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.

Closed or Global - is that the only choice? South America's political tides hold an important lesson for Europe

Mauricio Macri, Argentina's new globalising President, casting his ballot in 2015. Photograph: Mauricio Macri vota by Mauricio Macri (License) (Cropped)

Europe, after nearly a decade of economic turmoil, seems to find itself on a precipice. Behind lie the shattered ruins of the social democratic consensus and the overbearing shadow of its failing replacement globalisation. Ahead in the darkness is sectarianism: populist, nationalist and authoritarian.

Populism in South America

While wrestling with this seemingly polarised and precarious position, Europe should look to South America. After its own struggles to shake off America imperialism, the Regan-Thatcher neoliberal doctrine, a crisis of poverty and, in parts, conservative authoritarianism, South America saw a popular electoral revolt in favour of populist parties offering social rights.

In obviously varying circumstances, but with some common discontents, from Hugo Chavez's Bolivarian Socialists in Venezuela 1998, to Nestor Kirchner's Peronist Justicialists in 2003, and Evo Morales' Campesino Socialists in 2005, and others in between, a so-called pink tide overturned the neoliberal status quo.

Despite the obvious allusions to socialism, the popular campaigns for social rights where fought within an increasingly closed state system, with overtly nationalist overtones - and frequently at the cost of political rights and transparency. Those who began as reformers faced accusations of endorsing narrow and unshakeable parties of power, with the "typical vices: personalism, clientelism, corruption, harassing of the press" (Bosoer & Finchelstein, 2015).

Populist-Globalist Revolving Door

As social conditions have undermined the globalist response to Europe's crisis, economic conditions have undermined South America's closed populist system. Weak exports have led to a continuing downturn (The World Bank, 2016) - exposing the fact that it is easier to maintain repression if social rights keep being extended along with the money to fund them.

As Europe is increasingly turning from globalism to find populism ahead, South America is doing the opposite. Mauricio Macri, for Republican Proposal party and Cambiemos coalition, presented Argentina with an open globalised alternative to the closed populist nationalist government of the Justicialists in 2015 and was elected President.

But there is little reason to believe that South America's new open global option is likely to meet any less dissatisfaction than it has in Europe, where the 2008 financial crisis, and the sovereign debt accrued in managing it, was seen as an opportunity by the globalised financial sector - ostensibly pressing the idea that governments are not above the law, in order to effectively claim rent on state debt.

Argentina itself already has long experience of wrangling with this system, that has used American courts to try and force state policy on repayment of national debts, accumulated through bond sales. The power of that global finance sector and its power to shape fiscal policy, in effect essentially shaping the economics of entire states, is all too familiar a subject of exasperation in Europe.

The Role of Social Democracy

While South America has struggled for stability between populism and globalism against a back drop of military juntas, in Europe, for a time, there was shelter to be found within social democracy. The social democratic project provided safeguards against either extreme, closed and global, while trying to include the benefits - like social rights and widespread access to capital and investment.

However, the 2008 crisis undermined social democracy. Its adherent parties have been severely weakened, perhaps fatally. Too many times, social democracy chose to back the alienating establishment instead of reforming it and the moderate left, in Europe and South America, found itself shackled to neoliberalism as part of a desperately defended mainstream.

South America's leaders responded to economic pressures by advancing a closed system. Leaders in Europe, after 2008, embraced the global system to overcome its problems. Now, with both under pressure, they seem ready to swap. But neither have proved to be a sound solution.

What is needed is a 'new' social democracy, a replacement for the old and worn out system. But a new balance has to be found. It isn't enough to be a part of the establishment, to be an insider, taking the edge off of its worst extremes. A consensus that recognises the demand for political liberties, civil rights and pluralism alongside social rights, that embraces an open society through internationalism rather than globalism.

Right now, the choice presented to the people of South America and Europe is between closed and global. But it doesn't have restricted to these exclusive polar positions. It is a false and exclusionary dilemma. A better consensus is possible.