Could I have done more? The question that haunts Stephen Corby
I knew my friend was in a terrible way – three days before he died I told my wife I was worried he was going to kill himself. But I didn’t tell him that.
His final moments were sea and sky. Summer heat and salty air, mixed with tears, perhaps, at least when I picture it. Or was he as staunch in death as he used to seem in life?
This suicide, his loss, brought up memories of the last one to hit me. A different hemisphere. A cold bedroom, a house I’d laughed with him in. But they were both alone, in the end. Even hope had left them.
Is it wrong to picture how they died? Is it possible not to? I think everyone does. I can imagine the despair – I’ve been there – but it’s the final moments that haunt me: visceral images stabbing the mind’s eye as I suffer through the funerals of two men too much like me.
Both in their fifties, both with children.
The last unimaginable moments, imagined ceaselessly. Was there enough time, in their final flails, to panic, or feel regret?
I found myself hoping not, and then so, anger battling sorrow as I refused to publicly cry. How could they do it? How did they find the bravery? How did a painful death look better than another breath?
Most of all, I worried and wrenched and railed and self-loathed over another question: Could I have done more? Because what I and everyone else in their lives had to accept, in both cases, was that we knew they were in pain. That this ending was possible.
And so I set out, as a journalist does, to seek answers. Can you help, can anyone? If you’re worried that someone is on that dark path, can you walk it with them, or haul them off it?
And why men? Why are three-quarters of all suicides in Australia the unfairer sex?
Journalists have long been taught that suicides are stories we shouldn’t tell, that raise questions best not asked. I quickly ran into something called the “Mindframe Guidelines” for media coverage, which insist that I don’t tell you how my two mates died, because mention of method can lead to an increased risk for those who are already vulnerable.
I can tell you that the reason more men die by their own hand than women is not because they try more often, but because the violent methods they tend to choose are more successful. Just don’t ask what those methods are.
All of the no-saying led me to fear that perhaps there was nothing I could have done, that raising even the word “suicide” with my falling friends would have been a disaster. But it turns out that’s exactly what I should have done. An omission weighed now with regret. Fiona Shand, Associate Professor at the Black Dog Institute, sinks my heart with her gentle, professional advice. “That very first point of contact is so important – it’s about recognising something’s wrong with a friend or a colleague and being comfortable enough to have that difficult conversation and to ask, ‘Are you thinking about suicide?’” she says.
“It’s a scary question to ask, because what if the answer is yes? People also get scared and think, ‘Well, what if I put the idea into someone’s head by mentioning it?’ But the research doesn’t back that up – the research actually tells us it’s safe to ask and, in fact, people are often quite relieved if they have been thinking about suicide and someone asks them about it, and then they get a compassionate, non-judgmental response. The sense of relief from just being open about it is huge. The next step is trying to get that person the kind of help they need.”
I knew my Sydney friend was in a terrible way – indeed, three days before he died I told my wife I was worried he was going to kill himself. But I didn’t tell him that; I fumbled through conversations saying I was worried about him.
Shand says I shouldn’t feel bad, that at least I’d tried, but I couldn’t help thinking that what I’d done was the equivalent of saying to a friend with an obvious drinking problem, “Are you sure you want another one?” instead of “I think you’re an alcoholic.”
Richard West, 69, still can’t believe none of his colleagues said anything to him about the nakedly downward spiral of depression and drink he was hurtling through – ending with a suicide attempt 10 years ago that left him with one foot through death’s doorway.
“I was a very reckless alcoholic and yet no one, in my entire career, sat me down and said, ‘Richard, you’ve got a problem.’ And that’s astounding because there were times when I was inebriated at work, slurring in meetings, and no one said a thing.”
Richard’s drinking drowned his first marriage, and then, just after he’d lost his job in the banking industry, he was struck by an unimaginable tragedy. As a volunteer speaker for the mental health support organisation Beyond Blue, he regularly stands up in front of people and tells his story in the hope that it will help others. “It’s not easy to talk about, but if I’m going to have any success in lowering the stigma about these things, I have to share exactly what happened, so I do,” he explains.
“My 20-year-old son died with my ex-wife in a car crash in England. He was driving and my daughter, who was 10 at the time, was in the back seat. The miracle was that she survived without a scratch, despite being trapped in the car for hours with her dead brother and mother until they could cut her out.
“This would be tough for any person ... but for an alcoholic, you deal with it any way you can, and I went down and down, the alcoholism got worse. You just get to the stage where you think the world, and everyone in it, is going to be a better place without you. The belief in that is so strong that nothing will stop you from believing it. And so I took that step, I took a lot of medication and only because of a very lucky intervention by my wife did I survive.
“Mind you, I still reached the point where my family was told to say goodbye because they were going to turn the machines off. Miraculously, I survived.”
Richard’s memories of his almost-final moments are clouded, because he says he’d been drunk for days, passing out and waking to immediately drink again. But he knows he thought, with absolute certainty at the time, that he was doing the right thing.
“You’ll hear that it’s a selfish act – and it is, it absolutely is – but you have to think about the person who’s considering that act. In their stress they’re not aware of the selfishness of what they’re doing, they just really think everyone they love will be better off if they’re not here, not being a burden any more.”
Dr Grant Blashki, a GP and Lead Clinical Advisor for Beyond Blue, says doctors hear that argument time and again. “As a GP I ask people all the time, are they thinking about it, and the fact is that suicidal thoughts are incredibly common ... you’d be amazed at how often, when I ask people why, they say ‘I just think it would be easier for everyone else if I wasn’t here.’ We’ve done research into this, and it’s what’s called the ‘perceived burdensomeness scale’. It is hard for most of us to understand but in the sadness and irrationality of depression, people do get to that point where they think the world would be better off without them.”
We all fear cancer, dementia and car accidents, but perhaps we don’t worry enough about suicide. It’s the biggest killer of young people in Australia (ages 15 to 24), but the highest proportion of suicides occur during mid-life; men aged 40 to 54 account for more than a quarter of male deaths by suicide.
“It’s so common, we’re talking about more than 3000 people a year in Australia. That’s nine a day, seven of whom are men,” Blashki says. “So, as a GP, I say to people who are in that state: ‘Don’t kid yourself, if you do this it will be a complete disaster for your kids, for your family. That voice telling you everyone will be fine and will just get on with their lives without the complications of you is a very dangerous voice, and it’s a real risk.’”
I’ve heard that voice myself. Perhaps you have, too. It was half my life ago now, in the midst of a real anus of an annus horribilis when I found myself living in a converted cupboard in London, holding a small bottle of sleeping pills and an even smaller hope that I’d ever be happy again. (You are allowed to talk about suicide methods if they fail.)
In just a few months I’d lost my father, then watched one of my best friends die in hospital, followed by my girlfriend leaving me for another man after declaring she didn’t think I was coping well enough with the first two tragedies.
I felt like I had solid grounds to be depressed, and drunk, even more so than usually in a bleak English winter when every day looked dark, dank and unbearable.
I did think about those pills – some nights I wanted them more than life itself – but what always stopped me was the logical argument, the absolute certainty, that such a move would be inexcusably cruel to my friends and family.
How can it be possible to forget all about the other people in your life, to wipe their feelings, or negate them? Matt, who volunteers as a Lived Experience Adviser for the Black Dog Institute, has managed it. In his case, the overwhelming desire to die, to swallow as many pills as he could and check out immediately, hit him so hard and fast that he had no time to think about anyone else. Not even his husband, who was in the house with him at the time.
“The catalyst was a really shitty phone call with my boss,” says Matt, 50. “I’d always thought of work as my life; that was my identity. After this call – and obviously it had been a really tough time at work – I just thought I was the worst person in the world, and before I knew it I’d taken 60 tablets.
“When I woke up on the lounge my husband was there, and I was just like, ‘Oh, f..k. I woke up.’ I’d never said anything to him, I never wrote a note, it was just an absolute spiral and I didn’t think about him at the time. And my husband’s brother had committed suicide not long before, so the guilt afterwards…
“People ask what was going through your mind, but I just felt I had no alternative, there was no other option, because I could not resolve the pain or the torture that was going on in my head about work. I just had to get out.”
Matt knows his state of mind in that moment was far from uncommon. He’s a member of The Men’s Table, a group of blokes with similar experiences who get together regularly to talk, and he says the stories are chillingly similar. “We’ve all had the conversation that when you’re in that moment, nothing else really matters, no one else really matters – that’s the thought process,” he says.
I know that’s not always the case, of course. A few years ago, when one of my most beloved mates – a man of such sunny disposition that he was orbited by adoring friends – took his final, fatal steps, I know he was thinking of his family. Alongside a note to his wife telling her it wasn’t her fault, that there was nothing she could have done, he taped a Stanley knife to the wall to make it easier for her to move him before their two children came home from school.
It was that act of kindness, amidst the cruellest thing he could have done to her, that broke me utterly when I heard it.
This story has taken a long time to write, more than a year, and in the first month of research, two more men I knew took their own lives. One of them was an older neighbour who’d had enough of a debilitating disease. The other, from the same street, was a shocking bolt from the blue: a man who was suffering, but no one knew. Two more heart-aching, head-shaking funerals, and it led me to wonder, are humans the only creatures that kill themselves?
The famous “lemmings over the cliff” is an urban myth, according to Dr Fiona Shand. “As far as we know, other animals don’t engage in suicidal behaviour,” she says. “The thinking is that they are not able to understand the inevitability of death in the same way as humans. Dogs can pine to death, but that behaviour, not eating, is probably driven by distress, not by a plan to die. Most experts don’t believe animals have the capacity to plan their own death.
“I think our unique ability to anticipate the future in a sophisticated way is a double-edged sword. It allows us to do wonderful things – to create, build, imagine – but it also allows us to become hopeless, to imagine a future filled with only pain and despair.”
Shand points me to the work of clinical psychologist Edwin S Shneidman, “the father of suicidology”, who coined the term “psychache” and claimed there would be no suicide without it. “Pain is the core of suicide. Suicide is an exclusively human response to extreme psychological pain,” Shneidman wrote.
So is our level of psychache getting worse?
“Traditionally, we’ve seen suicide as something that’s caused by mental ill health, but increasingly we’re recognising that it’s much more complicated and that, in fact, there are a number of social and economic factors that contribute,” Shand explains.
“For men in that middle-age range, it’s often around family and relationship breakdown, job loss, and the other thing that we’ve seen coming out of the research is that men tend to be more affected by economic downturns, I guess because of that traditional breadwinning role and the risk of loss of income, loss of status.
“So we do see when unemployment rates go up, that tends to affect male suicide rates more than it does female rates.”
It might come as a surprise to hear that suicide rates plateaued, and even dropped, during the pandemic. One theory experts share is that there was a sense of “we’re all in this together” in dealing with the crisis. “And secondly, we had the government response to income uncertainty – JobKeeper,” Shand says. “There’s a definite link between income uncertainty and the rate of suicide. In other countries it’s been shown that providing cash transfers to people in extreme poverty has an impact on reducing suicide rates.”
While the rate fluctuates, there has been a gradual increase in suicides in Australia over the past 20 years, Shand says. “The last time we saw a real peak was in the 1990s, when interest rates were really high and there was a lot of economic distress. So, yes, an environment a bit like we’re in now.”
Statistically, then, it seems there’s a good chance someone reading this article is in need of help, and if you are, and if you’re not ready to go and see your doctor, Blashki has some advice. “If you are in a crisis, always take it seriously and get urgent help from Lifeline or other support services – most people know not to ignore chest pains, and suicidal thoughts are also big red flags for your safety,” he says.
“When the acute crisis has passed, I try to get people to do their own suicide prevention planning. There’s even an app for it, called Beyond Now, where you put in your reasons to live – nice photos or videos of your kids or your family, or sometimes people make a video for themselves when they’re feeling good, so that their rational self is available to help them, later, at 2am, when they feel like shit, and they can talk themselves down. The app gets about 50,000 downloads a year, which tells you how common these issues are.
“The app also helps you to enlist the help of other people; you make a list of people you can talk to, who know you’ve been having suicidal thoughts, and through the app you can forward your suicide prevention plan to those people.
“Sharing that is confronting, and it’s not for everyone, but you’re saying, ‘If I get into trouble, here’s what you need to do to help me.’
“If people have a suicide prevention plan, it really helps them when they’re in that crisis, and research shows it increases the likelihood that they’ll reach out for help.”
There are even more frightening, frustrating funerals than those where everyone knew the departed was careening out of control. The ones where no one saw it coming, where the victim kept the pain and the plan entirely to themselves. To watch family and friends stand up and say they just wish their father, best mate or brother had told them something was wrong is to see the kind of despair time will not repair. There are too many questions with no hope of answers.
While it seems impossible, there is some hope of getting to even these silent sufferers because, while they choose not to tell anyone, there is one place people do go when they’re feeling suicidal – Google. The Hope Exchange project, with the assistance of the Google Ads behemoth, is aiming to identify people in their minutes of need by looking at their search terms, and offering personalised help.
Dr Sandersan Onie, an experimental psychologist from the Black Dog Institute, says research shows that between 40 and 50 per cent of people do not seek help from friends or family prior to a suicide attempt. “But we know that a lot of individuals will often search things in the privacy of their search engines that they may not tell another living soul,” he says. “The reason we’re investing a lot in this area is because a lot of people have actually told us, after their crisis has passed, that even though they’re not actively seeking help, a lot of them really wish somebody would reach out to them.
“And in this case the tools used by the advertising industry – the Google Ads AI – can be tools for good. I’m looking at people who are searching with specific suicide-related keywords and even searches about depression and loneliness, and then meeting them with a tailored ad, breaking through the noise and offering to help.”
Onie ran a trial across Australia in 2021 and found that, while the average engagement for an online ad (meaning people who click on a link and engage with a page in a meaningful way) is 3.75 per cent, his specifically targeted offers of help had a rate of 20 per cent.
So where did those ads take people in crisis?
“When someone is contemplating suicide, we have to get rid of all the superfluous things, so we sat down with more than 20 people with lived experience of suicide and said, ‘If you were in this situation, what would you like to see?’” Onie says. The result was a set of landing pages on the Black Dog Institute website offering everything from advice and personal stories to relaxation techniques and, using location services, the address of the nearest medical centre.
Onie says the next logical step is to do something similar on social media sites like TikTok, which young people increasingly use as search engines. For now, though, he says the figures demonstrate that Google searches are a very effective way to target people in need. He points to data showing that, in 2013, there were 6.75 million health-related searches per day, and by 2019, daily attempts to reference Dr Google had reached 1 billion. In 2023, the estimate was 86 billion searches related to health, every day.
So does Onie find working in the area of suicide rewarding, or harrowing? “On a personal level, I think it gives my own experiences and, unfortunately, my own pain some meaning, knowing that I can help people from what’s come out of my own life,” he explains, before a long pause. “Unfortunately, I was diagnosed with a major depressive disorder, and I was incredibly suicidal for quite some time. That experience definitely helps to motivate my work. Because I’m not just looking at it from the lens of being a scientist, but going, ‘OK, how did I feel about this, as a person, and is there any way that somebody could have helped me more during that time?’”
The worst thing about these funerals is the love. So many people pouring forth their fondness, the smiling slideshows of better days, so many stories about what a fantastic, unique and beloved person the deceased was. If only I could grab them, in that last fatal second, and bring them here, to hear all this.
At least I now know what I did wrong, or didn’t do at all for my friends. Next time, and I hope there isn’t one, I’m going to talk about suicide. Perhaps it’s something we should all be less afraid to discuss openly. It might just save someone’s life.
Lifeline 13 11 14; beyondblue.org.au;
blackdoginstitute.org.au; themenstable.org
