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What if someone I love might be suicidal?

Suicide prevention week has just come to a close. Many people have been touched by suicide, whether they or someone they know has had suicidal thoughts, an attempt, or completed suicide. In the U.S., 123 people on average complete suicide* every day (source).

Some common warning signs of suicide include…

  • Increased alcohol and drug use
  • Social withdrawal / isolation
  • Searching for methods of suicide online
  • Giving away possessions
  • Hopelessness
  • Anger, agitation, or aggression
  • Sleeping too much or too little
  • Unpredictable and erratic behavior
  • Feeling like a burden
  • Feeling like they have no future or there is no point in life
  • Unbearable physical / emotional pain
  • Sudden relief or improvement

If someone you love is exhibiting a few of these symptoms, please talk to them. It does not matter what exactly you say, as long as you are there to support them and are willing to listen. With that being said…

Do not be afraid to ask if your loved one is thinking about suicide. Suicide is not something we talk about much in Western/U.S. culture. It can feel uncomfortable and invasive. Some people may even fear that by asking, they are “putting the idea” of suicide in someone’s head. On the contrary, by asking, you are giving the person an opportunity to open up about something that they may be feeling ashamed talking about. Suicidal thoughts are far more common than you might think. If on the other hand, they haven’t thought about suicide, it would take a lot more than just being asked to sway them to complete such an extreme act.

What if I ask, and they say yes, I have suicidal thoughts? Here are some follow-up questions that can help you decide what to do next:

  • How often do you have suicidal thoughts? / Is this common for you?
  • Have you ever attempted suicide before? When was the most recent time?
  • Do you have a plan?
  • How would you do it?
  • Do you have access to the materials you need to complete your plan?
  • Do you have a timeline or a date in mind?
  • On a scale of 1-10, with 10 being “I plan to kill myself right after this conversation” and 1 being “the thought has crossed my mind briefly,” how serious are your suicidal thoughts right now?
  • What is keeping you from carrying out your plan? (Common answers include… I don’t want to hurt my family, my religion is against it, curious to see what happens next in my life, hope that my life will get better, fear of dying)
  • What would you do if your suicidal thoughts got worse?

If after asking some of these questions, the person seems to be at high and imminent risk of attempting suicide, call 911. They will send EMT’s who will take this person to the ER and take it from there.

If, on the other hand, the person is having thoughts, but has no plan, or does not intend to act on their plan, ask them what they would do if their suicidal thoughts got worse.

What if I ask what they would do if the thoughts got worse, and they say they don’t know? At that point, you would help them develop a safety plan. Here’s how you do it:

  • Encourage them to think of a couple of people they could contact.
  • If they cannot think of anyone, encourage them to contact you, or a suicide hotline. The national suicide prevention line is available 24/7: 1-800-273-8255.
  • Encourage them to call 911 or go directly to an ER. There, they can be further assessed for risk by professionals. Then they will either be released or admitted to an inpatient psychiatric unit.
  • If they are not already engaged in outpatient mental health services (like individual or group therapy), encourage or help them link to these services. Most areas have a community mental health center that will provide services for lower fees if needed.
  • Help them write a list of reasons to live. These can be big reasons, like, “my kids,” or little things that give or used to give them some pleasure in life, like “my morning cup of coffee.”

If you really aren’t sure what to do, call 911. The person may get upset with you in the short-term, but it is so much better to be safe than sorry.

As mentioned earlier, these conversations are extremely important to have and can be life-saving. At the same time, please be aware that suicide is never the survivors’ fault. You are not responsible for anyone else’s decision to end their life. If someone you love has attempted or completed suicide, it is totally normal to blame yourself and/or struggle emotionally. Please talk to someone you love and trust about it, and/or seek mental health services yourself.

-Rebecca

*”Complete suicide” is a more neutral way to say “commit suicide,” since commit has a criminal connotation.

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