World Mental Health Day 2019
“According to the WHO, more than 800,000 people die by suicide a year, making it the principal cause of death among people fifteen to twenty-nine years old…. The object of making suicide prevention the theme of World Mental Health Day in 2019 is to attract the attention of governments so that the issue might be given priority in public health agendas around the world……Getting people to talk about a subject that tends to be taboo and about which many hold mistaken and prejudiced ideas will help the community to learn about the risk factors so that they can identify and learn to address them…. oftentimes, people who suffer from mental illness lack access to mental health services, sometimes because there are no services in their community and sometimes because they must wait months to be seen.” – Dr. Alberto Trimboli, President, World Federation for Mental Health
Find out more here: https://wfmh.global/world-mental-health-day-2019/
According to the ONS, 6,507 deaths by suicide were recorded in the UK in 2018, with the highest rates in Scotland and Wales, and roughly 75% of UK deaths by suicide being men. 
|Risk factors||Protective factors|
|Societal||• difficulties accessing or receiving care|
• access to means of suicide
• inappropriate media reporting
• stigma associated with mental health,
substance abuse or suicidal behaviour which prevents
people from seeking help
|• the ability to easily access effective mental health support
and treatment when needed
• experiences of trauma or abuse
• experiences of disaster, war, or conflict
• experiences of discrimination
|• being in full-time employment
• having supportive school environments for children and young people
|Relationships||• isolation and lack of social support|
• relationship breakdown
• loss or conflict
|• having strong and supportive social connections (such as positive
relationships with family, friends, partners etc.)
|Individual||• previous suicide attempts|
• self-harm behaviours
• mental ill-health
• drug and alcohol misuse
• financial loss
• chronic pain
• family history of suicide
|• problem-solving skills and coping skills that help people to manage
in difficult circumstances
• feeling hopeful or optimistic toward the future even in times of stress
Roughly 1 in 10 young people will self-harm at some point. While many people who engage in self-harming behaviour do not wish to die, there is research to suggest that individuals who self-harm are at an increased risk of attempting or completing suicide. As such, anyone who self-harms should be taken seriously and offered help.
MIND describes potential causes including that any difficult experience can cause someone to self-harm. Common reasons include:
- pressures at school or work
- money worries
- sexual, physical or emotional abuse
- confusion about your sexuality (see LGBTQ mental health)
- breakdown of a relationship
- loss of a job
- an illness or health problem
- low self-esteem
- an increase in stress
- difficult feelings, such as depression, anxiety, anger or numbness
MIND also provides advice on how to help yourself now as well as long term help if you are self-harming. Guidance exists on seeking help through the NHS, as well as through organisations that offer support and advice for people who self-harm, as well as their friends and families.
- Samaritans – call 116 123 (open 24 hours a day), email email@example.com, or visit your local Samaritans branch
- Mind – call 0300 123 3393 or text 86463 (9am to 6pm on weekdays)
- Harmless – email firstname.lastname@example.org
- National Self Harm Network forums
- YoungMinds Parents Helpline – call 0808 802 5544 (9.30am to 4pm on weekdays)
- Full NHS list of Mental Health Helplines
Symptoms and Causes
It is normal to feel down for short periods of time; most people will experience ups and downs from time to time. However, depression can be an illness needing treatment when symptoms are more severe, last longer and occur frequently.
Symptoms of Depression include low or irritable mood, inability to enjoy day-to-day life, decreased or increased sleep or appetite, feeling hopeless, helpless or worthless, decreased energy, attention or concentration, and in severe cases thoughts of self-harm or suicide.
Depression can start after a specific event in your life (e.g. perceived or actual rejection after an audition, financial difficulties, unemployment, anticipated retirement from dance) or if you have a genetic vulnerability. It might be caused by your tendency to have negative thought patterns or may involve an imbalance in brain chemicals. You may get depressed after an injury as your inability to dance might affect your self-esteem and identity as a dancer.
Effects on dancers
Depression can affect your performance as a dancer, especially if you are not sleeping or eating well, have negative thoughts, poor motivation, or if you cannot concentrate. It can also increase your risk to injury as you may not be able to concentrate, may be less alert, may be distracted and indecisive, responding more slowly, making poor judgements, or your body might not be in its best condition because you may have been eating or sleeping poorly.
Dancer-specific treatment issues
Most people with depression are treated by their GP who may suggest self-help, talking treatments or antidepressant medication. Antidepressant medication is helpful in more severe depression cases but may have side effects (e.g. weight gain or sedation) that you may feel might affect your performance as a dancer. Talk to your doctor about it so that the antidepressant prescribed is suitable to your needs.
If you are depressed, it may or may not be beneficial to continue dancing before you get better. You may feel that pressure to dance or disappointment from poor performance might increase symptoms of depression. On the other hand, you may feel that stopping to dance might increase symptoms of depression because of the loss of identity as a dancer, loss of sense of achievement and decreased self-worth. A healthcare team should make this decision, involving you in the discussion. The decision should be based on what is best for you.
Suicidal thoughts should always be taken seriously and require immediate response (see GETTING HELP below).
- Effective health care
- Connectedness to individuals, family, community, and social institutions.
- Life skills (including problem solving skills, coping skills, and resilience (the ability to adapt to change, stress and adversity)
- Self-esteem and a sense of purpose or meaning in life
- Cultural, religious, or personal beliefs that discourage suicide
Crises and Emergencies
A mental health crisis can involve severe emotional distress or anxiety, inability to cope with day-to-day life or work, thinking about suicide or self-harm, or experiencing hallucinations and hearing voices. A crisis can also be the result of an underlying medical condition, such as confusion or delusions caused by an infection, overdose, illicit drugs or intoxication with alcohol.
If you are dealing with a mental health crisis or emergency you can call NHS 111 (for urgent but not life-threatening medical concerns) to speak to a fully trained adviser, or ask your GP practice for an urgent GP appointment, or visit accident and emergency (A&E), or Call 999 (for acute life-threatening mental health emergencies). You can also call the Samaritans on 116 123 or Saneline on 0300 304 7000 (4.30pm to 10.30pm). If you want to talk to someone right away, the mental health helpline page has a list of organisations you can call for immediate assistance.
If you are worried about a relative or a friend, encourage them to speak to their GP. If you are very worried about someone who is very unwell or a risk to themselves or others, you can ring NHS 111.
Dr Nicoletta P Lekka, MD, MSc, PhD, Consultant in General Adult Psychiatry, Honorary Senior Clinical Lecturer, Accredited Coach
RESOURCES ABOUT SUICIDE PREVENTION AND SELF-HARM
- International Association for Suicide Prevention (IASP) Resources https://www.iasp.info/resources/
- Are You Feeling Suicidal? How to Deal with Suicidal Thoughts and Feelings and Overcome the Pain https://www.helpguide.org/articles/suicide-prevention/are-you-feeling-suicidal.htm
- Suicide Prevention. How to Help Someone who is Suicidal and Save a Life https://www.helpguide.org/articles/suicide-prevention/suicide-prevention.htm
- Self-harm (MIND). Explains self-harm, including possible causes and how you can access treatment and support. Includes tips for helping yourself, and guidance for friends and families https://www.mind.org.uk/information-support/types-of-mental-health-problems/self-harm/
- NHS – Self-harm. Browse to find the video where an expert explains why young people may self-harm, and describes some of the different forms it can take. See Signs, Causes or Treatment. https://www.nhs.uk/conditions/self-harm/
Also “Sink or Swim: Our underwater dance film tackling mental health stigma”(MIND) https://www.mind.org.uk/information-support/your-stories/sink-or-swim-our-underwater-dance-film-tackling-mental-health-stigma/