Ben West was in his bedroom playing music when he heard his mum come up the stairs, singing to herself.
‘There was silence for a second as she opened my brother Sam’s door, then she started screaming and shouting my name,’ he says.
‘The distance from my room to Sam’s is about ten steps — but in my memory it took so long to get there, it was as if I was moving in slow motion.’
That day, January 21, 2018, had been a horrible grey, wet Sunday.
In the afternoon, the boys’ dad, Chris, who works in overseas development, left their home in Kent to get a train to London, where he was staying overnight for work.
Ben and Sam, then 17 and 15, did their homework and had supper with their mum, Michelle, and younger brother, Tom, then 13.
‘Sam pushed his food around his plate and didn’t want to talk,’ Ben recalls. ‘I remember feeling angry because I wanted our old relationship back.
The trauma and grief that Ben felt after Sam died was so obliterating it has taken him the best part of three years to persuade himself that his brother’s death wasn’t his fault
‘Sam had an amazing sense of humour and we had such a laugh together, but for several months he’d been quiet and introverted.’
Ben’s first thought on hearing his mum scream was that she had hurt herself. But as soon as Ben saw his brother on his bedroom floor, it was clear he’d taken his own life.
‘The shock was so great, I was emotionless,’ he says. ‘I went into a kind of primitive state. I knew he wasn’t breathing so I started CPR while my mum ran downstairs to call an ambulance.’
Ben, who was first-aid-trained by the CCF [Combined Cadet Force], performed CPR for almost 20 minutes before an ambulance arrived.
‘I was also trying to look after my mum because she was in such a state she was going into shock,’ he says.
‘As soon as the paramedics took over, I lay on the drive outside and threw up as police and emergency doctors raced past me.’
Doctors from the Kent, Surrey and Sussex Air Ambulance worked on Sam for three hours, performing a trauma thoracotomy — where the chest is opened allowing heart massage and defibrillation.
‘World-leading medicine was happening on my brother’s bedroom floor, but it couldn’t save him,’ says Ben.
‘At midnight, a doctor told us very gently and kindly that Sam wasn’t going to survive. That tiny last bit of hope was extinguished.’
The trauma and grief that Ben felt after Sam died was so obliterating it has taken him the best part of three years to persuade himself that his brother’s death wasn’t his fault.
‘For a long time afterwards, I was overwhelmed by a toxic cocktail of guilt and shame,’ he says.
‘I was absolutely convinced that I had killed him. I felt that if I’d understood his mental state better and been able to talk to him and support him more, somehow he’d still be alive.’
Sam had been suffering from depression and anxiety for four months, but confided only in his mum, who took him to the GP.
As the family had private health insurance, Sam began CBT [cognitive behavioural therapy, recommended by the National Institute for Health and Care Excellence for moderate to severe depression] in September 2017.
As Sam had had suicidal thoughts, his GP did not prescribe medication — some studies suggest antidepressants may initially increase the risk of suicide.
Sam didn’t tell anyone at school, Ben believes, because he was worried the information would be used to hurt him.
‘It still feels there is this deeply ingrained idea that, as men, we don’t have conversations about how we feel,’ he says. ‘And that’s something I regret deeply.’
Although Ben was told about his brother’s diagnosis, he says now: ‘I had no idea what depression or anxiety meant.
‘I remember, around that time, laughing in the face of a girl at school who’d had a panic attack and calling her pathetic.’
As Sam had had suicidal thoughts, his GP did not prescribe medication — some studies suggest antidepressants may initially increase the risk of suicide
He tells this story with bracing honesty to illustrate the colossal hurdles that anyone with a mental illness has to navigate, but particularly the young — and especially young men.
After Sam died, Ben received hundreds of messages from friends telling him of their own struggles. ‘I realised that almost everyone I knew, and everyone Sam knew, was going through something, and yet boys within the same friendship groups weren’t telling each other.
‘They all said: “Please don’t tell anyone.” Out of shame, they went to such lengths to conceal their experiences that you’d never have known.
‘Two of my friends, who I’ve known since I was four, told me they’d attempted suicide. I had no idea. And it was the same with countless others: I saw them every day and never guessed the mental turmoil they were in.’
The statistics on male suicide are absolutely heartbreaking and they haven’t changed for decades. In 2020, 75 per cent of all suicides in England, Scotland and Wales were men — a total of 4,657 men, most of them aged between 25 and 45.
That’s 13 brothers, husbands and sons taking their lives every day. Surveys show men are less able than women to spot signs of mental illness in themselves and less likely to ask for help, even when extremely unwell.
For instance, a YouGov survey commissioned by the charity The Mental Health Foundation in 2016 found that men are also less likely to disclose a mental health problem to friends and family.
More than a third of men either waited more than two years to tell those closest to them, or never told them at all. Instead, men are nearly three times as likely as women to ‘self medicate’ with alcohol and drugs.
Dr Jonathan Pointer, a clinical psychologist at online practice Therapy Sanctuary, says that while extreme mental health challenges are, of course,not exclusive to men, there is a difference in the expression of that pain.