Suicide prevention

In Canada, 10% of men and 13% of women in the general population has contemplated suicide at some point, and 2% of men and 6% of women attempted it. The highest risk is for late adolescents and emerging adults (15-24 year olds).

Depression and suicidal thoughts are surprisingly common, but not everyone who is depressed are suicidal. So how do you assess risk?

  • Talking about it is a start. 80% of people who attempt suicide talked about it before doing it. Unfortunately, they are not always taken seriously. In case of adolescents, parents might not take it seriously enough to get their teen help, or start and then terminate treatment prematurely. People do often callously say “ugh, kill me!” and the like, at the slightest inconvenience, but people having suicidal thoughts will probably show other signs.
  • You could just ask them straight up if they feel like they might want to commit suicide. Sometimes, they will just tell you, “You know what, yes I am.” And then you can move onto trying to help them. Inmost cases of disclosure, it is the week before the actual attempt. Suicide threats should take this very seriously, and most of those who talk about it do try and complete it. They may tell you directly, or they may allude to death or imminent death. If you cannot bring yourself to ask, find someone else who can.
  • Hopelessness is a strong sign. If they are constantly making self-defeating statements, and talking about failures like it’s stable (a permanent fixture of their life) and global (encompasses all aspects of their life, e.g., “I got a D in a course, I’m a terrible person who will never succeed”), there’s cause for concern. Hopelessness is a strong motivator for suicide.
  • Planning. Try to ascertain how much planning has gone into this. Did they buy a gun? Do they have an inordinate amount of sleeping pills in the medicine cupboard? Have they been composing a suicide note? Planning can also take the form of getting their affairs in order. They might be writing a will, selling or giving away their possessions, paying off debts and bills. They may also show a sudden interest/disinterest in religion (depending on what they were like before).
  • Previous suicide attempts are an indication that they’re at a higher risk of attempting again. They may also have a lot of unexplained anger, aggression or irritability.
  • Situational changes can sometimes push already vulnerable people over the edge. Try to determine if there has been a major change in their life recently. This may include but are not limited to,being fired/expelled, recent unwanted move, loss of a major relationship whether through death or break-up, death of a spouse/child/partner, especially by suicide, diagnosis of serious terminal illness, fear of burdening others, sudden unexpected fear/punishment.
  • Impulsiveness. Is it possible that they might act completely ok right now and then an hour later go to the pharmacy by some pills and swallow them right away?
  • Do they have access to the things they need to commit suicide? Blades, pills, guns?
  • Do they have a support system that might prevent them from actually committing the act? This could be family or close friends, even a pet. One of my profs told us a story about how this one guy had the access, planning, everything in place but couldn’t do it because he did not want to leave his dog behind. I personally knew someone who had similar thoughts but decided not to because it would hurt his parents.

What can you do to help? While I’m writing this part I’m going to assume you are not a clinical psychologist or a psychiatrist because they have different protocols they have to follow with their clients. And I know very little about that.

  • You can stay with them and ask why they feel that way. Often people feel trapped and don’t see a lot of options. They see death as a permanent solution to, what seems to them like a permanent problem. So maybe you can help them find a different way of dealing with whatever problem their having.
  • Sometimes they do not want for you to offer help. Sometimes they just want you to be a good listener. Listen to their problem with full attention. You can try to take away the isolation. Tell them you want them to live, tell them you are on their side and you’ll get through it together.
  • You could ask them if they wanted help. If the answer is even close to a maybe offer to walk them to the closest mental health center. This assumes you live near somewhere that has an MHC. Try to get them help right away, because they might say, “Oh yeah, you go home, I’ll give them a call.” But it’s most likely they will not. They may want help but lack the motivation to do anything about it.
  • Encourage them to reach out to their own social connections. Ask them if they had a big secret they wanted to tell, was there anyone they could tell? Ask them to write down three possible names on a piece of paper and the way they could contact them. Treat it like a to-do list. Sometimes we get so caught up in our loneliness, we forget that there are people in our very lives who do care.
  • Ultimately, if they do not want help, you can’t force them to get it. You can’t chain them to the dishwasher while you send for help. If someone is adamant that they want to end it all, you can’t really stop them. However, more than likely, any attempt to persuade them to stay alive will be met with relief. If still unsure, you can do one of the following:
  • Alert someone close to them, their family, or their roommate, someone who lives with them so they can keep a close eye on them. If they live alone, alert a family member anyway.
  • If you think they are in immediate danger, as in, they’re going to walk out of here and through themselves in from of a semi, you can call for help, call the police and ask them to help you drive the person to the hospital. They need psychiatric help and to be somewhere where they can be observed while help is provided.
  • Don’t talk down to them o their situation, don’t say things like, “You’re talking crazy.” It’s very diminishing and de-legitimizing and it doesn’t actually help. Do not guilt trip them, do not suggest that they’re being “selfish” for wanting to end their lives. Don’t tell them what their reasons for living are. Let them find out for themselves.

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