A few years ago I organised a public meeting about suicide. To spread the word, I put up posters around my town with the question, ‘How do we live with suicidal ideas?’ printed across them. The manager of a local launderette started taking the posters down. He said he was banning me from advertising on his premises because he was upset by that question.

We don't often create spaces where we can talk freely about the temptation to end it all. But it’s a consideration many of us will have at some point in our lives.  I think we need to acknowledge it’s an understandable response when we feel overwhelmed and there is no one to turn to. Unfortunately, the millions of pounds spent on trying to prevent suicide often miss this point.

In my old workplace, the managers ordered the tall, solitary conifer in the garden of the psychiatric ward to be sawed down after one man tried and failed to hang himself from it. In the mental health system, the emphasis is more on stopping the act rather than creating an accepting atmosphere where these tortuous feelings can be understood and possibly lived with. The danger is we attempt to keep people alive not by helping them find meaning, but by submitting them to tactics of control and surveillance.

Where does this state of panic about suicide come from? Why are we so frightened to sit with suicidal feelings, and to express them?  On the hill above where I live in West Yorkshire there is a circle of stones that offers me some clues. It’s known as ‘The Miller’s Grave’. In the late 1700s, a miller from the village of Heptonstall took his own life. As was the law, his body was excluded from the community; he was buried outside the parish at the crossroads between localities. But if you try to suppress something, you give it more power. There were reports of people travelling between parishes seeing the miller’s ghost as they approached the crossroads.  The fear created by these sightings opened up a debate about where best the miller should be buried. A group of people wanted to dig him up and repatriate him in his village cemetery, but another group was terrified of the consequences. A fight broke out and the men trying to protect the body were attacked. Such panic and confusion is indicative of the taboo and punitive approach we have had culturally towards suicide. The word 'commit' is a hangover from when it was still a crime.

Up until 1961, suicide was a punishable offence. Until 1822, the crown was entitled to the dead person's possessions, reducing many families to poverty. Suicide was made illegal in the mid 13th century but was seen as a mortal sin by the church long before then.  For our culture, the forbidden nature of the act distracts us from other possible meanings.

When African American slaves committed suicide it was often seen by abolitionists as a form of social protest In my own life, this is how I tend to view the decision to willingly precipitate one's own death.

I have had friends who killed themselves, and while it has been deeply painful, I have also tried to find ways to understand their decisions. When I was 18, Selina, a friend I made while in psychiatric hospital, jumped to her death from a Hackney tower block.  She had a fiery spirit and clearly, at times, was in a lot of distress, but the doctors’ only response was to sedate her.  The last time I saw her, she was trembling and dribbling because of the level of tranquilisers she was on. At her funeral hundreds of people turned up. I remember feeling this perplexed outrage – where had all these people been when she was in psychiatric hospital? It looked like too much too late.

I don't know what it was that Selina could no longer bear to live with, but my sense is that as a community we were not able to sit with her pain and help her find faith in the world again.  It was her death that inspired me to train as a psychologist and promote more holistic approaches to confusion and distress.  Rather than suppressing their experiences, I wanted to learn how to help people diffuse their conflicts in other ways.

"In order to understand suicidal behaviour in the absence of life threatening (or debilitating) illness, we need to look at the social situation people are in that they find unbearable."

Pete Shaughnessy was another friend who took his life. He was one of the people behind the Mad Pride movement (prominent in the early 2000s), which aimed to reclaim and celebrate being ‘mad’, and advocated for the rights of people treated within the psychiatric system. Pete was angry about the lack of respect he and others faced in the media, the employment system, and the mental health system. He talked about the need for “compassion rather than compulsion”, protesting against the use of force to manage challenging behaviour on wards. Pete had a lot to contribute when it came to improving the psychiatric system, but in our professionally-led society, there are few meaningful opportunities for people with his kind of knowledge and expertise. Highly critical of the policy of ‘social inclusion’ – hollow talk about involving marginalised groups that was nothing more than political posturing – he once said, “If society is going to continue to discriminate against us then I don't want their ‘social inclusion’. Society can fuck off.” I saw his suicide as a big fuck off to society and I wondered how best to respond to it.  

In a way, the mental health system has taken over the responsibility for policing suicidal behaviour that was previously held by the criminal law system. Now if you are thought to be suicidal, you can be detained in a psychiatric hospital and not discharged until that urge has been thought to dissipated. As a professional, working in the mental health system, I have seen how people who are suicidal are often described with words like ‘manipulative’ and passive aggressive. Because it is the mental health system’s job to keep people alive, if somebody is persistently suicidal, a fear of being held accountable can drive many mental workers to blame and judge the suicidal person. It seems that the idea of suicide as sinful still persists in our secular world.

The euthanasia movement challenges the idea that suicide is always bad or mad, arguing that people can make a rational decision to end their lives.  I knew a man who arranged to kill himself before the onset of dementia would make this unmanageable. His family respected his decision and they got the chance to say goodbye. Nevertheless, because of the illegality of euthanasia, he had to take an overdose in secret in order not to incriminate them. People who weren't close to him assumed he had been depressed. But this was not the case: he just wanted to leave life on his terms.

In order to understand suicidal behaviour in the absence of life threatening (or debilitating) illness, we need to look at the social situation people are in that they find unbearable. A friend of mine recently contemplated jumping off a viaduct. When I asked him about it, he said it was a sense of isolation that had driven him to that point: “I felt like nobody could comprehend my situation, and if I told anyone what had been happening in my life they would misunderstand me.”  

The more people feel judged and undervalued, the more tempting suicide becomes. It’s no wonder that in a society which frowns on unemployment and which still expects the man to provide, the male suicide rate is growing.  I facilitate self-help groups and meet many people who hear voices that tell them to kill themselves. Rather than reading these voices as the product of a mental illness, I understand them as being parts of the person that are so grief stricken they have lost the will to live.  Such grief needs a space to be acknowledged, felt, and heard.

In these self-help groups, we try to create safe spaces where everyone is treated as an equal and where people can grow in confidence and self-acceptance.  I am sure such groups have saved lives.  I think we will only find the will to live again when we experience social relationships that give us a sense of belonging and connectedness.

How do we break down the fear and shame that still surrounds suicidal thoughts and behaviour? We need to create public spaces where we don't just focus on prevention but take a more radical approach. We need to work out a way to live with the parts of ourselves that have lost faith in life.

Words by Rufus May and illustration by Andrea De La Concha

This piece is featured in the Mind Issue, now available for pre-order.