On World Suicide Prevention Day, Sunitha Ramachandran, senior volunteer and mentor in Samaritans Mumbai, a suicide prevention helpline, gives us a gamut of vital information on how to recognise and prevent suicidal thoughts and acts and seek timely help to save lives.
Could you tell us a little bit about the work being done by Samaritans Mumbai?
Samaritans Mumbai offers emotional support for those who may be stressed, distressed or even suicidal. Our helpline is available via both phone and email. We have been actively working in the field of mental health and striving to support those in need since 1968.
We are a 100% volunteer run organisation, where all the potential volunteers have to go through a rigorous training programme and selection process to become a volunteer. We aim to provide a safe space where anyone can talk based on the following principles:
- Anonymity - We assure complete anonymity. Callers can choose to divulge whatever details they want to.
- Confidentiality - We assure complete confidentiality. Whatever is shared will remain between the caller and Samaritans Mumbai
- Being non-judgemental - All volunteers are trained to be non-judgemental towards callers so that they can provide a safe-space for sharing
- Being non-discriminatory - We do not discriminate based on gender, religion, class, caste, national origin, physical or mental disability, age, sexual orientation, gender identity and/or any other distinction.
Apart from the helpline, our volunteers also engage in outreach activities and social media with a goal to increase mental health discussions.
What is the reach and impact of your suicide prevention helpline?
We began as a free service in Mumbai, where people needing our service would meet in person. In 1990s we began our phone line, and with this the start of a helpline. Our numbers are not toll free, so people from pan India may hesitate to call, but we have noticed that with the opening up of cellphones with cheaper call plans, we have been receiving calls from across India, and even abroad. Post the pandemic, as we handle our calls remotely, we have started having volunteers from across India as well. In 2018 we stared responding to callers via email, and we started getting emails from all over the world.
We can measure the impact from the increase in the number of calls and emails we are receiving. We can also subjectively see it when callers share positive outcomes with us. Often, during the call itself, we can see the caller being benefited. However, we train our volunteers to stay focussed on listening and emotional support, and not engage with outcome and impact.
How do you know someone maybe suicidal? What behaviours are the warning signs for suicide?
When someone is contemplating suicide, their words or actions may give clues that they may be at risk for hurting themselves. While these signs may show up in many individuals, each person is unique and different and thus not everyone may show similar warning signs. Some individuals may show no signs at all. Thus, if you feel concerned for someone around you, please do speak to them about how they are feeling.
While it is encouraged to be observant to any change in a person’s mood, behaviour or nature, the only way to know if someone is suicidal is to talk to them about it. While asking this may be hard, it’s made more difficult by the prevalent myth that talking about suicide can induce someone to see it as an option out of their pain. When handled sensitively, this is not the case, and the person feels less alone and distressed if they are encouraged to talk.
- Some common verbal warning signs may include someone talking about - killing themselves, having no reason to live, feeling hopeless, being a burden, dealing with a lot of pain.
- Some common behavioural warning signs that someone may display - Looking for a way to end their lives, such as searching online for methods, increased use of alcohol or drugs, withdrawing from activities, isolating from family and friends, reckless disregard for personal safety, visiting or calling people to say goodbye, giving away prized possessions.
- Some common emotional or mood based warning signs someone may display - feeling depressed, anxiety, loss of interest in activities once enjoyed, humiliation or shame, agitation or anger, mood swings, sudden relief or improvement in mood
Do remember if you are concerned for someone around you, please do try to talk to them with care and patience.
Is it safe to question someone thinking of hurting themselves? Will it increase danger of suicide?
The commonly held fear is that talking about suicide might either upset someone further or plant this idea in someone’s head. However, the recommendation is contrary to this fear. Research shows that it’s better to talk. A study via a questionnaire that asked high school students in the US about filling out a questionnaire about having suicidal thoughts or not, found that there was no increase in suicidal thoughts or depressive feelings in the days following answering these questions. In fact, the students who were most at risk of suicide (because they were depressed or had previously attempted suicide) experienced a small decrease in suicidal thoughts and depression. A similar study was conducted in Singapore with adults and found no ill effects about asking about suicide. Experts agree that talking about suicidal thoughts can be a relief to a suicidal person. It allows them the chance to talk about their problems and feel that somebody cares.
How should one approach a person coping with mental health issues? Are people comfortable talking about their distressed state of mind?
With sensitivity and respect. Respecting also that people may not want to talk, and accepting and giving them the space needed. Trust is earned and a rapport is built with constant and continuous care and warmth towards the person. Listening is a skill that can be developed, and includes training in important aspects like acceptance, non-judgement and empathy. People are looking for safe spaces to talk about their distress, and when we approach someone who we feel is agitated or distressed, we should be mindful of giving them such a space. It’s also important to understand our own shortcomings, of time, skill or patience. In case you feel it’s more than you can handle for now, then do refer and involve other support or caregivers when you feel the person needs support.
How do you address suicidal thoughts and behaviours?
Addressing suicidal thoughts and behaviours is based on embracing and accepting the person unconditionally. This enables them to share what’s truly on their minds, while giving them time and space to share and process their thoughts and feelings. Involving other caregivers is important, and keeping the persons trust is also vital. You can also take practical steps like taking away dangerous substances that they may use to harm themselves, keeping a close watch on them, and letting them know that they can talk.
How do you go forward, if the person is resisting help?
This is tricky, and calls for a larger engagement. You will need to involve family, caregivers and mental health professionals, if required. Making yourself available, and staying connected to them can help them feel supported.
How do you handle a situation where the person admits she is contemplating suicide?
They should be given a safe space to talk about what they are going through and encourage to seek help and support. To handle our own reactions of maybe fear or urgency, and being there for the person to talk to. This is about their pain, and the focus should remain on them.
What type of counselling is helpful for suicide survivors?
Emotional support like ours, counselling and therapy and perhaps medical support as well. Mental health professionals may have to get involved, and the families may need support as well. There are support groups for survivors and the family and perhaps these can be explored as well. We, and other helplines like ours, remain available for people to reach out and to talk.
How many calls does Samaritans receive per day? Has the Covid pandemic seen any increase in people calling your helpline?
We received about 20-25 calls per day, prior to lockdown. Our services were impacted and moved to remote support with reduced timings. Despite this, we saw an increase in calls with the general rise in distress and isolation. We saw a marked increase in calls from young callers and a rise in suicide ideation. People reported more stress arising from lockdown, more relationship issues, and a rise in stress relating to education and professional problems. We hope to increase our timings to be available to more people who need our service.
If you, or anyone you know needs to talk to someone in an accepting and unconditional space, please do reach out to Samaritans Mumbai at 8422984528 / 29 / 30, open all days 5pm to 8 pm. You can also email talk2samaritans@gmail.com
Website - http://samaritansmumbai.org
Instagram - https://www.instagram.com/samaritans.mumbai
Facebook - https://www.facebook.com/SamaritansMumbai
Twitter - https://twitter.com/SamaritansMum
Other helplines are here: https://www.patientsengage.com/resources/suicide-prevention-helplines-i…
Sunitha Ramachandran, a former banker, has over 7 years of voluntary work in suicide prevention.
