Are They Suicidal and What Should I Say?

Following on from yesterday's post on what I learned about suicide as a crisis negotiator and as someone who himself struggled at one point in my life, how do you know if a person is suicidal and what should you say to help them if you think that they are at risk.

Firstly, if you are reading this and are having thoughts of suicide I implore you to seek expert help. There are many wonderful people who can help you, some will do so for next to no cost. Secondly, know that if you are struggling you are not alone, you are but one of so many people who are struggling in the same way. Lastly, it is not a failing to ask for help, it is quite the opposite. You may feel like a failure but ignore those negative thoughts, be proud that you made it this far.

You have been strong enough to keep fighting by yourself and you don't need to do it alone. Show your true strength and reach out.

There are so many variables to consider when determining if someone is suicidal and each person may have one, two, or many of these common signs;

  • Increase in; mood swings, alcohol/drug intake, smoking, risk-taking, breaking the law, emotional outbursts, unexplained crying and destructive behaviour such as self-harming.
  • Lethargy, poor sleeping patterns, increase/decrease in appetite, poor grooming, increased sickness, bad judgement decisions and making mistakes.
  • They may express feelings of hopelessness and helplessness, have strong feelings of guilt and regret and won't talk about the future.

Because there are so many variables in each of us, and more so in the generational differences, what I have found in my work is that there are other indicators to look for;

  • Socialisation disappears altogether. They won't look at you when you talk to them, they won't want to talk with you at all, they won't want to meet with people, they won't even go outside as they try to isolate themselves from the world around them.
  • They may get 'busy' as they try to run away from their thoughts, they will try to distract their mind from what is going on inside their head by working harder. When that doesn't help they will stop working altogether and hide in their office, house, or bedroom to shut out the rest of the world.
  • They look pale, like death warmed up as the saying goes. The brain tells the body to shut down because it is under attack therefore blood will go to the vital organs, away from the surface of the skin, to protect itself.

So, what should you say to someone who you think is suicidal? The latest recommended sentence is to ask "Are you thinking of killing yourself?" In my humble opinion this is not what you should say. This is a sentence used by crisis negotiators to shock the person out of their current situation and to grab their attention. They are about to take their life and negotiators need to snap them out of this act. Most suicidal people I have spoken to have no idea what they are doing at the time of the attempt.

Frighteningly for me, I have heard of parents now asking their children each day "Are you thinking of killing yourself?" Seriously? A few things to think about when you use this sentence;

  • If it is used all of the time, is it normalising the sentence therefore losing its impact each time. Who knows, it may also have the reverse effect.
  • Does using this sentence lessen the chances of a crisis negotiator, a psychologist, or another professional, intervening? Probably because it has been used so many times before.
  • I recently worked with people in a unique industry who have been told to use this sentence with their clients if they think that the person is suicidal. Some of these industry professionals have become reluctant to meet with their clients in case the client says "Yes" to this question.
  • What happens if the person does say "Yes" to your question? Do you have the crisis intervention skills necessary to communicate effectively with the person or know what steps to take? If the suicidal person answers yes, you must act fast to immediately engage with them.

Now that I am no longer a crisis negotiator, I simply ask the person "Are you okay?" Australia run a very successful crisis intervention program based on this simple sentence. If you don't like that sentence, use another one that I also recommend "Is everything okay, you don't seem your usual self?"

Once the person starts talking, ask them about what they are thinking and feeling at that very moment. If there is a real risk of harm, phone the police, they are the only organisation who will do face-to-face intervention if there are environmental dangers. If the risk isn't so great, get the person to a professional or a doctor. If there is only a slight risk, there are plenty of counselling and support services available.

Once an intervention has commenced the following 24-hours are critical so you must get the suicidal person expert help once a disclosure has been made.

Guilt and regret from not doing something to help another person when they are in need will haunt you for a long time. We all have a duty of care to look after each other regardless of our relationship to that person. Let's help each other.