”The Swedish pioneer of suicide prevention research, Jan Beskow*, used to say that the term ”taking one’s life” is so much better than the usual ”suicide” or “self-murder” that is often used in everyday speech. When he explained why, one understands that suicide is neither a choice, a murder, nor a fate, but an accident – a psychological accident. It can be seen as a condition where the way out of unimaginable problems and extremely painful circumstances provides no other options than to remove life.”
This is our 6th concept – SUICIDE PREVENTION – in our series of a total of 10 concepts that we highlight during our 10th anniversary.
SUICIDE PREVENTION – “Not being able to live is not the same as not wanting to live”
The Swedish pioneer of suicide prevention research, Jan Beskow*, used to say that term “taking one’s life” is so much better than the usual “suicide” or “self-murder” that is often used in everyday speech. When he explained why, one understands that suicide is neither a choice, a murder, nor a fate, but an accident—a psychological accident. It can be seen as a condition where the way out of unimaginable problems and extremely painful circumstances provides no other options than to remove life.
Crises can hit anyone, but they pass. This is precisely what is so important to remember, as the suicidal state will eventually subside. Jan Beskow said that when you “take your life” you can’t stand life at that moment. It is too painful, and you see no other way out, you simply take your life, but for that moment. The mind wants instant relief, but the body wants to live.
In Sweden, approximately 1,200 suicides are committed per year**. Suicide is the most common cause of death among young men. A figure to compare with the approx. 200 people who die in traffic accidents**. By extrapolating the number of completed suicides, it is estimated that approximately 15,000 suicide attempts are made per year, in Sweden.
Suicide attempts, or a pronounced desire and thoughts about killing oneself (suicidality), may mean that one needs hospital care to get out of one’s condition. It is then important that the surrounding environment is healing in itself and not least that there is a supportive and present staff. But also, that the physical environment is secured from ligature points and objects that can be used for suicide. Such items can be everything from coat hangers, headboards, door handles and hooks.
The majority of suicides and suicide attempts in society take place in an environment other than a care environment. Suicide prevention, i.e. preventive work, is therefore extremely important. A large part of this work takes place through organizations, for example SPIV (Suicide Prevention in the West).
HealSafe Interiör supports SPIV financially, but above all we have learned a lot from them. We are interested in what the physical environment means for patients’ health and well-being in psychiatry, as well as what “physical” suicide prevention can do to reduce the risk of completed suicides in a care environment.
It is important to remember that even self-harm or attempted suicide can become an accident and lead to someone’s death, or serious life-long damage. In suicide research, they talk about different methods, so-called “modes” that are used for suicide. In healthcare, strangulation is the most common method. Therefore, HealSafe Interiör focused early on designing “suicide-preventive” furnishing products to minimize the possibility of attaching a noose to an object in the furnishing. An assortment that today includes, among other things, suicide-preventive and safe curtain rail systems, hooks and clothes hangers.
But of course, the issue is more complex than this example. It is the whole and how the environment creates and shapes relationships, i.e., the “socio-material”, which in itself has the greatest importance for people’s care. On the other hand, Jan Beskow, and others with him, believed that an interrupted suicide attempt can mean a kind of awakening and opening up to get out of the state of not being able to live, right then. As I said, it is not a chronic condition – not being able to live is not the same as not wanting to live.
In the book ”Handbok för livskämpar” by Filippa Gagnér Jenneteg, Susanne Tell and Jan Beskow, the authors share knowledge and experience about suicidality and ways to face it, and come out of it. Among other things, they give examples of what characterizes an acute suicidal crisis:
- If your problems feel impossible to solve, when you have struggled for a long time without having succeeded and suicide feels like the final solution to your problems and your psychological pain.
- If it causes unbearable psychological and physical pain.
- If it feels like you are alone in the whole world and that no one can help you.
- If you have a plan for suicide ready and intend to put it into action.
For people who find themselves in the midst of an unbearable crisis, the book also provides concrete advice. Among other things, to break the loneliness, to tell others how it is and to see it through. It will fade away, and the strongest and most acute emotions gradually release. This is such important information to combat the myth that suicide is a choice and/or predestined. It is not. It is a psychological accident that there should be more resources to prevent.
If someone dares to tell you that they can’t cope with life, we need a society where it is not shameful to talk about anxiety, mental illness and psychological pain, or suicidal thoughts. It is also important to remember that mental illness and suicidality do not have a direct correlation. The taboo (to use Jan Beskow’s term), i.e., that it is uncomfortable, unwanted or “taboo” to talk about this part of being human, needs to be demolished. We can do that every day of the year. A simple way is to ask the open question “How are you?“.
*Jan Beskow (1931-2020), professor and psychiatrist, was one of the pioneers of the Swedish society’s work for suicide prevention and advocated seeing suicide as a psychological accident that can be largely prevented. With his strong commitment and research, Jan was one of the co-founders of SPIV (Suicid Prevention i Väst) and has meant a great deal to strengthen the work for suicide prevention and to reduce the “taboo” of suicide and mental illness. Jan was also an important mentor to HealSafe’s founder Franz James on issues of suicide, when Franz began his doctoral studies on the importance of the physical environment in custodial care.
** In 2021, 1,505 people killed themselves, 204 people died in road traffic.
Download text in Swedish – LINK
Download text in English – LINK
Händelseanalyser av suicid inom hälso- och sjukvården — En sammanställning och analys av händelseanalyser i Nitha Kunskapsbank
Folkhälsomyndigheten, 2019. Artikelnummer: 19050
Handbok för livskämpar. Filippa Gagnér Jenneteg, Susanne Tell, Jan Beskow. 2018. Libris förlag