The marking of World Suicide Prevention Day on 10 September each year is an opportunity to reflect. The World Health Organisation has called for a global dialogue about suicide, which some may find disconcerting, alarming, gloomy or hopeless. But in fact, the aim is to change the outcome and to stress an important message: suicides are preventable.

This is a crucial message across Africa, as the region grapples with the highest suicide rate in the world. In fact, while it was estimated in 2022 that 1 in 100 deaths in the world is a suicide death, a disproportionate burden is borne by low- and middle-income countries, where 77% of suicides occur.

South Africa is among the African countries with the highest suicide age adjusted rates globally, alongside Lesotho, Eswatini, Zimbabwe and Côte d’Ivoire, among others.

Care agencies around the world have consistently raised the plea to break the silence on suicide in a bid to aid prevention efforts, with the reduction of suicide mortality being identified both by the WHO as a public health priority and as an indicator in the United Nations Sustainable Development Goals.

However, stigma, shame, ignorance and bias abound in the arena of mental health help-seeking. To admit that one feels overwhelmed, that depression and anxiety are constant, unwelcome companions or that continued efforts at coping with life’s adversities seem futile, may feel impossible to admit, even to oneself. To take the additional step of admitting it to someone else, and asking for help, is a harrowing and deeply distressing idea for many of us.

To top it all, media reports on suicide often sensationalise tragedy, dragging out the dramatic details of the end to an often-well-known person’s life. Many people do not identify with these portrayals, do not wish to be the subject of gossip or discussion, or may even be triggered by graphic and sad descriptions if they are vulnerable. And so, ironically, even where there is coverage, taboos are upheld, voices are drowned out, and the cycle of silence is perpetuated.

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More effective dialogue

Suicide prevention strategies are effective. They work. And they are not out of anyone’s reach. Strategies which are proven again and again to help people who have thoughts of seriously harming themselves are the things we actually all know about. We just need to start somewhere. These strategies serve as protective factors which build the first line of defence against suicide risk.

This is what we need to be discussing – publicly and often.

What are these strategies? Relating to health care strategies, the first step is to seek appropriate care. Engage in psychotherapy that makes sense to you, that is proven to work, and conducted by a qualified and registered therapist whom you can trust.

Consult a psychiatrist or qualified medical professional to review any medication you have been prescribed and ensure that it is still correct and applicable to any underlying conditions. Do not default on any follow-up care suggested by your mental health care team.

If you prefer online information, seek out reliable and evidence-based mental health information from verified experts in the field and follow their advice, not the opinion of the majority on social media.

Use mental health helplines like the South African Depression and Anxiety Group (SADAG) and anti-suicide hotlines, listed below, when you need them – the person on the other side is qualified and ready to assist you and to take you seriously. Try these strategies again and again until you find the right support for you.

Additionally, lifestyle, self-help and community engagement strategies are really at the core of any positive mental health change. Be diligent about basic routines of sleep, eat, exercise, and mindful reflection to review your day. Close, positive relationships with like-minded friends and family – “having a tribe” – has-long term beneficial effects that will enhance and change your mood. Your medical team cannot be with you all the time, but your community, friends and family can. Your relationships with those you get on with, matter deeply.

Find activities that provide you with meaning, purpose, and compassion. For some it is nature, art, sport, travel, or music; for others it is teaching, tutoring, outreach for charity or conservation, or the mentoring of other people; for still others it is faith, care, or community volunteering. There is evidence that joining activities of this nature combats depression, creates hope, and changes people’s perception about their worth and their place in the world. Your school, university or faith-based communities have an abundance of activities where you can volunteer and where other people really do need you.

Many may scoff at these proven ideas about mental health care and self-care. Perhaps the reason is that it sounds so basic – but basic is not easy. It may also be because not everything works the same for everybody. An anecdotal report of a certain intervention not helping someone, does not mean there is nothing that will work for you. Reach out, find your fit, and in the process, find your purpose. You will also find life.

South African Depression and Anxiety Group (SADAG) Helpline:

0800 21 22 23 (8 am to 8 pm)

0800 12 13 14 (8 pm to 8 am)

Or SMS 31393

Suicide Crisis Helpline:

0800 567 567

If you are a registered UP student, contact the Student Counselling Unit for help: 0800-747-747, or send a call me message to 31393, or email [email protected]

Dr Hanlé Kirkcaldy, Clinical Psychologist and Head of the Student Counselling Unit at the University of Pretoria.
World Suicide Prevention Day is commemorated annually on 10 September.

Disclaimer: The opinions expressed in the article are solely those of the author and do not necessarily reflect the views of the University of Pretoria.

Additional sources: American Psychiatric Association, International Journal of Advanced Medical and Health Research.