Understanding Suicide Better
Understanding and Recognizing Suicidal People
Some significant losses to look for
Some attitudes to look for
Some behaviours to watch for
Additional indicators strongly associated with suicidality
Responding to a Suicidal Person
Understanding and Recognizing Suicidal People
Research indicates that for most people, suicidal ideation is
characterized by ambivalence - people contemplating suicide generally
state that they have both a wish to live and a wish to die. When
experiencing a suicidal crisis, ending their own life can seem like the
only available option for getting beyond an unbearable state of
anguish: were other viable options made available, most would choose to
live.
Research also indicates that 70 to 80% of suicidal people signal
their suicidal ideation through the expression of various recognizable
warning signs, such as publicly making preparations for their death;
expressing thoughts about suicide, death, and dying; and behaving in
ways that are uncharacteristic and/or worrisome. It also seems clear
the vast majority of people who seriously contemplate suicide are
experiencing treatable mental illnesses such as depression,
manic-depression, anxiety, psychosis, and drug/alcohol addiction.
What is also common to most acutely suicidal individuals is a recent
experience of great loss. This loss may be an existing or pending
change for the worse. The loss could also be the loss of hope that
things will improve in their future. What appears to be more important
than the nature of the loss is the individual's experience of it as
overwhelming or unbearable.
If the person is unable to cope with the loss, they may experience
an emotional crisis. Most emotional crises are characterized by
noticeable changes in behaviour, perceptions, feelings, and the
physical body. When you see someone change in any significant way on
the 'outside', it is a good idea to inquire about their wellbeing - it
may be an opportunity to initiate a suicide intervention.
Discover if they are, or have been contemplating suicide. Let them
know that help is available, there are supportive and skilled people to
call or see in person, and professionally trained people who can help
them make viable choices other than suicide. If you believe they are at
risk of harming themselves and/or someone else, please do not leave
them until they are with another trustworthy adult.
Some significant losses to look for
- Death of a loved one, especially by suicide
- A key relationship unraveling or ending
- Instability/turmoil at home/in one's family
- A severe change in social status or sense of belonging
- Unemployment, loss of a highly valued ability or activity
- Fear of disciplinary action/incarceration/physical violence
- Trauma from sexual or other assault
- Trauma from serious illness or injury
- Major financial/economic loss
- Depression: Nothing seems important anymore. Life's a bad joke.
- Hopelessness/helplessness: There is nothing I can do to change this.
- Purposelessness: There is nothing to live for; there is no point to anything.
- Worthlessness: I can't do anything right. No one cares if I live or die.
- Overwhelmed: I can't stand this anymore. This is way too much for me.
- Intense worry/anxiety: Everything is falling apart. Everyone is going to be disappointed in me.
- Recklessness/impulsiveness: I don't care if I break my neck.
- Elation: Everything is perfect now! (suddenly, after someone has been in a lot of distress)
- Increased use of drugs or alcohol
- Withdrawal/isolation from once enjoyable people/activities
- Risky impulsive activities
- Aggressive, violent behaviour; rage/revengeful acts
- Decreased or increased performance (school, work, hobbies, sports)
- Self-neglect (appearance or hygiene)
- Extreme mood swings
- Changes in energy level (up or down)
- Complaints about health
- Difficulty concentrating
- Decreased, increased or otherwise disturbed eating and/or sleeping
Additional indicators strongly associated with suicidality
- Preparation for Death.
- Giving away prized possessions, making a will, settling loose ends
- Saying goodbye or talking about going away unexpectedly, or with a sense of finality
- Talking about suicide, death or dying
- Saying things such as 'Life isn't worth it...' or 'Things would be better if I was gone...'
- Making jokes, poems, drawings or other references to suicide, death or dying
- Sharing/expressing morbid fantasy or plans about dying or death
- Previous unresolved or recent suicide attempt
Responding to a Suicidal Person
- Start the process of talking and reaching out. Find out about the person's feelings.
- Ask direct questions
such as 'Are you considering suicide?' 'Do you have a plan for how you
will kill yourself?' The more realistic, specific and lethal the plan,
the greater the risk. Take the answers seriously and listen and watch
for potential signals. - Be a supportive listener.
Accept the person's feelings instead of minimizing or judging them.
Tell them it is okay to feel the way they do. Try to understand things
from their perspective. Avoid joking around or acting shocked. - Offer help.
Let the person know you care and want to help. Be there to listen,
support and encourage them to get the help they need. Keep in mind that
it isn't your job to fix their life or solve their problems. - Help them help themselves.
Suggest people they can talk to, such as a parent or relative, close
friend, teacher, counsellor, doctor, or nurse. If they won't get help
for themselves, get it for them. Tell someone you can trust. - Call a Crisis Centre.
Crisis Centres give support and information to people in distress, as
well as to the friends and family who care about them. Anyone who is
suicidal needs the help of a professional and a Crisis Centre can
provide appropriate information. - Be firm and be focused.
Never promise to keep a suicide plan secret. Never dare a person or say
you don't believe them. Never leave a high risk person alone without
making sure that they have help.
We are not responsible for the decisions that someone else makes.
However, we are often in the best position to recognize and initiate
the first response to someone experiencing a suicidal crisis. Some
suicides (20%) occur without any warning and others occur despite the
very caring responses of friends, family and helping professionals.
Suicide is ultimately a personal choice - it is not our job to 'save'
someone else's life, only to offer them other options.