What Working in Suicide Prevention Organisation in London, UK Taught Me About Men's Mental Health and Suicide Prevention
Please note: this article discusses suicide. If you or someone you know is struggling, resources are listed at the end.
World Suicide Prevention Day just passed, and it's left me wanting to reflect on my time as a Suicide Prevention Therapist at James' Place Charity, what that work taught me, and how you can help if you know someone who's struggling.
For anyone unfamiliar with it, James' Place is a UK charity that provides free, rapid therapy to men in suicidal crisis. It was founded in memory of James, a young man who died by suicide despite having sought help, and its centres in London, Liverpool, Newcastle, and Birmingham aim to see men within days of referral, in a non-clinical setting built around trust and consistency of care.
Men, Mental Health, and Suicide
Men are still far more likely to die by suicide than women, and many never access mental health support before reaching crisis point. Part of this comes down to how men are often taught to relate to their own struggles: emotional openness can feel like weakness, asking for help can feel like admitting failure, and a traditional therapy setting can feel intimidating or disconnected from daily life. Crises can also come on quickly, triggered by a sudden loss, a relationship breakdown, or financial strain, rather than building up over years of visible symptoms.
This is exactly where therapy can help, when it's built with those barriers in mind. Feelings aren't always named out loud for many men; they surface instead as action, withdrawal, or irritability, shaped by social and gender norms that talk therapy doesn't always account for. With such deep stigmatization around men seeking help in the first place, reaching out often only happens once things have already reached crisis, if it happens at all. What actually helps is an adjusted therapeutic approach, one that meets men where they are rather than asking them to fit a conventional therapy mould, so they feel safe enough to engage and stay. Therapy isn't about telling men to simply open up; it's about building the conditions that make opening up possible.
The Work Itself
For over two years, my day-to-day involved sitting with men who had reached a genuine suicidal crisis, often within hours or days of being referred, sometimes with no prior contact with mental health services at all. My role was to carry out crisis and suicide risk assessments, provide short-term therapy, and work collaboratively with each man to build a safety plan he actually believed in, not just one that ticked a box.
Not every man who came through the door was accepted into full treatment, and even then, I'd offer a one-off safety planning session, because a single conversation, done well, can be the thing that gets someone through the worst night. Alongside direct client work, I regularly liaised with crisis teams and GPs to coordinate care and escalate support when it was needed, and referred men on to other services when that was the better fit. A significant part of my role was also outreach: going into communities across central and greater London, with a particular focus on the LGBTQIA+ community, to talk about suicide prevention before someone ever reached crisis point.
What It Taught Me
A few things became clear to me through that work that I still carry into every session I hold today:
Speed matters as much as skill. A man in crisis doesn't wait well. Being able to see someone quickly, sometimes within 48 hours of referral, often mattered more than any particular technique I used once we were in the room.
Crisis doesn't always look like a long history. Many of the men I worked with had no prior contact with mental health services. Their crisis was triggered by something sudden, like a breakup, a job loss, or a health scare, not a lifetime of visible warning signs.
The room itself is part of the treatment. A non-clinical, unintimidating space did real work before a single word was spoken.
Safety plans have to belong to the client. The ones that worked were the ones the man helped build, in his own language, with steps he actually believed he'd use, not a generic template.
Shame is often the real barrier. Many men carried a quiet sense that reaching out meant failing at being strong, or losing control over something they felt they should be able to handle alone. Creating a safe, judgement-free environment first, then naming that shame directly at the right moment, without judgement, was often what let the real conversation begin.
Outreach is prevention. Some of the most meaningful work I did wasn't in the therapy room at all: it was showing up in community spaces, especially within LGBTQIA+ communities, before a crisis had even started.
If You're Worried About Someone
You don't need to be a therapist to make a real difference to someone who's struggling. A few things I'd encourage, drawn from what I saw work again and again:
Ask directly. Asking someone if they are thinking about suicide does not plant the idea or make it more likely. It opens a door most people are quietly hoping someone will open.
Listen without rushing to fix it. You don't need the right words. You need to actually hear them, without minimising it, changing the subject, or jumping straight to solutions.
Help them get specific. A vague "let me know if you need anything" is easy to ignore. Helping someone name one concrete next step, like a call, an appointment, or removing access to a means of harm, matters far more.
Stay connected, not just present in the moment. A single check-in conversation is a start, not the whole job. Following up in the days after matters, especially since risk doesn't disappear after one good conversation.
Know when to bring in more support. If someone is in immediate danger, that's a moment for emergency services or a crisis line, not something to carry alone, for their sake and yours.
Why I'm Writing This Now
World Suicide Prevention Day may only come around once a year, but this work needs to happen year-round. Men are still dying by suicide at far higher rates than women, and many of them will never walk into a place like James' Place.
That's part of why I do the work I do now at Therapy by Miles. My time at James' Place trained me to work effectively with men and to adjust my therapeutic approach accordingly, rather than expecting them to fit a conventional mould, and that training has carried directly into my practice here. My practice in Bangkok is built around the same principle that shaped my time at James' Place: therapy has to meet people where they are, not the other way around. Every client, whether an expat navigating life far from home, a couple working through conflict, or someone carrying trauma they've never had language for, gets a culturally sensitive, collaborative space, because I don't believe in one-size-fits-all therapy. If you're a man in Bangkok who's struggling, or you're worried about someone who is, that door is open.
At Therapy by Miles, I offer individual, couple, and family therapy for anyone navigating anxiety, depression, unexpected life events, or complex trauma, alongside more specific work around multicultural and interracial relationships, non-traditional relationship structures, and the experience of expats, immigrants, and LGBTQIA+ clients. Sessions are trauma-informed and collaborative, with the aim of helping each client find clarity in a way that stays true to who they are. My practice isn't a crisis service, and it can't offer the same level of specialised, rapid-access suicide prevention support that James' Place provides, but I can still help with suicidal ideation and preventative work: building a safety plan, addressing what's underneath the distress, and connecting you with more intensive support if that's what's needed.
If you are having thoughts of suicide or are worried about someone else, help is available. In the UK, you can contact Samaritans free anytime at 116 123, or text SHOUT to 85258; for urgent mental health support you can also call NHS 111 and select option 2, call 999, or go to your nearest A&E. In the US, call or text 988 (Suicide & Crisis Lifeline). In Thailand, Samaritans of Thailand can be reached at 02-113-6789 (press 2 for an English callback line), daily 12:00–22:00; in an emergency you can also call 191 or go to your nearest hospital. If you are elsewhere, a local crisis line or emergency services can help you find immediate support.