People with a mental health concern are in a higher risk category for suicide. Prepare yourself for suicide talk so you know how to respond, no react. Suicide and suicidal thoughts are often viewed as shameful, so they become a taboo subject. This makes talking about suicide very difficult for both the person at risk and the caregiver.
Things to Seriously Consider
Know the signs and symptoms of suicide
- Risky or odd behaviours that imply life has no value
- Statements about hopelessness
- Words about sadness or loss
- Changes in self-care
Any major change in behaviour or expression of strong, unbearable, emotional pain is an invitation for you to respond.
Some common signs are:
- Giving away prized possessions
- Isolating from people and activities that are normally enjoyed
- Engaging in reckless activities
- Abusing alcohol/drugs
- Acting impulsively
- Getting things in order (paying off debts, tying up loose ends)
- Talking about feelings of desperation, worthlessness, anger, guilt, sadness, hopelessness, helplessness, or loneliness
- Changes in sleep patterns, appetite, interest in physical appearance, or sex drive
Also, listen for statements like, “I can’t take it anymore,” “No one can help now,” or “Everyone will soon be better off.”
Ask about suicide openly.
- Use the word “suicide”
- Do not blame or judge
If you suspect that your loved one is thinking about suicide, ask, “Are you thinking about suicide?” Don’t beat around the bush with questions like, “Have you ever thought you might not want to be here anymore?” If you skirt around the topic, your loved one will too. Even if they are not suicidal now, let them know they can talk to you about it anytime. Take a suicide intervention course so you will know how to respond. CMHA Durham offers a training program called ASIST.
Talk about both living and dying.
- Show that you understand
- Talk about possible reasons for living
It is not helpful to say that their thoughts are silly or not real. Instead, let them know that you see they are very sad and feeling like there is no escape. You will have to do this before talking about reasons for living. Let them express their reasons for wanting to die. This might give you clues to what might help them want to live. This may be a good time to talk about reasons to live. Let them know that they are not alone and that you value them and will do what you can to get them the help they need. Give them the number to a 24-hour crisis line to call if the urge to die seems strong.
Calculate the risks.
- Ask about a plan for suicide
- Ask about prior suicide behaviours
- Keep the person safe
- Develop a safety plan
- Disable the suicide plan
- Access crisis services
- Link with ongoing resources
You want to get your family member to a hospital where a doctor can assess their risk of suicide and help them. This may take time. In the meantime, ask them to agree to a certain time frame where they will not act on their suicidal thoughts. Don’t ask them not to think about suicide. Just ask for an agreement like, “I agree not to harm myself until after I meet with Dr. Smith at 2 o’clock.”
If your loved one has a specific plan, try to remove the means with their cooperation (take away pills or car keys, ask them to hand over the rope). Never put yourself in danger by trying to wrestle a gun or knife from their hands. Only intervene safely!
Find out about the mental health and crisis services in your community. There may be a mobile crisis team that can visit your loved one. Crisis phone lines are available in most places.
Call CMHA and ask for crisis numbers in your region (or visit www.cmha.ca). Call 911, or take your loved one to a hospital emergency department. Be prepared to wait: take a snack and something to help calm your family member (like a CD player or magazines).
If suicide has already happened, you need to deal with your own pain.
- Talk about your feelings
- Honour your loved one’s memory
- Recognize your own risk of suicide
Join a support group or go for counselling. Start a fundraising event or donate money to a mental health cause. Promote prevention activities in your community by speaking out about suicide and its impact on families.