Having spoken to many people who are suicidal, and having lost many friends. I need to say something really difficult.

I hope that the caring people in suicide research and mental health services have the right support and supervision themselves to pause for one minute to listen

We talk a lot about risk factors for suicide, at both individual and population levels. But there’s one that comes up when you listen to people who are suicidal, especially who have attempted suicide, and including people who go on to die by suicide, that I’ve never seen listed.

I can guess why we don’t talk about it. There are a lot of reasons why.

The risk factor is the effect of the person of having been told they need to ask for help, and help will be there, followed by the experience of asking for help and help not being there.

This risk factor could also occur without the person having been told they need to ask for help. The person asking for help when suicidal and help not being there.

The risk factor is about inaccessibility of help and exclusions. Sometimes in the presence of rhetoric about help.

This isn’t blaming individuals working hard to help, and it’s important we don’t get distracted by conversations about how hard helpers work here. Many helpers work hard in difficult conditions constrained by all sorts of things. It’s about impact on individuals and communities.

The individual impact of asking for help and help not being there when suicidal can be profound. It can lead to a catastrophic loss of hope at a time when hope is depleted. It can lead to profound shame. It can alter future behaviour around help seeking. It leaves people trapped.

The community impact of seeing someone being told to ask and some people getting help but some people not can be confusing and reverberates affecting other people’s ability to seek help. Imagine having to go to the same service after the death of a friend who didn’t receive help.

Yet when people with lived experience try to talk about this they’re sometimes silenced or not believed. Or it’s left in the “too difficult” pile and the profound implications of the way it affects people and those who care about them isn’t understood or is underestimated.

One of the reasons it’s underestimated is because of shame. Another is the false but pervasive “credibility gap” between people who experience non-helping responses vs people who receive help. Services platform voices who have had help and those who haven’t go largely unheard.

I’ve been shocked time and again in this field meeting caring researchers and professionals who seem unaware of how common it is for people to receive non-helping responses when they ask for help. Some people genuinely don’t know how hard it can be for some people to access help.

It’s difficult to talk about this. Some caring professionals and researchers are frightened acknowledging the help responses are not always right will put others off seeking help. But the help responses not always being right puts those who experience and witness it off help more

We need to talk about this. To address the false ‘credibility gap’ which has meant this hasn’t been heard from those who have experienced or witnessed it. We need to reduce the shame of talking about non-help responses. We need to prioritise help accessibility for people excluded