For the depressed or vulnerable, seeking help can often be a bridge too far. By Clem Bastow.

Infrequently asked questions about depression

They are a handful of events that seem disparate in every way other than their sadness: the death by suicide of a prominent actor in California, a vulnerable man in Oxfordshire who starved to death after his benefits were cut, the unattended death of an unnamed 89-year-old woman in Western Sydney.

If there is a common thread that runs through the reactions to these tragedies, however, it is one of muted surprise: words to the effect of, “We had no idea he was suffering”, “He never asked for help”, “I hadn’t spoken to her in a while.”

As more and more vulnerable people slip through the cracks, it is time to reconsider our manner of dealing with them. We keep them at arm’s length, as though depression or poverty is contagious, insist they seek help, and then react with dismay and surprise if they die. This doesn’t necessarily demonstrate a lack of compassion – after all, in encouraging people to seek assistance, we are trying to help them – but perhaps a certain naivety about what it is to live under extenuating circumstances.

Pride and shame are complicating factors for the depressed, impoverished or elderly. In the case of Mark Wood, the 44-year-old who starved to death in Oxfordshire, his sister told The Guardian, “He was quite a proud person … He didn’t want to impose on our mother.” The depressed and suicidal are often keenly aware of feeling burdensome. 

This is not a call to let vulnerable people wallow and be absolved of personal responsibility in seeking help, but rather to imagine the difference between tossing the usual crisis phone numbers at someone and sitting next to them as they punch in the digits.

Despite our technologically assisted “connectedness”, rates of loneliness, suicide and disaffection continue to rise. Is this, then, illustrative of the erosion of community? I am certainly not one to claim I live in a village: of the other 11 or so fellow renters in my small apartment block, I have met only one. When I heard my downstairs neighbour sobbing loudly one day, I stayed put, assuming a friend would be on the way to comfort her. Nobody showed up and the crying continued for more than an hour. 

When the decomposing remains of the unnamed Sydney woman were found, it was also discovered that she had left behind handwritten memoirs. Of her loneliness she wrote, “When we moved into our present house in 1966, the atmosphere of the streets was more or less one of a village formed by different nationalities. Today the friendly atmosphere of the neighbourhood is extinct. Except for a few privately owned houses, the whole neighbourhood has been transformed into apartment blocks or strangers. A smile and a good day or a helping hand have become as rare and as exceptional as a white whale.”

We admire “random acts of kindness” when, as reported by a click-hungry global news, they become meme-like. Yet it seems far more difficult to check on a lonely neighbour or depressed friend than it is to, say, pay off a stranger’s Kmart layby. As we now know, loneliness can kill. It speeds the decline of the elderly, worsens blood pressure and stress, amplifies dark thoughts, and can even affect the development of children’s brains. So how do we encourage ourselves to help each other?

Australians of a certain vintage may remember the jaunty “Do you need a hand?” series of public service announcements from the late 1980s, which implored everyday people to help each other out – most memorably when a mountainous truck driver in Stubbies helps a tie-wearing, sports-jacketed office worker start his stalled scooter. The ads were not, as some may have misremembered them, a government-sponsored initiative. In fact, they were a bit of stealth marketing from the Seventh-day Adventists.

Revisiting the distinctly dated ads, it’s hard not to be struck by the notion that a similar campaign, religiously affiliated or otherwise, wouldn’t float in 2014. As one YouTube comment sagely put it, “Doing this [today] may get you stabbed.” 

The closest equivalent today is R U OK? day (September 11), founded in 2009 by Gavin Larkin in an attempt to begin both a national conversation about suicide and encourage a community-based support of vulnerable people.

In a vaguely dystopian coincidence, “RUOK” is also the handle for a computerised “telephone reassurance” program, which contacts “an elderly person, home-bound individual or latchkey child on a daily basis”.

Upon R U OK?’s initial launch, I recall a barrage of texts and private messages that simply read “R U OK?”, which were not only easy (in my depressed state) to ignore, but felt glib – the conversational equivalent of
a hashtag.

Since then, those who’ve engaged with the campaign have done so on a deeper level, and so, too, has R U OK? itself. Importantly, it instructs people not just to “Ask”, but to “Listen”, “Encourage”, and “Follow Up”. The emphasis has shifted beyond one of simple inquiry towards face-to-face conversation.

In her memoirs, the 89-year-old Sydney woman wrote, “One has to fend for oneself. Some might ask why I am living on my own and why I don’t seek help from others. It might seem a queer behaviour for many, with so many helpers, but to me the answer is quite simple and it is ‘a complete lack of compassion and understanding’.”

It’s not sentimental or Pollyanna-ish to wonder whether we’ve grown apart from each other. But rather than reacting with surprise when these small tragedies occur, we must be careful not to let vulnerable people’s pride and shame and our own reticence and fear of them create a bitter cocktail that blinds us to our shared humanity. We must not expect that people seek help, but instead offer it.

This article was first published in the print edition of The Saturday Paper on Aug 23, 2014 as "Infrequently asked questions".

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Clem Bastow is a Melbourne-based writer and critic.