5 April, 2024

You’re on mornings with Nadia Mitsopoulos. ABC Radio, Perth and WA.

For many years I’ve specialized in treating really sick people who have failed to respond to treatment by other psychiatrist for depression. And one of the things I do is have a lot of contact with them because depression and suicidal thoughts are very painful conditions to have worse than kidney stones or heart attacks. One particular doctor described it as so when I would see these people perhaps a couple of times a week, it would allow them to cope with the pain.

But we tried to fix the underlying problem. Then I realized that while I’m away on holiday, they are left with nothing. So whether it was in Australia or from overseas, I got into the practice of calling people perhaps once a week, even if it’s a five minute call to another call, just to make sure they’re going okay. They know they are not forgotten.

And then once mobile phones came along, it was much easier to do this by text. And of course, if I can do it by text and I know what I’m going to say or do, and I do this all day as a professional, then I thought, why don’t I tell the very capable and very concerned people in our society what to do in that situation?

It’s very frightening when a family member says, I wish I was dead and I think I’ll kill myself now. And everybody is struck with fear and trepidation. And as you say, I don’t know what to say. And the same thing applies indeed to many medical professionals who don’t specialize, understandably, in mental health. So if we have this very simple app, as you say, prevent to suicide, what to say?

We’ve got hundreds of text messages. You just click on one and it downloads into the message section of your phone and you can send it as it is to somebody who is saying these sorts of things, or you can modify it and make it more personal.

So you basically in this app and then, you know, looking at it now you have the phrases ready to go. And I can can you just give us an example of what what are some of the messages? What are the phrases in the app that we can use?

Well, you would start off perhaps with something simple, like I’m a bit worried about is start. Is everything okay? Is there anything I can do? Or you might say you seem very, very quiet and a bit subdued. Is anything wrong? And then so that’s an issue of what to ask. And if the person then replies by text and indeed we all know the text conversations on sensitive subjects are much easier to have than 1 to 1 personal conversations.

Then you may ask, Are things so bad you wish you didn’t wake up in the morning and everybody knows what we mean by that sort of phrase. It’s not too confronting. And if the person expresses some degree of distress or doesn’t wish they didn’t wake up in the morning, you may ask, have you thought of doing something about this?

And so and then you might say what to do. You can say, look, can I keep contact with you each day? Can I tell other people about the problem? And indeed, one of the things that I would say is don’t be afraid to have these sorts of conversations with people because they are in a lot of pain and their brain is telling them the pain will never end.

Nobody understands and there is no hope. Now, if you keep up text conversations using the multiple texts we tell you, or unengaged just your ordinary common sense conversations with a person who is a friend of yours after all, or a family member of yours. That is immensely valuable because if you ask them what is wrong and you listen and they explain, this happened, that happened.

I found this and they said that. Sure, it’s not changed the practicalities of the situation, but humans feel so much better if they are not alone and if they feel somebody understands. And that’s half the battle is to make to convince them they’re not alone. Now, if it’s not just you, but a number of other people join in similar approaches, similar texts, similar messages, or WhatsApp messages or whatever way you want to use our app and then a safety net just basically being wrapped around the person who is wishing they weren’t alive.

Okay. And are these medically approved text messages?

Yes, they are indeed at that. And that gets over the problem of being afraid you’re going to say something that’s going to make it worse. And so they are medically approved by a whole range of mental health professionals. And and indeed, we are continuously refining it. We don’t want to be on our own. So we actually ask people to send us in texts that they think would be useful.

And it would and we would put them up on our app or on our website if we if we as a board approve them. So we we do want to be an ongoing interactive service with the community. We are also very grateful to live to experience Australia and roses in the ocean to organizations in the area who think this is a great advance and and do great work themselves and they have very carefully gone over our texts.

So we are in the process of modifying the language to a certain extent so that we can take on board continuous feedback from the community.

The other thing I noticed when you were sort of using some of your experiences earlier, it’s about intensive contact. So, you know, it’s not about just one conversation for a week or two weeks. And then that said, it’s about a continuing conversation. And you have basically in this app all these messages to carry on a conversation.

Well, you’re quite right because suicidal thoughts don’t just happen suddenly and disappear suddenly. They build up, usually over time due to emotional pain, like any physical condition, and they gradually subside. And finally, standard advice is, don’t tell me you’re problem. Go call a crisis line that that’s really not the best, I would suggest. And we’ve got very hard working people on the volunteer crisis lines, but they people can’t get through or or one phone call to a volunteer is not quite the same as daily contact with your best friends and with family members and so on.

And and indeed, I was just talking this morning to a patient of mine and her brother became quite suicidal due to problems in his life and she started using the app. He’s now much better. French is of course, is just going to try and see somebody. But what he felt found was that the messages it was, he said, very comforting, made him realize that the situation he was in was not hopeless, which is what he was telling himself, and that he was not alone and faced these things and indeed realized the impact and his suicide light would have on the family.

And indeed, if I may, I’d just remind the listener, the sad fact is that every day the equivalent of a plane load of people attempt suicide, it’s actually that that illness and the condition that kills twice as many people as in car accidents and injures twice as many people. And and the Australian Bureau of Statistics tell us that 3 million Australians have had strong thoughts of suicide. So we want to do something about that.

Yeah, and when someone and the frightening statistics, when someone talks about suicide, then what shouldn’t we say?

I suppose I don’t respond logically. I suppose you’d like to try to be glad that they they can confide in you. That’s, that’s a tribute to you that they want to tell you something very personal and very serious. And equally, you’re not expected to be a professional and you’re not expected to solve the problem. So the thing to do, first of all, is to encourage them to talk and explain how they feel and why they feel as I said, that then makes them feel at least Jo Mary understands, is interested, cares about me, wants to do more well, you know, wants to help so that so offering sympathy and understanding is invaluable.

You may not you may not think it is, but it really is quite invaluable. And as people talk about their problems and what you’re actually doing is you’re clarifying it to your own brain because your your brain is like a computer, which can resolve a whole lot of issues if it understands them. But if you’re just worrying about things and not putting words to them, your brain doesn’t really understand what’s going on.

It just knows you’re distressed.

How valuable would something like this then better people living in regional and remote areas, for instance, people that are caught up in natural disasters, which puts incredible stress on communities.

We all know there’s a huge shortage of mental health professionals and at 10:00 on a Friday night and somebody tells you those suicidal, you are not going to be able to get any professional help. And of course, this situation is continues in regional and remote areas. We have the same problem, as you say, quite rightly all over Australia.

And indeed the Victorian Farming Federation has just strongly welcomed this initiative for the same sort of reason. So rather than having, say, a one off visit to a GP and then you have to wait a week, a month, whatever it is for the next visit or to a mental health professional. And if you can find one, and this is something that families can rally around and use when somebody is talking about these sorts of things.

And indeed you can use the, the texts for people who are very depressed as well because suicidal thoughts creep in when people are depressed. So it is self-help. It’s and it’s easy to use.

You’re on mornings with Nadia Mitsopoulos on ABC Radio, Perth.