By Jessica Getty
Posted in Mental Health Resources
When a friend or a loved one expresses suicidality it is extremely difficult to know how to respond. Often people have no idea how to navigate this conversation and are afraid that they will just make the situation worse. However, talking with someone and letting them know you’re there can be a lifeline. There is no script for conversations like this as they are all unique, but there are some helpful things to remember. Below we list some of these tips and strategies that can help you navigate this extremely difficult and personal topic.
Opening the Conversation:
Ask the question directly
Talking about suicide is often uncomfortable, and one of the ways that people try to ease into the conversation is to be cautious with the words that they choose to use to ask the initial question. It is helpful to keep in mind that the subject is awkward for both sides, the person who is concerned and the person who is experiencing suicidal thoughts. For the person who is struggling, they are likely unsure of how to reach out for help and are feeling hopeless. Therefore, it is important for the helping person to be able to make the reach to connect in the most effective way possible. Using indirect language such as “do you want to give up?” leaves space for avoidance around getting to the heart of the issue. Naming the concern directly helps to let the person of concern know that you are not afraid to be with them in what they are going through. Try questions such as “are you thinking of suicide?”, or “have you wanted to end your life?”
Avoid leading questions
A leading question is one that is phrased in such a way that it implies that the person asking is looking for a specific answer in return. A general example of a leading question may be something like, “are you doing good today?”. Even though it is posed to the person responding as an option to say yes or no, it is much easier for the respondent to answer with a “yes”. This can be especially true if a different answer may be coming from a place of fear or shame.
When talking about suicide, it is common for someone to ask, “you’re not thinking of suicide, are you?”. Although this is a direct question, it is also phrased in a way that implies that the answer you are looking for is “no”. Of course, the answer that we all hope for deep down is “no”. We do not want the person that we love to be feeling that way. However, in order to really make a meaningful connection with someone and take the initial steps towards getting them help, we have to want the answer to the question to be honest, more than we want it to be “no”.
Listen openly to what they have to say
The person who is struggling has likely been carrying their sadness on their own for some time. Now that you have opened the door for the conversation to happen, let them tell you what has been going on from their perspective. Allow there to be space for silence if there needs to be. Try to avoid making assumptions, interrupting, or completing their sentences. If you are unsure about something that they are saying, ask openly “I’d like to know more about that, can you tell me?”.
Even in conversations where suicide is not part of the situation, there is a tendency for anyone in a supportive role to try to minimize a problem. Usually, this comes from the best of intentions because we want to let the person know that the problem that they are facing is not too big to handle. We say things like “it’s not that bad” or “don’t worry, you’ll be fine”. Although it is not the intention, what often happens is that statements like these make a person feel like their feelings aren’t being taken seriously. It is helpful to keep in mind that even if an issue may not seem like it would cause distress to someone else, it does cause distress for this person. Understand that what they are telling you is their own truth, and say something like, “I believe you that this has been hard”.
Let the person know they are not alone
The depression that accompanies suicidal thoughts leads to feelings of isolation. By having the initial conversation about what has been going on, you have taken the first step to letting the person know that they are not alone in what they have been going through. Make it clear to them that you are willing to continue to be there for them moving forward as well. This can mean anything from letting them know that you are available to talk more later on, to making a plan with them to help find further resources.
Avoid shaming or placing blame
Shame and blame are often introduced into conversations accidentally. In an attempt to offer guidance, it can be tempting to say things like “well this happened because…” or “you should/shouldn’t have done…”. There are a few reasons to try to avoid statements that may lead to feelings of shame or guilt. One reason is that the person who is struggling is likely already having some of these thoughts. Introducing more of these thoughts into the conversation might lead to them feeling worse and could push them away from the conversation. Another reason to keep in mind is that the primary focus of the initial conversation about suicide should be about offering support. Now is not the time to be trying to figure out why things have happened as they have. Focus more on the moment and on creating a bridge to the future.
Making a Plan:
Work together to invite trusted individuals into the conversation
The more people who can be there as support, the better. Whenever possible, ask the person who is struggling who they trust and would like to have involved. Trusted individuals could be friends, family members, teachers, counselors, coaches, members of a religious or spiritual group, or psychiatric and medical professionals. Identify what roles it would be helpful for each person to have as part of the support team. For example, the person may feel more comfortable texting a friend when they are feeling stressed, but like talking to mom in person when they need more support.
Connect with a mental health professional
If the person you are concerned about already has an outpatient therapist, connect with them as part of the support team. If the person does not have an outpatient therapist, you can make a referral for them. There are many options for outpatient therapy including traditional therapy in an office, school-based therapy, and in-home therapy. In addition to outpatient therapy, there are several different levels of care available including day programs and psychiatric hospitalization.
If you or someone you know is at immediate risk, please call 911 or go to your nearest emergency room.