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5 Steps to Take if Someone You Love is Suicidal


Written by, Kate Oliver, MSW, LCSW-C

Icon from Nuvola icon theme for KDE 3.x.

Icon from Nuvola icon theme for KDE 3.x. (Photo credit: Wikipedia)

Last weeks post examined how to determine whether someone is actually suicidal. This week, I want to give you general guidance should you ever have someone you know who is actively suicidal. As I said last week, the hospital is the place to be for anyone who is suicidal, however, there are a few measures you might want to take if you are on the fence about how serious the feelings are that your loved one is experiencing. This post is not intended in any way to constitute medical advice. I strongly urge you to call a mental health professional or suicide prevention hotline if you are having these concerns.

An important side note for teens. Sometimes friends ask us to keep a secret for them about their thoughts of dying. This is not a safe secret! Please tell an adult immediately- your parents, you school guidance counselor, or a trusted teacher, aunt or uncle is a good choice. Here’s the thing- you would rather have an alive, angry friend, than a dead friend who isn’t angry with you.

If you are suicidal, please seek help now. Suicide is what we in the mental health profession like to call a long-term solution to a short-term problem. I know so many people who once contemplated ending it all  who are sooo happy they decided to stick around.

5 steps to Take with a Suicidal Loved One (including what to do if they refuse to get help)

1. The first thing you need to do if you are worried that someone is suicidal is…ask! Asking can go like this:

Are you thinking about dying?

Do you ever think about killing yourself?

Have you ever considered taking your own life or hurting yourself?

Or any other way that sounds like it would work for you. There are a few important things to know about asking. The first important thing to know is that asking will not put the idea in someone’s head unless it was already there. This is, by far, the most common concern I hear about asking. I’ve asked so many people these questions that I cannot even count so let me tell you how asking typically goes from children through adults. I typically get one of two responses. One response is the, “I’ve thought about it a few times” response, or “I’ve been thinking about it a lot lately.” These are causes for concern and need to be addressed. The other, much more reassuring response is when the person you ask looks at you like you have just grown an extra head before saying no and telling you that you get too serious all the time. A third response, that I have not gotten (probably because the people coming to see me are looking for help) is a muted response without committing either way. That is a concerning response that also needs to be addressed. Seriously though, just ask if you are worried someone is feeling that way. If you have any indication that they are suicidal or even thinking about it, continue on to question #2.

2. The next question you want to ask someone is: Have you ever thought about how you would do it?

This question gives you insight into how serious the person is. I remember someone saying to me once that she thought about killing herself and then, when I asked this question, she said, something along the lines of, “If I could be promised that dying were easy, and all I had to do was push a button and it would be over, I know there have been times I would have done that. Until it’s that easy, I’m not going anywhere.” This is a more reassuring answer since it implies that while the person has thought about it, they have not thought in an in-depth way.

There are other people, however, who will tell you what they thought about doing in a way that lets you know they have planned, they are thinking about it and they are serious, unless they are able to sufficiently reassure you that that is how they used to think and that they no longer are thinking in that way. These are people who must be seen by a mental health professional immediately for further evaluation. In the meantime, if possible, try to make sure that the means of harm they would use (prescription drugs, ropes, guns, etc.) are not available. Also, if a person says something to you like the only way they would kill themselves is to jump off the Golden Gate Bridge in San Francisco and you live in Washington DC, you can breathe slightly easier. Still, to be on the safe side, I recommend everyone take the next step regardless of your level of concern.

3. Ask the person you are concerned about to make an agreement to go to the hospital or call the suicide prevention hotline if they feel as though they cannot promise safety. Ask them to promise you they will remain safe. Make them write it down if you need to in order to emphasize the agreement.

4. If you have any concerns that your loved one is still not safe to make good decisions, do not delay, get them to the hospital no matter what it takes. For a person that is not willing to go to the hospital, do not be too intimidated to call 911. That is what they are there for. As I stated earlier in this post, you would rather have a friend who is alive and angry, than a friend who is dead but still likes you. And, by the way, I don’t know anyone who ever stayed mad at someone who stopped them from dying. I know in my state, Maryland, there is also something called an “emergency petition” (you can just google emergency petition and the name of your state to find out about how to go about this in your state). An emergency petition is something a parent, partner, or mental health professional can fill out to get an order stating that the person must be evaluated by a mental health professional.   I have done emergency petitions before and, while I know people have visions of someone being taken away and institutionalized for years, I have yet to see that happen. What most typically happens is that the person goes to the hospital, gets evaluated, makes a safety contract, gets a support system and gets connected with counseling. If it’s helpful just think of it this way: hospitals are not any more interested in keeping people for psychiatric issues than they are for physical health issues. Insurance companies are just as invested in making sure people stay out of the hospital for this issue as they are for any other. In other words, don’t worry about getting someone to the hospital by whatever means necessary. In the end, you will be glad you did.

5. After it’s over, support your friend. Call them, check in with them and, get support for yourself. Remember, you never want to feel like the only person who is keeping someone else alive. It is not fair to either of you and is way too much pressure for one person alone.

Have you ever had to help someone in this way? What were your experiences?

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October 11, 2012 Posted by | Suicide | 3 Comments

Suicide Prevention: Determining if Someone is Suicidal

Written by, Kate Oliver, MSW, LCSW-C

Man thinking on a train journey.

Man thinking on a train journey. (Photo credit: Wikipedia)

Over the years, I have talked to many, many parents, partners, and spouses about what to do if you think someone you love might be suicidal. There are really two parts to figuring out about suicide, 1. determining whether someone is indeed suicidal, and 2. if the person is suicidal, figuring out the level of risk and making sure they are safe. I am going to tackle one section a week so stay tuned for next weeks post. I want to state at the beginning of this post that, of course, my advice here is general and should not be substituted for individualized mental health advice. If you absolutely know someone is suicidal, please take them to the nearest emergency room or contact your local mental health hotline. And, if you are reading this post because you have someone you are concerned about, even if they are not suicidal, please do your best to encourage and support them in seeking therapy as soon as possible. There are mental health services available to many in the United States even if you are under-insured or are not able to afford counseling.

Determining whether someone is suicidal

There are times when you absolutely know someone is suicidal, either you found a note, they told you they were, you find them in the process of attempting, etc. But other times it can be more difficult. Sometimes parents tell me they think their adolescent is saying they want to die in order to get attention. If this is happening, please stop for a moment to think how desperate you have to feel about getting attention in order to say this. I want to make sure that you know that, even with young children, any indication that someone is suicidal needs to be taken seriously. Even if you think they are trying to get attention, don’t you think it would be a good idea to give them some if things have gotten this extreme? I’ve actually come to know of quite a few people via the work that I do who have tried to “get attention” by attempting suicide in the hopes that someone would notice them. I wonder how many suicides are just that, someone thinking they are doing something to get attention but they actually end up dying. Pay attention! Here is what I recommend to all parents who tell me that their child is saying they are going to kill themselves for attention. Tell them you need to take any statement like that seriously and ask if they are serious. If they say that they are, take them to the hospital. Here’s the thing, I know you might say to yourself, “I don’t want to waste the time of the hospital personnel” or, “This kid is trying to waste my time.” Take them to the hospital. Tell them you love them and that you have to take this threat seriously. Sit with them for the hours it takes to be seen. If they are not suicidal, they will be so bored and so over it that by the time you have finished with it, they will never want to have to do that again. You will have nipped a nasty reaction in the bud. The alternative when you take them to the hospital is finding out that they were, in fact, serious and you took them right where they needed to be anyway.

Here’s the thing about the hospital. They are busy. They don’t want to take your child, your friend, spouse, etc. unless they think they need to. Just like they are not looking to keep people for any extra time after surgery, they are not looking to take in people who do not actually need to be there, so please do not worry, the person you take will not be admitted unless they need to be, in which case, you did the right thing.

Warning signs

Other times, you may have someone who you care about who you fear may be suicidal and not telling. Maybe they have had a series of unfortunate circumstances or are having a mental health issue, like a depressive episode. Here are some warning signs that a person is more likely to consider suicide as an option:

  • They have had recent loss such as a death in the family, ending of a significant relationship or loss of a job.
  • They have a history of depression. Depression is characterized in adolescents differently than it is in adults. Adults tend to have a loss of interest in their usual activities, difficulty attending to tasks, a sense of hopelessness. In children and adolescents, depression more often manifests as irritability and anger.
  • They have friends or family members who have committed suicide.
  • They have mentioned, even just in passing, that they should just kill themselves, or that they wish they could die. Sometimes they may talk about everyone being better off without them.
  • They suddenly begin giving away important items you would not expect them to give away and seem to be suddenly peaceful after a period of difficulty.
  • They begin to isolate themselves from friends and family members.
  • They have increased alcohol or drug use and/or impulsive or reckless behaviors.
  • They have previously attempted suicide in the past.

If you notice any of these symptoms, please take these next steps to ensure that your loved one is safe. Better safe than sorry, as they say. It is especially true in this case.

Stay tuned, next week I will write about what to do to support someone if you fear they are suicidal. In the meantime, here are a few resources.

National Suicide Prevention Lifeline: 1-800-273-TALK (8255)

American Foundation for Suicide Prevention

How to Know When You or Your Child Need a Therapist (help4yourfamily.com)

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October 4, 2012 Posted by | keeping children safe, Suicide | , , , , , , , | 9 Comments

   

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