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..., "Iím 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 - itís ok if you donít 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 donít 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 itís 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 itís evening and the person is not at risk, calls should be made the next day to these people informing them of the personís suicidal ideation. The mental health professional may make an adjust to the personís medicine, admit them into a hospital, etc.

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8) If you are at the personís 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 parentís crisis? Try to get the child out of there (AFTER the person is safe) and into a friend or relativeís 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.

Donít forget to take care of yourself. My best wishes to you.

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