I first wrote about male suicide and Open Dialogue a few days ago and I have posted in relation to the local situation on Open Dialogue online forums. I have been overwhelmed by the response from colleagues and online support and we have subsequently arranged an international meeting in relation to ways of managing male suicide and suggestions for providing preventive measures.
Death is still a taboo subject and it is often difficult for us as clinicians to explore the clients thinking and feelings in relation to taking their own lives. It is difficult for the clinician to broach the topic, because if we are aware of the despair what do we do about it and with the psychological distress are we strong enough to contain the feelings? There is also the ever present concerns of the organisation in relation to risk both to the self and others and the seemingly endless measurement of potential risk within the NHS. Services are understandably concerned about publicity, legal proceedings and the coroner’s court, they need to be seen to have done sufficient. Unfortunately many suicides particularly young males have never accessed services or even their GP’s often their own family and friends are unaware of their difficulties.
I was recently speaking to a man of my acquaintance who was telling me how shocked he had been by the suicide of a young man who had been working for him as a labourer. The young man who had 2 small children and a partner had been into work on the day of his suicide and my friend his employer had not noticed anything different about his presentation yet that night he hung himself.
Young men are a particularly difficult group to engage yet are often disproportionately represented in substance misuse and psychosis services which makes them vulnerable to thoughts of ending their own lives. Also young men are perhaps not as emotionally aware and perhaps excessive recreational alcohol use is also masking a very real despair. Young men too have had to adapt to a change in society and the roles of women and their own position growing up. Social media too has a disproportionate impact on this group, something older males have not experienced. Men are being encouraged to discuss their issues more but there is still a taboo about seeking psychological support and talking about their troubles. The question of what being male in today’s society means? There are also still certain cultural and religious groups where an expression of male emotion would be deemed weakness or unmanly.
My Open Dialogue colleagues all of whom have taken part in the trainings have many suggestions about how we can improve things in my district. The idea of using Open Dialogue ideas and setting up some training in addition to approaching the issue in a more holistic, generic fashion has assisted me in thinking of what would be helpful to put in place outside the framework of NHS mental health services.
Author Bio: Jane Hetherington, Principal Psychotherapist at KMPT and an employee at Early Intervention Services in Kent, has completed Open Dialogue course and will be a part of the new Open Dialogue service. She is trained as an integrative psychotherapist and has experience working in primary care, substance misuse, and psychosis services. Here, she writes about a few psychotherapeutic theories.