How to Help a
Suicidal Person
by Patty Fleener M.S.W.
1) If someone threatens or makes
statements referring to suicide, TAKE THEM SERIOUSLY. Many people have taken
their lives when people thought their statements about suicide were
"manipulative" or the person was being "melodramatic."
Many people have died "accidentally." They may
take some medication for example just to get others to hear them and feel they
will be discovered and saved. Instead of calling attention to their needs, they
in fact, died.
2) If the person is telling you either in person
or over the phone that they ARE going to kill themselves, you call 911 RIGHT
NOW. Law enforcement will come to the person’s home and take them to be
evaluated by a mental health person. Even if you feel in your heart, that they
will not take their life, you go by what they are telling you. Don’t wait to get
over to their house to call 911. You call 911 RIGHT NOW from wherever you are
at.
If the suicidal person forbids you to call, is
angry about it or upset, you call ANYWAY. If you need to go to a neighbor’s home
to call, do it. If it’s in the middle of the night, wake up the neighbor and
make that call.
If the person is calling from an unknown location
and discusses suicide, try to find out where they are. You cannot send someone
to them if you don’t know where to find them.
What if that person has you in confidence and
makes you swear that you will not tell anyone how they are feeling? Do you keep
that confidence? NO! Would you be a lousy friend, mother, etc. if you broke that
confidence? NO! Suicidal discussion automatically ends confidentiality.
A person in crisis may not be aware
that they are in need of help or be able to seek it on their own. They may also
need to be reminded that effective treatment for depression is available, and
that many people can very quickly begin to experience relief from depressive
symptoms.
Ask these questions first:
San Francisco Suicide Prevention below
says:
Things to watch for when assessing potential risk...
Remember
"P.L.A.I.D. P.A.L.S."
Plan
Do they have one?
Lethality
Is it lethal? Can they
die?
Availability
Do they have the means to carry it
out?
Illness
Do they have a mental or physical
illness?
Depression
Chronic or specific
incident(s)?
What if the person does not "qualify" for the
above statements? Do you not take them seriously? YES! ALWAYS take people
seriously when suicide is discussed. If they truly want to die, they may not
tell you the truth about their plan.
All it takes is for someone to say "I am going to
kill myself" to call 911. When law enforcement comes, they will assess the
person. They will talk to the person. There are times where the person is not
"taken" by law enforcement, but I do believe it is helpful to have law
enforcement there to talk with them.
After you have taken emergency measures as
described above, or the person is not in immediate risk, what do you say to
them?
Do not:
Judge them
Show anger toward them
Provoke
guilt
Discount their feelings
Tell them to "snap out of it"
Do:
1) Acknowledge and accept their feelings even if
they appear distorted - "you sound like you are feeling abandoned...," "that
must have hurt you terribly...," how does make you feel"? "are feeling like
there is no hope"? etc.
2) Be an active listener- repeat some of their
statements back to them to let them know you are listening. For example, "so
what you are saying is..., "I’m hearing you saying you hate yourself...," so
receiving that letter made you feel abandoned..." "I hear you saying you want to
die," etc.
3) Try to give them hope and remind them what they
are feeling is temporary, without provoking guilt. "I know you feel you cannot
go on, but things will get better," "What you are feeling is temporary," "I
believe in you and that you will get better," "There is a light at the end of
the tunnel - it’s ok if you don’t see it now."
4) Be there for them. If they are not there with
you, go to them or have them come to you. It is better if you go to them, in
case they can their mind and don’t show up where you are.
5) Show love and encouragement. Hold them, hug
them, touch them. Allow them to show their feelings. Allow them to cry, to show
anger, etc. Let them know you hear them and are there for them. Let them know it
is ok to feel what they feel, even if it is distorted. Let them know you accept
them right where they are now. If you love them, tell them.
6) Pamper them. Feed them if they are hungry. Let
them shower if you feel that will help them. Rent a movie if they feel like it.
Turn on their favorite music if it makes them feel better.
7) Help them get some help. If phone calls are
needed for counseling, drug recovery, Dr. appointments, etc., encourage them to
make these calls. ( See my page entitled "Are you Suicidal." There are some
resources listed there). It is better if they call, but it’s ok it you need to
make these calls if their level of functioning is low. If they have a counselor,
psychologist, psychiatrist, etc. this is a good time to call them if the person
is still at risk. If it’s evening and the person is not at risk, calls should be
made the next day to these people informing them of the person’s suicidal
ideation. The mental health professional may make an adjust to the person’s
medicine, admit them into a hospital, etc.
8) If you are at the person’s home, remove any
item/items the person may use to hurt themselves with. Grab their medication or
weapon. Make these items inaccessible to the suicidal person until they are
safe.
9) Is there a child or children of the suicidal
person witnessing their parent’s crisis? Try to get the child out of there
(AFTER the person is safe) and into a friend or relative’s home. This situation
is extremely traumatic for children. Many times we think they are asleep but
they are fully aware of the situation at hand.
They may prepare for death by giving away prized possessions,
making a will, or putting other affairs in order.
They may withdraw from those around them.
Change in Sleep Patterns - insomnia, often with early waking or
oversleeping, nightmares
Change in Eating Habits - loss of appetite and weight, or
overeating
They may lose interest in prior activities or
relationships.
A sudden, intense lift in spirits may also be a danger signal,
as it may indicate the person already feels a sense of relief knowing the
problems will be ended.
One or more diagnosable mental or including physical or sexual
abuse substance abuse disorder
Family history of mental or substance abuse disorder
Family history of suicide including family, peers, or in news or
fiction stories
Family violence, including physical or sexual abuse
Prior suicide attempt/attempts Firearm in the home
Exposure to the suicidal behavior of others, including family,
peers, or in the news or fiction stories
Recent suicide attempt by a friend/family member
Recent Loss - through death, divorce, separation, broken
relationship, loss of job, money, status, self-confidence, self-esteem, loss of
religious faith, loss of interest in friends, sex, hobbies, activities
previously enjoyed
Change in Personality - sad, withdrawn, irritable, anxious,
tired, indecisive, apathetic.
Change in Behavior - can't concentrate on school, work, routine
tasks
Diminished Sexual Interest- impotence, menstrual abnormalities
(often missed periods).
Fear of losing control- going crazy, harming self or
others
Low self esteem- feeling worthless, shame, overwhelming guilt,
self-hatred, "everyone would be better off without me"
No hope for the future - believing things will never get better;
that nothing will ever change
Suicidal impulses, statements, plans; favorite agitation,
hyperactivity, restlessness or lethargy.
Strong wish to die, preoccupation with death,
Increased alcohol and/or other drug use
Inability to tolerate frustration
Inability or unwillingness to communicate
Sexual promiscuity
Neglecting personal appearance
Theft &/or vandalism
Depression
Exaggerated &/or extended boredom
Carelessness &/or accident prone
Unusually long grief reaction
Hostile behavior
Truancy
Family disruption, especially divorce
Running away from home
Abrupt ending of a romance
Poor performance in school.
REMEMBER: The risk of suicide may be greatest as
the depression lifts. They may now have the energy to commit the act.
Also remember, that you can only do what you are
able to do. If your friend or loved one is intent upon ending their life, you
can only do so much. You are NOT responsible for their behavior. None of us can
control others. This is a myth that some of us hold on to.
If you witness some of the above signs, try to
talk with the person and get them some help.
If you feel the person is at risk of ending their
life, even if they deny it, call 911 so that they may be evaluated.
The Latterman Petris Short Doyle act states that
people can be held in a hospital against their will for three days IF they are a
danger to themselves, or to others or are gravely disabled. After those three
days, it goes to court and the judge decides if the person can be held
longer.
(This essay can be found at
http://www.mental-health-today.com/suicide/sui2.htm)