According to Angela Vorster, Clinical Psychologist at the School for Clinical Medicine at the University of the Free State, 23 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.

“If we look at statistics, it may be difficult to find statistics on mental illness, depression and suicide, especially for the Free State, but it is fair to assume that the Free State will have comparable statistics regarding these conditions like the rest of South Africa,” she said.

She added that if we look at the lifetime prevalence of depression in South Africa, it is around 9.7% which is an estimate, so that is about 4.5 million people who will experience depression in their lifetime. It is also important to note that 70% of people who attempt suicide have a mental health illness.

“Our most important task in trying to prevent suicide particularly in the Free State, is to get people to speak about their mental health. We have this culture of showing the bright side and not wanting to speak about our difficulties and seem vulnerable. We know that our men are at risk of suicide and depression and we suspect that one of the factors is that men are taught not to talk about how they feel and they are taught not to be vulnerable,” she added.

In Vorster's opinion piece, she added that 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.

“We all have some difficulty regarding our mental health throughout our lifetime and we should normalise it, and what do you do? You go to specialists, who would be psychologists and psychiatrists. 

"Something that is also very important to note, because we have very few psychologists and psychiatrists in South Africa, a recent statistic shows that we have about 2.5 psychologists per every 100 thousand South Africans."

She added that this means that we cannot rely only on mental health professionals to provide support, we need our communities to raise awareness and start speaking about mental illness without stigmatising it.

Further in her opinion piece, she added that people with a mental illness look happy in their photos. And when someone ask them if they are okay, they say yes. Because they do not feel like they deserve to feel better. They do not want to be bothered. 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 do not have the energy. It is 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?”

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.”

The question she answers is: 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."

Vorster added that the best advice most of the time is that if you are worried about someone, talk to them, ask them.

“Very often people will not say I am suicidal and I want to kill myself, they will say things like, 'I wish I could escape, I just wish this could end and I wish I could just sleep forever'.

"I think  what is extremely important is that we pretend to ignore children who are depressed and suicidal,” Vorster said.

She added that children as young as six years old can be suicidal, and that we should never underestimate the potential for self-harm and suicidality. The second most common cause of death in people aged 15 to 29 is suicide.

“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 South African Depression and Anxiety Group (SADAG) suicide emergency helpline.

International Association for Suicide Prevention

SADAG suicide emergency helpline: 0800 567 567

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