Suicide is not a nice subject and I apologise to any reader who has experienced first-hand the devastating effects of someone close taking their life, whatever the circumstances. I further apologise to anyone who regards suicide as a sin or who has a religious belief that it is wrong. I totally respect your belief but I do not hold it myself. Of course, I think suicide is tragic, especially if the person concerned is young. Whether it is a waste of a life I don’t feel qualified to judge. That it impacts many other lives is hurtful indeed.

We are very insistent on the dignity of life, and rightly so. Many people lead unacceptably undignified lives due to poverty, ill health and poor relationships. We make efforts to help them lead a dignified, useful life. Our efforts don’t always succeed. We need to increase them. We should also be prepared to help people have a dignified death. Perhaps a doctor’s second oath should be “Thou shalt not kill but need not strive officiously to keep alive”.

A friend who had had Alzheimer’s disease for seven years, been in a nursing home all that time unable to control any of his bodily functions and clearly not recognising anyone who visited him, caught pneumonia. His wife asked the nursing home not to send him to hospital. The director of the nursing home overrode her request, saying that his ‘duty of care’ obliged him to do so. The pneumonia was recovered and my friend lived for another eight months. I do not criticise the Director but I also don’t regard that as dignified or kind.

What of the person who wants to take their own life? In practice many more people do so than we imagine. A slip of – or ignoring – the pill dose, a change of mindset that says it’s time to go. I have known dozens of people where a trained hospital Sister has said ‘s/he turned his / her face to the wall and just died’. The rhythm of life often tells us when it is over.

Depression is the main cause of suicide. It covers many situations. Loss of a beloved spouse / companion, physical pain or deterioration that start to be unbearable, failure of job / career leading to unemployment, possibly long-term, and a sense of personal failure all lead to feelings of utter hopelessness and despair. There is a point where we find getting up to face the world too challenging. There is also a point where depression is a disease.

It is wise always to look first at whether there are physical reasons for someone’s depression. A review by a good doctor establishes that. S/he may want to put someone on a drug to relieve the depression. Obviously if a professional person decides that, then it is wise to listen to them. The drugs associated with depression can be addictive and should be used carefully. Wherever possibly the person should be helped and encouraged to become independent of them. Easier said than done but wonderful when achieved.

At the diagnosis stage – the most important stage of treating any disorder physical or mental – the possibility of attention-getting must be considered. As a business we do not normally handle suicide watches although we never refuse to do so when asked. Some young people who have talked to us and who are suicidal need attention. They may have been neglected or abused at home or school. Need for attention is a very real problem and not nearly as within a person’s control as you might believe.

It can result from a disrupted childhood. It is not sinful or evil. It is a cry for help. Those who need attention should get it fully while at the same time being encouraged and helped gradually to become less dependent on others affections. The attention they require is unconditional love. Sometimes a pet can provide that. Sometimes a counsellor has to.

The love I am talking about is not all-consuming and it is certainly not sexual. Desperate people do transfer their emotional affections to helpers. Experienced helpers know how to handle this in a way that is sympathetic but doesn’t permit clinging. Often the way to help people for whom psychological or physical disorder has been ruled out is to coax them to realise your support for whatever they decide, including suicide. This can work when they then realise that you will regard their decision as honourable, whatever it is.

The warning signs of depression are lack of appetite, poor sleep pattern, loss of interest in whatever the person usually enjoys, lethargy and exhaustion. A tidy desk that suddenly becomes untidy, an unexpected and uncharacteristic obsession with television or the computer, tendency to be reclusive and not want to meet people. Stress, for reason or no reason, is a major cause. These are, of course, also signs that someone is physically ill.

Depression is illness but not always the sort that medication will solve. Newfound fear of death following a close call may bring on depression. Loss of money and security is a big factor, too. Inward-looking experiences that we all have to some extent – and from time to time – are potential triggers to a negative view of life. When they become excessive we are at risk of turning our thoughts to suicide.

Professional organisations like the Samaritans do a fantastic job. Their remit is to prevent suicide. Certainly preventing rash, unthinking suicides is hugely valuable. But preventing a suicide doesn’t always tackle the cause of the problem. Like the Samaritans, whoever deals with a suicide watch needs to keep close contact for what may be a long time afterwards. Getting someone to realise their self-worth is no quick fix.

You can’t play with people’s lives. They are valuable and precious. Being prescriptive with them would imply God-like abilities none of us has. We do have the ability to reason, to pay attention and to explain why self-worth exists even for the wildest, most colourful life.

Most of all we can do what a potential suicide wants more than anything else. We can deeply care. Mother Teresa used to say she cared for the one in her arms.

When someone knows they are ‘the one in your arms’ you have done your very best.