World Suicide Prevention Day 2024: Changing the narrative

Dr Stella Rendall, Research Psychologist at Mental Health Innovations, discusses the importance of changing the narrative on suicide through open conversation. Highlighting Shout’s text-based support for autistic individuals, she emphasises how compassionate communication can reduce stigma and provide vital support to those experiencing suicidal thoughts.

Suicide is a significant public health concern in the UK. The Office for National Statistics (ONS) reports that 6,069 suicides were registered in England and Wales in 2023, corresponding to a provisional rate of 11.4 deaths per 100,000 people. Each suicide carries extensive social, emotional and economic consequences, profoundly affecting families, friends and entire communities.

This year’s World Suicide Prevention Day focuses on 'changing the narrative on suicide', with a call to 'start the conversation'. The aim is to highlight the importance of reducing stigma, and encouraging open conversations as essential strategies in suicide prevention. Changing the narrative involves rethinking how we view this complex issue, shifting from a culture of silence and stigma towards one rooted in openness, understanding, and support.

Open conversations are also important for raising awareness about suicide and enhancing understanding of the factors that contribute to it. Starting conversations about suicide, however, can be incredibly challenging. Stigma can surround talking about it, which often leads to fear and discomfort when bringing it up and to concerns that talking about suicide might exacerbate the situation or introduce the idea to someone who had not considered it. Learning how to initiate these conversations can be empowering for both those experiencing suicidal thoughts and those offering support.

One of the most effective ways to overcome the barriers to discussing suicide is through direct and compassionate communication. Employing empathy and non-judgmental language is crucial, as language that shows respect for someone’s experience helps break down barriers related to stigma.

Using clear and direct questions reduces uncertainty, and creates a safe environment for honest conversation. For example, while directly asking someone “are you thinking about suicide?” can feel daunting, it often brings relief to those struggling, as it validates their pain and demonstrates genuine care. Additionally, listening without judgement, avoiding the urge to immediately offer solutions, and simply being present can foster deeper conversations and reduce feelings of isolation.

In our conversations with Shout texters, suicide is the most common discussed issue in conversations with those who self-identify as autistic in the post-conversation survey, representing 46% of all conversations.

To gain a deeper understanding, we conducted thematic analysis of anonymised data from autistic texters. This person-centred approach to data analysis aims to provide further insight into texters’ lived experiences and the underlying reasons for their decision to seek support.

Our analyses reveal that many autistic texters face challenges in managing various stressful situations, such as work-related stress (starting a new job, interacting with colleagues), academic pressure (exams, coursework, navigating peer relationships, changing schools), caregiving responsibilities, relocating, financial difficulties, physical health issues and relationship problems. Our research shows that many autistic texters had recently experienced traumatic events, such as bullying, harrassment, and verbal, physical or sexual abuse, which had a negative impact on them.

Notably, we also found that feelings of loneliness and isolation are underlying factors that exacerbated texters’ distress. Autistic texters described difficulties with communication and social interaction, leading to feelings of loneliness and disconnection. Many expressed that others lacked empathy, often due to a misunderstanding of their emotions, needs and experiences. Isolated with their thoughts and without adequate support, autistic texters found it difficult to cope after facing adverse life events. They viewed their challenges as overwhelming, which contributed to suicidal thoughts and behaviours.

How texting can provide a safe space for autistic people

Shout provides a safe and confidential space where people in distress can express their feelings and receive empathetic and non-judgemental support primarily through text-messaging. For many experiencing suicidal thoughts, discussing their feelings aloud or face-to-face can be uncomfortable, making the anonymity of texting a more comforting option. Texting is particularly suited for autistic people who often find verbal communication overwhelming due to difficulties in interpreting others’ emotions, facial expressions or tone of voice. More than half of autistic texters (57%) say they feel more comfortable expressing their feelings through texting rather than talking. By offering support through text, the service removes common barriers that often discourage many people, including autistic texters from seeking help, providing a safe space to start crucial, life-saving conversations about suicide.

Our trained Shout Volunteers engage in conversations about suicide with autistic texters with compassion, patience, respect and directness. They listen with empathy, recognising the unique challenges autistic texters’ face, while validating their experiences and providing reassurance and understanding. They ask clear and direct questions about suicide, always prioritising texters’ safety. Additionally, they offer support and hope, ensuring texters feel they are not alone.

This approach builds trust, which is crucial in conversations about suicide, and establishes a safe place where texters feel comfortable expressing their thoughts and feelings without fear of judgement. Overall, these experiences offer autistic texters a sense of solidarity, understanding and acceptance, all of which are crucial for suicide prevention. Of the autistic texters who reached out to Shout for support with suicidal feelings, 70% have found the service helpful. By fostering a safe and supportive environment of acceptance and understanding, Shout helps to break down the stigma surrounding conversations about suicide, making it easier for texters to express their feelings more openly and get the support they need.

Engaging in open conversations about suicide is essential for reducing stigma and raising awareness. By normalising discussions, fostering supportive environments and practicing compassionate communication, individuals, communities, organisations and governments can break the silence surrounding suicide and encourage people to seek support without fear of judgement.

Ultimately, open conversations hold the potential to save lives and offer hope to those struggling with suicidal thoughts.