The Tragic Facts About Suicide No One Wants to Talk About | Men's Health Magazine Australia

The Tragic Facts About Suicide No One Wants to Talk About

Suicide is the no.1 killer of Australian men in their prime. It's time to man the defences

Save for the pinstriped waistcoat and red power tie he sports on his company website, Bernie Mitchell doesn’t present as your standard real estate wheeler and dealer. Then again, he doesn’t come across as someone who tried to take his own life with a 25-centimetre knife either.

Soft-spoken, with unveiled eyes, Mitchell projects an air of calm assurance bordering on serenity when we meet in the office of his property management company above the stylish furnishing stores of Sydney’s Waterloo. Dressed in a black sweater and jeans, the 42-year-old’s warm greeting offers a jarring contrast to the knowledge that, at 24, he was so hollowed out that death seemed preferable to life.

Beyond the mysterious workings of brain chemistry, the reasons remain troublingly elusive. The product of a solid and loving middle-class family, he enjoyed an expensive private school education, a loving partner, a clear direction in life and few apparent demons. Probe for any great emotional knots and you learn that, if anything, “I’m an over-sharer”. By his own lights, he’s also a joker and “a glass half-full guy . . . no, more like a glass-full guy”.

It was this uncomplicated version of himself that completed a cabinetmaking apprenticeship while living at home, before deciding there was more money to be made as an insurance broker. Hungry to succeed, he completed a three-day sales course and jumped headlong into a commission-only job. It was, he recalls, a “real boiler-room” environment: 50 salespeople in an open-plan office, 40 cold calls a day, 70-plus hours a week, fortnightly sales targets. Most recruits lasted three months.

Clearing that first hurdle, Mitchell moved into an apartment with his high-school sweetheart, Sam, but something wasn’t right. “I was exhausted and I didn’t understand why,” he recalls, shaking his head gently in the way you might express wonder at the first time you noticed a mole had changed colour. “I’d never not looked forward to going to work on Monday. But now I was tired . . . tired . . . tired.”

After a year in his job, he found himself in front of a doctor, being told he was suffering from depression. “I didn’t understand it – this wasn’t me,” he says, the sheer implausibility of it still evident in his eyes. “Nothing was wrong with my life.”

Prescribed antidepressants, he now struggled to make it into the office for more than a couple of hours a day. “It was a case of get up . . . brush your teeth . . . brush your hair . . . make the toast. Every step was a big effort.” He struggled to put a sentence together or think straight. “I was scared to get on the phone. I forgot how to do my job. I was thought-stricken.”

Then, out of the blue, a spike in his mood. But rather than presage his escape from depression, it led to a diagnosis of bipolar disorder. What was going on with his brain? Sinking further into a deep funk, he now rarely ventured out of the unit, except when Sam dragged him along to see friends. Beset with anxiety attacks and experiencing mood swings as often as every 20 minutes, he was prescribed eight different drugs, none of which provided relief.

“It was draining. There was a feeling of despair, hopelessness, of life tumbling down, of not being able to do anything to stop it. My head hurt and I lost the ability to see ahead. I was worried about money, about work, about whether I would ever recover. Death began to look like the only way out. I just wanted the pain to end.”

And so, on a late spring day, he flicked on the TV after Sam had left for work, then returned to bed, his mind in turmoil. Hours passed. Finally he rose, found himself looking at the high priestess of positivity, Oprah Winfrey, on the TV, and switched it off. Rummaging in the kitchen drawer, he drew out a long knife, a housewarming present from his parents.

“I sat down on the lounge, my thoughts going to and fro, just trying to work up the courage. I ruled out thrusting it into my heart – I was worried about hitting a rib – before putting the knife to my arm.”

He cut, deep enough for blood to flow, but not so deep as to be fatal. Instantly, he knew he needed to cut more savagely to finish the job. “I really wanted to follow through. But at the same time I had an inkling that it wasn’t right that I should want to do this.”

That flimsy, floating thought turned into a lifevest. He stared at the phone on the table in front of him, picked it up, and dialled a doctor who’d been treating him over the preceding year. “I said ‘I have a knife to my arm’, and when he asked me to not do anything, that was enough, his voice was enough, just knowing he cared.”

Eighteen years on, the last few words hang in the air between us. Recognising that someone, anyone, cares seems like a small concession to continue living. All too often, though, it’s one men aren’t making.

“I didn’t understand it – this wasn’t me,” he says, the sheer implausibility of it still evident in his eyes. “Nothing was wrong with my life.”

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Six men die by suicide every day in Australia. Every . . . single . . . day.

That’s six sons, brothers, fathers and – according to Australian Bureau of Statistics figures released earlier this year – together they made up three-quarters of the 2864 people who took their own life in 2014, the latest year for which statistics are available.

Why the gender imbalance? The explanation is threefold. Men are more impulsive, more sensitive to financial distress – the bread-winner tag endures – and more likely to choose violent, and hence more effective, means. Equally confronting is the knowledge that, for men between the ages of 20 and 44, suicide is the number one cause of death, ahead of road accidents, disease and any health issue you care to name. It wasn’t meant to be this way.

Back in the Nineties, a national summit on suicide saw a surge in services and programs designed to tackle the issue head on. In the intervening years RUOK Day (ruok.org.au), Soften The Fuck Up (softenthefckup.spurprojects.org) and programs like Mental Health First Aid (mhfa.com.au) have risen to the challenge. For all that, the 2014 ABS figures revealed the highest suicide rate since 2001, prompting Lifeline Australia chairman and former NSW Liberal Party leader John Brogden to call for suicide to be declared a national emergency.

Brogden followed up by recommending that the suicide toll be published like the road toll. He wants it in our faces and under our noses, a pungent and nagging reminder that we walk among wounded individuals who need our support. He spoke, of course, from experience, his call coming on the 10th anniversary of his own attempted suicide aged 36, made after he resigned from politics for inappropriate conduct.

As one of the Mental Health First Aid program’s founders, the University of Melbourne’s Professor Tony Jorm shares Brogden’s concerns, while stopping short of declaring the 2014 figures a trend. It will be some years, he says, before we can be sure they are not “a statistical blip”.

In the meantime, Jorm is placing his faith in programs like his – MHFA has been adopted in 23 countries since its inception in 2001 – that put the emphasis on equipping people to fill the space between the suicide candidate and services on stand-by to help. His one reservation?

Men, he says, need to do more to help other men.

“Men need to lift their game,” he insists, pointing out that when instructors present the MHFA program in workplaces, male faces are notable by their absence. “When it’s voluntary and when it comes to caring, it’s women who overwhelmingly turn up.”

Which is strange, isn’t it, considering that we’re the ones taking our own lives, the ones crying over mates and fathers and sons? The ones who, as Bernie Mitchell attests and the statistics highlight, can be knocked sideways by life no matter how strong a wind is at our back when we first leave harbour.

MY FIRST ENCOUNTER with suicide came before I was even out of primary school, when a friend’s mother overdosed. Then, while visiting remote aboriginal communities in the Northern Territory a decade ago, a teenage boy hanged himself. That same year, a former work colleague swallowed pills before wading into a Melbourne river. More recently, a friend jumped from a Sydney headland, leaving behind two high-school-age children.

“The truth is, most people know someone, and that’s a huge motivation,” says Jorm.

If you happen to be one of those fortunate people who don’t know anyone, here’s the thing. Yes, deeply scarred battlers from broken or abusive homes, unemployable heroin or ice addicts, men with severe psychological problems – they all feature among the suicide statistics. But then, so do lawyers and accountants, heavy-machine operators and electricians, teachers, soldiers and policemen. Men who, behind their suits and their uniforms and their King Gees, are picked apart by unrelenting pressure and six-minute billing units, trauma, toxic marriage breakdowns, financial setbacks, grief. Men who, for all you know, could be you if you could just peer into your future.

As US psychologist and suicide expert David Jobes observed, “every man is capable of reaching a desperate place where suicide can move onto his psychological radar screen. But who goes there, when, how and why is this unique interplay of biochemistry, social forces, family modelling and other factors. How those queue up is remarkably complex and specific to the man who’s struggling at that moment.”

Complex and specific. But there are aspects those who end their own life share too: a sense of being trapped in their lives, a belief they’re a burden on others, and a gradual disconnection from the world and everything that inhabits it. Bernie Mitchell recalls loving the woman he shared an apartment with; he just didn’t feel anything for her.

When it came to a choice between life and death, though, it was the realisation that someone cared for him that stayed Mitchell’s hand. Which is precisely where you enter this story.

Because all but a very few people actually want to die. Like Bernie, they just want their pain to stop. And while they’re weighing their choices, being reminded that there’s someone who cares for them – even when it’s obvious to all those around them that many people care for them – can be the thread that draws them back to safety.

In the process, they’re reminded of one incontestable truth, a truth often cited as the most potent barrier preventing them moving to the final act: that while their pain might end, it merely passes to those around them.

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MELBOURNE SOCIAL WORKER Russell Miles concedes he comes from a long male line of “worry warts”. It’s an understated descriptor – his father, a railway man like his grandfather before him, worried himself into suicide.

Life continued to throw brickbats Russell’s way when his wife, Rosemary, died of breast cancer, leaving him to raise three sons. Another challenge arrived when his middle son, Nick, was diagnosed with Asperger’s syndrome and grew into a young man locked in battle with the black dog. As someone who taught a TAFE course that included suicide prevention, Russell was alert to his son’s struggles and made every effort to keep Nick engaged and connected.

It wasn’t easy, even as Nick took part-time jobs in pubs and aged care, joined his older brother Chris at the gym, and turned his passion for drawing into art classes. “You just want to lock them in a room so they can’t hurt themselves, but that’s not practical,” says Russell.

Instead, searching for ways to boost Nick’s spirits and knowing he had fond memories of childhood trips to Tasmania, Russell suggested a holiday there early last year. He and his partner, Louise, would drive around the island before rendezvousing with Nick and his younger brother, Liam, in Hobart.

Two days before they were due to meet, Russell’s phone rang. It was Chris. “I remember it so clearly. He said, ‘Nick’s dead. He’s killed himself’. I went numb.”

Nick, 22, had walked a kilometre from the home he shared with his father to a railway line and then waited for a train. Says Russell: “From talking to the policeman I have a mental image of the driver sounding his horn repeatedly, frantically, and trying to stop. Of Nick’s utter determination and the driver’s utter distress as he tried to prevent it.

“Trains were our family thing, and I’ve got no end of photos of Nick with trains. Now there’s this hideous thing that spoils a memory.”

Somehow, Russell is able to look back on the “deep grief” Nick felt after his mother died when he was just nine and allow “that was a lot for him to carry and he doesn’t have to carry it anymore”. But it’s an insufficient salve. “The level of awareness, of knowing what he must have gone through . . . that tears me up.”

Was there anything he’d learnt that he could apply in his role as a social worker?

“That as much as we’d like it, there aren’t any ready-made responses that fit every case. It’s such an individual thing. If I look at how I might have done things differently, I can’t see anything, but I’m still the parent and so I’m still responsible.

“I know I will carry this until the day I die.”

You can’t help but wonder: would hearing that have impelled Nick to step off the track?

“I remember it so clearly. He said, ‘Nick’s dead. He’s killed himself’. I went numb.”

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SO, WHAT TO DO? How do you, at ground level, play a part in reducing the suicide toll?

By being as subtle as a sledgehammer.

“It’s a very hard conversation to ask someone ‘Are you thinking about suicide?’,” explains Jorm, “but without being able to use that word the sufferer is isolated. Once you open that conversation up, you open the gateway for support. Facebook friends aren’t going to do it.”

It’s a new spin on manning-up, and a decidedly uncomfortable one. For both parties. A 2015 Medical University of Vienna study of male suicide survivors found that, for some of the men, the “feelings associated with being vulnerable provoke greater anxiety than the thought of being dead”.

The sentiments would come as no great shock to Gerald Haslinger, an MHFA instructor in Sydney. One of the 44-year-old’s earliest memories, “when I was three or four”, was hearing how his godmother’s son had found his father hanging in the attic of the block of apartments where they lived in Austria.

“So I guess you could say it’s always been an area of interest,” says Haslinger, who acquired his own experience of grim outlooks – “I went to some very dark places” – in 14 years working in finance. Changing tack a decade ago, he completed a psychology degree and, like a spelunker who’s extracted himself from a deep cave, now spends his days returning to comfort others mired in the gloom.

“When someone says, ‘I feel like shit and I don’t think I can do it anymore’, I’d like to think we’ve moved beyond saying, ‘Don’t be stupid, you’ll feel better with a couple of beers in you’, and taking them down the pub. It’s an invitation to help.

“Women are much better at bringing in others to help solve shitty situations. Men try to solve things internally at first and only externalise when we’re right on the edge, if at all.”

And this is where another, distinctly male, trait needs to be suppressed: our impulse to problem-solve.

“What they want to hear is, ‘That must be really hard’, not suggestions on how to fix it,” says Haslinger. “You need to be willing to get in the hole with them for five or 10 minutes, and resist the temptation to pull them out.”

Having spent years after his suicide attempt battling to achieve equilibrium, Bernie Mitchell agrees. “You don’t want them to be a doctor. It’s just a matter of being together. And don’t give them the option by asking, ‘Do you want me to come over?’, because they’ll say ‘No’. It’s best to swing by. As uncomfortable as that might be, they’ll appreciate it.

They just may not say it.” Think of that connection as providing a barrier between thought and deed. And obstacles, whether physical or psychological, are remarkably effective at preventing suicides. A recent Black Dog Institute study found that barriers and signs installed at notorious suicide locations – barriers that could be easily bypassed by a determined person – cut suicide attempts by up to 90 per cent.

“Most people who think about suicide are ambivalent . . . so if someone is blocked, they get extra time to think about other options,” explained the report’s author, Dr Karolina Krysinska.

Haslinger puts it another way. “It’s rare that anyone wakes up and is 100 per cent certain they’re going to kill themselves that day. Everyone has a tug of war. They know they’ll devastate their parents, their kids.”

In that tug of war, simply showing you care carries more weight than you might credit.

Haslinger recalls one hard-drinking client who’d received the rough end of the pineapple in life. He’d talked openly about suicidal thoughts and when he didn’t turn up for a scheduled appointment or answer his mobile, Haslinger became worried.

“I called his work and he wasn’t there either, so I called the police and asked them to go around to the boarding house where he was living to check on him. I’ve got one of those voice-to-text mobiles and the next day I get a text: ‘I’m a wife’. I’m thinking, ‘Why’s my wife sending that?’. Then I realise, it’s from this guy – ‘I’m alive!’.”

“When I next saw him he gave me a bit of a grief: ‘Thanks for sending the cops around’. But then 15 minutes after he leaves I get a text: ‘Thanks for caring enough to send help’.”

BERNIE MITCHELL DRAINS his coffee and attempts to summarise his life since he put down that knife.

For more than two years afterwards, he relied on disability payments while undergoing a course of electroconvulsive therapy (“It didn’t work for me”) and refining the mood-stabilising, antidepressant and antipsychotic drug regimen he remains on to this day. Sam and his family stayed close, “reminding me that the future I couldn’t see was there. People say snap out of it, but it took me two years to fully understand my condition. There is no snapping out of it. It’s a sort of blindness.”

Ultimately he married Sam, built a business, had five kids, took up scuba diving and wrote a book about living with bipolar disorder (Bipolar: a path to acceptance). He also had “about 400 psychotherapy sessions delving into the broken person you become because of depression, and looking at what brought you to that place”.

He still has days when three emails is three too many. “I know it and I just go home.”

Can he put his finger on the one thing that has stopped him sliding back?

“At the age of 24 I learnt what is important in life. Value every moment; your family and friends, the breeze on your face, the smells as you walk down the street. I realised that long before a lot of others.”

As I digest that, I notice something I hadn’t in the previous two hours. Mitchell doesn’t wear a watch.

He’s living . . . in the present.

3 Steps to Prevent Suicide

Ask
If you suspect someone might be suicidal, don’t tip-toe around the subject – ask them outright: “Are you thinking about suicide?” Don’t worry that you’ll plant the idea in their head. The reality is there’s quite a build-up as people imagine ways they might take their life – what experts call ideation. Most people with thoughts of suicide want to talk about it. They want to live but desperately need someone to hear their pain and offer help to keep them safe. If they don’t want to talk, don’t give up. Try another time, or let someone else (parents, a counsellor, another mate) know you’re worried.

Listen
If they say “Yes”, let them do most of the talking and don’t dismiss their feelings or judge them. Listen to their story without imposing your own outlook. They’ll often feel a great sense of relief that someone wants to talk about their darkest thoughts.

Act
Talk about steps you can take together to keep them safe. And don’t agree to keep it a secret. You shouldn’t be the only one supporting them and you may need help to persuade them to get help. If you feel they are in immediate danger, call a crisis line like Lifeline (13 11 14) or 000. If you can get in straight away, visit a GP or psychologist with them. Even if the danger is not immediate, suicidal thoughts may return, so ask them to promise to tell someone if they do – it will make it more likely they will.

If you have been affected by this story, support is available here.

Lifeline: 13 11 14

Suicide Call Back Service: 1300 659 467

Beyondblue: 1300 224 636

www.ruok.org.au

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