Understanding Suicide: A Compassionate Guide
How to Help Navigate Suicidal Thoughts: What You Need to Know
In 2020, I became certified in Mental Health First Aid, gaining valuable insights into assisting individuals experiencing a mental health crisis. Just as in traditional first aid, it's crucial to remember that our role is not that of a doctor; rather, we are responsible for initial steps to aid the person until they receive professional help. Today, I'd like to share what I've learned about assessing the risk of suicide or harm in such situations.
Did you know that the first step when helping someone through a mental health crisis is to assess the risk of suicide or harm? Before offering nonjudgmental listening, providing reassurance and information, encouraging appropriate professional assistance, and suggesting self-help and support strategies, we must first assess the risk of suicide or harm. While it may seem drastic, it's the primary task in crisis situations. If there's any indication that the person may harm themselves or others, immediate professional help must be sought, even if the individual resists.
If you suspect that someone might be at risk for suicide, it's crucial to address it directly by asking about suicidal thoughts. Do not shy away from using the word "suicide." Your question should be direct and concise. For example, you could ask:
"Are you having thoughts of suicide?"
"Are you thinking about killing yourself?"
Expressing confidence when dealing with a suicide crisis can provide reassurance to the person in distress. It's important to debunk the myths that talking about suicide can plant the idea in someone's mind or that discussing it implies they're not serious. In reality, discussing suicide might be their way of expressing the depth of their emotions and struggles.
Recognizing signs of suicidal feelings in someone is crucial. Here are common warning signs to be aware of:
Expressing a desire to harm or end their own life.
Actively seeking means to commit suicide, such as acquiring pills or weapons.
Discussing or writing about death, dying, or suicide, including on social media.
Experiencing a deep sense of hopelessness.
Displaying intense anger, rage, or a desire for revenge.
Engaging in reckless or impulsive behaviors without apparent thought.
Feeling trapped and believing there's no way out of their situation.
Escalating alcohol or drug use.
Withdrawing from social connections, including friends and family.
Exhibiting anxiety, agitation, and disturbances in sleep patterns (either insomnia or excessive sleep).
Undergoing drastic mood swings.
Expressing a lack of purpose or reason to continue living.
It's important to note that individuals may exhibit one or multiple signs from this list, and some may display signs not mentioned here.
When speaking with someone who is suicidal, follow these guidelines:
Express your care and willingness to help.
Show empathy and understanding.
Explain that thoughts of suicide are often linked to treatable mental health issues, offering a glimmer of hope.
Emphasize that these thoughts are common and don't necessarily lead to action.
Suicidal thoughts are often a cry for assistance and an attempt to escape emotional turmoil. Encourage the person to share their feelings and reasons for wanting to die; this can provide immense relief.
Address specific problems they're facing, allowing them to discuss issues that may seem insurmountable. While you can offer support, refrain from attempting to solve their problems yourself.
To gauge the seriousness of the situation, follow these steps:
A. Determine the person's level of intent regarding suicide. Ask them directly if they have a plan for suicide by posing three crucial questions:
Have you decided how you would kill yourself?
Have you decided when you would do it?
Have you taken any steps to gather what you'd need for your plan?
Greater planning indicates a higher risk, but remember that the absence of a plan does not diminish the seriousness of their thoughts. All thoughts of suicide must be taken seriously.
B. Consider additional risk factors:
Has the person been using alcohol or drugs? Substance use can increase impulsive behavior.
Have they previously attempted suicide? A history of attempts raises the likelihood of further attempts or completed suicide.
Once you've determined that the risk of suicide is present, take immediate action to ensure the person's safety.
To ensure the person's safety:
Never leave an actively suicidal person alone. If you can't stay with them, arrange for someone else to be present.
Provide them with a 24/7 safety contact, such as a helpline, a supportive friend or family member, or a mental health professional. The National Suicide Prevention Hotline is 1-800-273-TALK. In cases of immediate danger, call 9-1-1.
Encourage them to recall past sources of support, which could include a healthcare provider, psychologist, a trusted friend or family member, or a community group like a club or church.
Avoid using guilt or threats to dissuade suicide, such as saying, "You will go to hell." Instead, focus on empathy and understanding.
Regarding professional help:
During the crisis:
Always prioritize seeking professional help when dealing with a suicidal individual, particularly if they are experiencing psychosis. If the person has a weapon or displays aggressive behavior towards you, it's essential to involve law enforcement to ensure your safety.
Recognize that the person might be hesitant to involve a professional, and if you have a close relationship with them, you may worry about pushing them away. Understand that some individuals with suicidal thoughts may not immediately see the need for professional help.
After the crisis has subsided:
Ensure the person receives the necessary psychological and medical assistance they require.
When someone asks you to keep their suicidal thoughts a secret:
Never agree to secrecy about their suicidal plan.
Respect their privacy but include them in decisions about who else should know.
In closing:
Despite our best efforts, some individuals may still die by suicide.
Mental Health First Aid is a skill-focused training course that educates participants on mental health and substance-use issues. To obtain your certification, please visit their website for more information.