Let’s Have a Conversation
You Can Talk About Suicide
1. Starting a Conversation with Someone who Might be Thinking of Suicide
Choose where you would like to talk, maybe somewhere where you will not be disturbed. Be mindful of your own attitudes towards suicide and make sure to keep an open mind to a difference in beliefs to yours.
Most importantly, be prepared to hear both answers. The person might say no to thinking about suicide, but they might also say yes. They might also get defensive and refuse to talk to you. This conversation can be emotional and distressing, so make sure you are ready to whatever the person might say. If you do not feel that you can have this talk, it’s okay. Don’t push yourself into something you don’t feel ready for. Instead, seek someone the person cares about, a loved one, to speak to them instead.
If you are suspecting that the person is at risk of harming or killing themselves, it’s important to act promptly. Start your conversation with a simple, “how are you” or “how have you been”, and then listen carefully. Describe the actions or behaviours that have caused you to be worried about them, focusing not on what they’ve been doing but rather what you’ve observed.
Ask directly
At some point in the conversation, you need to ask about your concerns. It’s important to ask very clearly and very directly. For example, you could ask:
“Are you thinking of killing yourself?”
“Are you having thoughts of suicide?”
Stay away from vague terms, such as “Are you thinking of doing something?”, or questions which are judgemental or expect a no answer, such as “You’re not thinking of doing something stupid, are you?”. Do not use guilt or blame with statements such as “you have so much to live fore’’ or dismiss them and say “everything will be fine”. Do not call their bluff or challenge them, and do not interrupt you’re your own stories and experiences. These questions can lead to the person feeling guiltier and more ashamed at what they are experiencing, and will be less likely to talk to you about what is really going on.
A common misconception is that you will be putting the idea in the person’s head by asking them about suicide. This is not true. On the contrary, asking them about this allows them the opportunity to speak out about what they are experiencing, and shows you are ready to have the conversation as difficult as it may be.
2. Assessing the Situation
How to react in a very delicate situation.
If they answer ‘yes’
It is common and natural to feel panic or shock when the person admits to thinking about suicide. Remember that you are a human being. For the purpose of being there for the person, try to hold back any negative emotions and focus on being there for them. Appearing calm, empathic and confident can help the person feel the same way, as you figure out a way forward together.
Thank them for being honest and sharing their feelings with you. Be gentle and curious, ask them to describe what they are experiencing and how they are feeling. At the same time, reassure them that they can talk about whatever they feel comfortable, and that it’s okay if it gets too hard.
Understanding urgency
All talk of suicide needs to be taken seriously. A common misconception is that the person might be saying they want to die as a way of getting attention. Remember that even if this is the case, the person still needs urgent professional help, and any thoughts of suicide need to be addressed immediately.
Some warning signs of suicide can include:
- Having a plan
- Knowing how they intend to carry out suicide
- Whether they have decided to kill themselves
- If they have access to weapons or other means to end their lives
- If they have been using drugs or alcohol. Intoxication increases the risk of the person acting on suicidal thoughts
- If they have attempted or planned to die by suicide in the past
During the conversation, it’s important to get as much information as possible, such as any recent changes to the person’s life or if they have recently started receiving treatment for mental health.
Whilst the signs above increase the urgency of the situation, a lack of plan or of the other signs does not ensure safety. It’s important to guide and assist the person to immediate professional help.
If they answer ‘no’
If the person answers ‘no’, make sure to maintain a good relationship and repeat that you are there for them and ready to support them. Offer to go to an appointment with a mental health specialist if they find it difficult to do this on their own. Sometimes, helping with practical supports such as driving to appointments or getting someone groceries can make a world of a difference.
If the person has said they are not thinking of suicide, but you are still concerned that they might hurt themselves, reach out to a professional to guide you. There are 24/7 helplines who will be able to assess the case with you and guide you accordingly. Trust your gut feeling and address any doubts or concerns you might be experiencing.
Whatever you do, never promise to keep a conversation to yourself. If they ask you to keep what you’ve discussed a secret, explain that you care about them and do not want to see them in harm. Guide them to a mental health professional and be there for them.
If the person is at risk but is not willing to seek help, you might need to do this without the person’s concern. If the person is at risk of harm or has harmed themselves, call 112 immediately.
3. Making a Safety Plan
In most cases, the person does not want to die, but find it difficult to keep on living the life they are living.
A person who is suicidal should not be left on their own. Reassure the person that thoughts of suicide are common, but it does not mean that they need to be impacted on.
Create a safety plan together. Studies show that safety planning can help reduce the intensity of the suicidal thoughts and increase the person’s ability to cope.
Help the person make their surroundings safe. Help them get rid of items that they can use to harm themselves.
Ask them if they have other friends or family they feel comfortable talking to and offer to be there for them when they speak to them. The more support you can find from the person’s family members or loved ones the better.
List reasons to live, and have it somewhere easily accessible. Have a list of professional help available, including support lines and online chats, and seek professional help. If the person used to be followed by a mental health professional, help them contact them to set an appointment or accompany them to a psychiatrist or to hospital.
Check that they can stay safe until a particular time and agree to check in on them. Make sure this is a reasonable and realistic timeframe. Focus on the supports the person can seek if they feel the thoughts of suicide are getting stronger.
4. Taking Care of Yourself
Self-care strategies.
This topic can generate a wide range of feelings, especially if you are supporting someone who is experiencing suicidal thoughts, has attempted suicide or has lost someone to suicide. It can be rewarding, confusing, stressful and overwhelming.
Self-care is essential during these times. It can be easy to overlook your own needs during these moments. You need to make sure that aside form supporting others, you are also taking care of yourself.
Here are some tips to help you:
- Make sure you are staying connected with your loved ones and taking care of your own needs.
- Set boundaries on how much support you can offer and how long for
- Do not take the situation as your sole responsibility; have other people involved so that you can all support the person
- Consider talking to your employer about what has been happening and see if there are any logistics that can be adjusted, such as having flexible hours even temporarily
- Take a break and take part in other activities, such as going for walk or going for a swim
- If you feel that the events have been particularly distressing, reach out for professional help. Speak to a mental health specialist to process what has been going on