Written by: Erin Mongiello & Taylor Boyle
Let’s talk suicide and suicidal ideation. No, let's really talk. Let’s start with saying the word suicide. It’s okay to say it! While talking about suicide or suicidal ideation may be uncomfortable, a simple conversation can truly save a life. Let’s discuss ways to support someone who is suicidal and how to seek help.
Some factors that put someone at an increased long-term risk for suicide are:
- Prior suicide attempts
- Family history of suicide
- History of mental health conditions such as severe depression, anxiety disorders and psychotic disorders
- Substance misuse
- Impulsivity or aggressiveness
- Serious family problems
- Breakups or other major relationship losses
- Access to means for self-harm (unsecured firearms, prescription medications, poisons)
- Social isolation
- History of traumatic experiences such as sexual violence or severe episodes of racial prejudice/violence, bullying
- Lack of access to mental health care
- Multiple exposures to suicide in one’s community or through unsafe coverage of suicide in the media
Signs that your loved one may be experiencing thoughts of suicide:
- Being sad or moody: They may have long-lasting sadness and mood swings. Depression is a major risk factor for suicide.
- Sudden calmness: They suddenly become calm after a period of depression or moodiness.
- Withdrawing from others: They choose to be alone and avoid friends or social activities. They also lose interest or pleasure in activities they previously enjoyed.
- Changes in personality, appearance, sleep pattern: Their attitude or behavior changes, such as speaking or moving with unusual speed or slowness. Also, they suddenly become less concerned about their personal appearance. They sleep much more or much less than typical for that person.
- Showing dangerous or self-harmful behavior: They may engage in potentially dangerous behavior, such as driving recklessly, having unsafe sex or increase their use of drugs and/or alcohol.
- Experiencing recent trauma or life crisis: Examples of crises include the death of a loved one or pet, divorce or break-up of a relationship, diagnosis of a major illness, loss of a job or serious financial problems.
- Being in a state of deep despair: They talk about feeling hopeless, having no reason to live, being a burden to others, feeling trapped or being in severe emotional pain.
- Making preparations: They begin to put their personal business in order. This might include visiting friends and family members, giving away personal possessions, making a will and cleaning up their room or home. Often the person will search online for ways to die. Some people will write a note before attempting suicide.
- Threatening suicide or talking about wanting to die: Not everyone who is considering suicide will say so, and not everyone who threatens suicide will follow through with it. However, every threat of suicide should be taken seriously.
Okay, so now what?
A national poll conducted in 2020 found that while 95 percent of those surveyed would do something if someone close to them was thinking about suicide, almost 70 percent of respondents identified barriers that keep them from discussing suicide with others.
Talking to someone you love about suicide may be the toughest and most uncomfortable conversation you ever have, but it may also be the most important.
Here are some tips and tools to eliminate these barriers and help start the discussion if a friend or loved one is suicidal.
The power of that initial ask, ability to listen openly without judgment , having readily available resources and/or a safety plan is key when supporting a suicidal friend or loved one.
Start the initial ASK:
- Discuss changes you have noticed and why you are concerned.
- Ask them directly, “Have you thought about killing yourself?” or “Are you having suicidal thoughts?”
Practice Effective LISTENING:
- Do not try to solve their issues. Instead, show compassion and support.
- Let them know that you will be there for them. Give them time to manage intense emotions.
- Listen without judgment and wait to respond until they have shared their feelings.
DETERMINE, to the best of your ability, if they are in immediate danger:
If you feel that someone else’s life is in danger, this is an emergency — you must take immediate action to keep everyone safe. Call 911 (or a local crisis line) or go to your nearest emergency room. Under no circumstances should you leave them alone.
Tips For Calling 911
- Let 911 operators know that your loved one is experiencing a mental health crisis. Many communities have responders trained to support someone experiencing a mental health crisis, so it’s important that they have this information.
- Specifically ask if there is a crisis team. These specialists are trained to intervene in these situations.
- Provide as much detail as possible about the situation.
No Immediate Danger
If you are confident that your loved one is not at immediate risk, and that you can manage the situation, consider the following steps. Keep in mind that even if it’s not a physical “emergency,” it is still an urgent situation that should be addressed as quickly as possible.
Utilize available RESOURCES:
- Reach out 24/7 to the 988 Suicide an d Crisis Lifeline by dialing or texting 988 or using chat services at suicidepreventionlifeline.org to connect to a trained crisis counselor.
- Text Line is free, 24/7 support for those in crisis. Text 741741 from anywhere in the U.S. to text with a trained Crisis Counselor.
Create a SAFETY PLAN:
- Identify triggers. What led to me feeling this way? Describe what led to the crisis.
- Analyze thoughts and behaviors that may be indicators of active suicidal ideation. What are some red flags that can indicate help is needed?
- List ways to internally cope. How can I distract myself from these thoughts?
- List ways to externally cope. Who can help distract you from these thoughts?
- Create a list of coping strategies. What are some things I can do instead of ending my life? i.e. Breathing, exercising, screaming, calling a friend, etc.
- Create an emergency contact list. Who can I call for support in a crisis?
Items that could be dangerous (like prescription and over-the-counter medications, alcohol, cleaning supplies, sharp objects, belts, ropes, and especially guns and bullets) should be locked up or removed from the home. If necessary, constant and direct supervision of your loved one may be needed to keep them safe.