This year, the World Health Organisation’s theme for World Suicide Prevention Day is ‘Changing the narrative on suicide’, encouraging us all to include destigmatising discussions around mental health in our daily interactions:
“The call to action encourages everyone to start the conversation on suicide and suicide prevention. Every conversation, no matter how small, contributes to a supportive and understanding society. By initiating these vital conversations, we can break down barriers, raise awareness, and create better cultures of support.”
The importance of this message is underscored by the statistics – suicide is the second leading cause of death among people aged 15-29 in our country; in 2019, South Africa reported 13 774 deaths by suicide. What is particularly jarring is that 10 861 of these deaths were men, a staggering 79%. Taking these statistics into account, perhaps we should focus on how to talk to our youth – in particular our male youths – about mental illness.
Assuming young men are fine
In providing psychotherapy to many people from this demographic, my observations are that we tend to speak less to male teenagers and young adults than we do to their female counterparts. We (parents, siblings, friends) tend to assume that these deep-voiced, confident-looking young men are fine. That they will ask if they need help, even though many of my male patients describe feeling incredibly lonely. Longing for their parents and siblings to touch base with them more frequently and to ask them about how they are doing psychologically.
It is surprising how little other people need from us. 90% of the people who come to me for psychotherapy report that they only need a WhatsApp, phone call, or quick check-in from their loved ones a few times a week to improve their sense of belonging and connection. This is equally valid for female patients, but what I find is that generally (not always) girls and women are socialised to be more open about our emotions and to ‘tend to and befriend’ others. This helps us to establish and maintain psychologically intimate relationships with others, thus providing somewhat of a buffer to mental struggles.
Now, I am well aware that teenage boys are possibly the most difficult group to try to talk to. Usually, any attempt to elicit emotional content is met with rebuffs and one-word responses. Angry, irritable young men are particularly challenging to connect with and it is often much easier to just leave them be. Assume that they will be okay. But what we do know about this group is that they are very likely to self-medicate and withdraw instead of reaching out for support and treatment. Cannabis, alcohol, tobacco, and vaping are easily accessible and serve to enhance the cool, party-boy persona that so many depressed young men work very hard to establish. Behind the therapy door, their anger and bravado dissolve into abject despair and desolation. Many of them acknowledge wanting to die because they feel like a failure or because they feel that they are under too much pressure from their families to provide financially or to achieve career goals that seem unattainable. You see, behind an angry, aggressive young man frequently lies fear, trauma, and depression.
Make sure they are safe
And these patients are the lucky ones. The ones who have been able to access campus or school psychological services. How do we help all the other walking wounded out there? By the simple act of checking in with our boys. Think about the boys, teenagers, and young men in your life and ask yourself if you know the following about them:
• how have their friendship groups changed over the past few weeks?
• do they have any concerns or fears about their sexuality or sexual health?
• what scary or upsetting things have happened to them this year?
• do they know that they can talk to you about anything that worries them – without fear of criticism or judgement?
• what does their daily life look like – what do they eat (so many of our youth are hungry!)?
• do they use substances – are they worried about this? Would they like to reduce their use?
• do they feel safe where they move about in their daily life?
• what makes them happy? What do they look forward to in their day?
So, what stops us from talking to our young men about these questions? Is it our own discomfort with topics that we ourselves would prefer to shy away from? I guarantee you that the awkward moments of starting conversations with the young men in our lives pale in comparison to the devastation of losing them to self-death. Do not underestimate the power of simply asking someone how they are doing and acknowledging your own struggles in these conversations. Our vulnerability invites others to let down their guard and allows them to ask for help. Perhaps they would not ask in those exact words, perhaps we need to listen carefully to hear what they are really saying from underneath the tough exterior.
In the words of the late Ricky Rick, whom we also lost to suicide: “Ladies and gentlemen, I’m about to be out, but if you never see me or hear from me again, I want you to remember that you have to take care of the people that are close to you. Make sure they are safe.”
• The National Suicide Crisis Line on 0800 567 567. This number is free, operates 24 hours, and offers counselling in all 11 official languages.
• Dr Reddy’s Mental Health Helpline on 0800 21 22 23. This number is free and operates from 08:00 to 20:00 every day.
• Cipla Mental Health Hotline on 0800 456 789. This number is free and operates 24 hours.
• The Adcock Ingram Depression and Anxiety Helpline on 0800 70 80 90. This number is free, operates 24 hours, and offers counselling in all 11 official languages.
• The Substance Abuse Helpline on 0800 12 13 14. This number is free, operates 24 hours, and offers counselling in all 11 official languages.
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Click here for the South African Depression and Anxiety Group or contact (0800 567 567) or LifeLine (0861 322 322).