Suicide is a hard thing for many of us to even fathom. Losing a loved one is always difficult, but suicide leads to an array of conflicting emotions as loved ones attempt to pick up the pieces, understand, process and heal. We hope that you will never have to go through losing a loved one to suicide. However, it is important to know the warning signs for suicide.
According to the CDC, warning signs to suicide are:
Talking about being a burden
Being isolated
Increased anxiety
Talking about feeling trapped or in unbearable pain
Increased substance use
Looking for a way to access lethal means
Increased anger or rage
Extreme mood swings
Expressing hopelessness
Sleeping too little or too much
Talking or posting about wanting to die
Making plans for suicide
How can we help a friend or family member who may be struggling with thoughts of suicide? According to Bethe1to, there are 5 effective action steps for communicating with someone who may be suicidal.
1. Ask the question – “Are you thinking about suicide?” Ask in a direct, unbiased manner which can open the door for effective dialogue. Do not ever promise to keep their thoughts of suicide a secret. Studies suggest that asking about suicide can actually reduce suicidal ideation.
The flip side of the “Ask” step is to “Listen.” Make sure you take their answers seriously and not to ignore them, especially if they indicate they are experiencing thoughts of suicide. Listening to their reasons for being in such emotional pain, as well as listening for any potential reasons they want to continue to stay alive, are both incredibly important when they are telling you what’s going on. Help them focus on their reasons for living and avoid trying to impose your reasons for them to stay alive.
2. Be There. This could mean being physically present for someone, speaking with them on the phone when you can, or any other way that shows support for the person at risk. An important aspect of this step is to make sure you follow through with the ways in which you say you’ll be able to support the person – do not commit to anything you are not willing or able to accomplish. If you are unable to be physically present with someone with thoughts of suicide, talk with them to develop some ideas for others who might be able to help as well (again, only others who are willing, able, and appropriate to be there). Listening is again very important during this step – find out what and who they believe will be the most effective sources of help. Increasing someone’s connectedness has shown to be a protective factor against suicide.
3. Help Keep them Safe. First of all, it’s good for everyone to be on the same page. After the “Ask” step, and you’ve determined suicide is indeed being talked about, it’s important to find out a few things to establish immediate safety. Have they already done anything to try to kill themselves before talking with you? Does the person experiencing thoughts of suicide know how they would kill themselves? Do they have a specific, detailed plan? What’s the timing for their plan? What sort of access do they have to their planned method?
Knowing the answers to each of these questions can tell us a lot about the imminence and severity of danger the person is in. For instance, the more steps and pieces of a plan that are in place, the higher their severity of risk and their capability to enact their plan might be. Or if they have immediate access to a firearm and are very serious about attempting suicide, then extra steps (like calling for emergency help or driving them to an emergency department) might be necessary. The Lifeline can always act as a resource during these moments as well if you aren’t entirely sure what to do next.
4. Help Them Connect. Helping someone with thoughts of suicide connect with ongoing supports (like the 988 Lifeline) can help them establish a safety net for those moments they find themselves in a crisis. Additional components of a safety net might be connecting them with supports and resources in their communities. Explore some of these possible supports with them – are they currently seeing a mental health professional? Have they in the past? Is this an option for them currently? Are there other mental health resources in the community that can effectively help?
One way to start helping them find ways to connect is to work with them to develop a safety plan. This can include ways for them identify if they start to experience significant, severe thoughts of suicide along with what to do in those crisis moments. A safety plan can also include a list of individuals to contact when a crisis occurs.
5. Follow Up. After your initial contact with a person experiencing thoughts of suicide, and after you’ve connected them with the immediate support systems they need, make sure to follow-up with them to see how they’re doing. Leave a message, send a text, or give them a call. The follow-up step is a great time to check in with them to see if there is more you are capable of helping with or if there are things you’ve said you would do and haven’t yet had the chance to get done for the person.This type of contact can continue to increase their feelings of connectedness and share your ongoing support.