Care to QPR: How suicidal distress can show in men

Mr Ellis, 56, first experienced suicidal thoughts at about the age of eight and now works in suicide prevention for Roses in the Ocean, the national organisation for lived experience of suicide.

He is also a member of the Illawarra Shoalhaven Suicide Prevention Collaborative.

Read more: In just one hour, you could learn to save a life from suicide

"I'm a survivor, I've cared for people who are in distress, my kids live with suicidal thoughts, I live with continuous suicidal thoughts," Mr Ellis said.

"I've lost way too many people to suicide, so family, friends, colleagues."

While it sounded "a little unusual", he said, "suicide's a normal topic of conversation around our dinner table, it always has been".

Men are more likely to die of suicide than women, accounting for over 75 per cent of the 477 lives lost to suicide in NSW this year.

Nationally, men aged over 85 years have the highest age-specific suicide rate for males, even though they account for the smallest proportion of male suicides; meanwhile, those aged 50 to 54 have the highest suicide rates of those aged under 80.

Mr Ellis said there were "so many different drivers".

For older men around retirement age, he said, they might think about not achieving what they set out to do when they were younger; some became socially isolated after losing their partners.

Mr Ellis said the physical changes that came with ageing could also be difficult.

"Men quite often like to think of themselves as really strong and virile and able to take on the world. There's a certain point in time for everybody where that diminishes and you start to maybe think about what the future holds," he said.

Read more: Budget will include $22m for Wollongong Hospital upgrade, says health minister

Other potential factors leading to suicidal distress in men can include financial stress, lack of access to children, and Family Court issues.

For his part, Mr Ellis traces his suicidal thoughts back to childhood trauma.

He said it was a misconception that the majority of people who experienced suicidal distress or died by suicide had on ongoing mental health issue.

"Suicide is incredibly complex. It's not just a matter of giving up, like not having the desire to live," he said.

Illawarra Shoalhaven Suicide Prevention Collaborative project manager Clare Leslie said there was a long-standing belief in Australian culture that men should uphold traditional masculinity by staying brave, strong and stoic.

"We understand that it may also be those very traits that make it difficult for men to reach out for help - particularly when seeking help requires vulnerability," Ms Leslie said.

Mr Ellis said there was "a little bit of a myth that men don't reach out for help".

"They actually do, but maybe it's in a more subtle way," he said.

Generational differences, he said, could change how people showed they needed help, but often isolating themselves in some way was part of it.

Mr Ellis said reaching out for support could also take the shape of risk-taking behaviour.

"So if you see someone changing their behaviours, it could even just be somebody asking to talk to you," Mr Ellis said.

The stigma attached to suicide can stop men - and people more generally - from feeling able to put their feelings into words.

"We know that the issue of suicide is complex and individual. But we also know that improving the overall mental health and social connectedness of men can reduce the risk of suicide," Ms Leslie said.

Mr Ellis acknowledges that asking someone if they are thinking about suicide can be a confronting question to pose.

As part of the Mercury and Illawarra Shoalhaven Suicide Prevention Collaborative's campaign Care to QPR, community members are invited to take up a free, one-hour online course that gives them the skills to 'question, persuade and refer'.

It teaches people how to identify the warning signs that someone might be thinking about suicide; confidently ask a person if they are thinking about suicide; and connect them with appropriate support.

Read more: How's your mental health? I asked the Illawarra's mayors

"It's OK to let someone know you have noticed they are struggling and ask them if they are experiencing thoughts of suicide," Ms Leslie said.

"By completing the one-hour online QPR training course, you can be better prepared for that conversation."

Mr Ellis said a key part of helping someone thinking of suicide was simply "sitting with them in their distress" and giving them space to talk.

"If you're with someone and they're having thoughts of suicide or in suicidal distress, and they're communicating with you, realistically in that moment they're safe. So there's no immediate need to... grab the phone, hit the panic button, do anything, or say you've got to call emergency services," he said.

"I'd be exploring what's happening for them."

Signs that you or someone you know might need support include:

Mr Ellis is now at the point that he can recognise some suicidal thoughts as simply that - thoughts.

Other times he finds himself in a more deep-seated anguish, but he has put in place strategies to help manage any suicidal distress.

Mr Ellis has chronic pain and knows that when his pain increases and his sleep decreases, his thoughts of suicide rise.

When that happened, he said, he knew he had to keep an eye on other aspects of his wellbeing: ensure he was eating well, drinking plenty of water, and exercising.

Mr Ellis said he also had people around him he could talk to, the main one being his wife, and he had good support mechanisms with his psychologist and psychiatrist.

To sign up for one of 500 free QPR courses, so you can identify signs of suicidal distress and offer support, visit www.suicidepreventioncollaborative.org.au/training/question-persuade-refer.

Reading this on mobile web? Download our news app. It's faster, easier to read and we'll send you alerts for breaking news as it happens. Download in the Apple Store or Google Play.