More than a visitor: a reflection for World Suicide Prevention Day

Next Friday (10th October) is World Suicide Prevention Day. I have written before in this blog about the challenges of mental health for older people in society. Those challenges are even more acute when it comes to considering the prevention of suicide amongst the older population.

This year’s theme is ‘Creating Hope Through Action’ and aims to empower people with the confidence to engage with the complexity of ‘hope’. There are dozens of organisations including well known ones like the Samaritans who campaign on World Suicide Prevention Day under the National Suicide Prevention Alliance (NSPA).

Together, they ask the governments in the UK and Ireland to make suicide prevention a priority and help raise awareness about how we can each support each other better.

On the day itself we are being asked to share the things that we do which helps us feel hopeful when we are going through a difficult time. For example:

  • Reaching out for a coffee with our best friend
  • Taking a walk in the fields and letting the wind blow everything away
  • Go for a run along the seafront

Suicide affects many people in Scotland. In 2020, 805 suicides were registered in Scotland (575 males and 230 females). These numbers comprise deaths coded to ‘intentional self-harm’ and to ‘events of undetermined intent’. See

Throughout my life I have worked with people affected by suicide and mental health challenges and whilst it is always dangerous to make any statement in this area because of the risk of it becoming trite, I think there is one thing more than anything else I have learned and that is that communication and talking are so vitally important. It is one of the reasons why I get so angry that for too many of our older citizens, whether they use social care supports or not, as a society we have steadily reduced the opportunities and chance to chat and talk, to listen and to be available. If social care is about anything it is about the dimension of care which is social and relational rather than simply about task and function.

Now I am the first to admit that conversation and communication is not easy especially if someone is distressed, anxious and upset. There are times when we worry about saying or doing the wrong thing but in most of those instances doing nothing can be just as bad.

Since its creation Public Health Scotland has produced some fantastic short animations to help individuals address the challenges of communicating on hard issues including listening, questioning and responding. You can access these through the NES website

There are a whole host of reasons why someone might be at risk of suicide including family breakdown, insecurity of life including employment, alcohol and substance misuse and so on, but over the years we have often ignored factors relating to age as key influencers.

During the pandemic many older individuals felt a sense of powerless, they endured isolation and exclusion, a sharp loss of contact and routine, and some developed a sense of worthlessness because of the way society was perceived as valuing older age. There were some older adults who felt that they were a burden to family and friends and many experienced bereavement without the usual supports of ritual and family for their grieving.

Increasingly professionals are aware of these heightened risks and some resources have been developed to support us all to be aware of the risks of suicide in older age not least as a result of the pandemic. I would personally commend the NHS Education Scotland work in this space.

Talking and listening, supporting and being present are all so critical perhaps especially at times of memory and community celebration. World Suicide Prevention Day allows us to focus on the importance of this work as professionals and as individuals and I hope we can all take some time on that day to reflect what we do as individuals and organisations and what more we might be able to do.

There are also times and spaces where silence interrupts the talk, and it is easier and better simply to sit and to be with another. It is in those spaces that I find, along with others, that poetry offers a unique insight into the emotions that many of us struggle with.

Some of you might know the poetry of the activist and mental health campaigner P.Bodi  who for me provides short but deep insight into the struggle of living and loving. In her work ‘Inherit the Dawn’ P.Bodi writes poems for hope. They are poems written for anyone who has ever struggled with their mental health, and for those who are in need of compassion, empathy, and gentle reminders to keep going.

“I will do as the flowers do

Inherit the dawn.

Tell me of the morning

And the gentler days beyond.”

It is this necessity of grasping hope which is the at the heart of the work of many poets who have written about a depth of despair that has cut them to the core, perhaps no more eloquently than Mary Oliver who has across her career written and spoken openly about issues of mental health and challenge.

I leave you with her poem, ‘When death comes.’

“When death comes

like the hungry bear in autumn;

when death comes and takes all the bright coins from his purse


to buy me, and snaps the purse shut;

when death comes

like the measle-pox


when death comes

like an iceberg between the shoulder blades,


I want to step through the door full of curiosity, wondering:

what is it going to be like, that cottage of darkness?


And therefore I look upon everything

as a brotherhood and a sisterhood,

and I look upon time as no more than an idea,

and I consider eternity as another possibility,


and I think of each life as a flower, as common

as a field daisy, and as singular,


and each name a comfortable music in the mouth,

tending, as all music does, toward silence,


and each body a lion of courage, and something

precious to the earth.


When it’s over, I want to say all my life

I was a bride married to amazement.

I was the bridegroom, taking the world into my arms.


When it’s over, I don’t want to wonder

if I have made of my life something particular, and real.


I don’t want to find myself sighing and frightened,

or full of argument.


I don’t want to end up simply having visited this world “

Donald Macaskill