National Suicide Prevention Week
September 9–15, 2018
Suicide deaths can stem from a variety of causes, but many deaths are consequential of untreated mental illnesses like depression, or substance use disorders involving drugs or alcohol. Suicide is preventable, and it can begin with mental health first aid. This National Suicide Prevention Month, you can take action by learning how to provide first aid for someone who may be experiencing suicidal thoughts.
What Is Mental Health First Aid for Suicide Risk ?
Mental health first aid is help offered to someone who is having suicidal thoughts or experiencing a crisis related to a mental illness like depression or anxiety. Mental health first aid for suicide risk aims to potentially save someone’s life by reducing their risk of harm and providing comfort and support.
This kind of first aid is not designed to heal a mental illness but can help someone transition from an intense moment of crisis to a state of calmness so that they can seek professional care. Anyone can offer mental health first aid, and it can be provided until appropriate treatment can be received or until the crisis resolves.
How to Tell If Someone Is At Risk of Suicide
Before you can intervene to potentially save a life, it’s important to be familiar with the factors that can influence someone’s risk of suicide and be able to recognize suicide warning signs.
Suicide Risk Factors
Some people may face an increased risk of suicide if they experience certain physical, behavioral or environmental factors.
- Health-related factors: serious mental illness like depression, drug misuse or alcohol addiction, a traumatic brain injury or chronic pain.
- Environmental factors: access to lethal means (e.g., guns in the home), prolonged stress, traumatic life events or exposure to a suicide.
- Historical factors: previous suicide attempts or a family history of suicide or domestic violence.
Suicide Warning Signs
Someone who struggles with suicidal thoughts may exhibit warning signs through changes in their moods, the way they talk and how they behave.
- Mood-related warning signs: general apathy or a loss of interest in activities, irritability, humiliation, rage, depression or anxiety.
- Verbal warning signs: talking about killing themselves, saying they feel hopeless, saying they feel like a burden to others, talking about feeling trapped or expressing inescapable pain.
- Behavioral warning signs: aggression, fatigue, avoiding family or friends, sleeping too much or too little, increased use of alcohol or drugs, giving away prized possessions, calling loved ones to say goodbye or searching online for materials or means to kill themselves.
First Aid for Suicidal Thoughts or Behaviors
If someone you know is experiencing suicidal thoughts or exhibiting suicidal behaviors, don’t wait for their family members or other loved ones to intervene. Assume you are the only one who will reach out to them. You can intervene with mental health first aid techniques.
Important Note: If someone has a deadly weapon and is threatening to kill themselves or harm others, call 911 for immediate assistance. Do not attempt mental health first aid if there is an immediate threat to your safety.
Listen and Watch for Serious Warning Signs
One of the most serious warning signs of suicide risk is when someone threatens to harm or kill themselves, even if the threat is veiled as a joke or offhand remark. People may think that if someone talks about suicide then they aren’t serious, but this is a myth. Talking about suicide may be an indicator that someone is already planning to take their life. With this in mind, assume that every suicide threat is genuine.
Other immediate warning signs to watch for include looking for materials or means to kill oneself, posting on social media about death or suicide, behaving recklessly or actively using drugs or alcohol.
Talk With the Person Privately
If you see serious warning signs of suicide, find a quiet place to intervene with first aid support. If you suspect someone is at risk of killing themselves, it’s important to speak with them as soon as you can, but do so in a safe, private environment where they can feel comfortable talking openly.
Ask Questions to Assess Suicide Risk
To determine whether someone intends to take their life, ask several important questions and listen nonjudgmentally.
- “Are you thinking about killing yourself?” This question must be direct and to the point, and it’s important to ask this in a straightforward tone, without dread or judgment. Alternatively, you could ask, “Are you having thoughts of suicide?” Don’t be afraid to say the word “suicide,” as it does not convince someone to take their life. In fact, it can have the opposite effect. Talking openly about suicide with someone who is experiencing suicidal thoughts can encourage them to speak up about how they’re feeling.
- “Have you decided how you would kill yourself? Have you decided when you want to do it? Have you taken any steps to obtain the materials you would need to carry out your plan?” More extensive planning usually means a higher risk of suicide. However, it’s important to remember that the absence of a plan is not enough to ensure someone’s safety.
- “Are you using alcohol or other drugs?” Substance misuse can make someone more susceptible to act on their suicidal thoughts.
- “Is this the first time you’ve thought about killing yourself?” A history of suicidal thoughts and attempts can make someone more likely to follow through with their plan to end their life.
Listen Without Judgment
One of the best ways to help someone who’s having suicidal thoughts is to listen if they want to talk. Let someone know that you take their concerns seriously by making eye contact, facing your body toward them, nodding your head, and most importantly, not interrupting.
Someone who struggles with suicidal thoughts deserves to be seen and heard as a human being who needs love and support, not as a problem that needs to be fixed. Providing mental health first aid is about helping someone cope with distressing urges and emotions by offering reassurance and it is not a time for you to interject your opinions on how they should handle the situation.
By offering mental health first aid support, you’re essentially saying, “I care about what you’re going through. Your life matters to me.” Voicing these thoughts out loud can be beneficial, too. Your acknowledgment and validation of their feelings can be incredibly helpful, and your empathy can go a long way. However, avoid saying, “I understand,” even if you’ve faced suicidal thoughts in the past, as this can discourage the person from talking about their situation.
Offering reassurance can include:
- Expressing empathy.
- Telling the person that their life makes a difference in your life.
- Telling the person that suicidal thoughts are common and that they do not have to be acted on.
- Clearly stating that suicidal thoughts are often associated with a treatable mental health condition.
During this conversation, avoid overarching platitudes like, “Everything’s going to be OK,” or minimizing their feelings by saying, “You’ll get over it.” Avoid using guilt or threats to scare them out of attempting suicide, and leave religious reasoning like, “You’ll go to hell,” out of the conversation. Don’t attempt to debate the value of life with the suicidal individual or use logic or reasoning to get them to “think clearly,” or in a way that makes sense to you.
Remember that mental health first aid is not about you being able to “fix” the situation or make someone’s suicidal thoughts go away. It’s not your responsibility to act as a therapist. You can only offer support, caring reassurance and guidance toward professional resources.
Encourage Appropriate Professional Care
Your first aid response is meant to help someone who is experiencing a mental health crisis, and cannot take the place of long-term, professional mental health care. When someone is safe, calm and ready to talk through their options, you can effectively guide them toward helpful resources for professional care. However, if the person does not want to discuss this with you, suggest they call the National Suicide Prevention Lifeline at 1.800.273.8255. Trained counselors may be able to guide them to local resources for care.
Appropriate professional care options you can suggest:
- A primary care physician.
- A mental health counselor or psychologist.
- A psychiatrist.
Additionally, encourage the person to think of people or organizations who have helped them in the past. They may be a doctor, psychiatrist, mental health practitioner, close friend, family member, community group, church group or other organization that can be helpful.
What to Do If You Struggle With Suicidal Thoughts
If you’re having suicidal thoughts, know that you’re not a bad person and that it is OK to ask for help. You deserve to receive mental health first aid just as much as anyone you love does, but don’t wait for someone to reach out if you’re thinking of ending your life. Treat yourself in the same way that you would treat someone who needs your support.
You’re not alone, you’re not a burden and there are caring individuals who want to help you through this difficult time. If you’re in a crisis, speak with someone immediately by calling the National Suicide Prevention Lifeline at 1.800.273.8255. Trained crisis counselors on this line are waiting to answer your call and offer you support and guidance, day or night.
If you struggle with suicidal thoughts, don’t give up. Whether or not you believe it right now, you matter, and your life matters to someone else. You’re strong enough to carry on, despite what you’re feeling. There are reasons to keep living, and your story can give someone hope someday. You matter, please stay.
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