When It Is Darkest Why People Die by Suicide and What We Can Do to Prevent It

An evidence-based self-help book on understanding and preventing suicide.

When you are faced with the unthinkable, this is the book you can turn to.

Suicide is baffling and devastating in equal measures, and it can affect any one of us: one person dies by suicide every 40 seconds. Yet despite the scale of the devastation, for family members and friends, suicide is still poorly understood.

Drawing on decades of work in the field of suicide prevention and research, and having been bereaved by suicide twice, Professor O’Connor is here to help. This book will untangle the complex reasons behind suicide and dispel any unhelpful myths. For those trying to help someone vulnerable, it will provide indispensable advice on communication, stressing the importance of listening to fears and anxieties without judgment. And for those who are struggling to get through the tragedy of suicide, it will help you find strength in the darkest of places.

Rory O'Connor is a Professor of Health Psychology at the University of Glasgow where he leads the Suicidal Behaviour Research Laboratory. He is a world leader on suicide research and prevention and has been working in this area for 25 years. In January 2021, Rory became President of the International Association for Suicide Prevention (IASP) and he is also a past President of the International Academy of Suicide Research (IASR). He has published extensively in the field of suicide and self-harm and has contributed to six BBC documentaries on suicide. You can find him on Twitter: @suicideresearch

Introduction 1

Part 1 Suicide: An Overview 15
   1 The How, Who and When of Suicide 17
   2 What Suicidal Pain Feels Like 35
   3 Myths and Misunderstandings 47

Part 2  Suicide Is More About Ending the Pain Than Wanting To Die 65
   4 Making Sense of a Suicide 67
   5 What Suicide is Not 79
   6  Towards An Integrated Understanding of Suicide 87
   7  The Integrated Motivational–Volitional  Model of Suicidal Behaviour 101
   8  Crossing the Precipice: From Thoughts  of Suicide to Suicidal Behaviour 141

Part 3  What Works to Keep People Who Are Suicidal Safe  185
   9 Brief Contact Interventions 187
  10 Safety Planning 193
  11 Longer-Term Interventions 213

Part 4  Supporting People Who Are Vulnerable to Suicide or Bereaved by Suicide 227
  12 Asking People About Suicide 229
  13 Supporting Those Who Are Suicidal 241
  14 Surviving the Aftermath of Suicide 259

Epilogue 275
Resources 277
Acknowledgements 285
Endnotes 289
Index 339