Preventing Suicide

From: The Canadian Mental Health Association

Suicide. We would rather not talk about it. We hope it will never happen to anyone we know. But suicide is a reality, and it is more common than you might think. The possibility that suicide could claim the life of someone you love cannot be ignored. By paying attention to warning signs and talking about the "unthinkable," you may be able to prevent a death.

Who is at risk?
People likely to commit suicide include those who:

- are having a serious physical or mental illness,
- are abusing alcohol or drugs,
- are experiencing a major loss, such as the death of a loved one, unemployment or divorce,
- are experiencing major changes in their life, such as teenagers and seniors,
- have made previous suicide threats.

Why do people commit suicide?
There are many circumstances which can contribute to someone's decision to end his/her life, but a person's feelings about those circumstances are more important than the circumstances themselves. All people who consider suicide feel that life is unbearable. They have an extreme sense of hopelessness, helplessness, and desperation. With some types of mental illness, people may hear voices or have delusions which prompt them to kill themselves.

People who talk about committing suicide or make an attempt do not necessarily want to die. Often, they are reaching out for help. Sometimes, a suicide attempt becomes the turning point in a person's life if there is enough support to help him/her make necessary changes.

If someone you know is feeling desperate enough to commit suicide, you may be able to help him/her find a better way to cope. If you yourself are so distressed that you cannot think of any way out except by "ending it all," remember, help for your problems is available.

What are the danger signs?
Some warning signs that a person may be suicidal include:

- repeated expressions of hopelessness, helplessness, or desperation,
- behaviour that is out of character, such as recklessness in someone who is normally careful,
- signs of depression - sleeplessness, social withdrawal, loss of appetite, loss of interest in usual activities,
- a sudden and unexpected change to a cheerful attitude,
- giving away prized possessions to friends and family,
- making a will, taking out insurance, or other preparations for death, such as telling final wishes to someone close,
- making remarks related to death and dying, or an expressed intent to commit suicide. An expressed intent to commit suicide should always be taken very seriously.

Prevent a suicide attempt
If you are concerned that someone may be suicidal, take action. If possible, talk with the person directly. The single-most important thing you can do is listen attentively without judgement.

Talking about suicide can only decrease the likelihood that someone will act on suicidal feelings. There is almost no risk that raising the topic with someone who is not considering suicide will prompt him/her to do it.

Find a safe place to talk with the person, and allow as much time as necessary. Assure him/her of your concern and your respect for his/her privacy. Ask the person about recent events, and encourage him/her to express his/her feelings freely. Do not minimize the feelings involved.

Ask whether the person feels desperate enough to consider suicide. If the answer is yes, ask, "Do you have a plan? How and where do you intend to kill yourself?"

Admit your own concern and fear if the person tells you that he/she is thinking about suicide but do not react by saying, 'You shouldn't be having these thoughts; things can't be that bad." Remember, you are being trusted with someone's deepest feelings. Although it may upset you, talking about those feeling will bring the person relief.

Ask if there is anything you can do. Talk about resources that can be drawn on (family, friends, community agencies, crisis centres) to provide support, practical assistance, counselling or treatment.

Make a plan with the person for the next few hours or days. Make contacts with him/her or on his/her behalf. If possible, go with the person to get help.

Let the person know when you can be available, and then make sure you are available at those times. Also, make sure your limits are known, and try to arrange that there is always someone that he/she can call at any time of day.

Ask who else knows about the suicidal feelings. Are there other people who should know? Is the person willing to tell them? Unfortunately, not everyone will treat this issue sensitively. Confidentiality is important, but do not keep the situation secret if a life is clearly in danger.

Stay in touch to see how he/she is doing. Praise the person for having the courage to trust you and for continuing to live and struggle.

What to do following a suicide attempt
A person may try to commit suicide without warning or despite efforts to help. If you are involved in giving first aid, make every effort to be calm and reassuring, and get medical help immediately.

The time following an attempt is critical. The person should receive intensive care during this time. Maintain regular contact, and work with the person to organize support. It is vital that he/she does not feel cut off or shunned as a result of attempting suicide.

Be aware that, if someone is intent on dying, you may not be able to stop it from happening. You cannot and should not carry the responsibility for someone else's choice.

What can you do if you are feeling suicidal?
The beginning of the way out is to let someone else in. This is very hard to do because, if you feel so desperate that suicide seems to be the only solution, you are likely very frightened and ashamed. There is no reason to be ashamed of feeling suicidal and no reason to feel ashamed for seeking help. You are not alone; many people have felt suicidal when facing difficult times and have survived, usually returning to quite normal lives.

Take the risk of telling your feelings to someone you know and trust: a relative, friend, social service worker, or a member of the clergy for your religion. There are many ways to cope and get support. The sense of desperation and the wish to die will not go away at once, but it will pass. Regaining your will to live is more important than anything else at the moment.

Some things that you can do are:

- call a crisis telephone support line,
- draw on the support of family and friends,
- talk to your family doctor; he/she can refer you to services in the community, including counselling and hospital services,
- set up frequent appointments with a mental health professional, and request telephone support between appointments,
- get involved in self-help groups,
- talk every day to at least one person you trust about how you are feeling,
- think about seeking help from the emergency department of a local hospital,
- talk to someone who has 'been there" about what it was like and how he/she coped,
- avoid making major decisions which you may later regret

Do you need more help?
If you or someone you know is feeling suicidal and you need more information about resources in your area, contact a community organization, such as the Canadian Mental Health Association, which can help you find additional support.