Knowing a young person who is on the verge of suicide is an extremely distressing experience for anyone, and an experience frontline youth workers are increasingly having to face.
The need to address the problem has prompted action throughout the UK.
Last week, the Department of Health launched three suicide-prevention pilots in England to work specifically with young men (YPN, 15-21 September, p3).
Training available
In Scotland, suicide-intervention training is being rolled out to staff from all of the country's 32 local authorities (YPN, 15-21 September, p6). And in Northern Ireland, children's commissioner Nigel Williams is to co-host a symposium on suicide early next year.
But despite such momentum, Christine Lewis-Davies, senior manager at CLD Youth Counselling Trust in Herefordshire, believes too many people are falling between the gaps in services. The trust, which received 850 referrals from schools and youth services last year, aims to help 11- to 25-year-olds get help quicker by assessing and counselling them within a week of referral.
"Early intervention is vital for young people to get them into the system, otherwise they will either drop out or go on a child and adolescent mental health service waiting list," says Lewis-Davies.
Telephone helplines are often the first places desperate young people turn to and many are receiving more and more calls about suicide.
Norman Hamilton is a volunteer co-ordinator for Saneline and helps to support other volunteers. "I would say about one in three calls is about suicidal feelings or suicide 'ideation', where the caller is thinking about it," he says.
"Young people are often ashamed of their suicidal feelings, so trying to help them open up is important. It's tempting to find instant solutions, but you have to respect their feelings. It's about giving them space to say out loud what they cannot say anywhere else."
Trying to get young people to open up over the phone can be tricky, but asking questions such as when and where their problems started can help.
Hazel Norbury, counselling supervisor at ChildLine, says: "We train our volunteers to ask questions such as, 'do you really want to die or do you want things to change?' The fact they are calling means they are hoping something can change."
It is also crucial to find out why a young person wants to take their own life in the first place. "We try to find out when they started feeling suicidal, what was happening in their lives at the time, and what life was like before," says Norbury. "We try to get them to talk openly. It's easy to dismiss someone who says they feel suicidal, but for a child to consider death is pretty serious."
Stressful work
Maintaining confidentiality is vital to gaining young people's trust, but when it comes to the crunch, letting young people know the boundaries first goes a long way to helping them get access to services, says Saneline's Hamilton.
Sometimes helpline workers had calls from a young person during, or just after, a suicide attempt. "We've had instances where a young person has taken pills and called us, but we will keep them on the line and the worker will try to get their address," says Norbury. "We will do follow-up calls with the hospital to keep the contact with the young person."
Inevitably, volunteer stress is a big issue, so ensuring that workers are supported is crucial. "A lot of workers are nervous about having someone's life in their hands," says Hamilton. "It's a big burden, so training is vital. Volunteers need someone they can talk to about the calls they receive. This way they don't have to take the responsibility home with them."
Tony MacLaren, project co-ordinator at the Breathing Space helpline in Scotland, believes good supervision for workers helps. "If a youth worker has a young person in trouble, I would hope a supervisor was available.
Then they don't have to make decisions themselves, which can be traumatic," he says. "Remember, the worker can't solve the problem, but can be a listening ear and try to understand their world."
