By Rick Rawlins, LCSW (Click HERE for a complete bio)
Recently there has been increased media attention and awareness given to the topic of suicide. Too often the subject of suicide causes people to feel uncomfortable and not want to discuss it. Yet when someone is suffering and considering suicide, talking about it is exactly what is needed.
Suicide occurs in every section of society; from children, to teenagers, to young adults, the middle-aged and the elderly. It occurs with adults that are married, single or divorced. It occurs with those with strong religious beliefs and those with no religious beliefs. It occurs with those that are rich and those that are poor. In short, suicide occurs in every section of society and likely has already impacted your life in some way. From a loved one, to a neighbor, to a friend of a friend, you’ve likely already been impacted by suicide. But when it’s a child, or a spouse, or a friend who is currently having a suicide crisis, the question of how to respond can be overwhelming.
But there is good news. There is hope.
Part of the good news is that suicidal thoughts are often a function of the very treatable mental health condition of depression. When the depression is properly treated, typically the suicide risk is alleviated. The important part is recognizing the suicide crisis, talking with them about the concern, persuading them to seek help and following through to ensure treatment is obtained.
Another part of the good news is that those contemplating suicide often give warning signs prior to any suicide attempt. When someone close to them is able to recognize these warning signs, intervention can occur that can literally be life-saving.
So what are the signs that someone may be contemplating suicide? While specific signs are different for each person, generally signs occur in four main areas:
1. Direct verbal clues: statements such as “I wish I were dead.” or “I’m so miserable I’m going to kill myself.”
2. Indirect verbal clues: statements such as “Everyone would be better off without me.” or “You won’t have to worry about me any longer.”
3. Behavioral clues: actions such as putting personal life matters in order, giving away prized possessions, a significant change in behavior that indicates hopelessness (or even a change from previous hopelessness to sudden relief).
4. Situational clues: events that create a sudden loss, such as breaking up with boyfriend / girlfriend / spouse, loss of a job, loss of freedom (arrest, terminal illness, bankruptcy).
Still many ask, “If I see the warning signs, then what? How do I respond?”
Often the fear of not knowing how to respond causes many not to intervene. There is also a fear of that discussing the issue will “cause” the person suffering to think about suicide. The reality is, if you are thinking they appear so miserable that suicide may be something they’d consider, you can bet they’ve already thought about it. Talking to them about this concern will not cause them to suddenly contemplate commiting suicide, but rather can bring relief that someone cares and wants to help.
A nationally recognized suicide prevention model is “QPR”, which stands for Question, Persuade, Refer.
When someone is contemplating suicide, there are three steps to take:
1. First, ask the QUESTION “Are you thinking about committing suicide?” Be direct, yet supportive in how you ask them. Don’t ask the question in ways that are judgemental, such as “You wouldn’t do anything stupid, would you?” Those questions don’t lead to open discussion but further the secrecy that increases suicide risk.
2. Second, if they respond that they are considering suicide, follow up and PERSUADE them to get help. The key to persuading someone to get help is to LISTEN. Allow them to talk about what is happening and listen for clues as to what they are considering. The goal is to persuade them to get further help and support.
3. Third, REFER them to get help. One great resource are the many crisis lines available to call and obtain help (see end of blog post for numbers). If they are actively suicidal and you fear they cannot be left alone, they may need emergency assistance at a hospital. Whatever route seems best, it’s important to make sure they follow through with obtaining help. Don’t let them say “Sure, I’ll get help” and hope they follow through. Instead, you make the call or stay with them until help is obtained.
Remember that suicide is a permanent solution to a temporary problem. The key to preventing a suicide is to question, persuade to seek help, refer to a place that can help and then follow through with getting help.
Suicide Help Lines:
1-800-SUICIDE – (1-800-784-2433) – National Hopeline Network
1-800-273-TALK – (1-800-273-8255) – National Suicide Prevention Lifeline
Salt Lake Area Crisis Line: 801-587-3000