Review of a Lecture: Suicide

I went to a couple lectures today by Professor John Swinton of Aberdeen University (biography, Centre for Spirituality, Health and Disability) about Suicide as well as the church's response to mental illness, suicide, and survivors of suicide. A few things stood out for me.

Suicide or suicidal ideation is most often the result of a break in trust between the individual and the social environment, therefore it is both communal and relational . Another was the picture of severe depression as an abyss, as described by a participant in one of the studies described. The person is at the bottom of an abyss, sometimes seeing a trace of light and other times, sitting in complete darkness. As the chances of getting out of this abyss looks utterly hopeless, suicide seems to be the most logical and rational choice to end the hopelessness and despair. Even if they do get out of the abyss, as the person walks around the edge of the abyss, the person fears they will get sucked down into that abyss again.

Reasons for depression and suicidal ideation are often founded in losses: loss of tradional roles, social supports, sense of meaning or purpose, employment, etc. It can be the result of confusion over identity or the result of a culture of suicide where someone has 'succeeded' and it has now been modeled and, to some degree, accepted as an option. People with the highest risk are individuals with a history of mental illness, particularly affective disorders, schizophrenia, or alcohol addictions (possibly other addictions?). The phenomenon called 'anomie' can also lead to suicidal thoughts - a state of isolation and anxiety due to a lack of social control and regulation. In this case, there is a sense of alienation and detachment. Often, individuals feel they are in "no man's land". Sometimes, suicide gives the person a perceived sense of control. They can be quite angry if the suicide attempt was not 'successful', as the one thing they felt they could control did not succeed. Unemployment is a significant factor, as employment provides a sense of meaning. We frequently identify ourselves with our profession or job title. A lack of employment may lead to poverty and loss of relationships which leads to lower personal well-being.

Interestingly, research presented in the lectures suggest participating in a faith community on a regular basis appears to correlate to lower suicide rates. It is suggested this is due to the social community as well as the opportunities that arise from participation in regular gatherings where crisis intervention can occur because people can respond to needs. A sense of belonging to a group and being accepted gives a sense of protection. Regardless, mental illness still overrides the benefits of belonging to a group. On a different note, but related to faith, there is a phenomenon described as 'the double bind of religion' where people state God doesn't allow them to commit suicide and they are angry with him for that.

Recommendations to provide appropriate support for individuals includes creating safe spaces that are culturally relevant - places where people can do what they are best able to do. We also need to rename success - we need to re-evaluate how we define success. Should we be measuring something else as a mark of success? We also need to provide strong, positive and healthy male and female role models as the loss of identity has become a significant issue. Young people today do not know what it means to be manly or womanly, which can result in confusion.

Something I'd like to explore more from these lectures is the idea of Caplan groups. This is a bringing together of pastoral as well as non-religious supports (including professionals), to discuss how to best integrate the individuals experiencing suicidal ideation, individuals who are survivors following attempt(s), individuals with mental illness, etc. Interestingly, it was pointed out that it is essential each profession (including pastoral care) maintain its integrity of the profession so as not to lose the benefits that each profession brings. Each profession needs to stay true to themselves. As an Occupational Therapist, this idea struck me as essential because this is a profession that seems to easily meld into other professions or get replaced by someone of a different professional background without the team really understanding the benefits an Occupational Therapist can bring to the table. In the case where mental illness is a strong factor for the individual seeking support, it is easy for the professions to meld towards the psychologist or psychiatrist perspective.

Other notes that came out in discussion include:

• lament is a form of worship. Also, how can faith communities (or other communities) provide space (literally and figuratively) for emotional release. A suggestion was developing a wailing place. A place that allows for sounds of lament.
  
• it is important to know your scope (skill level) and to know the resources available to refer when necessary. Referring doesn't mean dropping that individual when you make that referral. If necessary, you can accompany the individual to the referral.
• in relation to faith communities, it is important to be flexible - different styles of worship, accommodations required, understanding, etc. Not everyone is in the same place at the same time (spiritually and personally speaking).
• churches should speak to the life, creating a sense of hope.
  

And now to leave you with some questions. Feel free to comment as you wish.

• How can faith communities (or communities of practice or communities in general) counter stigma associated with mental illness and help seeking?
• How can education directly address suicide and suicide prevention?
• How will congregations or communities be educated?
• How can a faith community discourage suicide and still support without condemnation?
• How can faith communities support and encourage isolated individuals, persons with mental illness, persons at risk of suicide, suicide survivors, and those who have lost loved ones to suicide?
• What would it look like if we actually lived by grace (as opposed to judgment)?