk
Cam's Den
An emotional wellbeing website for children aged 7-10 years.
www.camsden.co.uk

Childline
ChildLine is the UK's free, national helpline for children and young people in trouble or
danger.
www.childline.org.uk

Counselling Directory
Aims to provide the UK with a huge counselling support network, enabling those in
distress to find a counsellor close to them and appropriate for their needs.
http://www.counselling-directory.org.uk

CyberMentors
CyberMentors is all about young people helping and supporting each other online. If you
want to talk to someone about bullying or just want to chat about something that is
bothering you, just drop a CyberMentor a message or ask to chat to them online. The
site is safe and secure; you can keep all your chats and messages private. There are
also counsellors available for anything really serious.
cybermentors.org.uk

Get Connected
Supports young people’s emotional wellbeing by ensuring that they find access to the
most appropriate help on any issue wherever they are in the UK.
http://www.getconnected.org.uk/

Hands On Scotland
A new NHS website resource for anybody working with children and young people
http://www.handsonscotland.co.uk/

Headroom
BBC Headroom is a campaign to encourage you to look after your mental wellbeing. It
contains videos and surveys about life's ups and downs, wellbeing guides, and
information about Headroom events.
www.bbc.co.uk/headroom

Mental Health Foundation

Founded in 1949, the Mental Health Foundation is a leading UK charity that provides
information, carries out research, campaigns and works to improve services for anyone
affected by mental health problems, whatever their age and wherever they live.
http://www.mentalhealth.org.uk/

MIND
MIND is the leading mental health charity in England and Wales, and works for a better
life for everyone with experience of mental distress.
http://www.mind.org.uk/
National Nightline
National organisation of NightLine student helplines in Universities across the UK.
http://www.nightline.ac.uk/

NHS Choices
NHS Choices has thousands of pages of practical advice on health and wellbeing, plus
videos, blogs and local service directories.
www.nhs.uk

NHS 24
nhs24.com provides comprehensive up-to-date health information and self care advice
for people in Scotland.
www.nhs24.com/content

Reach Out
Reach Out's aim is to improve young people’s mental health and well-being by building
skills and providing information, support and referrals in ways we know work for young
people.
ie.reachout.com

Relate
Relate provides counselling, sex therapy, relationship education and training to support
couple and family relationships throughout life.
http://www.relate.org.uk/

Royal College of Psychiatrists

The professional and educational body for psychiatrists in the United Kingdom and the
Republic of Ireland. Also offers information about mental health problems.
http://www.rcpsych.ac.uk/

Teens First For Health - by Great Ormond Street Hospital

A website providing mental health advice for teenagers. Featuring an A-Z of mental
health topics, people's real stories, information on drugs, lifestyle, therapies and more.
www.childrenfirst.nhs.uk/teens/health/mental_health/index.htm

TheSite.org
A website providing factsheets and articles on key issues facing 16-24 year-olds, as
well as hosting a community area for peer-to-peer support.
http://www.thesite.org/

Young Military Veterans Football Programme

Play football to improve physical and emotional health and wellbeing.
Inside Right ex-servicemen's Football

Alchohol misuse
Drinkaware
Drinkaware aims to change the UK’s drinking habits for the better. We promote
responsible drinking and find innovative ways to challenge the national drinking culture
to help reduce alcohol misuse and minimise alcohol-related harm.
http://www.drinkaware.co.uk/

Bullying

Bullying Online
A UK charity helping parents and pupils deal with school bullying
www.bullying.co.uk

Bereavement

Cruse Bereavement Care

Cruse Bereavement Care exists to promote the well-being of bereaved people and to
enable anyone bereaved by death to understand their grief and cope with their loss. The
organisation provides support and offers information, advice, education and training
services.
Cruse House,126 Sheen Road, Richmond, Surrey TW9 1UR
tel. 0844 477 9400
www.crusebereavementcare.org.uk

Help is at Hand
A resource for people bereaved by suicide and other sudden, traumatic death from the
Department of Health in the UK.
http://www.dh.gov.uk/

Marie Curie Cancer Care

Offers documents to cope with bereavement, helping children cope with death, and
other issues associated with terminal illness.
Marie Curie publications

Survivors of Bereavement by Suicide (SOBS)

SOBS aim is to provide a safe, confidential environment in which bereaved people can
share their experiences and feelings, so giving and gaining support from each other
Centre 88, Saner Street, Hull HU3 2TR
Helpline: 0844 561 6855
http://www.uk-sobs.org.uk/

The WAY Foundation

A self-help support group run entirely by volunteers for men and women widowed aged
50 and under. All members (approx 1200 nationally) have been widowed themselves
and we aim to offer support, help and understanding to those finding themselves in the
unfortunate position of losing a partner at a young age.
http://www.wayfoundation.org.uk/

Drugs and alchohol

Adfam
Adfam is a national charity working with families affected by drugs and alcohol and is a
leading agency in substance related family work. They provide a range of publications
and resources for families about substances and criminal justice including an online
message board and a database of local support groups.
www.adfam.org.uk

Depression

Depression Alliance
Offers help to people with depression, run by sufferers themselves. Website includes
symptoms of depression, treatments for depression, and local groups.
www.depressionalliance.org

Aware
A voluntary organisation in Ireland that aims to provide support group meetings for
people with depression and their families.
http://www.aware.ie/

Divorce

Divorce Aid
If you or someone close to you is going through divorce or separation, we hope to guide
you through the emotional and legal journey as well as providing assistance about
finances and children. Time is a healer; spend some time with us. From distress to
recovery, you are not alone and it will get better.
www.divorceaid.co.uk

SeparatedDads
SeparatedDads was formed to offer a unique reference point on being away from or
separated from your children.
http://www.separateddads.co.uk/

Domestic violence
Respect
Respect runs a phoneline for people who are abusive or violent towards their partners
and are looking for help. The Respect Phoneline 0845 122 8609 provides information
and advice about support services and programmes to anyone who's concerned about
their behaviour
www.respect.uk.net/

Farming

Farming Help
The Farming Help partnership was publicises the sources of support and help that are
available to farming people experiencing stress.
www.farminghelp.org.uk

HIV

Terrence Higgins Trust

Delivers health promotion campaigns and direct support to people who are at risk or
living with HIV across the UK.
www.tht.org.uk/

Lesbian and Gay

Lesbian and Gay Switchboard

Find your local branch of the switchboard, a voluntary organisation aiming to provide a
24 hour information, support and referral service for lesbians and gay men.
http://www.llgs.org.uk/

Families Together London

Families Together London is a London-based support group for the parents, families
and friends of lesbian, gay, bisexual and transgender (LGBT) people
www.familiestogetherlondon.com

Mental health

Rethink- Severe Mental Illness

Rethink is a campaigning membership charity involving people with severe mental
illness and carers, with a network of mutual support groups around the country. Rethink
is also the largest voluntary service provider in mental health, helping 7500 people each
day.
www.rethink.org/

Saneline
Saneline is a national mental health helpline providing information and support for
people with mental health problems and those who support them. 0845 767 8000 1pm -
11pm.
www.sane.org.uk/

Youthspace
A website aimed at people aged 14-25 experiencing mental health problems which
offers information, films made by young people and clinical advice.
www.youthspace.me/

Prison

Nacro
Provide a range of services, including housing, employment, youth activity and family
support for people who have been in prison or who are at risk of offending.
www.nacro.org.uk

Rural stress

Rural Stress Helpline

Rural Stress Helpline is a confidential listening and signposting service for rural people.
http://www.ruralstresshelpline.co.uk/

Self-harm

FirstSigns
A user-led organisation that provides support to people dealing with self-Injury.
www.firstsigns.org.uk

Stress

Sort out stress

This is a website for men. It offers ideas and advice for dealing with stress. It was put
together with the help of young men in Camden.
www.sort-out-stress.co.uk
Suicidal

Maytree
Based in London, Maytree offers a place of safety for befriending and support to those
who are feeling suicidal.
http://www.maytree.org.uk/

50. Sources of information

Centre for Suicide Research
Based in the University of Oxford Department of Psychiatry, the research group is
investigating the causes, treatment and prevention of suicidal behaviour.
cebmh.warne.ox.ac.uk/csr/

Centre for Suicide Prevention

Based at the University of Manchester, this centre brings together a number of research
projects in the field of suicidal behaviour
www.centre-suicide-prevention.man.ac.uk

Independent Advisory Panel (IAP)

A website providing a resource for those working within the different custodial sectors to
share good practice and learning on preventing and reducing the number of deaths in
custody.
www.independent.gov.uk/iapdeathsincustody

The Sainsbury Centre for Mental Health

An independent charity that seeks to influence mental health policy and practice and
enable the development of excellent mental health services through a co-ordinated
programme of research, training and development.
www.scmh.org.uk

Telephone Helplines Association

The Telephone Helplines Association is a registered charity which works with helplines
to ensure that callers receive the highest quality response.
www.helplines.org.uk

Suicidal tendancies
Question
A good friend of mine has been harming herself for some time. Recently she's told me that
she wants to commit suicide. She seems to have thought about it a lot, saying she already
knows where and how, but not when.

I'm really worried about her and just don't know what to do. She made me promise to not
tell anyone so I feel I've betrayed her just by writing this. But the thing is I'm finding it all
hard to cope with and have started to feel depressed myself.

I don't know what to do. I want to help her, but I also don't want to break my promise any
more than I already have. How can I help her? And how do I help myself, I just want to be
able to sleep at night again.

Answer

It sounds like you've been having a difficult time and have been supportive to your friend. Equally, it
is clear your friend is going through a lot at the moment and it is great she trusts you enough to tell
you how she is feeling.

Supporting someone you care so much about can be lot to take on, especially when they've asked you
not to tell anyone. Although you might feel you've done all you can, you can continue to help by
simply being there to listen without judgement. Befrienders International has further information
about helping a friend who is suicidal.

The fact your friend has asked you not to mention her issues to anyone else suggests she may feel
awkward or embarrassed about how extreme her thoughts and emotions right now. If your friend feels
awkward about anyone else knowing, such as her family and friends, perhaps it would be helpful for
her to speak to a professional about how she is feeling, for instance, a counsellor. Details of local
counselling services can be found by contacting Youth Access on 020 8772 990
begin_of_the_skype_highlighting 020 8772 990 end_of_the_skype_highlighting.

Speaking to someone face to face can prove quite hard when someone is feeling particularly
distressed. SANELINE is a national, out- of -hours mental health helpline offering confidential, non-
judgemental emotional support and practical advice. You or your friend can call them on 0845 767
8000 from 12pm-2am everyday. They will also be able to offer information regarding local counselling
and self-harm services, which could help your friend further.

Also, National Self-Harm Network is a UK focused survivor-led organisation, committed to

campaigning for the rights and understanding of people whom self-harm. Priority is to support
survivors and people whom self-harm but they also support the people it indirectly affects, like family
and friends. People can discuss the issue and gain effective support on their discussion boards.

Being emotionally involved with someone who is experiencing such intense issues is admirable, but
also very draining. It sounds as if you have been a great friend, but you have taken on a lot and it is
important that you do not feel bad for writing to askTheSite. In order to continue being there for your
friend, it is crucial that you bear in mind your friend is ultimately responsible for her own actions. Also,
is there anyone to support you?

Depression can be a very isolating experience and you need not be alone. It can be treated with or
without medication, combined with a form of talking therapy such as counselling. Your local doctor
(GP) will be able to go through the options available with you.

Remember for non-jugdmental emotional support Samaritans is available 24 hours a day. Their
number is 08457 909 090 and their email address is jo@samaritans.org.

Updated: 09/09/2009
Supporting someone who self-harms
Discovering someone you care about self-harms can leave you feeling worried,
confused and a bit useless, but there are things you can do to help. TheSite.org
guides you through it.

Do...

 Aim to be a good listener - allow the other person to speak without interruption or judgement.
For them, self-harm may feel like the only way to express very strong and deep-seated
emotions. If someone feels able to open up to you this can be a huge breakthrough, so tread
carefully.
 Read up on the subject - many organisations offer invaluable information and tips on
techniques to break the cycle of self-harming.
 Look after yourself - it's hard to support someone if you are feeling overwhelmed or out of
your depth. Setting boundaries to what you can offer and getting some support for yourself
are important.

A film from young people at charity 42nd Street explains how you can support those who experience
self-harm.

Help

Don't...

 Panic if you're not sure how to react to news that a loved one is self-harming - often simply
being there is enough. "Opening up to my friend and admitting I'd been burning and cutting
my arms for two years brought overwhelming relief and shock," said Marcia, 17. "She told me
afterwards that she felt at a loss as to what she should say or do, but it was OK - just having a
hug and knowing I had told someone was enough for a start."
 Assume that people who self-harm are looking to commit suicide. Hurting yourself can be a
way of dealing with pent-up emotions, such as anger or tension, and doesn't necessarily follow
the same pattern as someone who is looking to end their life.
 Expect a 'quick fix'. For some people self-harm is a habitual way of responding to painful
emotions they feel unable to control it. Underlying causes such as abuse or low self-esteem
are what need to be addressed.

Being honest

It's OK to feel upset if someone close to you tells you they've been harming themselves. If you feel
unable to cope with the situation it's important to tell them you need extra help, and it's OK to let
them know that you feel upset they are hurting because you care about them.

Respecting feelings

Very often, self-harm remains a secret which can add to the problem and make asking for help harder.
Someone who is self-harming might feel very alone and worry about being labelled as attention-
seeking, mad, or a freak. Although you might be shocked, self-harm is surprisingly common and rates
of self-harm in the UK are among highest in Europe. It can be helpful to reassure someone who self-
harms that they are not the only one and that there are sources of help and support available.
 When I told my boyfriend about my self-harm, he freaked out and got really
upset, accusing me of being selfish.
Blame game

Seeing someone you care about hurting can be difficult to bear and will bring out the urge to protect
them. So when that person is hurting themselves, this can stir up complicated emotions and even
make you feel angry towards them. As with all self-destructive behaviours, you may want to scream
"Just stop it!" at the person, but try to remember that they are not to blame for the way they are
feeling and that the issue is more complicated than that.

Good intentions

Self-harm can become a ritual or habit used regularly as a coping mechanism. Try to avoid setting
goals or pacts, such as: "If you promise not to hurt yourself between now and next week, you're doing
really well," unless the person asks you to do this. It's impossible for someone in this situation to
promise how they are going to feel at any given time as they come to terms with their problems.
Making promises they can't keep could result in feelings of failure, shame and more secrets. "When I
told my boyfriend about my self-harm, he freaked out and got really upset, accusing me of being
selfish," said Marcia. "I ended up comforting him and agreeing never to hurt myself or mention it
again. But it wasn't that simple - I carried on self-harming in secret until I felt able to tell a friend. I
understand it was difficult for him, but if I'd just been able to talk to him it would have saved months
of heartache."

Encouraging someone to get help

Take the initiative and find out about mental health and other support services in the area. It may also
help if you support a loved one to make an appointment and offer to accompany them. As with all
mental health issues, a neutral observer can prove easier to talk to than someone close, especially if
there underlying trust issues that make it difficult to open up. "It's important to go at the other
person's pace and give them chance to set their own goals and find what works for them," says Tessa
Gregson from young people's mental health service, 42nd Street.

Updated: 28/10/2010

Written by Liz Nicholls