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Preventing Suicide

Preventing Suicide



According to Statistics Canada approximately 3,500 Canadians (about 2,700 men and 800 women) die each year from suicide. The number of individuals who attempt suicide is even higher. What makes people take that step? It is usually an extreme sense of hopelessness and desperation. Survivors say that they do it in order to escape from unbearable emotional and sometimes physical pain. If you think that someone is suffering so much that they might attempt suicide you can intervene. Below are the basic strategies for helping someone you know. The idea is not to cover every possible way to prevent suicide but rather to outline the basics.

The golden rule of suicide intervention is openly discussing the topic with the person. Probably the main reason why people feel uneasy about bringing it up is that they think that talking to someone about suicide has the potential to somehow give them an idea or push them towards actually doing it. There is no evidence that this is the case (it goes without saying that calling them up on it is out of the question). On the contrary, if you bring up the topic, let the person speak freely, listen without judgment, and resist the desire to give advice for a quick fix, you will probably be giving the person an opportunity to voice their pain. As a result of being understood by you they will feel less lonely and more hopeful. Hope is the best known antidote for suicide. Another reason people are reluctant to help by talking about suicide is that they simply don't know what to say. Here are some suggestions:

If you suspect that a friend or a relative is at risk you might consider saying something like this (in a compassionate way): "You seem to be quite hopeless. I've heard that people who feel this way sometimes think of suicide. Have you had any thoughts of hurting yourself?" If the person says "no" leave it at that, do not interrogate them. If they say "yes" then the next golden rule is to stay curious. Ask questions such as "How often do you think about it?" "When was the last time?" "Have you ever attempted before?" "Do you know anyone who had?" "Are you really planning to do it?" "What's your plan?" When you ask a question, make sure to stay silent and give them enough time to answer it. This is very important, because if you are being curious but at the same time keep interrupting them by asking another question they might not feel understood. If, on the other hand, you give them room to answer each question they will feel that you care and they will feel more hopeful. When they speak, listen for any signs of hope and point it out to them. Then you can say: "I hear that a part of you is trying to escape from the pain by dying and there is another part of you that is more hopeful and wants to live, is that the case?" Most probably they will say "yes." You can then say that you support the part of them that wants to live and start discussing ways to make that part stronger. How do you make that part of them stronger? By talking about their resources.

It is convenient to think of resources as internal and external to the person. External resources would be supporting friends and family, the clergy for their religion, or community-based mental health services. Internal resources are usually their own strengths. Virtually everyone is good at something, be it public speaking or making pancakes. If you know the person well enough you can offer your opinion on what you think they are good at (without pushing it on them.) Remember that at the end of the day it's their internal resources that'll keep them alive so it is very helpful to get them in touch with some of them. Ask them about their future. Don't be surprised if their initial response is that they don't have any. Ask them if they had any dreams or goals in the past; chances are they still secretly wish for that. Ask them to elaborate on those dreams. What's in the way? Are there any parts of the dream that can still be realistic? Stay genuinely curious about their dreams and ask them more questions. Watch for any signs of smiles or humor when they describe their dreams. If they make a joke or genuinely smile at a joke you made, then your job is done for now, you can simply enjoy the rest of the conversation with them. At the end you can suggest them to talk to their family doctor if thoughts of suicide come up again. It is a good idea to agree to meet with them in the near future for an activity they enjoy.

Note: If the conversation does not go that well and you are concerned that the person has a well defined plan to do it soon and has the means (guns, knives, pills, etc.) of acting on it (especially if they had attempted in the past) you might need to be more proactive and let them know that you are really concerned for their safety and that you want to talk to their family members or even with emergency services if the situation is unfolding at a fast pace. If you think that they might do it now, do not leave them alone and offer to take them to the emergency department of a local hospital (make sure you are the one driving or call a cab.) It is always a good idea to call a suicide intervention hotline (the number for Toronto is 416-408-HELP). Do not agree to keep it a secret! If you hold your position firmly and caringly they will most probably appreciate it. It is important to remember that despite your best efforts the person may still follow through with their plan to kill themselves. It is also important to know that you are not responsible for someone else's choice to end their life. You might need to tap into your own internal and external resources to cope with that situation.