Skip to main content
Civil Service

Man Up, Man Down – you are not alone

Posted by: , Posted on: - Categories: Health & Wellbeing
Graham Ralph, Deputy Director - UK Visas and Immigration with his daughter Libby

Man Up, Man Down – you are not alone

A little over 18 months ago my 18 year old daughter Libby took her own life. She had Anorexic Nervosa, Autism Spectrum Disorder and Borderline Personality Disorder. My darling daughter struggled every day and decided to end her life as she had lost hope. She felt she was saving herself and her family the pain of living through her illnesses.

This sounds like an all too common story – teenage girl with an eating disorder takes her own life… but it is not the most common story – this is …

Every two hours a man in the UK takes his own life. Suicide is the single biggest killer of men aged under 45 and accounts for 74% of suicides in the UK.

This startling fact suggests that men suffering with mental distress may not be receiving or asking for the help they need. Men often feel they cannot say they are depressed or anxious or considering taking their own life. This could be because of the influence of “macho” conditioning that tells men to "man up" and demands that "boys don't cry".

Most suicidal people don’t want to die - they just want to remove themselves from an unbearable situation, and for the pain to stop. It’s a decision made when other decisions seem impossible and they feel that other people will be better off without them.

Talking about suicide can save lives

My colleague Lucy Vallis, the Mental Health Lead for UK Visas and Immigration, writes: “On a warm summer evening five years ago my friend Dave took his own life - he was 47 years old.

“He showed warning signs – a loss of hope, a feeling of helplessness, a despair that couldn’t be articulated. The following year, I took the Applied Suicide Intervention Skills Training (ASIST). Had I taken this earlier, I may have been able to prevent it. Talking about suicide is the single most important thing we can do.”

Asking someone if they feel suicidal or are planning to end their life may not feel like the right thing to do but in fact professionals recommend asking direct questions about suicide.

Some people worry that this might indirectly encourage the person who is feeling suicidal to act on their feelings but research shows that speaking openly about suicide decreases the likelihood of the person acting on their feelings. The ASIST training teaches us to do just that #TALKSUICIDE  to save a life.

Suicide prevention training

My friend Debbie Pennington, a People Lead in the Office of Security and Counter Terrorism, recently used ASIST to help a colleague.

“I became ASIST trained about 2012, after losing my ex-husband to suicide in his 40s. His father, also in his 40s, and younger brother (aged 23) had died by suicide. Our daughter is now 25 and her father’s death still has a huge impact on her life.

“Since being trained I have supported several men, who have not been able to see a way out of the darkness they find themselves in. However, if they are happy to talk, then there is a little window of hope.

“Dashing from one meeting to another recently, I passed a male colleague whom I knew vaguely. I said “Hi” and continued to walk, but I knew something wasn’t right. I stopped and asked him if he was okay and he said he wasn’t. He was reluctant to open up so I cancelled my meeting and stayed to talk to him. He told me that he had reached a point where he no longer wanted to live.

“We went for a walk, and spent the next couple of hours talking. When we parted, he wanted to go home to his family and agreed to take advantage of the support that was available to him.

“My ASIST training gave me the skills and the confidence to ask the difficult question, “are you thinking of suicide?” and provide the necessary support to help someone not lose his life to suicide.”

World Suicide Prevention Day

We are raising awareness of suicide for World Suicide Prevention Day on 10 September.

Having suicidal thoughts is more common than you realise but talking about those feelings is difficult. Take this day to reflect and think about how you are feeling or how a colleague might be coping. Is there someone you can talk to about your feelings? There is no right or wrong way to start a conversation about suicidal feelings, but starting the conversation is the most important part.

If you’re feeling suicidal please talk to someone, there is no shame. If you can’t talk to a relative or friend, you can contact the Samaritans 24/7 on 116 123, your GP or your nearest accident and emergency department.

If you’re worried that a friend or colleague may be suicidal then talk to them. Ask them directly if they have ever contemplated self-harm or suicide and encourage them to seek professional help. In an emergency call 999 for an ambulance.

ASIST training is available from a variety of external bodies including:


Barbara Beetle Foundation

Action Mental Health


Sharing and comments

Share this page


  1. Comment by Tanup Gadhia posted on

    Thanks for sharing. Very brave.

  2. Comment by Harpal posted on

    thankyou for this heart-rending post.

  3. Comment by Joe posted on

    Highest suicide rates, Prison rates, Homeless rates, Surely linked? and also with how society views what it is to be a man and how men themselves view what it is to be a man...I hate the 'man up' or 'be a real man' comments that you often hear in society and media especially in films etc. were the man is expected to be the hero, to save the day, or the possessive 'look after his woman' etc.

    Firstly, you cannot look after anyone unless you look after yourself.

  4. Comment by Debbie Pennington posted on

    Thank you to all who have commented on this post. We really appreciate the opportunity to talk openly about suicide and the impact it has.


  5. Comment by Emma Topp posted on

    Thanks so much to Graham, Lucy and Debbie for this blog and raising awareness of this important issue. Thanks also to others who have responded with their personal experiences. Opening up is difficult but it goes a long way to helping others who may be experiencing similar difficulties and thoughts.

  6. Comment by Virginia Eyre posted on

    Thank you so much for your blog, Graham. I am so sorry for the heartbreaking loss of your precious daughter. You raise some really important issues that we as a society as well as a civil service need to be much more open and talk about. Mental illness needs to have the same recognition and acceptance as any other ailment that might strike us down in our lifetimes. It is vital to remove the taboo and any stigma of weakness, so people - men in particular - don't feel ashamed to ask for help.

    I have a caveat around one aspect of your blog. It is where your colleague expresses their regret that, if they had taken some MH training earlier, they might have been able to save a life. As you will know from your own heartbreak, many who have been bereaved by suicide have spent years trying to get the deceased to seek help for their condition but, either the medical and therapeutic interventions were unsuccessful, or the sufferer refused to recognise or admit that they needed help (so often, as you say, this is because the sufferer felt unable to admit they had mental health issues because of the taboos and social stigma attached). In spite of this, the bereaved still torture themselves with the things they could or should have done that might have changed the choice made by their family member or friend. The guilt and self-recrimination can be appalling. So, for the benefit of other reading, I want to say how important it is to remember that, in encouraging people to talk about MH and suicide, we don't make the mistake of sending a message that suggests the sufferer's nearest and dearest were to blame for their decision.

    I worked in another department a year or two ago and they ran a campaign on MH with the tag line "If only I'd..." As the widow of someone who took their own life, it shocked and haunted me every which way I turned: the wall posters, cafeteria table props, cup coasters.

    My daughter was only 8 when her father took his own life (Jan 2017) and even she thought she must be to blame in some way: she should have been nicer to her daddy, she should have done more to show him how much she loved him. Please remember, that when encouraging people to be accepting of mental health issues, there are people out there that need to hear above all else "it wasn’t your fault…”

  7. Comment by Gavin Thomas posted on

    Thank you Graham, Lucy and Debbie for both sharing with us their experiences and for promoting this really important topic.

    May I also commend you for the fantastic work that you have been doing to break the stigma associated with Mental Health and for being there to support your colleagues.

    I was really pleased to learn that Debbie's efforts were acknowledged in the New Year's Honours list. I am still awaiting sight of her photo with her honour.

    When I was looking into WSPD2020, I was shocked to hear of the increase in the number of suicide incidence in 2019.

    As we all seek to return to some sense of normality after the Lockdown, I really do hope that colleagues will continue to be kind to others, stay connected and look out for those who might still be finding day to day life a bit of a struggle.

  8. Comment by Toni posted on

    This is such an important topic. There are so many different triggers for suicide.
    My Nephew attempted to take his own life after a sudden isolated psychotic episode. (His first). His Father tried to stop him, and a scuffle ensued in which the father was injured. My nephew was taken to the police station, where he was put on suicide watch, but the Mental Health Crisis Team took 62 hours to reach him, by which time he was too tired to engage with them. They left, stating that he was un co-operative, and the Police were unable to hold him any longer, so he was charged and transferred to Prison. After a short while, he was taken off of suicide watch despite my Sister pleading with the person in charge, and insisting that he was intent on ending his life. She was told that there was nothing in the cell with which he could harm himself... they were wrong … He committed suicide in custody at the age of 25, having never been in prison in his life.
    There is still so much to be done in the field of Mental Health. I fear that resources already stretched to the limit will be further tested by the M.H. problems brought about by Covid 19.
    I applaud everyone who has taken the ASIST and other training, and is now trying to help those who are often unable to help themselves. Thank You so Much!

  9. Comment by Angela Burgess posted on

    This is such an important issue and I really appreciate the contributors opening up and sharing their experiences - it was a very brave thing to do, so thank you.

  10. Comment by Anthony Simm posted on

    Difficult topics very well covered and with an obvious desire to help and support discussions, awareness and action around suicide and mental health. Thank you to all who have contributed and for sharing such personal stories.

  11. Comment by Ian Westwood posted on

    A really important blog and one I can totally understand having battled some real demons about 4 years ago, where I suffered horrendous post-natal depression and had various thoughts that would surprise those close around me and who know me well. I did at times have the thoughts around not being able to speak up and 'not being man enough' and 'just dealing with it' as I was the male, but my perception has really changed and I would encourage males, and females to speak up and not suffer alone, however, I get this is not always an option. Great blog, and thank you for sharing your experiences

    • Replies to Ian Westwood>

      Comment by Debbie posted on

      thank you for sharing your story. I am glad you are in a better place. Post-natal depression is something that men don't talk about so thank you for being open and honest. We need to move to a place were people can reach out and not suffer alone.

      Take care and please shout to anyone of us if you want to talk.

  12. Comment by Debbie Pennington posted on

    Thanks for your comments Fran.

  13. Comment by Fran Mahoney posted on

    Another really good blog on this issue. Thanks for producing it Graham, Lucy and Debbie. Very thought provoking and would be great if everyone could take a pause and think about the suggestions posed towards the end of the article. It may save someone's life.

  14. Comment by Sophie Burke posted on

    This is an incredibly important blog, thank you so much for sharing.

    • Replies to Sophie Burke>

      Comment by Debbie Pennington posted on

  15. Comment by geoff walker posted on

    I lend my full support to this as 3 years ago I too tried to take my own life but I was rescued off a local bridge by the police and sent to a priory hospital in west sussex under section 2 of the mental health act. If I hadn't have had such wonderful treatment from 12-1 nursing and getting the right medicinal support I dread to think where I would be now. Life has changed for me for the better and I live a happy and structured life that I deserve and hopefully offer support to anybody suffering with poor mental health

    • Replies to geoff walker>

      Comment by Debbie Pennington posted on

      Thank you for sharing and I am so glad that you got the support you needed it. Really pleased that you are now in a better place and enjoying life.