Kristian Pollock, John Moore, Catherine Coveney & Sarah Armstrong ‘Being suicidal’ as a coping mechanism: the presentation of suicidality among callers to a national emotional support helpline Kristian Pollock, John Moore, Catherine Coveney & Sarah Armstrong

Samaritans Crisis service Non-directive listening Self determination To support callers in despair and suicidal To prevent suicide Non-directive listening Self determination Suicidal thoughts and feelings should be discussed at every contact

The Evaluation Mixed methods Analysis of email (55) and texts (3) observation in 9 branches Interviews with Callers (48) Volunteers (66) Analysis of email (55) and texts (3) Online survey (1309) open responses Researcher training

Suicidal thoughts and actions 19% Samaritans calls 0.6% report calling during suicidal act Compared with 46% of online survey respondents 9 % report calling during suicidal act 15% of caller interviewees 75% reported established history of suicidal thoughts and actions

Being suicidal as a regular occurrence ...most of the callers who phone up, even the ones who are saying they’re attempting, at the back of your mind, you feel that they’re probably not going to. V219 ...there are some callers who phone very regularly who are quite often quite dramatically suicidal, so they’ll explain that they’re sitting with, sitting, you know, next to a railway line or the bridge, or next to a bottle of pills, or something. V270

Being suicidal as a chronic state I think Samaritans are the best thing since sliced bread and I have been dealing with suicidal thoughts on a daily basis for 15 years and they are crucial to my survival. S104 Not many people know that I am struggling with death fantasies on a daily basis either, and I can’t talk to anyone except you. ES544

Being suicidal as a way of coping Sometimes I take overdoses of tablets just to take the edge of things. It’s a way of carrying on. ES514 Not sure what I am going to do tonight, as Overdosing was on the cards, probably just do it and sleep it off, then there isn’t really a point in doing it, not sure what’s going on. ES503

Being suicidal but not wanting to die I do take overdoses and I have threatened to jump off the suspension bridge and all things like that. But it’s more to get rid of the pain rather than having a long-standing plan to actually kill myself. So, I sometimes try and explain that to them. S135 The closest I have gotten would be somewhat planning it. I wouldn’t do it, but I would want to. I think about it a lot. I’m not dangerous, but I could admit it, even though I don’t like saying it, that I am suicidal. When I say I’m not dangerous I mean that I don’t really attempt to kill myself when I plan to. ES530

Contacting Samaritans as a pre-emptive measure ...the only time when I don’t ring Samaritans is when I’m...those rare occasions when I’m basically in advanced planning mode. I’m really suicidal and just sort of working out how and when and stuff. And at those times the only person ...I can talk to...basically, it’s my professional mental health team. (S161)

Selective disclosure and concealment I have been taking one less diazapam than I am supposed to take and hidingit. It's one of my many plans for killingmyself… I have not mentioned any of this to the team because, this morning, I was in danger of being sectioned. I lied and said that I had suicidal ideations but that that was all. (ES533) And there isn’t any kind of threat, I think, that whatever you say will be sort of written down and used as evidence, as it were. It’s not going to go on your notes, and I think some people are worried what they’ll say will go on their notes and then be used against them in some way. (S113)

‘A port in a storm’ but not ‘a crutch for life’ Samaritans value callers who express suicidal thoughts and feelings But on an episodic rather than ongoing basis Caller dependency is discouraged Callers value Samaritans As a place to express suicidal thoughts and feelings As an on going resource to help them cope Samaritans supports the construction of an identity of ‘being suicidal’ among callers which has little bearing on its overriding project of preventing the occurrence of ‘suicide’