1 00:00:02,600 --> 00:00:04,680 This programme contains some scenes 2 00:00:04,680 --> 00:00:07,720 which some viewers may find upsetting 3 00:00:07,720 --> 00:00:09,720 and some strong language. 4 00:00:15,240 --> 00:00:17,600 The word that you hear is "selfish." 5 00:00:17,600 --> 00:00:19,160 I think, erm, 6 00:00:19,160 --> 00:00:21,440 that used to get bandied around quite a lot, like, 7 00:00:21,440 --> 00:00:22,760 "Why would they be so selfish? 8 00:00:22,760 --> 00:00:25,080 "Look at the people they're leaving behind." 9 00:00:27,000 --> 00:00:32,080 They literally think that everybody else around them will be 10 00:00:32,200 --> 00:00:34,280 far better off without them there. 11 00:00:43,640 --> 00:00:45,720 The voice in my head said, "Jump now!" 12 00:00:48,040 --> 00:00:49,160 And I did. 13 00:00:52,000 --> 00:00:53,760 Your world is turned inside out. 14 00:00:56,240 --> 00:00:58,480 And the shock is extraordinary. 15 00:01:00,480 --> 00:01:03,200 Quite simply, if I knew 10% of what I now know, 16 00:01:03,200 --> 00:01:05,720 it's highly likely that my son would be alive. 17 00:01:07,880 --> 00:01:09,680 I'm Dr Xand van Tulleken. 18 00:01:10,960 --> 00:01:13,760 Over the years, I've seen lots of people coming through the doors 19 00:01:13,760 --> 00:01:16,720 of A&E after they've attempted to take their own lives. 20 00:01:18,560 --> 00:01:23,480 But for me, there's one UK statistic that is particularly worrying. 21 00:01:23,480 --> 00:01:26,840 The hard fact is that suicide kills more men under the age of 50 22 00:01:26,840 --> 00:01:28,200 than anything else. 23 00:01:28,200 --> 00:01:31,000 More than car accidents, more than cancer. 24 00:01:31,000 --> 00:01:36,080 According to the statistics, the most likely thing to kill me is me. 25 00:01:36,560 --> 00:01:37,880 And I want to know why. 26 00:01:54,120 --> 00:01:56,760 RADIO: Roger, we just received a CAD. 27 00:01:56,760 --> 00:01:58,800 It said it, "Looks like he may jump." 28 00:01:58,800 --> 00:02:00,840 We might have a job. 29 00:02:00,840 --> 00:02:01,840 Battersea. 30 00:02:04,320 --> 00:02:07,720 I'm joining the night shift at Tower Lifeboat Station in London 31 00:02:07,720 --> 00:02:09,800 to see what it's really like on front line 32 00:02:09,800 --> 00:02:12,960 of the fight against suicide in this country. 33 00:02:12,960 --> 00:02:16,520 RADIO: Make your way down and just stand by for further information. 34 00:02:28,160 --> 00:02:31,240 Reports that the person is now out of the water. 35 00:02:31,240 --> 00:02:33,560 RADIO CHATTER 36 00:02:35,640 --> 00:02:37,720 Fortunately, in this case, the man is already 37 00:02:37,720 --> 00:02:40,520 receiving help by the time we arrive. 38 00:02:40,520 --> 00:02:44,720 RADIO CHATTER 39 00:02:44,720 --> 00:02:47,120 RADIO: ..safe and well. And we understand that 40 00:02:47,120 --> 00:02:51,240 he's waiting with one of your landside units at that location. 41 00:02:54,280 --> 00:02:58,520 But this call-out is just one example of a much bigger problem. 42 00:03:02,400 --> 00:03:06,920 In the UK, someone takes their own life every 90 minutes. 43 00:03:12,000 --> 00:03:15,600 It's estimated that for every person who dies by suicide, 44 00:03:15,600 --> 00:03:17,200 20 more people attempt it. 45 00:03:18,640 --> 00:03:21,640 That's got egg on it, which is good protein. 46 00:03:21,640 --> 00:03:23,200 This is the meat one. 47 00:03:24,320 --> 00:03:25,680 And the sad fact is 48 00:03:25,680 --> 00:03:28,200 that if it weren't for the many last-minute interventions 49 00:03:28,200 --> 00:03:31,840 by teams like this, the death rate would be much higher. 50 00:03:34,080 --> 00:03:36,200 People who've been trying to take their own lives, 51 00:03:36,200 --> 00:03:37,960 are there people where you get them out 52 00:03:37,960 --> 00:03:40,000 and they're glad that they weren't successful? 53 00:03:40,000 --> 00:03:44,200 A lot of people are just so desperately sad, and they'll tell 54 00:03:44,200 --> 00:03:46,560 you, "I just wanted to end it all today." 55 00:03:46,560 --> 00:03:49,240 Some of them will swim away from the boat. 56 00:03:49,240 --> 00:03:51,880 We've had people duck-dive back under the water 57 00:03:51,880 --> 00:03:54,800 to try and end it all, but then we've had a lot of people tell us 58 00:03:54,800 --> 00:03:58,120 that they regretted it, just deciding on that particular day 59 00:03:58,120 --> 00:04:01,320 that they'd had enough and wanted to end it all, but then we've 60 00:04:01,320 --> 00:04:03,920 managed to get some feedback from them 61 00:04:03,920 --> 00:04:06,560 letting us know that they're all right and, 62 00:04:06,560 --> 00:04:11,440 "Thank you so much for saving me. I was just having a bad day." 63 00:04:14,520 --> 00:04:17,920 It's clear to me that to prevent more suicide deaths, 64 00:04:17,920 --> 00:04:21,120 we need to intervene much earlier. 65 00:04:21,120 --> 00:04:23,880 But in order to do that, we need to better understand 66 00:04:23,880 --> 00:04:27,120 what causes someone to get to the point of suicidal crisis 67 00:04:27,120 --> 00:04:28,520 in the first place. 68 00:04:31,960 --> 00:04:36,440 When I was younger, I found the idea of anyone thinking about 69 00:04:36,440 --> 00:04:40,720 or trying to take their own life impossible to relate to. 70 00:04:40,720 --> 00:04:45,800 But 20 years on, a lot of things have happened. 71 00:04:45,960 --> 00:04:48,800 I've got a son who lives thousands of miles away, 72 00:04:48,800 --> 00:04:50,280 which I feel very guilty about. 73 00:04:50,280 --> 00:04:52,920 I worry about him. I worry about his future. 74 00:04:52,920 --> 00:04:56,040 I worry about money. I worry about my career. 75 00:04:56,040 --> 00:04:58,640 I've messed up relationships, and... 76 00:04:59,600 --> 00:05:02,680 All of those things make me relate 77 00:05:02,680 --> 00:05:05,680 to thoughts of suicide quite differently. 78 00:05:10,000 --> 00:05:12,600 I now feel that I can relate to them 79 00:05:12,600 --> 00:05:15,280 because I've experienced them myself. 80 00:05:15,280 --> 00:05:18,080 And it's made me realise that no-one is immune 81 00:05:18,080 --> 00:05:20,480 to the effects of suicidal thoughts. 82 00:05:23,760 --> 00:05:25,200 It was a cold, crisp day. 83 00:05:25,200 --> 00:05:28,040 The sun was shining and it was bright and normal. 84 00:05:30,320 --> 00:05:32,920 And, in that sense, there was no difference between that Monday 85 00:05:32,920 --> 00:05:34,040 and any other Monday. 86 00:05:35,960 --> 00:05:39,320 I became aware that something maybe wasn't right when I heard, 87 00:05:39,320 --> 00:05:41,160 strangely enough, on the radio, 88 00:05:41,160 --> 00:05:45,640 a traffic report that mentioned the name of our village. 89 00:05:45,640 --> 00:05:47,280 And we only live in a small village, 90 00:05:47,280 --> 00:05:50,040 and you never hear your village on the radio particularly often, 91 00:05:50,040 --> 00:05:53,040 and that obviously caught my attention. 92 00:05:54,920 --> 00:05:57,480 Almost exactly the same time as 93 00:05:57,480 --> 00:06:00,000 there was a very large knock on the door. 94 00:06:00,000 --> 00:06:03,080 And some very large policemen walked into our house... 95 00:06:04,600 --> 00:06:07,640 ..and obviously informed us as to what had happened. 96 00:06:09,520 --> 00:06:10,840 They leave you a leaflet. 97 00:06:12,480 --> 00:06:14,920 And it was rather as if somebody had opened the front door 98 00:06:14,920 --> 00:06:16,960 and thrown a hand grenade into our house. 99 00:06:20,440 --> 00:06:22,320 And you're staring into an abyss of grief. 100 00:06:22,320 --> 00:06:24,120 I can only describe it like that. 101 00:06:24,120 --> 00:06:25,720 Your world is turned inside out. 102 00:06:33,920 --> 00:06:36,600 Well, this is just like thousands of other village stations 103 00:06:36,600 --> 00:06:38,120 up and down the country. 104 00:06:38,120 --> 00:06:41,120 This is where Edward used to get the train up to Cambridge 105 00:06:41,120 --> 00:06:44,120 for his sixth form college every morning and every afternoon. 106 00:06:45,120 --> 00:06:47,440 Edward told five different medical professionals 107 00:06:47,440 --> 00:06:51,040 that he wanted to potentially take his life on the railway. 108 00:06:51,040 --> 00:06:52,560 And nobody told us. 109 00:06:52,560 --> 00:06:54,640 Even though he had explicitly given his consent 110 00:06:54,640 --> 00:06:57,600 for his parents to be consulted, on two occasions. 111 00:06:57,600 --> 00:06:59,360 The very simple fact of the matter is 112 00:06:59,360 --> 00:07:02,240 if I'd known at all that my son had any suicide ideation 113 00:07:02,240 --> 00:07:04,640 involving the railway, do you honestly think I would have 114 00:07:04,640 --> 00:07:07,320 let him go anywhere near the railway station in the very village 115 00:07:07,320 --> 00:07:09,600 that he lives in and travelled on every single day? 116 00:07:09,600 --> 00:07:10,600 We were never told. 117 00:07:18,040 --> 00:07:19,400 Hey, son. 118 00:07:20,760 --> 00:07:23,240 When Edward died, he was head boy at his school 119 00:07:23,240 --> 00:07:26,440 and had recently been offered a place at Cambridge University. 120 00:07:27,480 --> 00:07:31,320 We should not underestimate the catastrophic scars 121 00:07:31,320 --> 00:07:34,520 that suicide has on society. 122 00:07:34,520 --> 00:07:36,160 Time does not heal all. 123 00:07:37,360 --> 00:07:38,760 You just learn to manage. 124 00:07:40,080 --> 00:07:43,160 And you go through a period where 125 00:07:43,160 --> 00:07:45,000 you wish the world would stop turning. 126 00:07:47,000 --> 00:07:50,240 Ever since Edward's death, Steve has been trying to understand 127 00:07:50,240 --> 00:07:52,240 how it could have been prevented. 128 00:07:53,680 --> 00:07:56,560 It was really here that my journey into the whole issue 129 00:07:56,560 --> 00:07:59,960 of mental health and suicide began, two and a half years ago. 130 00:07:59,960 --> 00:08:02,400 I stood next to my son's coffin, here in this church. 131 00:08:03,840 --> 00:08:05,880 I made him a public promise. 132 00:08:05,880 --> 00:08:09,000 I promised him that I would thoroughly investigate 133 00:08:09,000 --> 00:08:11,640 his terrible demise, but at the same time, 134 00:08:11,640 --> 00:08:14,360 I would thoroughly investigate the whole issue of mental health 135 00:08:14,360 --> 00:08:15,520 and suicide. 136 00:08:15,520 --> 00:08:18,040 And what was clearly happening to his generation, and indeed, 137 00:08:18,040 --> 00:08:19,480 across our society. 138 00:08:22,080 --> 00:08:25,400 Traditionally, researchers trying to understand what leads someone 139 00:08:25,400 --> 00:08:28,000 to take their own life have looked to mental illness 140 00:08:28,000 --> 00:08:29,640 for an explanation. 141 00:08:36,560 --> 00:08:38,360 My biological mum and dad... 142 00:08:40,000 --> 00:08:43,720 ..dealt terribly with severe mental illness, 143 00:08:43,720 --> 00:08:47,720 which they masked and coped with by using hard-core drugs and alcohol. 144 00:08:50,960 --> 00:08:54,360 They would leave us in very dangerous situations, 145 00:08:54,360 --> 00:08:57,760 barely clothed, lying in a diaper, maybe, 146 00:08:57,760 --> 00:08:59,720 screaming and crying not to be neglected. 147 00:09:01,320 --> 00:09:06,240 Until one motel clerk heard our screams and cries and said, 148 00:09:06,400 --> 00:09:08,240 "Enough is enough." 149 00:09:08,240 --> 00:09:09,760 And he called the police. 150 00:09:14,560 --> 00:09:17,040 So the beginning of my life was very traumatic. 151 00:09:20,000 --> 00:09:22,040 And one day, Debbie Hinds showed up. 152 00:09:23,040 --> 00:09:25,000 And very soon thereafter took me home. 153 00:09:26,920 --> 00:09:29,360 I had a beautiful childhood after that. 154 00:09:29,360 --> 00:09:33,400 And both my sister Elizabeth, from a different family, and myself, 155 00:09:33,400 --> 00:09:37,080 were adopted on the same day, March 17th, 1986. 156 00:09:39,840 --> 00:09:43,960 In fourth grade I'd heard voices, like auditory hallucinations, 157 00:09:43,960 --> 00:09:46,440 but I didn't know what they were - I was in fourth grade. 158 00:09:46,440 --> 00:09:49,240 And of course I didn't tell anybody, because I was scared. 159 00:09:50,880 --> 00:09:55,160 And I had a complete... What they would then call a mental breakdown. 160 00:09:58,000 --> 00:09:59,280 My mum picked me up... 161 00:10:01,160 --> 00:10:03,320 ..we had a family meeting. 162 00:10:03,320 --> 00:10:05,000 I was then to see my first psychiatrist 163 00:10:05,000 --> 00:10:06,440 in a few days after that. 164 00:10:08,080 --> 00:10:09,480 It was terrifying. 165 00:10:14,680 --> 00:10:18,880 Kevin was diagnosed with bipolar disorder with psychotic features. 166 00:10:20,680 --> 00:10:24,600 It is, uh, 6am. Time to get to work. 167 00:10:26,440 --> 00:10:29,200 So, I'm going to share with you guys my morning routine. 168 00:10:29,200 --> 00:10:30,480 Morning coffee. 169 00:10:33,000 --> 00:10:36,400 I'm going to take my medications before I work out. 170 00:10:36,400 --> 00:10:40,840 And this one here is a mood stabiliser and antidepressant. 171 00:10:42,000 --> 00:10:44,320 Formerly known as manic depression, 172 00:10:44,320 --> 00:10:47,960 bipolar disorder can cause people to become hyperactive, 173 00:10:47,960 --> 00:10:50,320 followed by long periods of feeling very low. 174 00:10:51,680 --> 00:10:53,520 And it's a big, smelly pill. 175 00:10:53,520 --> 00:10:54,880 And then this one here. 176 00:10:54,880 --> 00:10:58,320 This is my second anti-psychotic, because, as I said, 177 00:10:58,320 --> 00:11:01,800 without these kind of medications, my psychosis 178 00:11:01,800 --> 00:11:03,200 can get pretty terrifying. 179 00:11:04,400 --> 00:11:09,480 I probably have suicidal ideations two-three times a month. 180 00:11:09,880 --> 00:11:13,160 Um... Planning, much more rare. 181 00:11:13,160 --> 00:11:14,760 Once every couple of months. 182 00:11:16,200 --> 00:11:20,240 I take this regimen twice a day every day. 183 00:11:20,240 --> 00:11:24,360 I take them at the same time, no matter the time zone. 184 00:11:24,360 --> 00:11:28,200 Because that allows your brain to get used to 185 00:11:28,200 --> 00:11:32,040 your daily function, and it actually lends itself 186 00:11:32,040 --> 00:11:36,000 to helping someone with mental illness stay as stable as possible. 187 00:11:36,000 --> 00:11:37,120 Here we go. 188 00:11:37,120 --> 00:11:38,320 Bottoms up. 189 00:11:39,600 --> 00:11:44,240 We know that having a mental illness can increase your risk of suicide. 190 00:11:44,240 --> 00:11:46,960 The level of risk varies for different conditions, 191 00:11:46,960 --> 00:11:49,920 and research shows that worldwide, people like Kevin, 192 00:11:49,920 --> 00:11:52,240 who suffer from bipolar disorder, 193 00:11:52,240 --> 00:11:55,480 are up to 30 times more likely to die by suicide 194 00:11:55,480 --> 00:11:57,440 than the general population. 195 00:12:05,360 --> 00:12:08,960 I was having this constant conversation with a man 196 00:12:08,960 --> 00:12:11,120 in the mirror that I know longer knew. 197 00:12:12,680 --> 00:12:16,720 He would tell me how horrible I was, how useless I was. 198 00:12:18,840 --> 00:12:21,240 "Kevin, you're so fucking worthless." 199 00:12:22,440 --> 00:12:24,240 "Nobody cares about you." 200 00:12:24,240 --> 00:12:25,280 "Nobody loves you." 201 00:12:26,680 --> 00:12:28,040 "Everyone hates you." 202 00:12:35,680 --> 00:12:38,320 "I'm going to kill you." 203 00:12:38,320 --> 00:12:39,920 "And there's nothing you can do." 204 00:12:44,680 --> 00:12:47,320 That would replay and repeat every day. 205 00:12:49,720 --> 00:12:51,880 I so wanted to live... 206 00:12:53,120 --> 00:12:55,920 ..but my...my brain was trying to kill me. 207 00:13:13,480 --> 00:13:17,320 Trying to predict and prevent suicide attempts 208 00:13:17,320 --> 00:13:20,360 is heartbreakingly difficult. 209 00:13:20,360 --> 00:13:23,760 Mental illness is obviously a very important factor, 210 00:13:23,760 --> 00:13:27,720 but the majority of people with a diagnosed mental illness 211 00:13:27,720 --> 00:13:30,680 will never go on to attempt suicide. 212 00:13:30,680 --> 00:13:35,080 And the reality is that there are many, many more people out there 213 00:13:35,080 --> 00:13:38,400 with suicidal thoughts who are not in contact 214 00:13:38,400 --> 00:13:40,200 with mental health services. 215 00:13:45,520 --> 00:13:48,120 The extent of this problem was recently revealed 216 00:13:48,120 --> 00:13:51,480 in a ground-breaking survey published by Men's Health magazine. 217 00:13:53,160 --> 00:13:56,960 So I've come to meet the magazine's editor in chief, Toby Wiseman, 218 00:13:56,960 --> 00:13:59,560 who's agreed to talk me through some of the results. 219 00:14:01,480 --> 00:14:03,200 Toby, you've reached out to your readers 220 00:14:03,200 --> 00:14:06,240 and you've got 15,000 of them to respond 221 00:14:06,240 --> 00:14:08,240 to a survey about their mental health. Mm-hm. 222 00:14:08,240 --> 00:14:10,520 One of the bleakest stats in here, 223 00:14:10,520 --> 00:14:14,160 which you've just put in a black box right in the middle of the page, 224 00:14:14,160 --> 00:14:18,200 is that 56% of the men who responded admitted 225 00:14:18,200 --> 00:14:20,040 to having had suicidal thoughts. 226 00:14:20,040 --> 00:14:22,280 So, most men who you asked... 227 00:14:22,280 --> 00:14:23,560 Yes. 228 00:14:23,560 --> 00:14:25,920 ..had thought about killing themselves. 229 00:14:25,920 --> 00:14:28,760 What's interesting about that statistic is it's not necessarily 230 00:14:28,760 --> 00:14:31,840 to say that 56% of men are mentally ill. 231 00:14:31,840 --> 00:14:36,120 Suicide, the inclination to take one's own life, 232 00:14:36,120 --> 00:14:39,240 or at least even consider it, isn't necessarily 233 00:14:39,240 --> 00:14:43,640 wrapped up with someone having a long-standing mental condition. 234 00:14:43,640 --> 00:14:48,480 But, nonetheless, it is indicative of a situation that men 235 00:14:48,480 --> 00:14:50,720 are disproportionately finding themselves in 236 00:14:50,720 --> 00:14:53,320 which desperately needs attention. 237 00:14:53,320 --> 00:14:57,280 It's a shocking statistic, but there were other results from the survey 238 00:14:57,280 --> 00:15:00,840 which Toby thinks may shed light on why so many of these men 239 00:15:00,840 --> 00:15:04,920 have thought about suicide despite having never been diagnosed 240 00:15:04,920 --> 00:15:06,400 with a mental illness. 241 00:15:07,760 --> 00:15:12,440 Well, perhaps the starkest one is the fact that 70% of our respondents 242 00:15:12,440 --> 00:15:16,480 acknowledge that their own personal mental health 243 00:15:16,480 --> 00:15:19,280 was not what they would term good. Um... 244 00:15:19,280 --> 00:15:21,200 I mean, that really stood out to me, that one. 245 00:15:21,200 --> 00:15:23,600 Yeah. I think throughout the whole of this survey, 246 00:15:23,600 --> 00:15:26,240 what's really, really sort of come to light is that there is 247 00:15:26,240 --> 00:15:29,720 this conflict in notions of masculinity, 248 00:15:29,720 --> 00:15:33,200 in the sense that all men these days subscribe to the idea 249 00:15:33,200 --> 00:15:35,000 of the new man. 250 00:15:39,040 --> 00:15:43,520 But I think men are in general struggling to reconcile that 251 00:15:43,520 --> 00:15:46,800 with an older, shall we say, idea of masculinity, 252 00:15:46,800 --> 00:15:50,040 which is still hard-wired, certainly into a certain generation 253 00:15:50,040 --> 00:15:52,440 of some 30-50-year-olds. 254 00:15:52,440 --> 00:15:56,520 And so I think through our surveys we learned that 255 00:15:56,520 --> 00:15:59,560 men still define themselves by their career. 256 00:15:59,560 --> 00:16:02,560 It gives them a sense of self-esteem. 257 00:16:02,560 --> 00:16:04,600 I think men still find... 258 00:16:04,600 --> 00:16:07,200 Of a certain age, think very much that they should be 259 00:16:07,200 --> 00:16:11,440 the, um, the breadwinner and supporting the family. 260 00:16:11,440 --> 00:16:15,440 And the struggle in trying to reconcile those different ideas 261 00:16:15,440 --> 00:16:19,680 results in this kind of isolation and panic and withdrawal. 262 00:16:22,880 --> 00:16:26,360 Despite the difficulties that many men find themselves in, 263 00:16:26,360 --> 00:16:29,400 Toby thinks his survey shows that men are not unaware 264 00:16:29,400 --> 00:16:31,440 of the danger this poses to them. 265 00:16:33,080 --> 00:16:34,720 But the key thing, I think, 266 00:16:34,720 --> 00:16:37,560 and I think this really gives you more of an insight 267 00:16:37,560 --> 00:16:42,640 into the complexity of the issue, is that 69% of men were fairly good 268 00:16:43,040 --> 00:16:48,000 at identifying markers of poor mental health in their friends, 269 00:16:48,120 --> 00:16:53,080 in their family, partners, and intervening to help remedy that. 270 00:16:53,080 --> 00:16:56,360 And yet not being able to look at themselves in the mirror, 271 00:16:56,360 --> 00:16:58,480 acknowledge that they personally have a problem, 272 00:16:58,480 --> 00:16:59,520 and to act upon that. 273 00:16:59,520 --> 00:17:01,960 Do you think that's because people don't know where to go, 274 00:17:01,960 --> 00:17:04,760 or do you think it's that self-care feels, um, self-indulgent, 275 00:17:04,760 --> 00:17:06,000 or weak in some way? 276 00:17:06,000 --> 00:17:07,680 I think people do know where to go. 277 00:17:07,680 --> 00:17:11,080 I think perhaps men sort of back themselves into a corner 278 00:17:11,080 --> 00:17:14,320 where they don't feel able to, or at least sort of 279 00:17:14,320 --> 00:17:17,520 fighting some kind of internal dialogue between the man 280 00:17:17,520 --> 00:17:21,440 they feel they should be, and yet the man that they can't help but be 281 00:17:21,440 --> 00:17:25,080 is preventing them from speaking out. 282 00:17:30,760 --> 00:17:33,480 Just like the men in Toby's survey, 283 00:17:33,480 --> 00:17:36,720 I sometimes find it hard to ask for help when I'm feeling down. 284 00:17:38,200 --> 00:17:41,080 It makes me wonder how many of the men I know 285 00:17:41,080 --> 00:17:43,320 might be struggling in the same way. 286 00:17:46,720 --> 00:17:51,800 I first met Dan Turnbull, he was a barman at my local bar, 287 00:17:52,000 --> 00:17:55,280 The Black Bull, which is where we all used to go. 288 00:17:55,280 --> 00:17:57,200 We had very similar interests. 289 00:17:59,000 --> 00:18:03,480 I guess we were both into the social scene, we liked going out. 290 00:18:03,480 --> 00:18:07,720 Um, I mean, when I think back, we would be out five days a week. 291 00:18:09,560 --> 00:18:11,840 He was the most confident, outgoing, 292 00:18:11,840 --> 00:18:16,080 funny guy you could ever possibly meet, 293 00:18:16,080 --> 00:18:18,280 and you couldn't help but warm to him. 294 00:18:21,160 --> 00:18:24,840 Dan built up such a persona that everything is 295 00:18:24,840 --> 00:18:26,480 absolutely fine in my world. 296 00:18:26,480 --> 00:18:27,920 He was one of those. 297 00:18:27,920 --> 00:18:29,880 He didn't really talk about his feelings. 298 00:18:31,320 --> 00:18:33,520 And to the outside looking in, he had everything. 299 00:18:33,520 --> 00:18:36,800 And I think he worked really hard to try and protect that image, 300 00:18:36,800 --> 00:18:38,640 and I think he worked too hard in the end. 301 00:18:38,640 --> 00:18:41,920 I think he was struggling, and we could tell he was struggling. 302 00:18:41,920 --> 00:18:44,320 I mean, to talk about social media, 303 00:18:44,320 --> 00:18:46,960 certain things he was putting on when he'd a drink, 304 00:18:46,960 --> 00:18:51,200 where you understood that something's not quite right here. 305 00:18:51,200 --> 00:18:54,640 Unfortunately, the circle of friends that we had, 306 00:18:54,640 --> 00:18:58,280 because of the type of guy Dan was, they saw it as banter, 307 00:18:58,280 --> 00:19:00,560 so they would get involved in banter, 308 00:19:00,560 --> 00:19:03,200 and I think that didn't help. 309 00:19:03,200 --> 00:19:06,160 I think what Dan needed was an arm round his shoulder, 310 00:19:06,160 --> 00:19:11,200 but nobody really understood just how low he'd actually got. 311 00:19:11,960 --> 00:19:15,680 And I think on the back of some pretty bad life events 312 00:19:15,680 --> 00:19:19,960 in terms of his relationships, and he'd lost his job. 313 00:19:19,960 --> 00:19:22,480 I think everything just started to cave in a little bit, 314 00:19:22,480 --> 00:19:24,320 and I could see the cracks appearing. 315 00:19:27,520 --> 00:19:30,240 I remember it so well, unfortunately. 316 00:19:31,440 --> 00:19:35,720 My friend Jamie rang me, and he just said, "Have you heard about Dan?" 317 00:19:35,720 --> 00:19:37,480 And I was, "Well, no. 318 00:19:37,480 --> 00:19:39,920 "What you mean, have I heard about Dan?" 319 00:19:39,920 --> 00:19:43,440 And he said, "Apparently he's tried to kill himself." 320 00:19:43,440 --> 00:19:45,480 And I just remember, I was just lost. 321 00:19:45,480 --> 00:19:47,760 I didn't know how to process this. 322 00:19:47,760 --> 00:19:48,960 I couldn't believe it. 323 00:19:50,080 --> 00:19:52,200 I made a couple of phone calls, 324 00:19:52,200 --> 00:19:57,200 I spoke to Danny, and he confirmed he was in the hospital 325 00:19:57,640 --> 00:20:00,080 and it didn't look good. 326 00:20:02,120 --> 00:20:05,560 And I remember stood in this pub waiting for a text, essentially. 327 00:20:05,560 --> 00:20:07,360 Just, "Look, please keep me informed." 328 00:20:08,600 --> 00:20:11,440 And I can still to this day see the text that came through. 329 00:20:13,280 --> 00:20:16,560 "He's gone." And I... 330 00:20:16,560 --> 00:20:18,960 What do you do? I just broke down. 331 00:20:18,960 --> 00:20:21,120 I didn't know what to do. 332 00:20:21,120 --> 00:20:23,560 Nothing... It just didn't make sense. 333 00:20:23,560 --> 00:20:24,960 Because I hadn't seen it coming. 334 00:20:24,960 --> 00:20:27,960 I'd understood he was down and he wasn't feeling great, 335 00:20:27,960 --> 00:20:32,760 but he was just the last person you could ever have imagined 336 00:20:32,760 --> 00:20:36,080 going through with something like that. 337 00:20:36,080 --> 00:20:38,880 And one of the worst parts about it for me, 338 00:20:38,880 --> 00:20:41,680 I've kept all of Dan's text messages. 339 00:20:41,680 --> 00:20:44,560 It's nice to keep him close and to be able to laugh and look through 340 00:20:44,560 --> 00:20:49,440 them, but just three months before he died he'd actually... 341 00:20:49,440 --> 00:20:52,880 He'd used the words, "I'm on suicide watch, mate." 342 00:20:54,120 --> 00:20:56,320 So looking back at that, it's difficult. 343 00:21:08,800 --> 00:21:11,560 The challenge of understanding of what causes someone 344 00:21:11,560 --> 00:21:15,040 to take their own life is further complicated by the fact that 345 00:21:15,040 --> 00:21:18,000 suicide rates are not the same across the country. 346 00:21:19,480 --> 00:21:21,720 So I'm headed up to the north-east of England, 347 00:21:21,720 --> 00:21:24,760 which has one of the highest suicide rates in the UK, 348 00:21:24,760 --> 00:21:28,440 to see if I can find out how your risk of suicide 349 00:21:28,440 --> 00:21:30,160 could be linked to your postcode. 350 00:21:36,560 --> 00:21:39,240 Statistics show that if you live in the north-east, 351 00:21:39,240 --> 00:21:43,200 you're around 35% more likely to die by suicide 352 00:21:43,200 --> 00:21:44,600 than if you live in London. 353 00:21:47,080 --> 00:21:51,400 I'm meeting Shirley Smith from the charity If You Care, Share, 354 00:21:51,400 --> 00:21:54,440 which works with people who have been bereaved by suicide 355 00:21:54,440 --> 00:21:57,280 and people who are thinking about taking their own life. 356 00:21:58,280 --> 00:22:02,760 The pink are female, the blue are male. 357 00:22:02,760 --> 00:22:05,800 Each represents a death by suicide. Wow. 358 00:22:05,800 --> 00:22:10,880 And these are only the referrals that have been made into service. 359 00:22:11,320 --> 00:22:14,360 What I guess is very, very depressing and very shocking is that 360 00:22:14,360 --> 00:22:17,840 you have two huge bags of pins down there, 361 00:22:17,840 --> 00:22:20,000 that you will keep filling this board. 362 00:22:20,000 --> 00:22:21,640 Unfortunately, yes. 363 00:22:21,640 --> 00:22:22,640 Wow. 364 00:22:23,760 --> 00:22:27,320 I'm looking at this, which is obviously not a very big town... 365 00:22:27,320 --> 00:22:28,680 No. 366 00:22:28,680 --> 00:22:30,800 And that's... 367 00:22:30,800 --> 00:22:35,600 In three years, 15 suicides, something like that? Mm-hm. 368 00:22:37,840 --> 00:22:39,520 That's unbelievable. 369 00:22:42,160 --> 00:22:45,800 Shirley set up the charity after losing her 19-year-old son, Daniel, 370 00:22:45,800 --> 00:22:48,920 to suicide in 2005. 371 00:22:48,920 --> 00:22:52,320 Before Daniel's death, he had not been diagnosed with a mental illness 372 00:22:52,320 --> 00:22:55,280 nor shown any outward signs of his intentions. 373 00:22:59,640 --> 00:23:03,160 So I want to know what Shirley thinks are the biggest risk factors 374 00:23:03,160 --> 00:23:05,920 causing the high suicide rate in her local area. 375 00:23:07,360 --> 00:23:11,600 Do you get any sense of what is driving that, 376 00:23:11,600 --> 00:23:14,640 what's different about living here, and dying here, 377 00:23:14,640 --> 00:23:16,520 compared to other places in the UK? 378 00:23:16,520 --> 00:23:19,360 I think that's a really difficult question to answer, 379 00:23:19,360 --> 00:23:23,000 because, you know, each death is individual. 380 00:23:23,000 --> 00:23:27,880 What we know through the likes of audits is that 381 00:23:27,880 --> 00:23:32,560 the three factors associated with, certainly within this area - 382 00:23:32,560 --> 00:23:37,440 bereavement, finance and relationship, 383 00:23:37,440 --> 00:23:40,200 or relationship breakdown. 384 00:23:40,200 --> 00:23:43,520 So there isn't really a chapter in any medical textbook 385 00:23:43,520 --> 00:23:47,160 on relationships, bereavement or finance. 386 00:23:47,160 --> 00:23:50,360 Those aren't things that typically your GP can offer you 387 00:23:50,360 --> 00:23:51,800 a lot of help with. 388 00:23:51,800 --> 00:23:56,320 Rates of unemployment are higher than the average in the north-east, 389 00:23:56,320 --> 00:24:01,240 and if you lose your job, that can have a huge impact on, you know, 390 00:24:01,240 --> 00:24:06,240 erm, your home, the way in which your relationship may suffer, 391 00:24:07,240 --> 00:24:10,920 and it can just be one of those that then basically it's like 392 00:24:10,920 --> 00:24:14,000 the domino effect, that it has an impact on others. 393 00:24:15,000 --> 00:24:17,240 But the problem goes deeper. 394 00:24:17,240 --> 00:24:21,040 Research shows that those in the lowest socioeconomic group, 395 00:24:21,040 --> 00:24:23,320 living in the most deprived areas, 396 00:24:23,320 --> 00:24:27,200 are up to ten times more at risk of dying by suicide than those 397 00:24:27,200 --> 00:24:30,440 in the highest groups living in the most affluent areas. 398 00:24:31,640 --> 00:24:34,520 You're dealing with this very, very complicated picture 399 00:24:34,520 --> 00:24:37,480 of all the different things that might lead someone 400 00:24:37,480 --> 00:24:42,160 to take their own life, and whether it's safety nets falling away, 401 00:24:42,160 --> 00:24:45,040 whether it's the experience of people around them, it's not... 402 00:24:46,880 --> 00:24:50,320 ..it's not something you can easily get a handle on. 403 00:24:50,320 --> 00:24:55,320 And, you know, those safety nets become an integral part 404 00:24:55,320 --> 00:24:58,800 of, um, staying alive. 405 00:24:58,800 --> 00:25:01,520 If you don't have that coping network, 406 00:25:01,520 --> 00:25:06,000 or maybe you're not aware of the support that's out there, 407 00:25:06,000 --> 00:25:07,240 you feel alone. 408 00:25:07,240 --> 00:25:11,680 And feeling alone, feeling hopeless, you know, 409 00:25:11,680 --> 00:25:15,920 is a very, very dangerous place. 410 00:25:22,600 --> 00:25:26,200 One other factor that can increase your risk of suicidal behaviour 411 00:25:26,200 --> 00:25:29,240 is knowing someone close to you who has taken their own life. 412 00:25:31,400 --> 00:25:36,440 Dan's death, it had a massive impact on me in a number of different ways. 413 00:25:37,720 --> 00:25:41,520 At the time, I was suffering with depression. Um, 414 00:25:41,520 --> 00:25:46,240 I was becoming a little bit too dependent on alcohol. 415 00:25:46,240 --> 00:25:49,440 It did feel like I was living a double life. 416 00:25:49,440 --> 00:25:53,760 I had this image on the outside of, um, 417 00:25:53,760 --> 00:25:56,760 confidence, outgoing, everything was going great. 418 00:25:56,760 --> 00:25:59,600 I've got a great job, all of this. 419 00:25:59,600 --> 00:26:02,640 Whereas inside, my head was an absolute mess. 420 00:26:04,080 --> 00:26:07,720 It was... It was hell on Earth. It was... 421 00:26:07,720 --> 00:26:09,960 Nothing made sense to me. 422 00:26:09,960 --> 00:26:12,400 Um, the simplest decisions I couldn't make 423 00:26:12,400 --> 00:26:14,840 because they were so many things in my head 424 00:26:14,840 --> 00:26:16,080 just bouncing off each other. 425 00:26:16,080 --> 00:26:17,320 I didn't know where to turn, 426 00:26:17,320 --> 00:26:20,200 I didn't know how to articulate how I was feeling. 427 00:26:20,200 --> 00:26:25,240 In one fell swoop, I lost my job, I lost my home and I went bankrupt. 428 00:26:27,840 --> 00:26:31,680 Those six, 12 months, I think it was around when my daughter was born 429 00:26:31,680 --> 00:26:34,400 as well, I'd never felt more lost. 430 00:26:35,600 --> 00:26:38,480 Sadly, I didn't talk to anybody about it. 431 00:26:38,480 --> 00:26:41,240 I just kind of kept it inside. 432 00:26:41,240 --> 00:26:45,520 It had a massive negative impact on the way I thought about everything. 433 00:26:45,520 --> 00:26:48,160 I just became so depressed as a result of it. 434 00:26:50,400 --> 00:26:52,200 Things have just got to the point now where 435 00:26:52,200 --> 00:26:54,240 I'd actually rather not be here - 436 00:26:54,240 --> 00:26:56,280 I genuinely meant that. 437 00:26:56,280 --> 00:27:00,040 And that was the point where I said, "I'm going to kill myself." 438 00:27:00,040 --> 00:27:02,360 It's a matter of when. 439 00:27:02,360 --> 00:27:06,440 And that was the only option I saw that was available to me. 440 00:27:07,760 --> 00:27:11,160 I got home, and I tried to hang myself. 441 00:27:11,160 --> 00:27:13,120 And it's... 442 00:27:13,120 --> 00:27:15,400 It's... 443 00:27:15,400 --> 00:27:18,680 That's quite a blunt way to say it, and I appreciate that 444 00:27:18,680 --> 00:27:22,200 it's not easy for a lot of people to hear or think about, 445 00:27:22,200 --> 00:27:24,600 but it's not a nice place to be at. 446 00:27:27,360 --> 00:27:29,240 It was that painful. 447 00:27:29,240 --> 00:27:32,440 You would think if you are serious about not wanting to be here, 448 00:27:32,440 --> 00:27:35,480 a bit of pain isn't going to stop you, 449 00:27:35,480 --> 00:27:37,720 but there was something stopping me to the point where 450 00:27:37,720 --> 00:27:39,760 I couldn't go through with that. 451 00:27:46,440 --> 00:27:48,480 It's almost like a Eureka moment. 452 00:27:48,480 --> 00:27:50,120 It was just... 453 00:27:50,120 --> 00:27:52,120 This isn't... This isn't the way it has to be. 454 00:27:52,120 --> 00:27:53,920 I don't have to go down this road. 455 00:27:57,320 --> 00:28:02,240 I just kind of re-evaluated things, re-evaluated my life. 456 00:28:02,240 --> 00:28:06,160 I almost made a decision that, "I'm here now. 457 00:28:06,160 --> 00:28:07,800 "I don't want to go anywhere. 458 00:28:07,800 --> 00:28:08,960 "Enough now." 459 00:28:10,000 --> 00:28:13,040 And things just started to slot into place a little bit. 460 00:28:13,040 --> 00:28:16,320 I became more comfortable in my own skin over a period of time. 461 00:28:16,320 --> 00:28:19,040 To think that if things had gone the other way, 462 00:28:19,040 --> 00:28:21,920 if things had gone a little bit too far, 463 00:28:21,920 --> 00:28:25,640 I wouldn't be here today to be able to explain that, 464 00:28:25,640 --> 00:28:28,880 the difference, and how that feels. 465 00:28:28,880 --> 00:28:32,240 It's scary, but at the same time it just gives me something else to be 466 00:28:32,240 --> 00:28:33,760 really, really thankful for. 467 00:28:56,040 --> 00:28:59,120 I'm beginning to get a handle on the wide range of factors 468 00:28:59,120 --> 00:29:01,280 that can lead to suicidal thoughts. 469 00:29:03,040 --> 00:29:05,480 But there's one thing I'm still no clearer on. 470 00:29:06,680 --> 00:29:11,360 Why is it that three times more men than women go on to die in this way, 471 00:29:11,360 --> 00:29:14,520 when far more women than men attempt suicide? 472 00:29:20,280 --> 00:29:24,160 I've come to Scotland to meet Professor Rory O'Connor. 473 00:29:24,160 --> 00:29:27,160 I want to see to see if he can explain what causes this disparity 474 00:29:27,160 --> 00:29:28,840 between the sexes. 475 00:29:31,680 --> 00:29:35,760 One of the things I'm still really struggling to get a handle on 476 00:29:35,760 --> 00:29:39,000 is why do more men take their own lives than women? 477 00:29:39,000 --> 00:29:42,440 One of the key parts of the answer is to do with method selection. 478 00:29:42,440 --> 00:29:45,360 Men sadly use more lethal methods of suicide, 479 00:29:45,360 --> 00:29:47,920 so when they attempt suicide, they're more likely to die. 480 00:29:47,920 --> 00:29:50,360 We've been doing work on pain sensitivity 481 00:29:50,360 --> 00:29:52,680 and physical pain sensitivity, and so again, 482 00:29:52,680 --> 00:29:54,880 we've looked at people who've attempted suicide, 483 00:29:54,880 --> 00:29:59,080 both men and women, and men's physical pain capacity, 484 00:29:59,080 --> 00:30:01,800 their physical pain tolerance, is higher than women. 485 00:30:01,800 --> 00:30:05,000 And that physical pain tolerance may develop over time. 486 00:30:05,000 --> 00:30:07,920 We don't really know how it develops, but we think it's partly 487 00:30:07,920 --> 00:30:11,960 to do with the fact that if men engage in more risky behaviours, 488 00:30:11,960 --> 00:30:16,760 engage in self-harm, engage in sort of more traumatic 489 00:30:16,760 --> 00:30:19,400 or experience more traumatic events, we think that may elevate 490 00:30:19,400 --> 00:30:21,040 your physical pain tolerance. 491 00:30:21,040 --> 00:30:23,840 And men arguably are less likely to seek help, 492 00:30:23,840 --> 00:30:26,720 and that's part of this puzzle of understanding why men 493 00:30:26,720 --> 00:30:29,160 are more likely to kill themselves than women. 494 00:30:29,160 --> 00:30:32,400 I guess, from my own experience, in my '20s, I had lots of friends, 495 00:30:32,400 --> 00:30:35,040 or at least I had lots of... I had a big gang. 496 00:30:35,040 --> 00:30:38,320 So I was at university, or my job involved lots of colleagues. Mm-hm. 497 00:30:38,320 --> 00:30:40,720 In a way that now it doesn't feel the same. 498 00:30:40,720 --> 00:30:44,360 I have a smaller group of people I can lean on. 499 00:30:44,360 --> 00:30:46,640 You wouldn't have to remove many people from my life 500 00:30:46,640 --> 00:30:48,240 for me to be pretty isolated. 501 00:30:48,240 --> 00:30:50,280 I mean, that's important that you mention that, 502 00:30:50,280 --> 00:30:54,360 because men in general, and this is a generalisation, I appreciate that, 503 00:30:54,360 --> 00:30:58,240 they invest a lot of their emotional support in their partner. 504 00:30:58,240 --> 00:31:00,640 Now, if their partner leaves them, or for whatever reason 505 00:31:00,640 --> 00:31:04,280 the relationship breaks down, that man is potentially isolated, 506 00:31:04,280 --> 00:31:06,440 or more likely to be emotionally isolated, 507 00:31:06,440 --> 00:31:10,720 because men don't tend to have the broader network of emotional support 508 00:31:10,720 --> 00:31:12,320 that women have. 509 00:31:22,680 --> 00:31:25,240 When people say, "Speak to a friend," 510 00:31:25,240 --> 00:31:27,880 and I think as a guy you hear this particularly, people go, 511 00:31:27,880 --> 00:31:29,600 "You've got to talk, you've got to open up, 512 00:31:29,600 --> 00:31:31,120 "you've got to speak to people." 513 00:31:31,120 --> 00:31:33,360 Do you literally mean just saying to someone, 514 00:31:33,360 --> 00:31:35,640 "Are you about to kill yourself, are you suicidal?" 515 00:31:35,640 --> 00:31:38,600 Indeed, there is evidence out there that asking somebody directly 516 00:31:38,600 --> 00:31:42,000 whether they're suicidal can actually protect them. 517 00:31:42,000 --> 00:31:45,280 Because it'll get them hopefully the help and support that they require, 518 00:31:45,280 --> 00:31:48,120 but also the sense that they feel listened to, 519 00:31:48,120 --> 00:31:50,840 this sense in which, actually, my feelings are validated 520 00:31:50,840 --> 00:31:53,440 and somebody cares about me. 521 00:31:53,440 --> 00:31:57,440 And that reaching out in moments of crisis can save a life. 522 00:31:57,440 --> 00:32:00,760 My brother does phone me every once in a while and go, 523 00:32:00,760 --> 00:32:03,000 "You're not going to kill yourself, are you?" 524 00:32:03,000 --> 00:32:06,600 And it's... It's light-hearted. It doesn't feel significant, 525 00:32:06,600 --> 00:32:08,080 but I hadn't... 526 00:32:08,080 --> 00:32:11,720 It never occurred to me that, um... 527 00:32:11,720 --> 00:32:13,520 That he may have saved my life, doing that. 528 00:32:18,640 --> 00:32:20,360 As I've seen so far, 529 00:32:20,360 --> 00:32:24,120 there are a whole range of factors that can lead to suicidal thoughts. 530 00:32:25,360 --> 00:32:28,320 But the problem is that none of these factors help to predict 531 00:32:28,320 --> 00:32:31,440 who will take their own life. 532 00:32:31,440 --> 00:32:33,600 And without the ability to predict, 533 00:32:33,600 --> 00:32:37,120 it is hugely challenging to prevent suicide deaths. 534 00:32:39,040 --> 00:32:41,760 But what is nice is that there is something that 535 00:32:41,760 --> 00:32:44,840 you don't need to be a health care professional to do, 536 00:32:44,840 --> 00:32:47,160 that I can start doing immediately - 537 00:32:47,160 --> 00:32:51,080 and that is communicating better and talking more, and asking people 538 00:32:51,080 --> 00:32:53,240 specifically about suicide. 539 00:32:53,240 --> 00:32:56,440 And I'm going to start by phoning my brother, 540 00:32:56,440 --> 00:32:59,320 who I probably should've asked about this a long time ago. 541 00:33:02,920 --> 00:33:06,200 We know that different people need different kinds of help, 542 00:33:06,200 --> 00:33:09,640 and in the UK, there is a diverse range of support on offer. 543 00:33:16,720 --> 00:33:18,960 But in the fight against suicide, 544 00:33:18,960 --> 00:33:23,080 the power of a single conversation should not be underestimated. 545 00:33:26,200 --> 00:33:28,880 Depression is a liar. 546 00:33:28,880 --> 00:33:30,320 And it tells you... 547 00:33:32,600 --> 00:33:35,880 ..horrible things about yourself, 548 00:33:35,880 --> 00:33:37,440 and it makes you believe them. 549 00:33:42,640 --> 00:33:46,920 I got onto the next bus that took me to the Golden Gate Bridge. 550 00:33:46,920 --> 00:33:49,560 I sat on the very back row in the middle seat, 551 00:33:49,560 --> 00:33:52,280 and I started screaming aloud at the voices in my head. 552 00:33:54,160 --> 00:33:57,560 The same words I would scream in the mirror. 553 00:33:57,560 --> 00:33:59,800 "Leave me alone!" 554 00:33:59,800 --> 00:34:01,960 "I don't want to die!" 555 00:34:01,960 --> 00:34:03,320 "Why do you hate me so much?" 556 00:34:03,320 --> 00:34:05,240 I remember saying that really loud. 557 00:34:08,880 --> 00:34:13,120 And now 100 people are looking right down the barrel of the bus at me 558 00:34:13,120 --> 00:34:14,840 and saying nothing. 559 00:34:16,200 --> 00:34:20,440 And you have to understand, I had made a pact with myself on that bus. 560 00:34:20,440 --> 00:34:24,560 If one person looks at me and says, "Kid, are you OK? 561 00:34:24,560 --> 00:34:26,400 "Is something wrong? 562 00:34:26,400 --> 00:34:28,040 "Can I help you, buddy?" 563 00:34:28,040 --> 00:34:31,160 I told myself if one person does that or a variation, 564 00:34:31,160 --> 00:34:33,720 I'll tell that person everything 565 00:34:33,720 --> 00:34:35,280 and beg for their help. 566 00:34:43,480 --> 00:34:45,720 Then the bus got to the bridge. 567 00:34:45,720 --> 00:34:48,400 I walked out to the bridge walkway, 568 00:34:48,400 --> 00:34:52,200 and I paced back and forth for 40 minutes, crying. 569 00:34:53,840 --> 00:34:57,680 Bikers, joggers, tourists, everybody. 570 00:34:57,680 --> 00:34:59,680 Police officers searching for suicidal people, 571 00:34:59,680 --> 00:35:01,960 they all went by me, twice. 572 00:35:01,960 --> 00:35:05,840 That's when a woman from my left approached me, 573 00:35:05,840 --> 00:35:09,720 pulled out a digital camera and said, "Will you take my picture?" 574 00:35:13,320 --> 00:35:14,680 She posed. 575 00:35:16,160 --> 00:35:18,080 I took her picture quite a few times. 576 00:35:20,240 --> 00:35:22,480 Then she walked away. 577 00:35:24,920 --> 00:35:27,560 And that's when I said, "Absolutely nobody cares." 578 00:35:30,800 --> 00:35:33,040 The voice in my head said, "Jump now!" 579 00:35:34,880 --> 00:35:36,440 And I did. 580 00:35:40,160 --> 00:35:42,800 The millisecond my hands left that rail 581 00:35:42,800 --> 00:35:45,560 and my legs cleared it, 582 00:35:45,560 --> 00:35:48,080 I had an instant regret for my actions... 583 00:35:49,400 --> 00:35:52,240 ..and the complete recognition that I just made the greatest mistake 584 00:35:52,240 --> 00:35:54,520 of my life, and it was too late. 585 00:36:01,120 --> 00:36:03,880 You hit that water like you're hitting a brick wall. 586 00:36:05,840 --> 00:36:10,800 The impact reverberated through my legs, into my lower back, 587 00:36:11,040 --> 00:36:14,000 and it shattered my T12 lower vertebrae. 588 00:36:20,080 --> 00:36:22,400 I went down 70 feet, 589 00:36:22,400 --> 00:36:23,880 and I opened my eyes. 590 00:36:27,680 --> 00:36:30,000 I couldn't hear the depressed thoughts. 591 00:36:30,000 --> 00:36:32,760 I could not hear the voice that was in my head telling me, "Jump now!" 592 00:36:32,760 --> 00:36:34,160 I couldn't hear any of that. 593 00:36:35,920 --> 00:36:40,880 Just the complete will to not die. 594 00:36:43,320 --> 00:36:46,360 I bobbed up and down in the water and I did the only thing I... 595 00:36:47,840 --> 00:36:49,280 The only thing I had control over. 596 00:36:50,320 --> 00:36:52,240 I prayed. 597 00:36:52,240 --> 00:36:55,720 I prayed on repeat, "God, please save me. I don't want to die. 598 00:36:55,720 --> 00:36:57,360 "I made a mistake." 599 00:37:03,440 --> 00:37:05,600 The coastguard got there. 600 00:37:05,600 --> 00:37:07,960 They fished me out of the water. 601 00:37:07,960 --> 00:37:09,680 This guy looks at me and he goes, 602 00:37:09,680 --> 00:37:11,640 "Kid, do you know what you just did?" 603 00:37:11,640 --> 00:37:14,400 I said, "Yeah, I do." 604 00:37:15,600 --> 00:37:17,320 Guy next to him said, "Why?" 605 00:37:19,840 --> 00:37:21,040 And I didn't know. 606 00:37:22,160 --> 00:37:24,560 I said, "I don't know. I thought I had to die today." 607 00:37:31,480 --> 00:37:34,720 they didn't give me a necessarily good chance of making it 608 00:37:34,720 --> 00:37:36,320 through the first night. 609 00:37:36,320 --> 00:37:40,000 The surgery, I believe, was ten and a half hours. 610 00:37:41,800 --> 00:37:44,040 My father was at his office downtown. 611 00:37:44,040 --> 00:37:46,280 He got to the hospital. 612 00:37:46,280 --> 00:37:48,720 I lay there, you know, broken, battered, mangled, bent, 613 00:37:48,720 --> 00:37:52,280 IVs in both arms, tubes everywhere and a mask over my face. 614 00:37:54,640 --> 00:37:58,680 And this man, who I had not seen cry in 19 years, 615 00:37:58,680 --> 00:38:00,720 waterfalls flew from his eyes. 616 00:38:09,840 --> 00:38:11,720 And my immediate reaction was guilt. 617 00:38:12,760 --> 00:38:17,600 And he looked down at me and he said, "No, Kevin, I'm sorry." 618 00:38:17,600 --> 00:38:20,360 And his immediate reaction was guilt. 619 00:38:20,360 --> 00:38:22,400 Guilt that belonged to neither of us. 620 00:38:26,600 --> 00:38:30,280 People think that I did this and, "Oh, he's all better now. 621 00:38:30,280 --> 00:38:32,920 "He realised he didn't want to die and now he's got his life back." 622 00:38:32,920 --> 00:38:34,320 No. 623 00:38:34,320 --> 00:38:37,280 Seven psychiatric hospital stays in the next 11 years 624 00:38:37,280 --> 00:38:38,920 for suicidal crisis. 625 00:38:41,200 --> 00:38:43,280 Which is fine, because I'm here. 626 00:38:49,040 --> 00:38:51,880 For decades, researchers across the globe 627 00:38:51,880 --> 00:38:55,160 have been investigating whether there is more that we can do 628 00:38:55,160 --> 00:38:57,800 to reduce suicide deaths. 629 00:38:57,800 --> 00:39:01,240 It is a hugely complex task, 630 00:39:01,240 --> 00:39:02,880 but there are glimmers of hope. 631 00:39:06,640 --> 00:39:09,960 In the very place where Kevin nearly lost his life, 632 00:39:09,960 --> 00:39:14,240 work has finally started on a surprisingly simple solution 633 00:39:14,240 --> 00:39:17,480 that could stop suicides at the Golden Gate Bridge forever. 634 00:39:20,560 --> 00:39:25,440 Until 2013, Kevin Briggs was a California Highway Patrol officer 635 00:39:25,440 --> 00:39:28,040 on the Golden Gate Bridge. 636 00:39:28,040 --> 00:39:32,080 I patrolled the bridge around 17 years. 637 00:39:32,080 --> 00:39:33,360 It's like home to me. 638 00:39:33,360 --> 00:39:36,840 It's where I worked, it's where I spent many, many years. 639 00:39:36,840 --> 00:39:38,840 I enjoy it. 640 00:39:38,840 --> 00:39:40,240 I think it's fabulous. 641 00:39:43,080 --> 00:39:46,720 During his time on patrol, Kevin got called to hundreds of people 642 00:39:46,720 --> 00:39:49,240 who were threatening to jump from bridge, 643 00:39:49,240 --> 00:39:51,440 but only two of them ever did. 644 00:39:51,440 --> 00:39:53,840 Everyone else came back from the edge. 645 00:39:56,720 --> 00:39:59,760 I think most people come back because they have that little 646 00:39:59,760 --> 00:40:02,840 glimmer of hope, and that's what folks need. 647 00:40:02,840 --> 00:40:06,480 Talking's important because many, many times, 648 00:40:06,480 --> 00:40:09,640 folks are just looking for someone to listen to them. 649 00:40:09,640 --> 00:40:12,960 Not to give them advice, not to write them a prescription, 650 00:40:12,960 --> 00:40:15,040 not to say, "You know would you should've done?" 651 00:40:15,040 --> 00:40:18,920 But to just listen, not to argue or blame or say, 652 00:40:18,920 --> 00:40:20,680 "How could you do this to me?" 653 00:40:20,680 --> 00:40:22,880 But simply to listen to what's going on, 654 00:40:22,880 --> 00:40:24,920 and I think that is a real key to this. 655 00:40:28,000 --> 00:40:32,080 But the problem for Kevin was that he couldn't always be there. 656 00:40:32,080 --> 00:40:35,680 Suicide attempts could happen at any time of the day or night, 657 00:40:35,680 --> 00:40:39,160 so he joined a campaign to help build a safety net 658 00:40:39,160 --> 00:40:43,160 that will run along the entire length of the Golden Gate Bridge. 659 00:40:43,160 --> 00:40:44,360 This is a big deal. 660 00:40:44,360 --> 00:40:46,880 We've been trying to get this for many, many, many years. 661 00:40:46,880 --> 00:40:50,320 And it's about 20 feet down or so from the sidewalk, 662 00:40:50,320 --> 00:40:54,760 and it's going to protrude about 20 feet out from the bridge, 663 00:40:54,760 --> 00:40:58,120 a marine material that will last, because this is a harsh environment, 664 00:40:58,120 --> 00:41:02,320 and if someone does decide to jump, they'll get caught into this mesh. 665 00:41:02,320 --> 00:41:05,560 It's very loose, and then the Fire Department will come out and assist 666 00:41:05,560 --> 00:41:07,400 those people out. 667 00:41:07,400 --> 00:41:09,480 So hopefully we can get them some help. 668 00:41:10,640 --> 00:41:13,720 Studies have shown that when nets or barriers have been installed 669 00:41:13,720 --> 00:41:16,560 on other bridges, they have dramatically reduced the number 670 00:41:16,560 --> 00:41:20,040 of deaths by suicide, not only in that location, 671 00:41:20,040 --> 00:41:22,640 but in the surrounding area as a whole. 672 00:41:22,640 --> 00:41:26,200 If we remove a means, that impulsive act, they won't do it, 673 00:41:26,200 --> 00:41:28,720 because they'll see that that means is taken away. 674 00:41:28,720 --> 00:41:30,480 I'm hoping this will stop suicides 675 00:41:30,480 --> 00:41:32,480 from the Golden Gate Bridge altogether. 676 00:41:35,720 --> 00:41:38,880 Although this is clearly a powerful intervention, 677 00:41:38,880 --> 00:41:41,960 it's unrealistic to think that we'd ever be able to restrict access 678 00:41:41,960 --> 00:41:43,720 to all methods of suicide. 679 00:41:47,600 --> 00:41:50,960 And that's why it's so important to be able to predict who is at risk 680 00:41:50,960 --> 00:41:52,880 before they reach crisis point. 681 00:41:54,560 --> 00:41:56,800 The problem is that there are so many factors 682 00:41:56,800 --> 00:41:59,800 which can lead to suicidal behaviour, 683 00:41:59,800 --> 00:42:02,440 from having a mental illness to being unemployed. 684 00:42:02,440 --> 00:42:05,800 And most people who have these problems don't attempt suicide. 685 00:42:07,120 --> 00:42:10,560 So predicting who will has so far been impossible. 686 00:42:15,440 --> 00:42:19,200 But Dr Joseph Franklin from Florida State University 687 00:42:19,200 --> 00:42:21,840 believes he may have cracked the problem of prediction 688 00:42:21,840 --> 00:42:23,440 using the power of mathematics. 689 00:42:26,920 --> 00:42:28,120 Is it Joe? 690 00:42:28,120 --> 00:42:30,480 Yes, Xand. Hey, very good to meet you. You too. 691 00:42:33,640 --> 00:42:37,080 So, we know that there are individual risk factors for suicide, 692 00:42:37,080 --> 00:42:40,640 so what's the problem with using them to predict 693 00:42:40,640 --> 00:42:42,640 who will die by suicide? 694 00:42:42,640 --> 00:42:44,680 I think it would be a lot like asking, 695 00:42:44,680 --> 00:42:46,600 "Why did this car break down?" 696 00:42:46,600 --> 00:42:49,760 I guess, looking at the car, I would have absolutely no idea. 697 00:42:49,760 --> 00:42:52,520 Yeah, precisely. It seems like an absurd question 698 00:42:52,520 --> 00:42:55,240 to ask why did this car break down without knowing a whole lot more 699 00:42:55,240 --> 00:42:57,280 about this particular car. 700 00:42:57,280 --> 00:43:00,520 Is it fair to say that's how lots of people and even researchers 701 00:43:00,520 --> 00:43:02,360 think about suicide? Exactly. 702 00:43:02,360 --> 00:43:04,440 And what we've discovered over time, 703 00:43:04,440 --> 00:43:06,920 through a couple of large meta-analyses that we've done 704 00:43:06,920 --> 00:43:09,480 is that, unfortunately, no one thing, 705 00:43:09,480 --> 00:43:12,520 or small group of things predicts much better than a coin flip. 706 00:43:12,520 --> 00:43:14,280 Really? Yes. Really?! 707 00:43:14,280 --> 00:43:15,800 Yes. 708 00:43:15,800 --> 00:43:19,080 So, instead, Joe and his team looked for a way to understand 709 00:43:19,080 --> 00:43:23,360 the interactions between multiple risk factors all at the same time. 710 00:43:24,480 --> 00:43:27,960 To do this, they used machine learning algorithms, 711 00:43:27,960 --> 00:43:32,000 something most of us use every day in the map apps on our phones. 712 00:43:33,360 --> 00:43:37,080 OK, so the app says sort of to 15 minutes to your office. Mm-hm. 713 00:43:37,080 --> 00:43:41,680 And it's using an algorithm to do that. 714 00:43:41,680 --> 00:43:43,000 Yeah, exactly. 715 00:43:43,000 --> 00:43:46,160 So what it's able to do that I as a human am not able to do 716 00:43:46,160 --> 00:43:50,240 is it's able to consider way more data that I could possibly consider, 717 00:43:50,240 --> 00:43:53,160 and it's also able to combine that data together 718 00:43:53,160 --> 00:43:56,800 in a much more complex way than I could ever possibly combine it. 719 00:43:58,200 --> 00:44:01,360 Joe's team developed algorithms to analyse thousands 720 00:44:01,360 --> 00:44:03,680 of Americans' health records, 721 00:44:03,680 --> 00:44:06,520 looking at details such as age and gender, 722 00:44:06,520 --> 00:44:09,040 as well as physical and mental illnesses. 723 00:44:11,080 --> 00:44:15,080 The algorithms work by considering combinations of up to 800 724 00:44:15,080 --> 00:44:16,840 of these factors at a time. 725 00:44:18,720 --> 00:44:23,400 You ingest all these millions of data points into your algorithm, 726 00:44:23,400 --> 00:44:25,040 and what does it give you? 727 00:44:25,040 --> 00:44:26,280 What does it spit out? 728 00:44:26,280 --> 00:44:29,000 Well, we're able to predict both non-fatal suicide attempts 729 00:44:29,000 --> 00:44:32,160 and suicide death with about 90% accuracy 730 00:44:32,160 --> 00:44:34,320 a few years before it happens. 731 00:44:34,320 --> 00:44:36,040 Wow. 90%? 732 00:44:36,040 --> 00:44:37,160 Mm-hm. 733 00:44:37,160 --> 00:44:40,800 It's astonishing that simply by looking at combinations of factors 734 00:44:40,800 --> 00:44:43,520 instead of taking any single one on its own, 735 00:44:43,520 --> 00:44:47,160 Joe's team could be transforming our ability to predict suicide 736 00:44:47,160 --> 00:44:52,240 from being no better than flipping a coin to a staggering 90% accuracy. 737 00:44:52,280 --> 00:44:55,680 This could completely revolutionise how and when 738 00:44:55,680 --> 00:44:58,320 we intervene in suicidal behaviour. 739 00:45:00,160 --> 00:45:03,200 So, we know the algorithms are good, 740 00:45:03,200 --> 00:45:06,080 whether it's driving across town or predicting suicide. 741 00:45:06,080 --> 00:45:07,520 But where do you go from here, then? 742 00:45:07,520 --> 00:45:09,160 What you do with this data? 743 00:45:09,160 --> 00:45:12,280 A huge part of what we need to do on our end is to work hard 744 00:45:12,280 --> 00:45:16,240 with clinicians to say, "Here is all of the evidence 745 00:45:16,240 --> 00:45:20,080 "of how clinicians are able to predict this 746 00:45:20,080 --> 00:45:21,600 "very dangerous phenomenon, 747 00:45:21,600 --> 00:45:25,800 "versus how the algorithm is able to predict this kind of phenomenon." 748 00:45:25,800 --> 00:45:29,080 Yeah. There are very few things more nerve-racking in medicine 749 00:45:29,080 --> 00:45:32,280 than trying to figure out, once you think someone is at risk 750 00:45:32,280 --> 00:45:35,200 of killing themselves, saying, do you let them leave the hospital 751 00:45:35,200 --> 00:45:36,360 or not? 752 00:45:36,360 --> 00:45:40,800 And putting that decision in the hands or in the microchip hands 753 00:45:40,800 --> 00:45:43,240 of a machine is a very difficult thing to do. 754 00:45:43,240 --> 00:45:44,680 Yeah, exactly. 755 00:45:44,680 --> 00:45:47,520 So I don't think that there's a clear answer at this point, 756 00:45:47,520 --> 00:45:50,920 but I think that these are the sorts of issues that various stakeholders 757 00:45:50,920 --> 00:45:53,800 need to get together to discuss. OK. 758 00:45:55,440 --> 00:45:59,280 What Joe's work suggests is that if we applied machine learning 759 00:45:59,280 --> 00:46:04,000 to the NHS database, we might be able to identify those at high risk 760 00:46:04,000 --> 00:46:06,600 of suicide with far greater accuracy. 761 00:46:08,240 --> 00:46:11,480 There are resource implications and ethical challenges, 762 00:46:11,480 --> 00:46:15,520 but this kind of new technology could save thousands of lives. 763 00:46:19,400 --> 00:46:23,640 So far, I've seen that both removing access to a means of suicide 764 00:46:23,640 --> 00:46:26,520 and improving our ability to predict who's at risk 765 00:46:26,520 --> 00:46:30,320 of taking their own life can be hugely powerful interventions. 766 00:46:35,440 --> 00:46:37,880 But in another part of America, 767 00:46:37,880 --> 00:46:41,480 a group of doctors are claiming that simply changing our attitude towards 768 00:46:41,480 --> 00:46:44,560 suicide could produce dramatic results. 769 00:46:46,440 --> 00:46:49,840 I'm in Detroit, and this city probably more than any other 770 00:46:49,840 --> 00:46:54,120 in America has the risk factors for a high suicide rate. 771 00:46:54,120 --> 00:46:58,400 Massive unemployment, high levels of crime, extreme poverty. 772 00:46:58,400 --> 00:47:01,200 And I'm off to meet a medical team who decided a few years ago 773 00:47:01,200 --> 00:47:05,240 to start a new approach to reducing suicide in this town. 774 00:47:06,320 --> 00:47:09,520 And at the heart of their approach is an idea that I think 775 00:47:09,520 --> 00:47:11,800 is pretty controversial. 776 00:47:13,160 --> 00:47:15,280 Here at the Henry Ford Health System, 777 00:47:15,280 --> 00:47:18,920 I'm meeting one of the founders of the Zero Suicide Programme, 778 00:47:18,920 --> 00:47:20,680 Dr Cathy Frank. 779 00:47:20,680 --> 00:47:22,760 Cathy. Hi. Hey. Nice to see you. 780 00:47:22,760 --> 00:47:25,080 How are you? Very nice to meet you. Thank you... 781 00:47:25,080 --> 00:47:27,600 The goal of the Zero Suicide Programme 782 00:47:27,600 --> 00:47:32,200 is to completely eliminate suicide among the health system's patients. 783 00:47:32,200 --> 00:47:34,760 How did the doctors and nurses react to that goal? 784 00:47:34,760 --> 00:47:37,000 That just seems like a huge amount to ask of them. 785 00:47:37,000 --> 00:47:41,680 We had a lot of staff who were very upset, thought it was unrealistic, 786 00:47:41,680 --> 00:47:44,840 thought they would get sued, it would put us at risk. 787 00:47:44,840 --> 00:47:49,600 But when you get down to the hard part of saying, "Well, 788 00:47:49,600 --> 00:47:52,440 "if it's not zero, what is the goal?" 789 00:47:53,560 --> 00:47:55,280 You really can't come up with another goal. 790 00:47:55,280 --> 00:47:57,320 No-one's got an answer. 791 00:47:57,320 --> 00:47:59,120 Yeah, I mean, is it going to be your loved one, 792 00:47:59,120 --> 00:48:00,520 is it going to be my neighbour? 793 00:48:00,520 --> 00:48:02,000 Who is it going to be? 794 00:48:02,000 --> 00:48:04,040 So, in real terms, it can only be zero. 795 00:48:05,240 --> 00:48:07,000 In order to get to zero, 796 00:48:07,000 --> 00:48:09,400 the Henry Ford team decided to change their approach 797 00:48:09,400 --> 00:48:11,720 to mental health care. 798 00:48:11,720 --> 00:48:14,720 They asked primary care doctors to start screening 799 00:48:14,720 --> 00:48:18,200 every single patient every time they saw them, 800 00:48:18,200 --> 00:48:20,680 regardless of what they'd come in for, 801 00:48:20,680 --> 00:48:23,720 to find out if they'd had suicidal thoughts. 802 00:48:25,320 --> 00:48:27,800 Each patient who was found to be at risk 803 00:48:27,800 --> 00:48:29,800 was referred for appropriate care. 804 00:48:30,880 --> 00:48:34,680 Whether that was talking therapy, medication, 805 00:48:34,680 --> 00:48:37,600 or even a visit to their home to remove firearms. 806 00:48:41,200 --> 00:48:43,440 I'm keen to see the programme in action, 807 00:48:43,440 --> 00:48:47,480 so Dr Frank is letting me sit in on a consultation with a patient. 808 00:48:47,480 --> 00:48:49,280 Hey. 809 00:48:49,280 --> 00:48:50,880 Thanks for coming. We appreciate it... 810 00:48:50,880 --> 00:48:53,760 Mike originally came to Henry Ford to treat his bowel complaint, 811 00:48:53,760 --> 00:48:55,400 Crohn's disease. 812 00:48:55,400 --> 00:48:57,440 But during that process, he was also asked 813 00:48:57,440 --> 00:49:00,080 if he'd had suicidal thoughts. 814 00:49:00,080 --> 00:49:04,240 So, Mike, when did you first encounter the system here? 815 00:49:04,240 --> 00:49:08,360 The process that started to ask you about suicide? 816 00:49:08,360 --> 00:49:12,240 My GI doctor, she asked me all of the gut questions. 817 00:49:12,240 --> 00:49:13,920 And that was for your Crohn's disease? 818 00:49:13,920 --> 00:49:17,360 Correct. I'll tell her, "I'm having trouble with this," you know, 819 00:49:17,360 --> 00:49:20,560 I'd mention the depression and anxiety and those things. 820 00:49:20,560 --> 00:49:24,400 And then she put me in touch with the behaviour health team here. 821 00:49:24,400 --> 00:49:27,280 Another important part of the programme is equipping patients 822 00:49:27,280 --> 00:49:30,560 to help themselves out of suicidal crisis. 823 00:49:30,560 --> 00:49:34,800 So today, Dr Frank is helping Mike to draw up a safety plan. 824 00:49:34,800 --> 00:49:38,800 You've been at points where it sounds like you were very close... 825 00:49:38,800 --> 00:49:40,720 Yes. ..to taking your life. Yes. 826 00:49:40,720 --> 00:49:44,120 So we want you to be able to rescue yourself. 827 00:49:44,120 --> 00:49:47,400 Sometimes it helps if I have someone to socialise with, 828 00:49:47,400 --> 00:49:49,840 somebody I can reach out to. 829 00:49:49,840 --> 00:49:52,600 Is that Mum and Kyle, or is that somebody else? 830 00:49:52,600 --> 00:49:55,320 Probably Kyle over 831 00:49:55,320 --> 00:49:57,720 my mum - I would go to him first. 832 00:49:57,720 --> 00:49:58,840 OK. 833 00:49:58,840 --> 00:50:01,600 It's striking that the process does involve friends and family 834 00:50:01,600 --> 00:50:05,000 in a way that, maybe when I trained, 835 00:50:05,000 --> 00:50:08,320 that would have not been a thing we would have done. 836 00:50:08,320 --> 00:50:09,520 Is that useful? 837 00:50:09,520 --> 00:50:11,920 For me, personally, it's essential. 838 00:50:11,920 --> 00:50:15,000 I have to have my friends and family involved. 839 00:50:15,000 --> 00:50:17,680 They are, like, the key to all this, so I need them involved. 840 00:50:17,680 --> 00:50:19,880 I need them to sort of 841 00:50:19,880 --> 00:50:21,920 know what's going on and how to react. 842 00:50:23,120 --> 00:50:27,200 You start this process, and what results do you see? 843 00:50:27,200 --> 00:50:28,840 Does any of it work? 844 00:50:28,840 --> 00:50:32,600 Yes, it did. Our suicide rate decreased by 80%. 845 00:50:34,000 --> 00:50:36,880 And we even had some years where it was zero. 846 00:50:36,880 --> 00:50:39,200 Wow. Wow! 847 00:50:39,200 --> 00:50:42,440 So it was very significant in terms of saving lives. 848 00:50:42,440 --> 00:50:45,640 That is almost unbelievable. 849 00:50:45,640 --> 00:50:49,360 The idea of getting, actually getting, to zero. 850 00:50:49,360 --> 00:50:51,960 I remember when I was training that... 851 00:50:53,960 --> 00:50:56,360 ..we would literally say, and people would leave the clinic 852 00:50:56,360 --> 00:50:58,280 and we knew that they were at risk of suicide, 853 00:50:58,280 --> 00:51:00,400 and almost to let ourselves off the hook, 854 00:51:00,400 --> 00:51:02,560 you'd say, "Look, we know we can't stop everyone. 855 00:51:02,560 --> 00:51:04,480 "We know that some of them will find a way." 856 00:51:04,480 --> 00:51:07,640 It was literally the opposite of what you're saying. 857 00:51:07,640 --> 00:51:11,440 Correct. That if we change the way we think about health care, 858 00:51:11,440 --> 00:51:13,320 we can prevent suicides. 859 00:51:16,160 --> 00:51:19,360 It's important to remember that Henry Ford is a private 860 00:51:19,360 --> 00:51:20,880 health care company, 861 00:51:20,880 --> 00:51:24,480 so despite the reduction of suicides among their patients, 862 00:51:24,480 --> 00:51:28,560 some have argued that the poorest people, who are the most at risk, 863 00:51:28,560 --> 00:51:30,800 are frequently not reached, 864 00:51:30,800 --> 00:51:33,480 because they do not have private health insurance. 865 00:51:43,360 --> 00:51:46,240 What I've seen in America is really encouraging, 866 00:51:46,240 --> 00:51:49,280 because it suggests that there is a whole range of approaches 867 00:51:49,280 --> 00:51:52,320 that could help us to reduce suicide deaths, 868 00:51:52,320 --> 00:51:55,160 and it's possible that there's a lot more we could be doing 869 00:51:55,160 --> 00:51:56,360 in this country. 870 00:51:58,120 --> 00:52:00,640 At the moment in the UK, the Government target is to reduce 871 00:52:00,640 --> 00:52:05,120 deaths by suicide by 10% before the year 2020. 872 00:52:06,360 --> 00:52:09,600 But many campaigners think we should have a much bigger goal in mind. 873 00:52:11,480 --> 00:52:13,880 Aiming for zero suicide, 874 00:52:13,880 --> 00:52:16,080 identifying everyone at risk and treating them, 875 00:52:16,080 --> 00:52:18,560 seems to me to be a much better idea. 876 00:52:18,560 --> 00:52:20,920 And, increasingly, there are a large numbers of people 877 00:52:20,920 --> 00:52:22,280 who feel the same way. 878 00:52:29,080 --> 00:52:33,360 Steve Mallon, whose son Edward took his own life in 2015, 879 00:52:33,360 --> 00:52:36,200 has spent the last year developing and initiative called 880 00:52:36,200 --> 00:52:38,120 the Zero Suicide Alliance. 881 00:52:38,120 --> 00:52:41,280 And today it's being launched at the Houses of Parliament. 882 00:52:41,280 --> 00:52:43,080 Hello. Very nice to meet you. How are you? 883 00:52:43,080 --> 00:52:45,760 Thank you so much for coming. It's a pleasure. Much appreciated. 884 00:52:45,760 --> 00:52:47,800 Well, I had such a good visit to Mersey Care. Yes. 885 00:52:47,800 --> 00:52:51,080 The aim of the Alliance is to bring the goal of zero suicide 886 00:52:51,080 --> 00:52:55,920 to the UK, and apply it to a range of sectors, including the NHS, 887 00:52:55,920 --> 00:52:58,600 education and the emergency services. 888 00:53:00,640 --> 00:53:04,640 I think it's amazing that you're not asking for more money in the NHS, 889 00:53:04,640 --> 00:53:07,640 but you're saying we can something better with the resources we have. 890 00:53:07,640 --> 00:53:09,160 There's no point asking for more money, 891 00:53:09,160 --> 00:53:10,640 because there isn't any there. 892 00:53:10,640 --> 00:53:13,040 So, frankly, I think the Government would be foolish 893 00:53:13,040 --> 00:53:15,600 not to support this, if only on financial grounds, 894 00:53:15,600 --> 00:53:18,200 because if we can prevent people reaching crisis, 895 00:53:18,200 --> 00:53:20,280 if we can prevent people taking their lives, 896 00:53:20,280 --> 00:53:22,520 we will not only improve the happiness of our society, 897 00:53:22,520 --> 00:53:25,160 but we will save billions in care costs 898 00:53:25,160 --> 00:53:28,600 and all of the costs associated with mental illness. 899 00:53:28,600 --> 00:53:32,920 It's estimated that each suicide death in the UK costs the economy 900 00:53:32,920 --> 00:53:35,520 over £1.5 million. 901 00:53:38,560 --> 00:53:43,040 So far, Steve has signed up around half of the NHS Trusts 902 00:53:43,040 --> 00:53:46,280 in the country to the Zero Suicide Alliance. 903 00:53:46,280 --> 00:53:49,520 And his hope is that, after today, the rest will follow. 904 00:53:51,160 --> 00:53:54,240 My beloved son Edward took his life on the railway 500 yards 905 00:53:54,240 --> 00:53:56,200 from where we live in Cambridgeshire 906 00:53:56,200 --> 00:53:57,720 a little over two years ago. 907 00:53:57,720 --> 00:53:59,800 It was six weeks after his 18th birthday, 908 00:53:59,800 --> 00:54:01,920 which we celebrated over there at the Shard. 909 00:54:05,400 --> 00:54:08,400 There are no words for such utter devastation. 910 00:54:08,400 --> 00:54:11,480 The experts will tell you that you have an increased chance 911 00:54:11,480 --> 00:54:13,920 of taking your own life if you have lost a close family member 912 00:54:13,920 --> 00:54:15,720 to suicide. 913 00:54:15,720 --> 00:54:18,720 Trust me when I say I know what that statistic looked like. 914 00:54:20,000 --> 00:54:22,480 A complete abyss of grief. 915 00:54:22,480 --> 00:54:24,640 At the bottom of that abyss, ladies and gentlemen, 916 00:54:24,640 --> 00:54:25,760 I made my son a promise. 917 00:54:25,760 --> 00:54:27,400 I stood next to his coffin at his funeral, 918 00:54:27,400 --> 00:54:29,920 and I vowed before the congregation that I would investigate 919 00:54:29,920 --> 00:54:31,880 his terrible death, and where appropriate, 920 00:54:31,880 --> 00:54:34,200 and in the most effective way, seek reform in his memory, 921 00:54:34,200 --> 00:54:36,600 and, indeed, on behalf of his generation. 922 00:54:36,600 --> 00:54:38,560 It's the very least he would've expected of me, 923 00:54:38,560 --> 00:54:40,080 and the very least he deserves. 924 00:54:41,560 --> 00:54:46,560 I obviously asked myself, was this a horrible accident, 925 00:54:46,640 --> 00:54:49,640 was this an isolated incident? 926 00:54:49,640 --> 00:54:51,680 Because obviously we don't live in a perfect world. 927 00:54:52,680 --> 00:54:56,840 And any system will have failings. Tragedies will always occur. 928 00:54:56,840 --> 00:54:59,200 And I very rapidly came to the understanding 929 00:54:59,200 --> 00:55:00,800 that this is not an isolated case. 930 00:55:00,800 --> 00:55:02,280 This happens every single day. 931 00:55:05,760 --> 00:55:08,520 If we took the very best of what we already do with the very best 932 00:55:08,520 --> 00:55:12,000 of intentions, from every part of the system and from every locality, 933 00:55:12,000 --> 00:55:14,240 and combine this in a single model, 934 00:55:14,240 --> 00:55:16,240 change some basic protocols and attitudes, 935 00:55:16,240 --> 00:55:17,880 and then deploy it everywhere, 936 00:55:17,880 --> 00:55:20,360 I'm convinced that we will rapidly push back the frontiers 937 00:55:20,360 --> 00:55:22,480 of both mental illness and suicide. 938 00:55:22,480 --> 00:55:25,000 This is what the Zero Suicide Alliance is all about. 939 00:55:25,000 --> 00:55:27,720 Society is now ready, and so are we. 940 00:55:27,720 --> 00:55:30,080 Ladies and gentlemen, I thank you for your attention. 941 00:55:30,080 --> 00:55:32,520 APPLAUSE 942 00:55:37,600 --> 00:55:41,040 Have we got a society in which my son would still be alive? 943 00:55:41,040 --> 00:55:43,280 We have not yet got there. 944 00:55:43,280 --> 00:55:44,920 But I'm determined that we will. 945 00:55:51,600 --> 00:55:54,640 It's incredible that Steve's managed to garner support 946 00:55:54,640 --> 00:55:56,520 not just from not only all over the UK, 947 00:55:56,520 --> 00:55:58,520 but from the highest levels of Westminster, 948 00:55:58,520 --> 00:56:00,720 to work on zero suicide. 949 00:56:00,720 --> 00:56:05,640 I had a very strong sense of how many people were in that room 950 00:56:05,640 --> 00:56:08,400 because they'd lost someone to suicide. 951 00:56:08,400 --> 00:56:11,240 And how important it is for the Government 952 00:56:11,240 --> 00:56:13,960 to make good on the commitments they made in that room. 953 00:56:15,360 --> 00:56:18,560 To prevent more people going through what Steve has gone through. 954 00:56:20,560 --> 00:56:23,680 One of the astonishing things that I found during the making of 955 00:56:23,680 --> 00:56:28,120 this programme is that funding for research into suicide prevention 956 00:56:28,120 --> 00:56:31,200 lags well behind many other areas of health. 957 00:56:32,280 --> 00:56:37,120 In fact, estimates show that there is 22 times more funding for 958 00:56:37,120 --> 00:56:40,760 each cancer patient than for each person affected by mental health 959 00:56:40,760 --> 00:56:45,840 problems, and suicide research gets an even smaller slice of that pie. 960 00:56:49,920 --> 00:56:53,160 What I've learned is that we have to think of all these deaths from 961 00:56:53,160 --> 00:56:55,200 suicide as preventable. 962 00:56:55,200 --> 00:56:58,000 I don't know if we can ever actually get to zero suicide, 963 00:56:58,000 --> 00:56:59,240 but I don't really care. 964 00:56:59,240 --> 00:57:02,480 I think zero suicide is the only mind-set to get us 965 00:57:02,480 --> 00:57:05,200 the reductions that we really desperately need. 966 00:57:05,200 --> 00:57:07,360 I think there are two things that we can do. 967 00:57:07,360 --> 00:57:09,400 The first is in the health care service. 968 00:57:09,400 --> 00:57:12,280 I think we should be moving towards a place where most health care 969 00:57:12,280 --> 00:57:15,520 professionals in most health care interactions are thinking about 970 00:57:15,520 --> 00:57:19,160 mental health, and possibly asking about suicide. 971 00:57:19,160 --> 00:57:21,800 And the other thing is something that you can do at home - 972 00:57:21,800 --> 00:57:23,080 that we can all do. 973 00:57:23,080 --> 00:57:26,880 Turn to the person next to you or phone a mate and ask them, 974 00:57:26,880 --> 00:57:28,680 not just, "Are you doing OK", 975 00:57:28,680 --> 00:57:31,520 but, "Are you thinking about killing yourself?" 976 00:57:31,520 --> 00:57:32,800 You might save a life. 977 00:57:32,800 --> 00:57:35,880 And if you're watching this and you are thinking about killing yourself, 978 00:57:35,880 --> 00:57:39,960 please reach out, tell someone, and get the help you need.