Don't Skirt Around the Topic of Suicide (article featured in The Tennessean)
Suicide is the second leading cause of death among teenagers and young adults in America. Because of the stigma and uncomfortable feelings sometimes associated with discussing suicide, it is a topic that is often avoided. Some people may not know how to approach the subject while others fear that talking about suicide will encourage a vulnerable person to make an attempt. Talking about suicide and asking direct questions is much more likely to prevent, as opposed to enable, a person’s suicide. Also, there could be warning signs that a person has considered suicide, and there are helpful ways to address the topic when you are concerned that a loved one may be experiencing such thoughts.
First, if you are concerned that a friend or loved one is severely depressed or may be contemplating suicide, look for warning signs and risk factors such as:
The person is giving away personal belongings; especially items that hold a special meaning.
The person is verbalizing that he/she is feeling suicidal.
The person is making passive suicidal statements such as, “I wish I could go to sleep and never wake up,” “I feel like there’s no way out,” “I feel hopeless/helpless/worthless,” “I can’t stand the pain any longer,” “This is too much to handle,” etc.
The person has made past suicide attempts.
A friend or family member of the person has attempted or completed suicide,
The person has a history of depression or other mental illness.
The person has a history of substance abuse.
The person has been bullied or has been the victim of emotional, sexual, or physical abuse.
If you determine that a person is at risk for and may be contemplating suicide, the following are useful ways of responding:
Listen. Often, people who are feeling depressed and hopeless are not looking for you to “fix” the situation. In fact, common responses like, “You have so many things to live for” or "This too shall pass” often lead a person to feel unheard and misunderstood. When a person is depressed and suicidal, he/she likely does not feel like the hopelessness will pass. Often, the person has been experiencing a prolonged feeling of sadness that has not improved. Depression can be severe and chronic and, for many people, a lifelong disease that does not “pass” with time.
Ask questions. People may avoid discussing suicide because it is an uncomfortable topic to address. However, if you fear that someone you know may be contemplating suicide, ask him or her directly if he/she is feeling suicidal. Don’t cushion the inquiry by asking indirectly or trying to gather collateral information to determine if the person is at risk. Simply ask the person outright. Also, ask the person if he/she has a plan for the suicide and if he/she has access to that plan. If a plan is identified, ask when he/she plans to carry out the plan. For example, you might ask the following questions: “Are you planning to commit suicide?” If the person answers “yes,” then ask, “How do you plan to do it?” If the person states that the plan is overdosing/shooting, etc., then ask if the person has access to the means by which they plan to complete the suicide. Such as, “Do you have any guns in your house or do you know where you would get one?” or “Do you have access to pills?” Contrary to popular belief, those contemplating suicide will often answer these questions honestly.
Remove potential weapons/means of carrying out the plan. Remove items from the person’s home or environment that may be used to complete a suicide. For example, removing items such as guns, knives, ropes, bed sheets, medications, car keys, etc., will hinder the person from being able to immediately carry out the plan.
Act quickly. If you suspect that a person may be suicidal, take action quickly. Don’t leave the person alone. Call 911 or take the person to the emergency room. If you are on the phone with the person, keep him/her engaged in conversation. Even if you think your loved one will be angry with you, don’t hesitate to call for help. Do not feel obligated to keep the suicidal ideation a secret, even if you initially agreed not to tell anyone.
Provide support. Continue to support the person through recovery. A person who has contemplated or attempted suicide needs a strong support system, even when he/she no longer feels suicidal. Social and familial support is key to a sustained recovery and the prevention of future attempts.
Don’t blame yourself. Family members and friends often feel extremely guilty when a loved one contemplates, attempts, or completes suicide. Although there are warning signs and potential ways of interrupting a suicide before it occurs, not all suicides are preventable. Some people are determined to end the pain that they are feeling and choose a very lethal means without leaving much time or room for intervention. Ultimately, suicide is no one’s “fault.” It is most often a response to the intense feelings of hopelessness associated with a very debilitating and chronic condition.