Sarah Markham: Online tool provides support for people with suicidal thoughts

As an individual with lived experience of anxiety, depression, and suicidal ideation, I was so happy to see “Staying Safe from Suicidal Thoughts” ( launched by 4 Mental Health last month. What makes this online resource different from other websites offering support to those in distress is the manner in which it offers genuine compassion, kindness, and simple practical ways to help keep people safer from thoughts of harm and suicide.

As I am aware from my own personal experience, people with suicidal thoughts don’t usually want to terminate their life, they may just want an end to their emotional or physical pain. The impulse to end one’s life may be short lived, or seem to be the only way to deal with mental suffering. Hence the importance of positive means of support and tools or interventions, such as, which might act as the tipping point back to safety. The website itself encourages people in distress to seek support from others, affirming that they deserve this, and shouldn’t have to deal with what they are going through alone. There are emotionally powerful and informed videos from people with personal experience of depression and suicidal ideation, and compassionate clinicians offer advice on how to get through difficult feelings and recover. focuses on helpful and practical ways in which the user can develop their own tools to keep themselves safe; specifically a Safety Plan. A safety plan is an intervention to provide people experiencing distress with a set of specific, concrete strategies tailored to their individual needs and circumstances, which they can use to counter suicidal feelings and other forms of distress. The safety plan adopts a problem solving approach to distress, which addresses any barriers to it being used by the individual. Loved ones and others who are explicitly mentioned in the safety plan should be educated about their possible role and responsibilities should the individual come to them for support.

Safety plans incorporate elements of several evidence based suicide risk reduction strategies that are a part of the Zero Suicide approach, including means reduction, brief problem solving and coping skills, social and emergency crisis support, and motivational enhancement for treatment. A safety plan can be created in a variety of settings including someone’s home, emergency departments, primary care, and secondary mental health, and is a key component of an effective and evidence based care management plan.

Safety planning may be used with individuals who have made a suicide attempt, experience suicidal ideation, or are at risk of suicide. Research demonstrates that effective safety planning has positive outcomes for patients and patient care management. Safety planning also emphasises collaboration between a patient and clinician and operationalises continuity of care. As one emergency department psychiatrist reported, “[safety planning] provides a bridge between the emergency care and outpatient treatment.”

Alys Cole-King, an expert in the field of pragmatic and compassionate biopsychosocial evidence based interventions to reduce suicide, is the driving force behind Alys is a consultant liaison psychiatrist who works in a clinical and public health role within the NHS. It has taken Alys, together with an expert advisory group (EAG) of international academics, mental health practitioners, and people with personal experience of suicideincluding myselffive long years to develop

As a survivor of a serious suicide attempt, I am aware that all too often, what is missing from mental health support is a genuine element of caring. This online tool changes that. It is full of genuine care, empathy, and compassion as well as sound, evidence based practice. I am happy and grateful that finally there is something for people experiencing despair that actually feels as good as the advice and support it offers.

Sarah Markham is an academic mathematician and patient representative currently pursuing a second PhD in theoretical computer science. She is a member of the BMJ Patient Advisory Panel.

Twitter: @DrSMarkham

Competing interests: None declared