No cost No waiting ..all it needs now is publicity by you.
Summary: Attempted suicide in Australia equates to a full plane crashing every day, injuring 95% of the passengers, (mainly our healthy young women) and killing 5%. 3-5% call crisis lines, but 70-80% hint or warn friends and family. Most people freeze. MessagesHelp.Org is an Australian pilot launched by the Australian Suicide Prevention Foundation with Rotary in Sri Lanka and RC Melbourne.
In a surprisingly simple and award-winning innovation, family, friends and colleagues are equipped with the phrases used by professionals, which they can send as powerful protective supports to the person at risk. Research proves repeatedly that higher rates of connections reduce suicidal thoughts, plans and acts. But if no one knows about this free service, suicide will continue to kill 2-3 times the number who die in car accidents. Rotary in Sri Lanka, Melbourne and internationally are keen to assist. We need help with publicity and website links; Rotarians are asked to assist.
If it was your family: 5 PM on a Friday night, a family member says “I won’t be around much longer”..then what? 60% of us freeze. Professionals are closed for days and are booked out for weeks. What do you do when someone close to you indicates in some way that they are thinking about being dead as a good option? Embarrassment hinders help-seeking. Attempted suicide is by far the main cause of death and injury for people aged 15 to 50 in many countries, at 2-3 times the rate of car accidents.
Why would my family think of suicide? People attempt suicide to escape emotional pain, either sudden pain after a personal trauma, or longer pain due to clinical depression (imagine the worst day of your life continuing for months). Research identifies 3 core totally convincing thoughts which then drive suicidal ideas, and which explain why inner circle people can say and do things that professionals and AI chatbots cannot !
1) “There is no hope of recovery so life is pointless” (Professionals can battle this with, techniques such as CBT, and with medication, backed up by family and friends reassuring recovery)
2) “I am a burden on people around me” (family and friends clearly have pivotal power in disputing this)
3) “I am alone, no one understands, and I don’t belong” (multiple contacts from family and friends can change this, especially as the person at risk withdraws, but usually still reads messages).
Same battle, different countries: Sri Lanka has a similar population to Australia, but far lower income levels and health resources. We were asked by Rotary Sri Lanka to help. A million living Australians (and presumably Sri Lankans) have attempted suicide, and hundreds more attempt daily. Attempted suicide in both countries is equivalent to a full plane crashing every day, where 95% are injured and 5% die. Strangely, and perhaps reflecting despair at what else can be afforded by the economy, the default advice in the media for the literally overwhelming number of people with suicidal thoughts (probably a million at any point in time) is to have a once off call with a hardworking lay volunteer on a crisis line. Only about 3-5% of people who attempted suicide have done this. No professional would suggest that one contact resolves significant suicidal ideas. Research confirms 70-80% of attempted and completed suicides have indicated/hinted at suicidal thoughts to friends or family. Repeated one to one contact with a therapist is the gold standard, but the costs involved mean the vast majority of people at risk actually get no help. Most attempted suicides occur outside working hours. A full-time health worker in reality is not available 80% of the time, when one calculates working hours, leave and public holidays. And what do family and friends say or do in the typical week gap between visits?
Rotary Melbourne and Rotary Sri Lanka, together with the Australian Suicide Prevention Foundation founded by member Dr David Horgan, are promoting an award-winning initiative not described anywhere else in the world. The remarkably simple idea is to mobilise and equip the inner circle of the person at risk using a no-training needed resource for immediate intervention 24/7. MessagesHelp.Org and its preceding award-winning app "Prevent A Suicide : what to say" supply hundreds of the phrases used by professionals that can be copied with one tap and sent to the person at risk. Messages from inner circle contacts have particular power and influence.
We all know it is much easier to discuss sensitive topics by messages or texts, rather than in person, especially for younger people. They attempt suicide most often, 75% being healthy young women under age 30. Concerned family and friends can wrap a progressive safety net around the person at risk by sending multiple medically approved messages. These messages are evidence-based, with repeated published research proof that connections reduce suicidal thoughts, plans and acts (Darvishi 2024, 692,000 participants).
Uniquely, the person at risk does not have to ask for help, as our protective messages can be sent as soon as members of their inner circle realise something is very wrong. Under “Ask” are initial questions to break the ice “I might be wrong, but it seems like you're not in a good place. Can I ask you about it?”. Our messages in that section escalate to multiple carefully composed questions re suicide itself, beginning with “Are things so bad you wish you did not wake up in the morning?” Other sections are “Say, Practical and Follow-up”. The person at risk does not have to call anyone or go anywhere but just read their messages. Our messages can be changed to be more personalised and more conversational. Each message further bonds the person at risk. It makes it much more difficult to proceed from suicidal thoughts to attempted suicide in the face of multiple contacts from the most important people in one’s life. Hence our phrase “More messages, more people, more safety”.
Highly individual human messages: Uniquely also, only family and friends can send high impact personal messages such as “I need you in my life” and “I want my children to know you as they grow up”. AI chatbots, volunteers or professionals cannot bring persuasive very personal relationships to bear. Another innovative approach we use is based on the fact that we all are well practised at giving advice to other people ! Hence the suggested message “If our positions were reversed and I had your problems, what would you advise me to do?” No one would advise another person with problems to suicide as a solution, so we confront why the person at risk is telling themselves to do something they would not advise anyone else to do?
Multiple people sending messages rather than one lone individual is encouraged. If required, the “Help choose” AI feature of the website can suggest which of our 300 messages seem more suited for various conversations. A “Crisis” page advises when professional intervention should occur, when it must occur, and the complexity of promises to be safe. Recognising the emotional stress involved dealing with a suicidal person, there is a detailed Support paper. After forty years of experience as a last resort psychiatrist, with research and teaching by David, there are multiple practical summaries on various aspects of suicide under “More”.
The messages on the Sri Lankan version of the website are in Sinhalese, Tamil and English. The AI translations were corrected by native speakers. Dr. Suresh Marcandan was pivotal in liaising with Rotary in Sri Lanka, and David and he were physically in Sri Lanka for a number of weeks. Lions also have joined the project. The various Rotary groups involved were very committed to the project, and there was a formal launch. This was preceded by multiple large screen advertisements around the capital sponsored by a local business. It is now planned to have an extensive publicity campaign which will be pivotal in the outcome of this project.
The chief psychiatrist of Sri Lanka, Prof Chathurie Suraweera, and David conversed over a number of meetings, and she is strongly in favour of the initiative and hoping to formalise government support for the project. Her department is reviewing the phrases from a psychiatric perspective, to ensure the subtleties were translated accurately. The idea of an extra suicide prevention service which is not only no cost to users or health services, but will reduce ambulance and emergency intervention costs is very appealing. Rotary in Sri Lanka are already very keen to initiate a similar service in India, which does of course have a huge population. The service has been designed to be easily replicated for other countries and for individual groups on request.
David presented this project by Zoom recently to a New York meeting of RAGMHI (Rotary Action Group on Mental Health Initiative) who reacted with very flattering feedback and are keen to help. By converting lone therapists to leaders of family suicide prevention teams, stress and outcome are shared.
You have heard of Prozac from USA because of publicity. But almost no one heard of Luvox from Holland, due to lack of publicity, an identical life-saving medication released years earlier. Which pathway will be the fate of this Australian innovation? Rotary Melbourne is considering ways of further supporting this AAA (anytime, anywhere, anonymous) extra health service. Please contact them or David (drdavidhorgan@gmail.com) if you can indeed help, even if simply by publicity by you or your contacts.. David is available to talk to interested groups.
Reference: Darvishi N, Farhadi M, Poorolajal J. The role of social support in preventing suicidal ideations and behaviors: a systematic review and meta-analysis.
Journal of Research in Health Sciences. 2024; 24(2): e00609.doi: 10.34172/jrhs.2024.144
