People considering suicide often feel very isolated and alone. They may feel that nobody can help them or understand them. They believe that suicide is the only way out of the difficulties that they are experiencing. Having a mental health problem does not mean a person will have thoughts of suicide – many don’t. However, mental health problems can affect the way people view situations. They affect motivation and openness to seek help, therefore we need to be particularly aware of the vulnerability to suicide that people experiencing mental illness can have.
1 Do something now:
If you are concerned that someone you know is considering suicide, act immediately. Don’t assume that they will get better without help or that they will seek help on their own. It’s easy to avoid being part of that help or to hope that someone else will step in. Reaching out now could save a life.
2 Acknowledge your reaction:
When you realise that you need to take action to help someone who is considering suicide, your natural reaction may be to:
• Ignore the situation and hope it will go away
• Look for quick-fix solutions to make the person feel better
• Criticise or blame the person for their feelings
• Tell the person they are being silly and trivialise the issue or dismiss them
These reactions are common but not helpful. It’s natural to feel panic and shock, but take time to listen and think before you act. If you find you’re really struggling, enlist the help of a trusted friend or helpline.
3 Be there for them:
Spend time with the person and express your care and concern. Ask them how they are feeling, hear their pain and listen to what’s on their mind. Let them do most of the talking.
4 Ask if they are thinking of suicide:
Unless someone tells you, the only way to know if a person is thinking of suicide is to ask. Asking can sometimes be very hard but it shows that you have noticed things, been listening, that you care and that they’re not alone. Talking about suicide will not put the idea into their head but will encourage them to talk about their feelings. They will often feel a great sense of relief that someone is prepared to talk with them about their darkest thoughts.
5 Check out their safety:
If a person is considering suicide it is important to know how much they have thought about it, so ask them about
• Have they thought about how and when they plan to kill themselves?
• Are they able to carry out their plan?
• Have they ever deliberately harmed themselves?
• What support can they access to stay safe and get help?
• How can you help them draw on connections with family, friends, pets, religious convictions, personal coping strengths and strategies?
Use this information to decide what to do. If you are really worried, don’t leave the person alone. Seek immediate help – see contact numbers listed on Lifeline’s website www.lifeline.org.au or phone Lifeline on 13 11 14. Remove any means of suicide available, including weapons, medications, alcohol and other drugs, even access to a car. Be aware of your own safety. For immediate crisis intervention when life may be in danger ring the ambulance or police on 000 or go to your local hospital emergency department.
6 Decide what to do:
Now that you have this information you need to discuss together what steps you are going to take. What you decide to do needs to take into account the safety concerns that you have. Don’t agree to keep it a secret. You may need the help of others to persuade the person to get professional help – or at least take the first steps to
stay safe. These may include their partner, parents, or close friends. Only by sharing this information can you make sure that the person gets the help and support they need. Sometimes the person at risk says they don’t want help. Yet we know most people are in two minds about suicide. Make keeping them safe your first priority.
Consider the long-term benefits of getting help for the person. It may mean risking the relationship you have
with them, but you could be saving a life.
7 Take action:
The person can get help from a range of professional and supportive people:
• Counsellor, psychologist, social worker
• School counsellor, youth group leader, sports coach
• Emergency services – police and ambulance
• Mental health services
• Community health centres
• Priest, minister, religious leader
• Telephone crisis support services such as Lifeline and Kids Helpline
When the person has decided who they are most willing to tell, help them prepare what they will say. Many people find it difficult to express their suicidal thoughts. Offer to accompany the person to the appointment.
After the appointment, check that they raised the issue of suicide and ask what help they were offered.
Help them follow through with the recommendations. In some situations the person may refuse to get help. While it’s important that you find them the help they need, you can’t force them to accept it. You need to ensure that the appropriate people are aware of the situation. Don’t shoulder this responsibility alone.
8 Ask for a promise:
Thoughts of suicide often return and when they do it is important for the person to again reach out and tell someone. Asking them to promise to do this makes it more likely that it will happen. Encourage the person to promise to call you, a GP or Lifeline on 13 11 14 if suicidal thoughts return, and to do this before they harm themselves.
9 Look after yourself:
If you’re helping someone who is considering suicide, make sure you also take care of yourself. It is difficult and emotionally draining to support someone who is suicidal, especially over an extended period.
• Don’t do it on your own. Find someone to talk to - friends, family or a professional.
• Recruit other people to help support the person you are worried about.
• Get in touch with carer organisations or support groups. Contact Lifeline on 13 11 14 to find what’s available in your area.
• Try not to let your concerns about the other person dominate your life. Make sure you continue to enjoy your usual activities, take time out to have fun and keep a sense of perspective.
10 Stay involved:
Thoughts of suicide don’t easily disappear without the person at risk experiencing some change. Their situation or feelings may change, or they may feel more supported and able to deal with it. In either situation, the continued involvement of family and friends is very important. Below are some tips to ensure the person at risk continues to get the best help possible:
• Ensure the person has 24 hour access to some form of support. This may be you, other family members and friends, or Lifeline.
• Accompany the person to appointments if possible. Your support can be a great encouragement.
• If you are the primary carer, try to establish a good relationship with the health professionals responsible for the person’s treatment. Your opinion and input is valid and may be very valuable.
• Advocate for the person. Sometimes a service or health professional may not be capable of meeting all the person’s needs. You can advocate for appropriate services.
• Discuss with the person what issues or situations might trigger further suicidal thoughts. Plan how to reduce this stress and what coping strategies can be used.
• Continue to be supportive but not overprotective.
• Encourage the person to write out a plan for how they are going to stay safe, the steps they will take and other people to get involved if things start to get rough. A clearly documented stepped plan is a useful tool to keep a person safe.