What can we do about taboo? Keeping mental health and suicide in the dark is killing young people

Taboo condemns us to ignorance and to repeat our failures through a lack of understanding. Photograph: On Mute by Katie Tegtmeyer on Flickr (License) (Cropped)

It is the mark of a free society that it tackles difficult questions openly. It braves the scrutiny of public debate for those matters that might otherwise have been hidden and emerges the wiser for it.

The closed and stifling world of taboo, by contrast, keeps uncomfortable matters closeted away, where it can ignore them. In doing so, however, there comes the greater risk of not understanding them.

In few areas is this more damaging than when it comes mental health. The stigma and discrimination, and the shame that follows, keeps mental health, and not least suicide, from being understood - preventing effective disclosure, diagnosis and treatment in the light of reason.

And this is no small matter. According to World Health Organisation numbers, by 2014, 800,000 people died by suicide each year. That is a huge number of people dying in a manner that is not widely understood, because taboo keeps it in the dark.

These taboos touch on every aspect of our lives and not least upon the lives of young people. In 2014, suicide was the second most prevalent cause of death amongst those aged 15-29 (Baker & CNN, 2014).

In the UK, the impact of suicide is even more profound. For Britain it is the number one cause of death amongst young people - in 2014, 1,556 young people under the age of 35 ended their lives. Even that number belies the reality.

Indeed, PAPYRUS believes these figures are the tip of the iceberg. In the UK, suicide has not been a crime since 1961, yet the law demands that coroners use the criminal standard of proof to conclude that a death was a suicide.

One of the frightening things about taboo is that, because it discourages open discussion or admission, it also hides the reality. All of this adds up, and the true number of lives lost to suicide is likely to be higher and attempts higher still.

Talking about suicide does not cause suicide and censoring discussion doesn't stop it. Rather, taboo and its inhibitions prevents what could be lifesaving communication.

The deaths of so many young people has sparked campaigns and led to the creation of organisations, like PAPYRUS in the UK, to help support young people and those close to them in order to prevent suicide.

The question is, how do we start the work of breaking up these damaging taboos?

The start comes in changing our own behaviour. By doing so, we can slowly reshape the world around us with our actions. The first step in that process is to talk.

In the UK, attitudes are clearly changing for the better. Articles pointing out the dangers of mental health taboos are appearing in popular media (Harvey-Jenner, 2016) and celebrities are taking to TV to talk personally about suicide (Ruby, 2015).

The very real momentum can also be seen gathering behind the push to put mental health on parity with physical health. Along with the advocacy of former Health minister Norman Lamb, progressive opinion has aligned with campaign (Perraudin, 2016).

The time has come for mental health to come out of the shadows. It's time for us to face the reality of suicide. Taboos only shut down reasoned debate, block discussion and understanding, and endanger lives.

If you are a young person having thoughts of suicide or if you are concerned that a young person make be at risk, please contact HopeLineUK, which is PAPYRUS’ confidential advice and support service. Call 0800 068 41 41, or Email pat@papyrus-uk.org or Text 07786 209697.

PMQs isn't fit for purpose. But it is the symptom not the disease

Week after week, the noise at Prime Minister's Questions has gotten louder. The half hour sessions have been drowned in noise growing more inconsiderate, more deliberately vindictive, with each passing week. Having to listen to the Conservative benches braying, on live television, to drown out the questions of the opposition, can be an exercise in masochism.

It seems pretty obvious at first look that PMQs is broken. And yet, it fits so perfectly within the Westminster system. That in itself is a sign of a much deeper problem in the British political system.

The essential trouble with PMQs is that it fits in a little too perfectly with the adversarial political culture in the UK. The two sides, the government and opposition, line up opposite to one another to, supposedly, hold the government to account.

The trouble is that this polemic is bias refined, a subjective contest where the government holds one view and thinks it is right and the opposition holds another and thinks it is right. What follows is a sparring match between the unstoppable and the immovable.

That contest is perfectly fitted to the UK's us-versus-them, first-past-the-post and winner-takes-all politics. Two implacable foes, coming from fixed positions having arguments that by their nature cannot be resolved. The government will do what it will and the rest is theatre.

There is certainly am uncontestable need for the public to see, in the flesh, what it is that each side stands for, argued for, hopefully, eloquently - maybe even persuasively. Yet PMQs is one the very few public moments in which there is an opportunity to enforce upon the government - handed extraordinary power in the UK - some kind of accountability.

However, when you cross the two purposes, the party publicity exercise and holding the government to account, only one of them is ever going to win. Accountability is sunk beneath bravado, noise and petty point-scoring.

In Scotland there has been attempt to début a revised First Minister's questions, changing up the system to provide more time for a calmer session with more interrogation. But even that is limited in what it can achieve.

It cannot escape a political culture of fixed adversarial positions and that is expressed, at its worst, in an exercise that is not supposed to be 'political' being consumed by politics.

Ideally, the process of holding the government to account would be something akin to a committee hearing. The Prime Minister would be brought before them and have to give acceptable answers to fundamental questions: What is your government doing? From where does it derive the mandate for that action?

The government's reluctance to put PM David Cameron into the election debates suggests an immediate weakness to this particular alternative: Would the party political machine ever submit to the Prime Minister and the government being put so clearly on trial? Probably not.

Right now the European Union's democracy is under scrutiny. But Westminster's shortcoming shouldn't be swept under the rug. Winner-takes-all makes a mockery of political representation and the adversary system simply reinforces the alienation of citizens from their government - keeping the real business far from the vigilant eyes of those who would want answers to the difficult questions that could hold it to account.