Suicidality and mental health: a psychosocial lens

We live in a society where suicide is becoming increasingly common. The 10th of September was World Suicide Prevention Day which is a day aimed at promoting the worldwide commitment and action to prevent suicide. SADAG reports that there are 23 known cases of suicide in South Africa per day, and for every person that commits a suicide, 10 have attempted it.[1] To add to these statistics, one can imagine how many more people think about suicide or have considered it at some point in their lives. There is a lot to be said about the reasons suicide has become such a common occurrence, more devastatingly, amongst young people. We need to question the reasons why many people find themselves backed against the wall in this way where suicide becomes one of the ways or the only way to deal with the challenges they face. Is this learnt helplessness? The pressure of living in continuous stressful and challenging circumstances or a lack of access to resources and skills that promote mental health? Part of the answer is that many people are faced with emotional pain, feelings of hopelessness and helplessness and are often unable to access help and support, or skills on how to cope with life circumstances. All this can prove too much to bear to the extent of considering ending one’s life. Most suicidal thoughts are centred around a need to end some sort of psychological or physical pain and having or seeing no other option.

The prevalence of suicidality in our community points to the mental health crisis we are facing as a society. We cannot talk about suicide without talking about depression, which is one of the more common mental health issues in South Africa. The lifetime prevalence of depression in South Africa is 9.7 % or 4.5 million and 70% of people who attempted suicide have a mental health illness[2]. These are alarming figures that require a more active role in the prevention of mental health illnesses rather that a reactive one. The problem with the reactive approach is that for one, the individual has already died, and secondly, the devastating impact has already been put in motion: loss of loved ones, secondary trauma to those who witness or hear about the suicide, and the seed of suicide may be planted in the family or community. Where options are few in times of crisis, most people, particularly young people may feel as though suicide may relieve their pain or distress.  With the scarcity of school and community based programmes that deal with issues of mental health, these cycles then go one for generations, devastating entire communities.

It is important that we interrogate the factors that contribute to the prevalence of mental health issues in our society. I’ll only share 3 below :

A.       Our inherited traits

We deal with historical and continuous traumas that have impacted the way we have been wired to deal with or perceive distress through our nervous systems or by observing the adults around us. This could occur both on the nature -(epi)genetics- and nurture-socialization- levels (transgenerational transmissions of trauma)[3]. It is important to be not only be mindful but proactive around the contextual factors that predispose certain members of society more than others, to adverse childhood experiences and continuous distressing circumstances.

B.       Continuous stressful environments

This speaks to the prolonged exposure to distressing experiences that compromise people’s ability to lead healthy (physiological and psychological) lifestyles. This prolonged exposure to continuous traumatic stress (CTS)[4] can lead to feelings of helplessness and despair where people end up feeling alone and without the possibility of positive change. These speak to issues of where you live, what socio-economic challenges you face, how safe is your environment, how much quality time you are able to have with your loved ones, etc. These factors more directly confront the policy issues around access to basic needs, protections/freedoms, including access to mental health services.

C.       The attitudes and stigma around mental health

Most people will go through some form of mental health issue at some point in their lives. While other people may be able to cope with or manage their mental illnesses, some may not have the resources to do so. It is important that we engage in topics about mental health as an empowerment and preventative measure to ensure that people are well informed about the importance of mental health and how to prevent, cope and manage when faced with threats to our mental health. This then extends to the ways in which we talk about mental health and how we perceive and treat those faced with mental health challenges in our society. We need to take responsibility for the ways we may contribute, through our ignorance and negligent language and attitudes, towards exacerbating effects that mental distress can have on individuals and communities.

The promotion of mental health is a major factor in the prevention of suicide, depression and other mental health illnesses. Mental health should be prioritised. Not only on the micro level, but on meso and macro levels as well. There’s a need for increased community awareness and engagement around issues of mental health for the purposes of psychoeducation and to empower people with resources and skills to better manage with mental health challenges. Effort must be put towards creating education around mental health and mental illness as a skill acquisition approach and not only as a response to risks.

Many may find it difficult to support others who are dealing with depression and suicidality as one may feel stuck not knowing what to do. It is normal to feel at a loss to help friends and loved ones as and this alone may be distressing to you. It can be challenging to feel like you have to fix or find solutions to your loved one’s distress. However, what’s important to note is that suicidality is not a problem or situation to be fixed, rather, we need to remember the individual who is going through this difficult period. Remembering the individual helps us better connect with the person through listening to them, reaching out, acknowledging their feelings and normalising these within their context. And supporting them as they access mental health support and seek out professional help. For those who may be looking to support someone dealing with depression or suicidality and wanting to make a positive contribution towards preventing suicide in your own homes and communities a few ways you can do so involve:

  • Taking the person seriously when they talk about wanting to kill themselves or feeling like suicide can be the answer to their pain.
  • Trust: Be honest and sincere when you talk to people who may be suicidal. Do not make promises you can’t keep and respect them and not force them to do things they may not want to do.
  • Refrain from trying to show them “The bright side” or cheering them up. Show empathy and see things from their point of view. This will allow you to be genuine and able to normalise their feelings within their context. Most times people need to be heard and understood.
  • Tell them that you care and show this by being willing to listen to them in their distress. Acknowledge their pain and explore with them other options to alleviating their pain or distress( these should be safe and could include reaching out to professional services)

The message here is really that suicide can affect any of us or our loved ones. Each and every suicide is devastating and has a profound impact on those around us. It’s important that we raise awareness, to stop the stigma and promote mental health-which is not merely the absence of mental illness, but a lifestyle, a way of being where each one of us is able to feel authentically, become active members of society, manage, and cope with our daily challenges and reach our full potential.

Written by Charlotte Motsoari

For more information and support, Please reach out to any of the following organisations’ helplines, they are there to support you through your difficult time.

CSVR telephone line: 071 241 1831

People are Dr Reddy’s Help Line- 0800 21 22 23

Cipla 24hr Mental Health Helpline-0800 456 789

Pharmadynamics Police &Trauma Line: 0800 20 50 26

Adcock Ingram Depression and Anxiety Helpline:0800 70 80 90

ADHD Helpline:0800 55 44 33

Department of Social Development Substance Abuse Line 24hr helpline:0800 12 13 14 or SMS 32312

Suicide Crisis Line:0800 567 567

SADAG Mental Health Line:011 234 4837

Akeso Psychiatric Response Unit 24 Hour:0861 435 787

Cipla Whatsapp Chat Line:076 882 2775 (9am-4pm, 7 days a week)

24 hour Healthcare Workers Care Network Helpline:0800 21 21 21 or SMS 43001

NPOWERSA Helpline:0800 515 515 or SMS 43010


[1] https://www.sadag.org/index.php?option=com_content&view=article&id=1877&Itemid=142

[2]https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3195337/ ; https://www.mhanational.org/conditions/suicide

[3] Brave Heart, M. Y.H., Chase, J., Elkins, J., & Altschul, D.B. (2011). Historical trauma among Indigenous peoples of the Americas: Concepts, research, and clinical considerations. Journal of Psychoactive Drugs, 43(4), 282-290.

[4] Stevens, G., Eagle, G., Kaminer, D., & Higson-Smith, C. (2013). Continuous traumatic stress: Conceptual conversations in contexts of global conflict, violence and trauma. Peace and Conflict: Journal of Peace Psychology, 19(2), 75–84. https://doi.org/10.1037/a0032484

Published by CSVR Trauma Clinic

This blog represents thoughts of therapist working within the CSVR Trauma Clinic. The focus is on understanding the drivers and impact of violence on individuals, families and communities to work towards violence prevention and the building of peaceful societies

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