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Death by suicide: the final symptom of mental illness

09 September 2022 | Story Angela Vorster | Photo Andrè Damons

Angie Vorster — Angela Vorster is a Clinical Psychologist at the School for Clinical Medicine, University of the Free State (UFS).

Opinion article by Angela Vorster, Clinical Psychologist at the School for Clinical Medicine, University of the Free State.

Twenty-three people will die from suicide today in South Africa. Another 460 South Africans will try to end their lives today. They are from different cultural groups, different income groups, attained different levels of education, speak different languages, range in age from childhood through to elderly, have different genders and sexual orientations. These people have very little in common except that their lives all ended due to the final symptom of an illness. People who experience thoughts of ending their lives describe this mental space as feeling grey. Their thoughts tend to keep returning to the futility of being alive, what a burden they are to those around them, how nothing will ever get better and that nobody can help them. They tend to experience feelings of worthlessness, self-hatred, guilt, hopelessness, immense sadness and despair. Their suffering and emotional pain are excruciating. Nothing is enjoyable anymore. There is nothing to look forward to. Everything is difficult, boring, scary or meaningless. Inwardly they are drowning. But very often they smile, do their job and pass their exams, go on dates and vacations, make plans for the weekend and check up on their loved ones. They look happy in their photos. And when someone asks them if they are okay they say yes. Because they don’t feel like they deserve to feel better. They don’t want to be a bother. They might not call a helpline or make an appointment to see a psychologist or go to their GP for anti-depressants. Because they just don’t have the energy. It’s exhausting pretending to be fine all day. The one thought that brings relief is that they can end this pain. And one day they do. And their colleagues, friends and family are left reeling with shock and disbelief. How could this have happened? How could they have missed the signs? What should they have done differently to prevent this?

The causes are as complex and varied

This is the purpose of World Suicide Prevention Day which takes place internationally each year on 10 September and through which the International Association for Suicide Prevention endeavours to increase awareness of suicidality, as well as to fight the stigma associated with suicide. Wanting to die can occur along with many other symptoms and disorders including, but not limited to, depression, post-traumatic stress disorder, bipolar disorder, psychotic disorders, personality disorders and substance dependence or abuse disorders. The causes are as complex and varied as the manner in which suicidality may present. It is dangerous to regard only certain signs and symptoms as indicative of suicide risk, because we know that suicide can be extremely unpredictable. There is no way to tell if someone is a suicide risk based purely on their behaviour. However there are certain factors which may indicate an increased risk for self-harm. These include, but are not limited to, having previously tried to end their life, having a psychiatric illness, being seriously ill or having chronic pain or the misuse of substances. Experiencing legal, relationship, financial or academic stressors may increase suicide risk, as well as having access to lethal means to end their life along with being unable to access mental health care.

So what can you do if you think someone may be at risk of self-harm? Say something. Talk to them. Tell them what you are worried about and give them the space to express how they feel without judgment or condemnation. Reach out to their support system and share your concerns with them. Encourage the suicidal person to make contact with a health care professional – this can be a psychologist, GP, psychiatrist, social worker, psychiatric nurse, counsellor or a suicide prevention help line. Other important members of our community who provide a great deal of assistance to suicidal people and their families include religious and spiritual leaders, teachers, support groups and employee assistance programmes. There are actually so many ways and places to receive health care and support; however the most significant barrier to making use of these resources is sustained by the stigma associated with suicide and mental illness. In our culture of toxic positivity where our photos are touched up, our statuses updated and our successes plastered on various social media platforms, the authentic act of acknowledging when we feel defeated, unhappy or like a failure has become a rarity. The more real, honest and vulnerable we can be about our ‘undesirable’ emotions and experiences, the more space we create for those around us to do the same. When we normalise not being okay at all times, we give ourselves and others permission to speak up when we need help. And this is our greatest weapon against suicide – authentic connection.

What suicide is not

We’ve explored what it may feel like to be suicidal, now let’s focus on what suicide is not. Suicide is not a moral failing. It is not because the person was weak or selfish, it is not because their family was dysfunctional or their faith not strong enough. Suicide is the final symptom of mental illness – and every single person is vulnerable to experiencing suicidal thoughts. Each one of us will be affected by suicide during the duration of our lives, either directly or indirectly. This is irrespective of how successful you are, how supportive your family is or how strong your religious convictions are. Dying by suicide is not a shame. It is not a failure. It is no different to a patient dying from any other disease. And just like any other illness there are symptoms we can look out for and treatments and medications that can assist in recovery.

Please think before you speak about someone who died due to suicide. I guarantee that at least one person in the conversation has suffered the pain of losing someone in this way. But you probably wouldn’t even know, because stigma silences. Stigma disconnects and alienates those who need support the most. Our words have the power to shame and silence, or to empower and encourage connection, which is lifesaving. Treat each conversation as though there may be someone present who is having suicidal thoughts or is working through the loss of someone they love due to suicide. Often we want to reach out and support families affected by suicide, but don’t because we are afraid of offending, or upsetting or because we ourselves are so uncomfortable with mental illness. But all these survivors of suicide need from you is your calm, empathetic, kind presence, a safe space to express difficult and messy emotions. Without being blamed or shunned or shamed. Support suicide survivors as though a terrible illness took the life of their loved-one. Because that is exactly what happened.

On 10 September this year I encourage you to light a candle and place it in your windowsill around 8pm wherever you are. This is in remembrance of those lost to mental illness and to show your support to those they left behind. In the words of the International Association of Suicide Prevention: “By encouraging understanding, reaching in and sharing experiences, we want to give people the confidence to take action. To prevent suicide requires us to become a beacon of light to those in pain. You can be the light.”

• If you or someone you know is at risk of self-harm please take a look at these websites and call the SADAG suicide emergency helpline.

International Association for Suicide Prevention

South African Depression and Anxiety Group

SADAG suicide emergency helpline 0800 567 567

News Archive

Dr Khotso Mokhele joins ranks of distinguished Chancellors

2010-11-21

Attending the inauguration ceremony are, from the left: Mr Pule Makgoe, MEC for Education in the Free State and member of the UFS Council; Judge Ian van der Merwe, Chairperson of the UFS Council; Dr Khotso Mokhele, newly inaugurated Chancellor of the UFS; and Prof. Jonathan Jansen, Vice-Chancellor and Rector of the UFS.
Photo: Dries Myburgh

Dr Khotso Mokhele joined the ranks of distinguished Chancellors of the University of the Free State (UFS) with his inauguration as the new Chancellor of the institution at a ceremony on Friday, 19 November 2010.

The lustrous ceremony took place on the Main Campus in Bloemfontein and was attended by hundreds of guests from all over South Africa.

Dr Mokhele said in his speech: “I am excited to have been invited by the UFS to join its community at the time when it is attempting to reinvent itself into an institution that will be counted amongst those that will shape the local, regional, national will, and by so doing, contribute to the shaping of an African will.”

Dr Mokhele follows in the footsteps of Dr Franklin Sonn, former Ambassador of South Africa in the United States of America and receiver of many awards, acknowledgements, and honorary doctorates, who retired earlier this year. Dr Sonn was preceded by Ms Winkie Direko, former premier of the Free State.

His acceptance of the role of Chancellor is a great honour for the UFS.

According to Prof. Jonathan Jansen, Vice-Chancellor and Rector of the UFS, it is a proud moment to welcome someone from the Province as the Chancellor of this university. With his strong academic values and deep sense of human compassion, Dr Mokhele is one of but a few uncompromising leaders. He is also an inspiring, determined pioneer and a role model to all our students.

Few have done as much to guide the development of science in South Africa since democracy in 1994 as Dr Mokhele. His vision and actions as a senior science manager have been guided by his deep conviction that for a truly democratic society to emerge in South Africa all people must be empowered to be its architects and must have unhindered access to those careers upon which our economy is built.

Dr Khotso Mokhele was born and raised in Bloemfontein. After matriculating from the Moroka High School he went on to study at Fort Hare, where he graduated with a B.Sc. in Agriculture, winning the Massey-Ferguson award for the best student in that field. As a recipient of the prestigious Fulbright-Hays Scholarship, he entered the University of California in Davis where he took a M.Sc. and a Ph.D. degree, both in Microbiology. He was awarded post-doctoral fellowships at the Johns Hopkins University School of Medicine in Baltimore, Maryland, and at the University of Pennsylvania, Philadelphia.

Dr Mokhele returned to South Africa in 1987, set on becoming a top-class academic and researcher. He held lecturing posts at the Universities of Fort Hare (1987-1989) and Cape Town (1990-1992). In 1992 he joined the Foundation for Research Development (FRD) as one of its Vice-Presidents. He succeeded to its presidency in 1996 and then from 1999 to 2006 became the first President of the National Research Foundation (NRF). He successfully merged the FRD and the Centre for Science Development of the Human Sciences Research Council. Under his visionary leadership the NRF has come to play a pivotal role in the development agenda of the country. He was also instrumental in the establishment of the South African Academy of Sciences serving as its founder president (1996-1998).

Dr Khotso Mokhele's contribution to science in South Africa has received wide recognition locally and abroad. He has received nine honorary doctorates. He was made a Chevalier of the Legion of Honour by the President of France in recognition of his personal efforts in strengthening scientific ties between France and South Africa, and was appointed a director of the Salzburg Seminar, an institution focused on global change, and subsequently a member of its Council of Senior Fellows.

He also serves on the boards of major companies such as Implats, Adcock Ingram and Afrox.

Complete speech (Pdf)

Media Release
Issued by: Lacea Loader
Director: Strategic Communication (actg)
Tel: 051 401 2584
Cell: 083 645 2454
E-mail: loaderl@ufs.ac.za19 November 2010

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