Suicide: Is it “your choice/your decision”? World Mental Health Day
Suicide Crisis is a registered charity which runs Suicide Crisis Centres. It has gained national and international attention as a result of its zero suicide achievement: http://www.suicidecrisis.co.uk
Clients inform us that mental health clinicians frequently tell them it is “their choice” or “their decision” to end their life. Clinicians seem to take the view that, if a person isn’t detainable under the Mental Health Act, that it is “their decision”, which they have the autonomy to make.
But is this the right approach? Does it show a lack of understanding of what it is like to be in suicidal crisis? A person who is intent on ending their life is usually thinking in a very different way from usual. Their thought processes are being affected by high levels of distress, or indeed by mental illness (such as depression or post-traumatic symptoms) at that point.
If we recognise that the person’s thought processes and their view of the world are likely to be altered at that point, then surely we should actively intervene to protect their life, not stand back and say “it’s your decision”. We should work tenaciously to help them survive. That has always been our view, but it seems at odds with the view of mental health clinicians.
One of our concerns is that by telling a person "It's your decision/choice", it risks appearing to “validate” the decision. That is how Joy Hibbins, the founder of Suicide Crisis, interpreted the phrase when crisis team members said it to her:
"Any decisions I make are influenced by this altered pattern of thinking. That is why I wish mental health and other professionals would stop telling patients 'It’s your decision' in a way that implies the patient is thinking rationally and clearly, and is fully well."
We value hugely the important work of other charities, but it appears that many of them also “respect the right” of a person to make the “choice” or “decision” to end their life.
In a year where we have seen an increase in the number of people dying by suicide, we’d like there to be a national focus on this issue and how things may need to change.