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Dealing with someone who considers comnating suicide ,COMMUNITY SAFETY There are a variety of reasons why people consider committing suicide, of which depression is one. There are also a variety of opinions about what one should do when a loved one or colleague threatens to commit suicide. Therefore, it is better to listen to those who are in the know about what we can do in such circumstances.

Compiled by Annalise Kempen
The South African Depression and Anxiety Group (SADAG) is one of the South African authorities eager to share information about depression and suicide. If you, a loved one or a colleague suffers from depression, anxiety or a mental illness, such as bipolar disorder, SADAG can lend a helping hand. It is Africa's largest mental health support and advocacy group and its website offers comprehensive mental health information and resources to help you, a family member or loved one to deal with it.
 

WHAT TO DO? SADAG recognises that some suicides may occur without any outward warning, but that the majority do not. Therefore, the age-old notion that prevention is better than cure is also true for suicide and, in this case, the most effective way to prevent suicide is to learn to recognise the signs of when someone is at risk and know how to respond to them. It is claimed that 75% of all suicide victims give some warning of their intentions to a friend or family member - this reminds us that all suicide threats and attempts should be taken seriously. The testimony of IS-year-old Thembi says it all: "Without SADAG, I'm not sure how I would have got the help I needed. I really thought about hurting myself, not wanting to be here at all, I really wanted to die.
 

There were a lot of signs -'.at, at the time, I just didn't recognise. I thought maybe it was just me growing up, being a teenager. Now I've got help and can help my friends too."

 DANGER SIGNS Previous suicide attempts - Between 20% and 50% of people who kill themselves have previously attempted suicide. Those who make serious suicide attempts are at a much greater risk of actually taking their lives. Talking about death or suicide - People who commit suicide often talk about it, whether directly or indirectly. Be alert to statements such as "my family would be better off without me". Sometimes, those contemplating suicide talk as if they are saying goodbye or going away. Depression - Although most depressed people are not suicidal, most suicidal people are depressed. Serious depression can be manifested in obvious sadness, but often it is expressed instead as a loss of pleasure or withdrawal from activities that had once been enjoyable. Be concerned about depressed persons if at least five of the following symptoms have been present nearly every day for at least two weeks: - depressed mood or moodiness; - change in sleeping patterns; - change in appetite or weight; - speaking or moving with unusual speed or slowness; - fatigue or loss of energy; - feelings of worthlessness, self-reproach or guilt; and - thoughts of death or suicide. Additional factors that point to an increased risk for suicide in depressed individuals are: - Extreme anxiety, agitation or enraged behaviour; - excessive drug and/or alcohol use/abuse; - a history of physical or emotional illness; and - feelings of hopelessness, helplessness or desperation. Suicide notes and plans are a warning factor. People who are considering suicide sometimes make final arrangements, such as giving away prized possessions, writing a will and making funeral arrangements.

WARNING SIGNS One of the ways to determine whether you or a friend/loved one is at risk is to honestly answer these questions as published in an article published in the Weigh-Less magazine entitled "The Darkness: Teen suicide looms". Are you withdrawn from friends and family, and have no interest in doing anything? Do you have excessive feelings of guilt, self-blame and failure? Have you lost interest in your appearance, and do you lack personal hygiene? Have you noticed changes in your personality? Are you constantly saying things like "I can't do anything right"."I'm totally useless" or "I'm hideous and pathetic?" Are you writing or painting about death? Are you engaging in risky behaviour such as drunken driving, playing suicidal games (such as suffocation games), taking drugs or practising promiscuous unprotected sex? Do you find yourself joking about suicide?

 SADAG adds the following issues as potential red flags: 111 I have lost interest in my hobbies - most of the time I would rather be alone. I often feel restless and tired. I have trouble concentrating on my homework or watching television. My appetite has increased/decreased. I have trouble sleeping or sleep far too much.

 If you answered YES to any of these questions, you should tell someone how you are feeling - a friend, a parent, a teacher, a priest/minister, or a youth group counsellor. Consult your doctor or a psychologist - remember, depression is treatable.

 If you answered YES to three or more questions you should make sure that you are not alone. Consult your doctor or psychologist and tell people close to you how you are feeling. You can also contact Life Line, Child Line or SADAG for help (see numbers below).

 WILLINGNESS TO LISTEN Those who feel suicidal, especially the youth, are not likely to ask for help directly, but if you recognise the warning signs you can take action to keep the person safe. A concerned individual who knows someone at risk should take the initiative to ask that person what is troubling them. Listen as they speak. If your friend/loved one is depressed, DO NOT be afraid to ask whether s/he is considering suicide.

 DO NOT attempt to argue 2 yone out of suicide. Instead, let the person know that you ca,-e nd let them understand that they are not alone; that suicidal fel' igs are temporary, that depression can be treated and that j' oblems can be solved. Help them to understand that these feelings will not last forever. AVOID the temptation to say, "you have so much to live for" or "suicide will hurt your family". Focus your concern on the well-being of the individual - don't make accusations and don't judge.

 WIIAT TO 1)0 IN A CRISIS If the signs become serious, you can take the following actions: Remain calm. Suicide attempts/thoughts should not be kept a secret - not between teenage friends or in any environment. If this happens at school, you should immediately tell a responsible adult such as a parent, a teacher or the school psychologist. In an acute crisis, take the person to an emergency room or walkin clinic - DO NOT leave the person alone until help is available. EN Remove drugs, razors, scissors, firearms, medication or any means of harm that could be used in a suicide attempt away from the potentially suicidal person. If the above options are unavailable call for help, such as SADAG's suicide crisis line at 0800 567 567 or an emergency service.

 POLL( )W-I You can take an active role by ensuring that the person at risk takes their prescribed medication and reporting any unexpected side effects to a doctor. Be there for that person by continually offering support after treatment has been initiated.

 TI IL ROLL OF SCIR )0LS IN SUICIDE PREVENTION According to the American National Association of School Psychologists (NASP), effective suicide and violence prevention is integrated with supportive mental health services, engages the entire school community and is embedded in a positive school climate through learner behavioural expectations and a trustful learner/adult relationship. One should therefore expect teachers to be familiar with the risk factors and warning signs of suicidal behaviour.

 The school psychologist and other crisis team staff members should be trained to intervene when a learner has been identified as a suicide risk. Such staff members should conduct suicide risk assessments, inform/warn parents, provide recommendations and referrals to community services and provide follow-up counselling and support at school.

Unfortunately, not all schools have access to a school psychologist. In such cases, specific staff members should be identified and trained to handle such situations.

 When a suicide occurs at a school or in a close community group, it is wise to seek help for friends who have threatened to commit suicide or who have attempted suicide in the past. It is vital to seek help immediately if a friend pressures you to commit suicide or to aid them in their attempt.

 WHAT CAN PARENTS DO? Parents need to take responsibility for, and be involved with, their children - after all, the parents took the decision to have children, and not the other way around. Parents therefore need to be informed and actively involved in decisions regarding their children's welfare. One of the ways in which schools and parents can work together is for parents to share information critical to risk, including mental history, family dynamics, recent traumatic events and previous suicidal behaviour.Although some may believe that such information is personal and private, it could literally be the difference between life and death for some children if teachers are more alert to a child's increased risk.

 If a school notifies a parent th?c t ieir child is at risk of committing suicide, the parent needs to rake responsibility for seeking assistance from a psychologist for thei cl.ild. It is advised that parents do the following: Take threats seriously; even when your child has calmed down and informed you that they "did not mean it", you should still be conscious of their behaviour and not assume that they were only seeking attention. Maintain communication with the school after an incident, which will allow the school to also provide follow-up support.

 Providing a proper support structure on various levels, including at school, at home and with friends, can lessen the potential risk of suicidal behaviour. This support structure includes: Family support and cohesion, including good communication peer support and close social networks learning adaptive coping and problem-solving skills, including conflict resolution having easy access to effective medical and mental health resources developing good self-esteem and a sense of purpose; andengaging cultural and religious beliefs which discourage suicide and promote healthy living.

 Raising teenagers is a challenge, and dealing with a teenager who is so unhappy with their life that they are willing to see it come to an end is something for which no parent is adequately prepared. But doing nothing to address the problem, or keeping silent about it, will only worsen the situation. Some parents' biggest worry might be about "what happens when others find out", instead of worrying about keeping their children safe and seeking help. Do not ignore the warning signs - suicide should not be a secret and you do not need to deal with it on your own. Help is available, just pick up your phone.

 IMPORTANT CONTACTS SADAG Suicide crisis line SADAG SMS service Child line Life line South Africa

 LIST OF REFERENCES Barnes, H. "The Darkness:Tee i 51 icide looms." Weigh-Less magazine. Accessed at www.clairene itc.i.co.za/claire-in-the-media/magazines/ the-darkness-teen-suicide-lo os.html on 14 January 2014. Hardcastle, M. "Information sheet on suicide - ten things you need to know about suicide." - Accessed at teenadvice.about.com/of/factsheetsforteens/a/lOthingssuicide.htm accessed on 13 January 2014. SADAG Facebook Friday - Teen depression and suicide prevention 15 February 2013. "Suicide in SA increasing." - Accessed at www.health24.com/ Medical/Depression/News/Suicide-in-SA-increasing on 13 February 2014. Talane, V. 2009. "Tackling teenage suicide in South Africa." Mail & Guardian. 18 November. "Teen suicide." - Accessed at www.sadag.org/index.php?option =com_content&view=article&id=1840&Itemid=153 on 29 January 2014.