Suicide Prevention
Interview with Amanda Stinton
I chat with Newborn Mothers educator Amanda Stinton from Our Fourth Trimester, who teaches the module on mental health in our Postpartum Education and Care Professional training. Together we discuss the importance of normalising conversations about maternal suicide, how to talk to someone having suicidal thoughts and where to find support. At the core of this conversation, we explore how we can be a helper, ready and willing to assist people who might find themselves in that place.
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About Amanda
Amanda is a perinatal social worker, author and illustrator. Amanda has worked for almost two decades contributing to improved mental and emotional wellness for individuals and communities, in counselling, education and consulting roles. After entering motherhood, Amanda founded her own private perinatal social work practice, Our Fourth Trimester, where she provides holistic parent-baby well-being consultations, preparing and planning for birth and the fourth trimester and ongoing support after birth.
We explore the following questions:
Can you tell us why its important that we start these conversations about preventing maternal suicide?
What else can we do? How can we be helping people in that space?
How do you navigate asking somebody if they're having thoughts of suicide?
What can we do to take care of ourselves when we're caring for someone else and it's starting to affect us too?
Can you tell us the difference between Lifeline and the Suicide Call Back Service? Where is the best place to start?
Tell us a little bit about your perinatal space that you've set up in Darwin.
Additional resources we spoke about:
Our Fourth Trimester: https://www.ourfourthtrimester.com/
Living Works: http://www.livingworks.com.au
Lifeline: https://www.lifeline.org.au
Suicide Call Back Service: https://www.suicidecallbackservice.org.au
The Conversation: https://theconversation.com/factcheck-is-suicide-one-of-the-leading-causes-of-maternal-death-in-australia-65336
Women’s Health Australia: https://www.alswh.org.au/shorthand/perinatal-mental-health/
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Transcript
Julia Jones:
Hello and welcome to the Newborn Mothers Podcast. Today, we are talking about a topic that most people feel very uncomfortable talking about, but something that is actually very important for us to talk about, particularly if we are working or living in the postnatal area. If we work with mums or if we are mums, it's really, really important that we start talking about suicide. A heads-up that today, we will be focusing on suicide prevention and won't be going into any details about specific suicides that have occurred, but if you do need any more support, please do call Lifeline and we'll also be providing some more resources for you at the end of the podcast and in the show notes.
I've got Amanda with me today who is a social worker, and she has 10 years of experience in counselling and mental health education. She has also worked for six years as a trainer for LivingWorks Australia, facilitating suicide intervention workshops. Amanda, I know through our work together, she is a graduate of Newborn Mothers Collective. She's also the founder of the Perinatal Space, which is based in Darwin, which provides individualized support throughout pregnancy, preparing to parent and postpartum, really designed to prevent problems and promote peace.
We talk about suicide in our postpartum work because many people don't realize that suicide is the leading cause of maternal death in Australia and actually in many developed countries around the world.
Amanda Stinton:
Sure. Thanks, Julia. Thank you so much for having me on your podcast. I think you've done a wonderful introduction of me, and I'm really, really excited to talk to you, I guess, with an overarching theme of hope about this topic. You're right. A lot of people are often very hesitant to have conversations about it, but it's so important and I'm glad we've got an opportunity to do that today.
Can you tell us why it’s important that we start these conversations about preventing maternal suicide? (02:40)
Julia Jones:
Yes. It's something that's very important to me and something that I think we really need to start talking about. And there is actually a lot of research showing that we do need to start talking about this topic. So can you tell us why that's important that we start these conversations?
Amanda Stinton:
Yeah, for sure. So I think I'm really lucky that in my training when I get to work with participants and have conversations about suicide, it often really comes up that it's not something that is talked about often. One of the really good things that we find that comes out of having conversations is that it can actually destigmatize and demystify suicide because what we know is that if there is less stigma around suicide, meaning, if people are more accepting and willing to look for assistance, then that is going to reduce the risk that people have. Also, when we demystify it, it makes people more likely to provide assistance to somebody who might be in need. So it's really important to talk about it for those two reasons, really.
Julia Jones:
Yeah. I loved some info you sent through before we were chatting about how it's important to see mental health as a spectrum and that it's actually quite common for people to have thoughts of suicide. I think when we know that, it changes the way that we feel, instead of feeling ashamed, we might be more likely to reach out for help. As a person working in an at-risk group, anyone who's listening to this podcast who works with mothers, whether before, during pregnancy or after pregnancy but then in that whole stage of life, that is a time when people are at increased risk of suicide.
Amanda Stinton:
You're right. It is important to note that there are groups amongst our population that are going to be statistically more at risk of suicide than others. But probably the biggest piece of advice I can give, which is actually really simple, is to focus on the individual that is in front of you and just have a conversation with them because, at the end of the day, the statistics have no bearing on that when you're talking about an individual person.
I think the point that you made about mental health exists on a continuum is really important because we know that from the statistics, and I hate talking about statistics but it is quite necessary sometimes to do with this topic, but we can gather that in Australia at any particular time, one in 20 people would be thinking about suicide. So when you think about it like that, it really does help to destigmatize because it just draws attention to the fact that it is, we'd love for the number to be lower, but it is a part of the human condition. And having thoughts of suicide, thoughts can come and go and they don't dictate who you are. They're simply a thought. So it's really important to just be present with the person that's in front of you and be respectful of them and their needs at the time.
Julia Jones:
Yeah. Just on a side note there, I noticed that one of the reports you sent through, and I'll try and include the links in the show note, but it was showing that in the public health system in Australia, women were a lot more likely to be asked about their mental health than women who are in the private hospital system. I was surprised by that.
Amanda Stinton:
Yeah, me too. I guess that's one of the things that I'm not a statistician and statistics are really interesting, but what's behind that? I'm not quite sure. Perhaps it could be particular training that professionals in the public sector are receiving that is different to public, but I'm not an expert in that area. I couldn't say, but it is interesting and it is important to consider.
What else can we do? How can we be helping people in that space? (07:15)
Julia Jones:
Yeah. In this space, what else can we do? I think you gave an analogy about a river. Can you talk about that a little bit as a way of understanding how we can actually be in that space and be helping people?
Amanda Stinton:
Yeah, for sure. So I guess just importantly to give a bit of a plug to the organization that I work for as a casual trainer, LivingWorks Australia, they use an analogy of a river in their training. It's really good because what it does is it shows us that if we think about a river and in environmental terms, it has contributaries or things that different waterways that flow into it and eventually, that river flows out into the sea. There are many things that can occur for us in our day-to-day lives that might cause us distress and may cause us to start thinking, having thoughts of suicide. So things like relationship breakdowns, financial pressures, a whole host of things that are going to impact different individuals in different ways. Then what can happen is that having these difficulties don't necessarily mean that someone is going to be thinking about suicide, but they can. Then once they start thinking about that, they go into the river of suicide whereby flowing down thoughts can lead to actions or behaviors and that can ultimately result in death.
So if we think about a river and a river having banks, what I guess our hope is through providing training right across Australia through LivingWorks Australia is that we want to increase the amount of people that are standing on the edges of those banks that are ready and willing and able to provide assistance to people that might find themselves in that river.
It's not dissimilar to physical first aid training, I suppose, in that if you do the DR A, B, C, D and intervene with somebody who might be having a heart attack, you're not expected to provide ongoing treatment and care to that person. You just actually helped in that particular time to keep them safe at that moment and then other people could come in and continue this care and support. So that's how the river analogy works. I hope it made sense.
Julia Jones:
Yeah, I love it. I really love it because it takes a lot of pressure off us, although some people listening to this podcast might have training in suicide prevention, but a lot of people listening to this podcast are much more in that space just as a support person, it might feel too overwhelming to take responsibility for someone's suicide. And you can't do that, and you're not trained to do that. But I love the idea that you could still just be one of hopefully many positive people standing on the bank and just helping them along that moment in their path.
Amanda Stinton:
Yeah, because the interesting thing that we do find out from talking to people and collecting data on this is that when you ask people what kind of person they're most likely to go to if they were having thoughts of suicide themselves, I don't know whether some people find this surprising, some people don't, but more often than not, it's not a professional. So if you're feeling really down and feeling like things are getting overwhelming and maybe suicide is on your mind, more often than not, people are wanting to reach out to a friend or a family member or someone who's just a friendly, caring face and less often going down immediately, anyway, going down perhaps the social worker, psychologist, GP route. So that's why it's actually really important that all of us, not just professionals, have a bit more of an awareness around suicide and how to help.
Julia Jones:
So if someone does come to us and tell us how they're feeling and we don't feel overwhelmed by that and we know what to do about that. I imagine obviously referring people is important but also your immediate response at that moment is also important.
How do you navigate asking somebody if they're having thoughts of suicide? (11:55)
Amanda Stinton:
Yeah, definitely. It probably brings me to a really interesting topic to talk about when you talk about suicide, and I guess it's that thought of asking the question that people are really, they feel really icky about, they're really unsure, and it is. It's a really scary thing to ask somebody if they're having thoughts of suicide.
But if you can imagine for somebody who might be feeling that way, it's actually really difficult to just come right out and say it. It's because of that stigma that does still exist and because of the uncertainty of, ‘Oh, I'm not really quite sure how this is going to be perceived if I do say it.’
In the training, we dedicate a lot of time because it's really important, so letting people know that it really is okay to ask somebody if they're thinking of suicide. You're not going to put the idea in their head. What we see, for those of us that have asked the question many a time, often find is that when you do you see a big sense of relief rush over the person's face because somebody has finally picked up on what's going on for them. Then they're able to move. If you don't know what you're dealing with, then you can't deal with it, can you? So it's really important.
Julia Jones:
Yes, I really think that's so important and such a simple and valuable thing that we can all start doing almost routinely in the way that perhaps the public hospital have it built into their training and their systems that they routinely ask these questions. I think it's important that we can start doing that too.
I can imagine that sense of relief. What I hear a lot from families who have lost someone to suicide is that they're really shocked and often, they have no idea that the person was feeling that way. It is hard if you were the person having those thoughts to be the one who's responsible for admitting that to someone and not necessarily knowing who's going to be a safe person to talk to that about without feeling ashamed or being blamed or any of that kind of thing. Even if they don't answer straight away, ‘Yes, I'm having those thoughts’, they know in the future if that comes up for them that there's someone safe they can go to.
Amanda Stinton:
It reminds me, too, a little bit of when we look at our current postpartum care practices that are available for women around Australia and in other parts of the world, I often find myself talking to parents, saying that perhaps you live in a time and a society whereby the care that you deserve is perhaps not forthcoming to you so in a way, it's up to you to seek it. We do that in the training as well a little bit in that it would be great if there was less reluctance for people to ask the question about suicide.
But because that does exist, we actually do a lot of work with people on if you are thinking of suicide, what's a way that you can clearly tell somebody and get the best support possible? Who are the key people that you can tell and how can you say it to make sure that you are heard?
Recognizing that if one in 20 people are thinking of suicide, and this often comes up in the training that we do, there are a lot of people that are actually helpers that have been in that boat themselves as well and might find themselves in that boat again. So it's about skilling us up to help others but also really importantly, to help ourselves as well.
Julia Jones:
Yeah, absolutely. Because suicide is more common in certain communities and certain families then often the person who has those thoughts, probably it's likely they know someone else who's also having those thoughts.
Amanda Stinton:
Yeah, that's right. So humans are tricky but we do what we can.
What can we do to take care of ourselves when we're caring for someone else and it's starting to affect us too? (16:16)
Julia Jones:
Yeah. That can be a really hard position to be in being a helper. So what can we do to take care of ourselves in those kinds of moments when we're caring for someone else and it's starting to affect us too?
Amanda Stinton:
Yeah, definitely. I am somebody who's really, really passionate about self-care, and I almost hate saying it in that way because there are a lot of things floating around about self-care that aren't particularly that helpful. But we do know that if you are not looking after yourself, then you're not in a good spot to therefore look after other people.
I don't know if you've heard of it, Julia, you probably have, lots of people have, but have you heard of Steve Biddulph, who's a developmental psychologist?
Julia Jones:
Yeah.
Amanda Stinton:
He's written a couple of best-selling books, I think, Raising Boys and Raising Girls. I was lucky enough to have a chat with him a few years ago now. He gave me a really great analogy about self-care that anybody who works with me now, chances are they've heard it, but he said to think of yourself as a tree with a root system. So again, a little bit like the river analogy, you'll have to work with me here, but if you think of really big, strong trees, perhaps even the kinds of trees that people tie swings on to swing on that they're that sturdy, what they have underneath the ground is really strong, deep, interconnected root systems.
It's a really good idea to think about our self-care practices as strengthening those roots of our tree because unless we're looking after ourselves down below the surface when people perhaps, at the moment we're talking about people who might be thinking about suicide and looking for assistance, then if they cling on to our branches for support, which is, again, as mothers, you've got lots of people clinging to you all the time for support, then they can be flung off if our root system isn't really under control and looking after itself as well. So it's a really good way to look about that self-care isn't actually just for yourself. It benefits everyone around you.
Julia Jones:
Yeah, I love that. And if you've got longer roots, they can reach more people.
Amanda Stinton:
Yeah, for sure.
Can you tell us the difference between Lifeline and the Suicide Call Back Service? Where is the best place to start? (18:59)
Julia Jones:
Yeah. Beautiful. Now, I know you've got a great blog post on self-care, so we'll share that in the show notes too. We just have two last resources to talk about. One is Lifeline, and the other is the Suicide Call Back Service. Can you tell us the difference between them? If anyone listening to this has found this content distressing or needs to talk further about it, where is the best place to start?
Amanda Stinton:
I think really commonly, there isn't a single person on the planet, living in Australia at least, who hasn't heard of Lifeline being tacked onto the end of lots and lots of different television programs and various things. It's for sure a fantastic service, but what we often find is that people don't really know much about it or how it works.
One of the really good things to do if you do find yourself being a helper to somebody who's at risk of suicide or feeling perhaps a bit that way yourself, it's really good just to give Lifeline a call and find out, what are they about? If I have somebody who's in need of assistance, what happens when you call? Because people are reluctant to use things that they don't understand.
One of the things about Lifeline that I think is really great is that every single person who answers the phone is actually trained in this workshop that I've referred to throughout the podcast, called ASIST that's run by LivingWorks Australia. They all have a pretty detailed understanding of how to have a conversation with somebody about suicide and how to help them get that safety to move on to the next step. So Lifeline is really awesome.
Julia Jones:
Sorry, I'll just pause you on there. Are you saying that people could even call in a preventative way? So if someone thinks they might be coming into a stage of their life that's going to be tricky, then it's a good idea to call Lifeline before you get to crisis point just so that you are familiar with that system and it makes the callback easier the next time around when you really need it.
Amanda Stinton:
Yeah, definitely. People can certainly do that.
Julia Jones:
Yeah. Cool. I love it. Tell me about the Suicide Call Back Service.
Amanda Stinton:
The Suicide Call Back Service works a little bit differently. It gives the service that it provides away in its title. You can call the service, and I think you can now even, I don't know about text but I'm pretty sure that you can email them to set up an appointment that you can have a conversation at a time that suits you. You might be going, ‘I know that this week is going to be a rough one’, and you can schedule in your call with somebody from the Suicide Call Back Service.
The other thing that a lot of people often don't know about that service is that it's also for the helpers. So if you're concerned about somebody or if you need to debrief after having a conversation with someone about suicide, then the Suicide Call Back Service is for helpers as well.
Julia Jones:
That's great. I just checked their website. You can call. They have online chat and they also have video chats, so that makes it really accessible. I think the idea of scheduling a call is great because I know if anyone is working in this space, I'm sure you've had experiences where you've had really tricky clients and you've been really unsure about the best way to move forward. Sometimes you even feel anxious about your next visit with them and how you're going to cope with that. So you could even book a call for after a visit. So say you're going to see a client who's in trouble, you can book your call for straight afterwards so that you can debrief with someone and get some strategies for your next visit.
Amanda Stinton:
Yeah, for sure. That sounds like a great idea.
Julia Jones:
Yeah. Cool. Okay. There's such good resources to share, so we'll make sure we pop them up in the show notes. I guess the last thing I want to add is just making sure that everyone understands that it is very common. That doesn't mean that it's good, but it's very common to have thoughts of suicide or even just mental health challenges at various stages throughout your life, and it's a really, really good idea to reach out and talk to people around you. Whether that is a professional or a hotline or a friend or a doula or a family member, it's a great idea to reach out, both as someone who's experiencing that difficulty and as someone who's perhaps noticing that someone else is going through a difficult stage.
Amanda Stinton:
Yeah, for sure, because we're not our thoughts. We often talk about that. You hear that a lot if you listen to any mindful meditations and things, it's quite common. Thoughts of suicide are exactly that. They're thoughts, and it's important to realize that they don't own you.
Julia Jones:
Exactly and if one in 20 people think about suicide, that sounds like a huge number, but obviously one in 20 people aren't actually following through on those thoughts, and that's important to know too that even if you have these thoughts, that doesn't mean that you're going to follow through on them.
Amanda Stinton:
Yeah.
Tell us a little bit about your perinatal space that you've set up in Darwin. (24:26)
Julia Jones:
Cool. Do you have anything to add, Amanda? Maybe tell us a little bit about your space that you've set up in Darwin.
Amanda Stinton:
So it's evolved. I guess my social work practice has evolved very much into the perinatal space since having my own son almost two years ago now and just going, "Oh geez. This is such a massive transformative time that there are lots of things that I know that I'm well resourced to provide people with to help them out." I've spent a lot of my career working with teenagers in high schools and funnily enough, it's a bit of a similar transition. If you follow that matrescence thing that Dana Raphael, who I know is somebody that you've read a lot about and really admire, it's such a transformative time for parents but especially mums. Mental health is one aspect, but I'm very much focused on prevention and the things that we can do to just make the time as amazing as it can be. It is amazing, and yeah, I'm really passionate about it.
Julia Jones:
Yeah, that's great. Thank you. Do you have anything else you want to add?
Amanda Stinton:
No. All good.
Julia Jones:
Awesome. Thank you so much. Just as you were talking and I was thinking, I don't know if it was Dana Raphael who coined the word matrescence, so if someone wants to correct us. I think it might have been someone else. I don't know.
Amanda Stinton:
I've read it somewhere but I read it one or two places.
Julia Jones:
Maybe it was her. Yeah, it's definitely getting to be a big thing now.
Amanda Stinton:
Yeah, for sure.
Julia Jones:
That people are understanding that transition more, and I think that's really cool that people are really recognizing that. Then big change is, obviously, I always say this, change often includes grief so people don't often talk about that. You talk about a change as being a good thing, and obviously it can be a good thing, but sometimes letting go of an old part of yourself or an old way that you used to live, that can also involve some feelings of loss as well. So it's a really emotional time, and I think people can do with a bit of extra support and someone who understands what they're going through. So I think that's great that you've set up that space in Darwin.
Also, before we started this podcast, we were talking about the suicide rates around Australia, and it turns out that WA where I live is one of the highest and Northern Territory where you live is the highest rate of suicide of anywhere. I think in Australia, it's important to mention when we're talking about suicide that perhaps and probably those statistics are so high because of the remote and Aboriginal populations are larger in those states, so Aboriginal people are more at risk of suicide. I think that's something we really need to work on as a country.
Amanda Stinton:
Yeah, for sure.
Julia Jones:
Thank you so much, Amanda. Thank you for bringing your expertise. It's not something that I'm skilled at talking about, so I really appreciate being able to bring you in for that. Thank you so much for sharing everything on our podcast.
Amanda Stinton:
Thank you. One last thing to end it on this, but I'll tell you, I'm not an expert on suicide. I'm not an expert on a lot of things, but I think that it's really important just for us to learn from each other. I say this in training all the time, very much that I'm not here with an expert hat on that. I always learn things in training every time I do it from a participant in the group. It doesn't have to be a big, scary thing.
Julia Jones:
Yes, I love that. I love that. Everyone knows I'm not a huge fan of the expert of things, but a much better way of saying it is that you're a helper on the bank of the river and now you're showing us how we can be helpers on the bank of the river too.
Amanda Stinton:
Yeah. Cool.
Julia Jones:
Awesome. Thank you, Amanda.
