The kids who don’t know they are too young to die

He was a teenage boy threatening to kill himself. He didn’t want to live any more, he said, and everyone would be sorry when he was gone. She was a teenage girl, his friend, desperate to talk him out of it. Her best effort belied her naivete: “You’ll be sorry if you do it!” (A week later, he tried and failed to kill himself).

“Neither of them understood that death was final,” says suicide researcher Dr Kate Blackmore. To such overwhelmed young people, suicide seems just one of many possible responses to life’s problems: “Suicide is just (another) act; it’s not something they separate from cutting yourself or taking drugs or driving a car too fast … They don’t really understand what death is.”

Australia has among the highest rates of male youth suicide in the world, with about 500 deaths in the 15 to 24 age group each year – a rate that has tripled since the 1950s. In contrast, the rate for young women has not changed since the 1960s.

Blackmore, a research fellow at Wollongong University’s department of public health, is part of the national effort to stem the tide. As part of the National Youth Suicide Prevention Strategy, her task has been to work out how to best educate young people, as well as professionals, in ways to minimise youth suicide. Her approach incorporated some revolutionary material – the views of the kids themselves.

Talking to focus groups of 30 city, semi-rural and rural teenagers in NSW, Blackmore found they did not want suicide prevention education for themselves. They wanted to be taught coping skills so they could better deal with crises in their own lives and help friends survive their problems. Forget the ambulance at the bottom of the cliff, they seemed to be saying – teach us how to keep from falling off it.

Most of the young people interviewed were from groups at high risk of suicide. They had emotionally or materially deprived or abusive backgrounds and many were unemployed or school dropouts. Several had attempted suicide.

Blackmore says she was floored by their insight: “Probably the most humbling part of the experience was the gradual dawning on me of how much wisdom actually resides with these young people and how appalling it is that they haven’t been listened to in the past.”
Their debates mirrored academic discourse about the issue, including arguments about whether the topic should even be raised with young people for fear of giving them ideas they may not otherwise develop.

“Most of the kids we interviewed said: ‘Don’t use the word suicide with younger kids’,” Blackmore says. “A lot of them had younger brothers and sisters still at home that they were very worried about. They said if they talked to them, they used language that they understood, and that didn’t scare them, like: ‘You must be feeling really, really bad’.

“Most felt that (classroom discussion about suicide) was not an issue for kids in the older levels of high school. But several said: ‘If you’re really depressed, if you have lost your job or your relationship has broken down, and someone says to you that suicide is what people do when they are really desperate, it can give you the idea’.”
But the teenagers did believe youth suicide prevention education for adults was a good idea. They wanted grown-ups to know what they needed. Top of the list, even with the toughest kids, was the need for a sympathetic adult who could truly listen.

Said one: “Parents just have to be able to, like, sit there and listen. Don’t get mad with what the kid says, or anything like that … I’ve been through it. I got kicked out of home and everything. It’s just … it’s scary.” Another talked about the need for understanding friends: “You just want them to talk to. Just make sure that someone can understand you, so then you won’t go any further.”

They also wanted help to see things more clearly: “I was 14. Sitting at the bus stop, waiting to go home, cutting my arms up with bits of broken glass because . . . just because of some of the things that happened, you know. I got abused when I was 11 and I didn’t tell no-one for years, because I thought it was me . . . Someone needs to be there to say something, you know? (To say) ‘It isn’t your fault’.”

Asked what else they wanted from a friend, parent or other adult in a crisis, the young people listed understanding and sympathy (free of blaming or judgmental attitudes) and information about where to go for help. They wanted professionals to be adequately trained, to have a uniform approach and to offer continuity of care.

Many were scornful of professionals with whom they had come in contact, particularly psychiatrists and school counsellors. They mistrusted school counsellors, Blackmore says, because they saw them as people who could get them transferred away from their friends to another school.

They saw continuity of care as central. Some had been shunted from one counsellor to another as a result of developing suicidal tendencies, after having sought help. Said one: “Why should a counsellor, because they feel uncomfortable all of a sudden, say: ‘Oh, I don’t know what to do with you no more. I’m scared of you now’? And then you’re dumped, like that . . .

“(You’ve) put your trust in them. You’re saying: ‘Help me; I don’t know what to do’. And they’re saying: ‘Well, I don’t know what to do with you either’. I’m not blaming them, but I am saying that can’t help the situation.”
They were also highly critical of hospital casualty staff. “Some casualty nurses see suicides as a waste of time,” says Blackmore, “You’re holding up this bed for someone who has had a heart attack or a severed limb, you self-indulgent little wanker!”‘

Blackmore knows one young woman who was slapped by her treating nurse. Another, an unstable schizophrenic who frequently overdosed when she had a psychotic episode, found herself in the hands of a sadistic nurse who gave her a gastric lavage three times in one visit to punish her for her frequent trips to casualty. One young woman told of being left on the floor until regaining consciousness after an overdose; another, of being called a “useless little slut”.

“It reinforces the kids’ idea that they are garbage and that no one cares what they do,” Blackmore says. She believes there is an urgent need for education about suicide in undergraduate courses for doctors and nurses.

But she is wary of some suicide prevention courses aimed at teachers and students. Programs that talk to kids about suicide in class are no longer seen as appropriate, she says, and she is concerned by some teacher training programs. “It’s important that teachers are conscious of risk factors,” she says. “Teachers probably know kids almost as well as parents; they spend every day with the same kids. If you have a kid whose performance suddenly drops off, who suddenly withdraws, or who does something about death in art or writing, it’s important to recognise that (as a warning sign).

“But to expect the teacher to take responsibility for anything more than that is dangerous. They must be told to refer on to someone who is trained to deal with a very depressed child.”

The young people interviewed, like Blackmore, were staunchly opposed to suicide education programs based on fear, which present horrific details about violent means of suicide and the potential physical consequences of failed attempts (such as warnings that a young person who survives hanging might be left with a paralysed face). Such stories might be scary, they said, but they were no help to a person in despair.

Blackmore says: “They also thought it was inappropriate to say that suicide is the morally wrong thing to do, because that just loads up kids with more guilt, potentially making someone who is borderline feel even worse about themselves.”

What they did want for themselves was easily accessible, easily understandable, practical advice on what to do in a crisis. And they had great ideas about how to distribute it. “We posed the question: ‘You have just hit Wollongong, you’re unemployed, you have nowhere to go, and you would like to get some information. What do you need?” Their answer: graffiti the name and phone number of a refuge on the wall of the local cop shop.

Says Blackmore, “These focus groups were very funny at times, but they also came up with some very sound ideas.”

* If you need someone to talk to about your troubles or are worried about a friend or relative, contact Lifeline, tel: 13 1114, or Suicide Helpline, tel: 1300 651 251.

Young people are at a higher risk of suicide if they:

* Live in rural or remote areas

* Are unemployed

* Have a profound mental illness

* Are Aboriginal or Torres Strait Islander

* Lack a trusted adult in whom they can confide

* Are struggling with their sexual identity

* Have suffered a recent loss or a shaming experience that is significant to them, even if it does not appear so to others

* Have previously attempted suicide

* Were victims of physical or emotional abuse as children

Signs that a young person may be suicidal:

* A sudden change in behavior, as when an extrovert becomes very quiet

* Obvious depression

* Excessive ongoing anger

* Loss of interest in things that used to give pleasure

* High-risk behavior, such as excessive drinking, dangerous driving or drug-taking

* Isolation from others, including a lack of friends, or a withdrawal from networks and activities at work or at school

* A preoccupation with giving away belongings and setting their affairs in order (a phase in which they can appear very calm) — Sources: Kate Blackmore and Lynn Bender, manager of Lifeline and Suicide Helpline.

First published in The Age.

The good son

HE WAS a nice Baptist boy from Blackburn with an urge to do good. She was a prostitute, the first of many to enter his life. She arrived at his office in St Kilda with her face all bruised. She wanted his help as a lawyer to get her off charges she faced in court that day. The night before, anxious and unable to find a vein in her arm, she had injected heroin into her face.

He kept her out of jail, that time. Delighted, she told him, rather indelicately, precisely how many clients she would have to service in order to pay the court’s fine. She invited him to lunch to celebrate the win; her choice of venue, a local soup kitchen. There she introduced him to the assembled street people as “the best legal eagle in town”. From a distant table came the wry observation: “God, things must be bad if lawyers have to eat here.”

The Reverend Tim Costello could have had no better introduction to St Kilda’s fringe-dwellers: their courage, their humor, their openness and their brokenness. The prostitute, Julie, told him she had been raped at 15 and had decided that no man would ever do that to her again. So she made them pay. “In a tragically coherent way, Julie was taking power back over her own life,” he writes. “Who was I to judge?”

“Who was I?” is the question central to autobiography. In Costello’s new memoir, Streets of Hope, he promises an answer, describing the book as a highly personal account of his life’s journey. In fact, the chapters that follow demonstrate what a private person such a public figure can be.

Costello gives a detailed picture of his social and political development; of how he came to be a lawyer, a preacher/prophet and, briefly, a politician. We hear much about his views on the dark forces rending Australian society; it is probably for his persistent critique of economic rationalism and its effect on community that he is best known – certainly to Premier Jeff Kennett.

But Costello offers only sketchy outlines of the forces that would have shaped him most profoundly: his relationships with his mother and father, with his wife and their children, and with his famous brother, Treasurer Peter. Costello shields them as carefully as he does his own deeper self; not for him the bruising intimacy of Frank McCourt or Nuala O’Faolain. “One of the reasons the book sat on the shelf for two years was that it was autobiographical,” Costello admits. “I actually have a fear of being too self-disclosing.”

He believes this is partly related to the fact that he wrote the book at 40: “It’s very difficult to be disclosing midway through your life. There’s this sense that it’s more appropriate at the end, when you have a better sense of what it all means and who you are.

“Secondly, it involves others. You aren’t just an individual who has this right to be open and vulnerable and show your wounds. You are in relationships with people. I knew that anything I said that was too revealing of family stuff would have all these ripple effects. I kept asking myself, `Is this fair to family, to wife, to colleagues?’ By the end of your life, your parents have gone, the kids can cope.”
The book was originally written as therapy, as a private exercise in finishing unfinished business. Costello is now a minister at the Collins Street Baptist Church, with a parish that covers street kids, the Stock Exchange and the Crown Casino.

But back in 1994, he faced the closing of several doors. His single term as St Kilda’s last mayor had been cut short by the council amalgamations he had fiercely opposed. Then the Democrats offered him a safe Senate seat. He initially accepted but later refused, for the sake of family harmony.

It must have hurt. Even now, a spasm passes over his face as he remembers. “It was about my parents, who would have found it just too painful,” he says, dragging his hands over his face as if suddenly tired. “We discussed how, once under a national spotlight where, potentially, the Democrats would hold the balance of power on Peter’s budget, the strains would be so great they’d blow family relations apart.

“It was also a bit about my wife – and she was right, I think, and now I accept this – saying, `Well, you’re not just a politician. In terms of calling and vision, there’s other aspects of who you are, and once you become a politician, that’s all you are’.”

He was sorely tempted because the Democrats allow conscience votes; he would probably have been as much his own agent as he is in his church. Unlike most other denominations, the Baptists have no central hierarchy to whom spokesmen are answerable. When Costello makes public comments, he is not representing any stance other than his own.

In religious terms, he says, “The Democrats have the prophetic role; that is, they’re not the priestly caste who governs and makes the laws. The prophets are always the ratbags who come from the margins and shake up the system …”
After the decision was made, there was still more emotional housekeeping to be done. Costello had already told the St Kilda community that he was leaving, and he stuck to this despite his grief at the prospect. His wife, Merridie, suggested he write it out of his system. The result is Streets of Hope, which he offered to Allen and Unwin two years later when they approached him to write a book.

He says he wants the book to answer the question he is most often asked: “Why do you see the world so differently to your brother, even though you’ve grown up with the same family and the same religious training and world view?”

The book provides a glimpse of one possible answer. He writes, “I remember my father often saying to me and my brother, `I do not care who is right or wrong; I am going to punish you both.’ As a parent, I now fully understand that it was borne of the weariness involved in adjudicating endless sibling disputes. But back then, that always struck me as flagrantly unfair.”

He thinks that this is what propelled him into law. But perhaps it also propelled both of them into struggling to differentiate themselves from each other, to be recognised in their separateness.

COSTELLO’S own answer to the question is that the family years are not the only formative ones, and that as a young man he was exposed to different people and ideas to Peter.

He writes of studying theology in Switzerland and discovering from his fellow seminarians that there are many perspectives: “The Italian students were always attuned to the revolutionary nuances and preferred Jesus in Che Geuvara garb. A Balinese student opened up the … possibilities of `the rocks crying out’, which resonated with an animistic world … The Africans never failed to observe the unmistakable struggle against imperialism in Jesus, a Jew, being executed by imperial Rome.”

It would have been an eye-opener for the boy from Blackburn. A minister who once lived in a Baptist community believes that Costello would have been exposed to rather a smug, narrow view of religion when growing up: “Blackburn Baptist is an enormous, wealthy community. Their theology is on the triumphalist side; because they are wealthy, they see that as a sign of God blessing them.”
If he needed any more to trigger a reaction against bourgeois complacency, he could not have picked a better place than St Kilda. He found himself passionately defending streetwalkers and abusing johns. He used his own car as an ambulance for locals having psychotic episodes, explained to his young children about the condoms and syringes littering the local park, and pacified residents when mentally ill parishioners ran naked down the street or urinated in letterboxes. His working life could not seem more removed from the power-suited world of his brother’s.

But some who know Tim Costello see him, too, as a very political character. A woman who worked in welfare at St Kilda at the same time he did says: “I’ve worked in social justice for years and in the main it’s made up of men like him, who are there because it provides them with a platform of sorts and fits in with their view of the world.

“It suits them to think there are forces of darkness and forces of good, and that the world is divided into people who care intensely about their fellow man and selfish bastards who don’t give a shit; it validates them because it puts them on the side of the angels.” Mind you, she admits, “He usually is on the side of the angels.”

And he does it with such style. Costello was recently up on the Gold Coast speaking to a gathering of 10,000 pentecostal and evangelical Christians. He’d caused a furore beforehand by telling the local paper that Hansonism was a form of paganism.

“There’s hysteria as I’m pulling up,” he says. “Churches have been pulling out; the organisers are upset and beg me not to say anything about Hansonism.

“Well, I preached a very evangelistic sermon. I said that in olden times, if we were Jews, we would take a goat here and we would ask the mayor to place all the sins of the Gold Coast on that goat, and then send the goat out into the wilderness. That was a scapegoat; that’s where the word comes from. And I said, `But we’re not Jews, and we’re not living in that period of time. We actually believe as Christians that Jesus is our scapegoat, that he bears our infidelities and lies and abuse of kids and drug abuse and crime; that he took them upon himself. And that, therefore, to scapegoat anyone, particularly the indigenous, Asians or single mothers, is actually to undermine the work of Christ.’

“And I saw these conservative people looking at each other, wondering, `Has he mentioned Hansonism or not?”‘

The preacher, the lawyer and the politician grin in mischievous solidarity.

Streets of Hope is published by Allen & Unwin at $19.95.

First published in The Age.