Some questions do not disappear with grief. They stay, quietly returning in the middle of an ordinary day, in memories of a conversation, a missed call or a moment that, in hindsight, might have meant something more.
For Sir Sajid Javid, one such question has followed him since July 2018: could he have done something to save his brother? Javid’s brother, Tariq, 51, died by suicide in a hotel near Horsham, West Sussex. Only afterwards did the family discover that he had been living with a physical health problem he had never told them about.
“If we had just known, if he had talked to us, perhaps we could have done something,” Javid said. “Maybe I could have made a difference. And I guess I will never know the answer to that.”
Author and journalist Poorna Bell knows the weight of that question. Her husband, Rob, died by suicide after struggling with heroin addiction and depression. Bell knew about his depression, but never believed he would take his own life.
Her experience reveals a painful truth: knowing that someone is struggling does not necessarily mean knowing how close they may be to crisis.
For Jevanjot Kaur, the crisis was something she experienced herself.
In an account shared by mental health charity Mind during South Asian Heritage Month, Kaur described being diagnosed with bipolar disorder in 2007 following the birth of her first child. She experienced psychosis, was admitted to hospital and later moved to a specialist mother and baby unit, where she was reunited with her child and began treatment.
Yet her journey was not only about managing a mental health condition. It was also about confronting the stigma surrounding mental illness.
Kaur said that in some South Asian communities, conditions such as bipolar disorder can still be associated with beliefs about black magic or karam, the consequences of a past life. Such attitudes can turn a health condition into a source of shame, making people reluctant to tell loved ones what they are experiencing or seek professional help.
The silence can affect entire families.
Kaur described how bipolar disorder affected her marriage and how her husband struggled to find support as a carer. Couples counselling, family education and support from organisations including Sikh Helpline UK helped them understand the condition and each other better.
Following a later episode, Kaur’s negative thoughts escalated and she became suicidal. She withdrew from friends and family for more than a year before finally speaking to a close friend.
That conversation became a turning point.
She went on to use cognitive behavioural therapy, journaling and self-care to understand her triggers and recognise early warning signs. Her story demonstrates that prevention is not always one dramatic intervention. Sometimes it is a network of smaller acts — listening, checking in, seeking treatment, learning the warning signs and making someone feel safe enough to speak.
That need for early intervention is increasingly evident among children and young people.
Figures analysed by the Royal College of Paediatrics and Child Health found that 6,269 children aged six to nine attended A&E with mental health problems last year — a 62 per cent increase since 2019. Overall, 75,491 under-18s attended emergency departments with a mental health concern, up 36 per cent from 2019.
A&E may be a vital safety net, but it cannot become the place where children wait for days because appropriate mental health support is unavailable.
The stories of Javid, Bell and Kaur are very different, but they meet at the same uncomfortable truth: suicide is rarely simple, and prevention cannot begin only when someone reaches breaking point.
It begins much earlier; by challenging stigma, making mental health conversations ordinary, improving access to support and teaching families to recognise when someone may be struggling.
It also begins with being brave enough to ask the question many people fear: Are you okay?
Samaritans stresses that people do not need to be mental health professionals to support someone experiencing suicidal thoughts. A conversation may not fix everything, but it can interrupt isolation and create a moment in which someone feels heard rather than alone.
For those bereaved by suicide, there may never be an answer to the question of whether they could have prevented the death.
But prevention asks a different question: What can we do now?
As World Suicide Prevention Day is marked on September 10, the focus must be on creating communities where people can speak before they reach crisis, where families know where to turn and where asking for help carries no shame.
Spotting the warning signs of distress in young people
For parents, distinguishing between ordinary teenage behaviour and signs of serious emotional distress can be difficult. Withdrawal, disrupted sleep, changing friendships or heightened emotions may appear to be part of adolescence but significant or persistent changes can sometimes signal that a young person is struggling.
With children and teenagers increasingly turning to social media and AI for support, understanding when distress requires intervention has never been more important. Dr Nihara Krause MBE, consultant clinical psychologist and CEO of stem4, explains the warning signs parents should look out for, how to safely talk to young people about suicidal thoughts, and what families and friends can do when a child needs help.
The warning signs parents may overlook or mistake for normal teenage behaviour
It’s easy to miss signs of distress such as becoming more private, changes in friendships, difficulties sleeping, becoming more emotionally volatile in adolescence since these signs are also associated with developmental changes during this time. However, if there is a significant change in the behaviours described, if several of these signs occur together, or if these behaviours increase and start to impact on the young person negatively, then parents and carers should take an interest. Good communication is key. Listen for increasing critical negative self-statements (eg. there’s no point to me), for an increase in high-risk behaviours that are harmful (eg. self-harm, increased alcohol misuse) and significant withdrawal and isolation from things they enjoy. External triggers can be a traumatic experience or a suicide in the family/friend.
Do not rely on performance as a measure of wellbeing. Some highly distressed young people continue to function well.
How parents can have a safe, open conversation with a child about suicidal thoughts
Talk to the young person directly and calmly. Set up some private time to have a chat or several chats. Present the fact that you’ve noticed they haven’t been themselves and then ask clearly ‘have things felt so difficult that you’ve thought about hurting yourself or ending your life?’
Do not minimise distress (‘why are you so sad when there’s so much to live for’) or be critical (‘you haven’t had any silly ideas have you?’)
If they tell you they have had thoughts then keep communicating by connecting to the emotions they feel, confirm you are pleased they were able to open up to you and say ‘it sounds like things are very difficult. Let’s get help together to support you through this.’
Although people worry about talking about suicide since they think it might be suggestible, research shows that talking about suicide helps to feel heard, and to engage in making a change.
The potential benefits and risks of young people turning to social media or AI when experiencing emotional distress
There are pros and cons to social media and AI. AI is immediately approachable especially at unsociable times when the young person may feel at their worst. Similarly online communities can be very supportive especially if the young person is socially isolated. However, digital support needs to link a young person to real life support and to measure risk. Generally young people who can access help in real life will use digital as a backup rather than as a first step or as the sole support.
What a parent, sibling or friend should do if a young person says they are thinking about suicide
Keep connected by talking, being with them. Ask them if they have a plan and if they do, then obtain emergency assessment or help through 111 or by taking them to A&E. If they have thoughts of suicide, feel very depressed or are self-harming then contact your GP and help your young person go to their appointment and help manage follow ups. At a time when psychological intervention is hard to access, parents or carers should advocate for their young person to access help. Siblings and friends should always be supported to approach a responsible adult. Be the parents or carer they are not scared to approach, listen and support. Don’t forget to get some support for yourself too.
Giving British Asian Communities a Language for Suicide
For many British Asian families, conversations about suicide can remain buried beneath generations of silence, cultural expectations and fear of judgement. But Anoo Bhalay believes that before suicide, there is often a long period of emotional pain that needs to be recognised, understood and heard.
A British Punjabi Sikh holistic therapist, Anoo Bhalay is co-founder of The Suicide Space CIC and a 2023 Churchill Fellowship researcher exploring cultural silences around suicide and mental health in diaspora communities. Her advocacy is rooted in personal experience: she grew up with suicide bereavement and has spoken about the lack of language available to discuss grief and loss within her community.
For Bhalay, one of the biggest barriers is the disapproval surrounding suicide. “This disapproval can manifest from inter-generational, religious or cultural ideologies,” she says.
Yet she argues that focusing only on suicide risks overlooking what comes before it — emotional pain, rumination, suicidal thoughts and self-harm. “Suicide is the end result of a period of unmanageable emotional pain,” she says.
Emotional pain, she explains, is often treated as something difficult, unwarranted or uncomfortable. But experiencing it is part of being human. The challenge is creating spaces where people can articulate that pain without being immediately judged, corrected or offered simplistic solutions.
“Appropriate language to perceive and explain is vital,” Bhalay says, adding that communicating emotional pain requires vulnerability from both the person speaking and the person listening.
For someone struggling, her advice is simple: talk to someone who will listen.
She believes listening services can provide an important outlet for people who feel unable to speak to those closest to them. Sharing what they are experiencing can help relieve the internal pressure created by carrying emotional pain alone. “There should be no misconceptions in expressing what you feel,” she says, stressing that listeners should not disapprove or apply judgement.
But suicide bereavement presents a different challenge.
Bhalay recalls not speaking about her own experience of suicide bereavement until much later in life. Looking back, she says that, particularly during childhood, she would have benefited from collective support from trusted adults.
Suicide loss, she explains, is multifaceted and permanent. Everyone affected may process the crisis differently, meaning there is no single comforting phrase that can make the grief disappear.
Her work has also made her question the role of culture, community and faith in responding to emotional distress.
British Asian communities often place considerable emphasis on collective resilience, perseverance, achievement and steadfastness. While these qualities can be sources of strength, Bhalay believes they can sometimes overshadow emotional wellbeing.
People may turn to family, community leaders or places of faith for guidance, hoping to be redirected towards resilience and stability. But Bhalay argues that communities must also ask difficult questions about how suicide and suicide bereavement are understood within religious and cultural spaces. “What is the protocol in community for suicide bereaved individuals in terms of managing grief and loss?” she asks.
Her experience has also challenged the idea that suicide is something distant from British Asian communities. She says she is no longer surprised when someone tells her they know, directly or indirectly, someone who died by suicide or attempted to take their own life.
“I believe that we have been saying that we are ‘not okay’ for a while now,” Bhalay says. The difference, she suggests, is that some people verbalise it while others communicate distress through behaviour.
Changing that requires communities to become better listeners.
For Bhalay, the first response to someone expressing emotional pain should not necessarily be a solution. It should be empathy, patience and a willingness to understand why that pain exists.
The shift from barrier to support, she argues, requires listening “without judgment”, without predetermined answers and without rushing to fix what cannot immediately be fixed.
The goal is to create spaces where saying “I am not okay” is not an admission of failure, but an invitation to be heard.
