Quite a common job to respond to is ‘suicidal person’ or ‘person threatening suicide’. What these jobs boil down to is a person who is struggling to cope with their life and have reached a point where the pain is so bad they need to escape it. The situation can be anything. To a person not involved in that person’s life may not seem that serious or it may be so bad it leaves you thinking ‘how the hell have they survived so long’.
Our training as ambulance people in mental health is limited and the only options we have to help them is either take to a local hospital Emergency Department for review by the mental health team or in some cases, in some areas we can refer directly to mental health teams.
Often the ambulance person can feel a little awkward, displays of raw emotion by a stranger are a little daunting and a lot of us feel embarrassed and unsure how to respond. I’m always scared of saying the wrong thing and making an uncomfortable situation even worse. It may be that I’m a middle aged male, brought up in the 60s and macho 70s but I definitely feel awkward. I’m glad that times seem a little more enlightened now and high profile celebrities, even the younger members of the royal family have made it ok to be emotional and talk about negative feelings.
It seems to me that one thing that all these people have in common is that their minds are trapped in a negative loop or set of thoughts. Mine used to be very negative; I’d often be set off down a negative, bitter chain of thought and would get really down and anxious. Then the anxiety and low mood would feed the thoughts and a vicious circle was set up. I’ve been through normal, modern life experiences, divorce, young children and death of loved ones. I’ve never been for formal counselling, I think with hindsight I should have, it may have speeded up the journey to where I am now, relaxed, grateful and content with life.
Instead of professional counselling I have spent a lot of time reading and researching the self help field. The things which have helped me most are: Cognitive Behavioural Therapy (CBT). The main things I’ve got from this are that the thoughts you are thinking may not necessarily be true or accurate. I have got myself into the habit of questioning my own thoughts if I find them negative. Mindfullness. This is something I am very much still getting to grips with. Observing my thoughts as they occur and not getting bogged down with them. I practice staying in the present moment as much as possible. The past is gone now and can’t be changed. Mistakes can be learned from but best not dwelt on. The future can be planned for but the only place we can do things is now. Here. I find I can always cope with what is happening now; I only get overwhelmed or stressed if I try to think too much about what will happen in the future. Gratitude. There’s a horrible phrase: ‘attitude of gratitude’ which sounds awful but does make a lot of sense. I find it helps me by regularly thinking about things I’m grateful for, it helps me put things in perspective and actually spending time thinking about things and people I love really puts me in a happy mood. Exercise. The benefits of exercise are well established in the field of mental health and it really works for me. I’m not a fan of gyms; I love to get my exercise in the fresh air. As well as the benefits of endorphin release with exercise I find that walking or running also has an extra benefit, the rhythmic slap of my feet on the floor is soothing and slows my mind down. Fun with Friends. Another no brainer. Making time to have fun with a few good friends really has got me through some hard times in life and is something I thoroughly recommend.
Being told to ‘cheer up’, ‘get a grip’ and ‘it’s all in your mind’ definitely do not help!
Back to our patient who is feeling suicidal. All I can do for him/her is talk to them and encourage them to accept the help that is on offer. This can take a long time as quite often the last thing the patient wants is to sit for ages in a busy emergency department. I find it frustrating at how limited my own personal scope is to help them, for these jobs I’m just a friendly taxi driver.