What do I do when someone is suicidal?

World Mental Health Day is on October 10th and this year, the theme is Suicide Prevention.

EVERY 40 SECONDS, SOMEONE LOSES THEIR LIFE TO SUICIDE. There are more deaths from suicide than from wars and murder together! Let’s just take a moment to let that sink in …

Furthermore, for each suicide it is suggested that there are more than 20 suicide attempts.

Suicide is the leading cause of death among young people aged 20-24 years in the UK and it is considerably higher in men, with nearly four times as many men dying as a result of suicide compared to women.

You don’t need me to tell you that every suicide is a tragedy that affects families, communities and has long lasting effects on the people left behind.

When someone we know feels suicidal, we can feel an overwhelming sense of helplessness, shock and fear, especially if we don’t really know how we can support them or whether to act on what they have told us. How do we know if we will say or do the ‘right’ thing if someone reveals that they are feeling suicidal?

Let’s take a look at:

  • Some of the myths surrounding suicide
  • Some of the warning signs to look out for
  • What you can do if someone discloses that they are feeling suicidal and
  • Contact details for Organisations that can help

Let’s take a look at some of the myths surrounding suicide?

There are many common misconceptions when talking about suicide, which can be dangerous. A lack of understanding could prevent vulnerable people from getting the right help at the right time.

Myth: People who talk about suicide are attention seeking.

More often than not people who talk about the idea of killing themselves are looking for help. Whether they have made suicide plans or not, is irrespective, the fact that they’re reaching out shows that they have something they want to talk about.

What can you do? Take the opportunity to ask them more about how they feel. Showing that you care about them and value their feelings could help them see that they can cope with the right support.

Myth: People who talk about suicide won’t really do it.

Almost everyone who attempts suicide has given some clue or warning.

What can you do? Don’t ignore any references to death or suicide, however indirect they may seem. Statements such as “You’ll be sorry when I’m gone” or “I can’t see any way out,” may indicate serious suicidal intent no matter how casually or jokingly said. If you feel you need assistance or guidance, seek professional advice, and never dismiss it as attention-seeking.

Myth: Don’t talk about suicide because it might give someone the idea to do it.

Suicide can be difficult subject to talk about. If you think someone close to you is having suicidal thoughts, it’s quite ‘normal’ to feel reluctant to bring the subject up in case it gives them the idea to do it.

What can you do? Discuss suicide openly. By asking someone directly about suicide you give them permission to tell you how they feel. People who have felt suicidal will often say what a huge relief it was to be able to talk about what they were experiencing. Once someone starts talking, they’ve got a better chance of discovering other options that aren’t suicide.

Myth: If a person is serious about killing themselves then there is nothing you can do.

You may think there is very little you can do when someone appears to be overwhelmingly distressed, but it’s important to realise that their feelings are probably temporary. Feeling actively suicidal usually only lasts for a short period of time.Most people experiencing suicidal thoughts do not want death; they want the pain to stop.

What can you do? Although we are not responsible for anyone else’s actions or behaviour, let’s not assume that there is nothing that we can do to help and support someone who is feeling suicidal – even if seems like they have made up their mind that they wish to end their life. Ask them how they are feeling. Sometimes people will talk about the facts of what happened, why it happened and what actions they are thinking of taking, but never say how they actually feel. Discussing your innermost feelings can be a huge relief. It can also give clues about what the person is really most worried about.

Myth: People who die by suicide are people who were unwilling to seek help.

Studies of suicide victims have shown that more than half had sought medical help in the six months prior to their deaths.

What are some of the warning signs to look out for?

It is important to acknowledge that everyone is different, and may express and cope with suicidal feelings in a different way. However, people rarely complete suicide impulsively – even if it seems that way to the friends and family they leave behind. Often contemplation of suicide is a result of someone being overwhelmed by a variety of life circumstances. Sometimes there may be obvious signs that someone is at risk of attempting suicide. For example, if they:

  • threaten to hurt or kill themselves
  • talk or write about death, dying or suicide
  • actively look for ways to kill themselves, such as stockpiling tablets

Other warning signs that may indicate a person may be at risk of attempting suicide are if they:

  • Have episodes of sudden rage and anger
  • Appear anxious and agitated
  • Are unable to sleep or they sleep all the time
  • Noticeably gain or lose weight due to a change in their appetite
  • Talk about feeling trapped
  • Act recklessly and engage in risky activities with an apparent lack of concern about the consequences – drug taking, alcohol abuse, reckless driving and taking unnecessary risks can all be indicators that a person no longer cares whether they live or die
  • Self-harm – including misusing drugs or alcohol, or using more than they usually do
  • Become increasingly withdrawn from friends, family and society in general – stop attending social functions and become difficult to contact.
  • Lack of interest in physical appearance – not wearing makeup if they usually do, not washing, not ironing clothes or taking care of themselves can indicate a lack of care.
  • Complain of feelings of hopelessness – statements such as ‘what does it matter?’ and ‘it’s never going to get better’ demonstrate that they see no way out of their situation. Studies have found that hopelessness is a strong predictor of suicide. People who feel hopeless may talk about “unbearable” feelings, predict a bleak future, and state that they have nothing to look forward to.
  • Talking a lot about death and suicide – if someone talks frequently about death and suicide, it’s likely that they’re thinking about it too.
  • Sudden appearance of calm – if they have been very depressed for a long time and they suddenly seem calm and happy, they may have made the decision to end their lives.
  • Put their affairs in order – if they make a will, give away their favourite possessions or make certain arrangements with family members, it could be because they are preparing to die.
  • Sudden reconciliation – apologising for or admitting to things that happened a long time ago can indicate that they’re laying old feelings to rest.

So, what can you do if someone discloses they are feeling suicidal?

As most people do not have this sort of conversation every day you may feel uncomfortable and unsure of what to say. This is entirely normal and understandable. However, you can help by being calm, supportive and non-judgemental. If you’re worried about someone close to you, it’s important not to panic. Here are some steps you can take:

Give them space to talk about it:

  • Create a safe place – when starting difficult conversations like this, choose a time and place where the person feels comfortable, and has time to talk. Allow the person who feels suicidal to talk freely and in confidence.
  • Listen – always listen attentively. It is important to listen carefully and to be patient while they are talking, without giving ‘advice’.
  • Observe body language – watch for signs of distress to get a feel for how the person is feeling. This will allow you to make a rational decision about whether to call for further assistance. It may be that they just need someone to talk things through with, and if you alert the authorities, friends or family this could create unwelcome drama and attention thus causing more distress.
  • Ask questions – the best way to help is to ask questions, especially open questions. This will give the suicidal person the opportunity to be honest with how they are feeling and will encourage them to think about other options that might not have occurred to them before.
  • Show empathy – try to show empathy. Please note that empathy is not the same as sympathy. Sympathy is saying you can identify with what a person is saying. Empathy is saying you appreciate how they must feel, even if you have never experienced it yourself.
  • Don’t leave them alone if they are ‘critically suicidal’ (see ‘what to do in an emergency’)

Be mindful of how you respond:

Avoid addressing their problems with your own experiences. When someone tells you that they are feeling suicidal you may feel like trying to cheer them up or telling them that they have no reason to feel like that, that there are people far worse off than they are. While these responses are understandable, they are not helpful. Let them know that they are not a burden, that you chose to be there for them because you care. Someone who wants to end their life is unlikely to want:

  • to feel rejected by friends, family or colleagues
  • people to change the subject when they are talking about how they feel
  • to be told that they are wrong or silly
  • to be patronised, criticised or analysed
  • to be told to cheer up or ‘snap out of it’
  • to be told that they should be grateful for having such a good life

Don’t take it personally:

Although it is tempting to believe that we could or should do more, it is important that we don’t make the suicidal thoughts about us. We could tie ourselves up in knots thinking of ways we could offer more support or ‘fix’ the situation. What is important is being non-judgemental while being supportive and showing understanding. We may not always know the right thing to do or say but someone’s suicidal thoughts and feelings are about them, not us.

Point them in the direction of other help:

What to do in an emergency: If you think someone is urgently at risk, call 999 or take them directly to the nearest Accident and Emergency (A&E) department. At A&E, immediate health needs will be dealt with and they may be referred to a liaison psychiatry team or the local on-call mental health services, such as the crisis resolution and home treatment teams.

Do not leave someone who is critically suicidal alone. If you believe that someone you are with is about to attempt suicide

  • Take them to the nearest hospital or call for emergency help
  • Do not leave them on their own.
  • Remove any medication or anything that could cause harm
  • Keep talking to them while waiting for professional help to arrive.

Remember to look after yourself: While it is incredibly distressing to experience suicidal thoughts and feelings, let’s not under estimate the emotional impact on those who are close to someone who discloses that they are suicidal. When we are offering support to someone who is suicidal, we can feel severely impacted emotionally, mentally and physically. We may give so much time, energy and attention to them that we forget to take care of ourselves. While it’s important to respect their confidence, you may need to talk to someone else about how you’re feeling. Don’t be afraid to ask for professional help or guidance if you need it, contact one of the organisations listed below.

Helpful Organisations:

CALM (Campaign Against Living Miserably)

Tel: 0808 802 5858 (17.00 – 00.00. 365 days a year)

Web: www.thecalmzone.net

A male suicide prevention charity offering help, advice and information

Childline

Tel: 0800 1111

Web: www.childline.org.uk

Childline is on hand to help anyone under 19 in the UK. Call 0800 1111 or contact them online. It’s free to use and completely confidential.

MIND

Tel: 0300 123 3393 (09.00 to 18.00. Monday to Friday, except bank holidays)

Web: www.mind.org.uk

Provide advice and support to anyone experiencing a mental health problem

PAPYRUS (Prevention of Young Suicide)

Tel: 0870 170 4000 (helpline available Monday to Friday 09.00 to 22.00, Weekends 14.00 to 22.00, Bank Holidays 14.00 to 22.00)

Web: www.papyrus-uk.org

Provides information for parents of suicidal children and supports those bereaved by suicide

Samaritans

Tel: 116 123 (24 hours, 365 days a year)

Web: www.samaritans.org

Providing 24-hour phone support, Samaritans is a national charity aiming to reduce emotional distress and reduce suicidal feelings so that fewer people die by suicide

Saneline

Tel: 0300 304 7000 (16.30 to 22.30 daily)

Web: www.sane.org.uk

Saneline is a national mental health helpline providing information and support to people affected by mental illness

Young Minds

Tel: 0808 802 5544 (Parents helpline. Monday to Friday. 09.30 to 16.00)

Young people: text the YoungMinds Crisis Messenger, for free 24/7 support across the UK if you are experiencing a mental health crisis – Text YM to 85258

Web: www.youngminds.org.uk

Young Minds offer a free confidential helpline for parents worried about their child or young person, offering practical advice of where to go next.

Siobhan Graham – Accredited Cognitive Behavioural Psychotherapist – www.SiobhanGraham.com