Dr. Val Farmer
Rural Mental Health & Family Relationships

What To Do If You Suspect Suicidal Risk

January 31, 2011

Suicidal thoughts are a common symptom of depression. Most teenagers or young adults have had passing thoughts of suicide. People confronted and overwhelmed with a major loss or tragedy may wish to escape their terrible pain.

With some exceptions, those who commit suicide and those who weather the storms and misery of life share this motive. They did not or do not want to die. The attractiveness of suicide lies in the promise of relief from overwhelming feelings of anguish, alienation, guilt, loneliness, frustration, anger, grief, and confusion - an intolerable situation from which there seems to be only one escape.

But there are avenues of escape from this inner storm of emotional turmoil and pain. One of the surest is the passage of time. Feeling or being suicidal is temporary. For the vast majority of people there may be a few minutes, a few hours or a few days when their despair makes them acutely suicidal. Acting out on suicidal thoughts during such a state of despair is a tragedy - a permanent solution to a temporary problem.

With the passage of time, the emotional pain recedes, circumstances change, hope returns and the will to live comes back. However, during that critical time of acute despair, the suicidal person needs support and care. Co-workers, friends and family who sense the threat can take steps to help bridge the time until hope and the will to live return.

What to do? It is a frightening experience and responsibility to be in this position. How can they overcome their own fears and feelings of inadequacy to confront this delicate and painful subject? What is the right thing to say? What is the wrong thing? How can they be helped? Here are a few guidelines for intervening in the life of a suicidal person.

- Be calm. The suicidal person will best respond to an authoritative person who projects a sense of strength and control coupled with care and concern. Be accepting and communicate that he or she is a special, worthwhile human being.

- Be a good listener. Try to pinpoint the causes of the suicidal thinking and feelings. Help him or her identify and express their pain and hurt. Don’t argue or debate the philosophical/religious reasons for living. Don’t lecture. Don’t try to talk him or her out of suicide. Don’t argue. Don’t analyze motives. Just listen.

- Don’t dismiss or undervalue what is being said. Don’t be shocked by what you hear. Don’t stress the pain or embarrassment a suicide would cause the family. Don’t offer "cheap" reassurance that things will be better. Don’t promise confidentiality.

- Ask open-ended questions. Draw the suicidal person out. Get him or her to think. In verbalizing thoughts, the suicidal person begins to gain a sense of control over their emotions. "What are you doing now about your situation?" "What have you done?" "How did that work out?" "Who might be helpful to you?"

- Ask specifically about suicidal plans. Mentally note how specific the plans are. Assess the lethality of the method and the availability of the means. The more specific the plans, the more lethal and available the means, the greater the risk of suicide.

- Be available. Share your willingness to be available to talk and listen. Don’t over promise something you can’t deliver. Be honest and realistic about your schedule.

- Explore resources. Find out whom the suicidal person might be willing to talk to about their situation - a priest or minister, a family doctor, mental health professional, or a special friend. If you are aware of community resources, mention the various sources of counseling available in the community. Your own experiences are especially helpful in making a "word-of-mouth" referral.

If you suspect immediate danger, take him or her to a hospital or involve law enforcement. Don’t leave the suicidal person alone. Isolation, both physical and emotional, poses the biggest risk for suicide. If you are satisfied that the danger is not immediate, then connecting him or her with professional treatment will suffice.

- Do something concrete. Set a time to talk again. Arrange for an appointment or a next meeting. Get him or her to agree to a course of action and commit to it. Give a specific time for the next meeting or appointment. Insist on their compliance. Your voice of authority and willingness to assume control is welcome.

- Obtain the help of others. Don’t carry this burden alone. Involve as many people as possible. Share your plans for getting others involved in this situation. Follow through with the plans you make and see to it that additional help happens. Mobilize and surround the suicidal person with their own support system of family and friends. Once the suicidal risk is out in the open, he or she will experience relief as the avenues of support open up.

Helping a person with suicidal thoughts doesn’t have to be a big mystery. The biggest obstacle is having the courage to ask the hard questions. Once you have broken through and get the suicidal person to talk and share their burden, the process of recovery has already begun. Listen. Keep them talking. Take control. Make plans. Marshall support.

Even the fiercest storms are temporary. This inner storm, like all storms, is temporary. This storm, however, is not a storm to be endured alone.