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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

Ford foundation funds higher education redesign

2005-06-23

The Ford Foundation has pledged a grant of almost R280 000 for redesigning higher education delivery at three campuses in the Free State.

According to Prof Magda Fourie, Vice-Rector: Academic Planning at the University of the Free State (UFS), the three campuses that will be affected by the strategic reconfiguration of higher education delivery are the Qwaqwa campus at Phuthaditjhaba and the Vista campus of the UFS in Bloemfontein and the Welkom campus of the Central University of Technology (CUT).

Prof Fourie says the three campuses were all affected by the restructuring of higher education, in line with the National Plan for Higher Education.

The Qwaqwa campus of the UFS that was part of the former University of the North was incorporated into the UFS in January 2003. Likewise the Bloemfontein campus of the former Vista University was incorporated into the UFS in January 2004.

The Welkom campus of the CUT was also part of the former Vista University and was incorporated into the CUT in January 2004.

“These incorporations pose a challenge in that we have to think creatively about the best ways of using these three campuses to service the higher education, training, skills development and human resource needs of the Free State,” Prof Fourie said.

“The grant from the Ford Foundation will primarily be used to draw up strategic funding proposals for the three campuses. The Qwaqwa campus of the UFS is a priority to us given the poverty and unemployment in a largely rural area of the Free State,” said Prof Fourie.

“A detailed consultation process will be undertaken in the Qwaqwa campus sub-region which will hopefully result in a comprehensive and a coherent suite of higher education activities being established on this campus,” said Prof Fourie.

“It is envisaged that the Qwaqwa campus will become a centre of excellence in the area of rural development. This vision is based on a focused integration of the core functions of a university – teaching, research, and community service – around the issue of rural development,” said Prof Fourie.

Prof Fourie said that various educational offerings including among others short courses, bridging and foundation programmes, and degrees could be offered, with a particular focus on providing courses of relevance to students from the local rural community and students from elsewhere with an interest in focusing on rural development studies.

She said the redesign of the three affected campuses is being managed as a project of the Free State Higher Education Consortium (FSHEC) consisting of all the higher education institutions operating in the Free State.

“The aim of the project is to establish how the Qwaqwa and Vista campuses of the UFS and the Welkom campus of the CUT can be used effectively to meet regional education and training needs, to serve the strategic priorities of the two higher education institutions and contribute to the sustainable development and poverty alleviation of the region,” she said.

The planning for the Vista campus of the UFS is still in an early stage. “We are looking at the possibility of developing this campus into a hub of education and training opportunities for Bloemfontein and Free State region. Further plans will be communicated later in the year,” said Prof Fourie.

Media release

Issued by:  Lacea Loader
   Media Representative
   Tel: (051) 401-2584
   Cell: 083 645 2454
   E-mail: loaderl.stg@mail.uovs.ac.za

23 June 2005

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