With an average of just over 25 suicides a year in Malta, it is calculated to be the 17th highest cause of death on the island. Bearing in mind the size of the island, and fluctuations in data, the rate does not cause the amount of concern it should, with Malta ranking 113th on a global scale in terms of average suicide numbers.
The Malta Independent on Sunday spoke to the CEO of the Richmond Foundation, Ms Stephania Dimech Sant, to ask what is being done to tackle the issue and how people can help. As the Foundation’s Mental First Aid Guidelines, which have been produced by Mental Health First Aid Australia, put it: “Suicide can be prevented. Most suicidal people do not want to die. They simply do not want to live with the pain. Openly talking about suicidal thoughts and feelings can save a life.”
When it comes to prevention, Ms Dimech Sant was increasingly adamant that education and removing stigma is invaluable. “We need to make people more aware that there is help available and the idea of reaching out must be ingrained in society,” she said, adding that people are still very cautious about the subject. “To tackle stigma, you need to tackle the fear of the unknown.”
Despite a number of opportunities for the public to call for information or support regarding a crisis through which they may be going, there is not yet a specific suicide prevention or intervention team. Agenzija Appogg’s 179 support line, the Crisis Resolution Malta campaign on 9933 9966, the online chat service for youth called Kellimni, and the Richmond Foundation’s own Casual Contact System – reachable on 2144 0324 – are all examples.
While the Appogg national support line deals with social issues such as child abuse, domestic violence and addictions, the other two also deal with a number of potential crises. The Casual Contact System, as Ms Dimech Sant explained: “Receives queries from the general public. Information is provided about mental health issues and the public is referred to the relevant services as necessary.”
Although the staff of all three of these help-lines are trained to deal with calls from people going through some kind of crisis potentially leading to suicidal ideation, there is still no system that pertains specifically to suicide prevention. In fact, research by this newsroom has shown that there are very few statistics readily available and the entire issue is seemingly tiptoed around.
The Foundation CEO proposed a potential ‘Crisis Intervention Team’ that could be called out to any place around the island where someone was in crisis. It would be led by trained professionals who would know exactly how to approach someone in the kind of vulnerable situation which they could potentially be in so as not to exacerbate the problem.
In order to tackle the public’s fear of the unknown, the Richmond Foundation’s Mental Health First Aid Course does educate people on a number of issues, including the delicate situation of suicide. Ms Dimech Sant described the course in its entirety as a way to “give training to the public to identify mental illness and crisis – including how to behave in the case of one, and who to contact.” The course provides the skills to give initial help to a person who is experiencing thoughts of suicide and it was expressly insisted that “all thoughts of suicide should be taken seriously.”
The main point of the guidelines regarding suicide in particular is that anyone has the potential to save a life if they know enough to identify ideation before it manifests, or even when they are in the process of doing so. Signs outlined include social withdrawal, increased substance abuse, an inability to sleep or sleeping too much and dramatic mood swings, among others.
The course also teaches listening tips and skills for dealing with a person in crisis as well as telling the public what not to do. The ‘don’t’ list includes not using guilt – ie telling the person they’re being selfish or that they’ll go to hell if they commit suicide, as well as not using the standard rhetoric of “cheer up” or “you have everything going for you”.
The most important point is to avoid being judgemental at all times, which includes being aware of your own attitudes towards suicide before approaching someone. If you cannot, there’s no shame in asking someone else who can.
With that in mind, it is important to realise that the guidelines are merely designed to help members of the public and in no way provide a qualification for dealing with crises directly. As the documents state: “These guidelines are a general set of recommendations about how you can help someone who may be at risk of suicide. Each individual is unique and it is important to tailor your support to that person’s needs.”
Anyone interested in the Mental Health First Aid course may obtain further information about it by calling Richmond Foundation on 2148 2336.