Often, when a person feels depressed or a friend or family member recognizes that someone is suicidal, he or she does not know where to turn. People experience suicidal feelings for countless reasons, some of them understandable, others very difficult to comprehend. But for the person in crisis, the thoughts and feelings tied to depression are very real and can seem perfectly logical.
Though there are many approaches that can be utilized when responding to a person who is in distress, is depressed, in crisis or suicidal, most emphasize the following basic guidelines that can be followed whether you are a friend, family member or health professional.
Take All Talk of Suicide Seriously
Since the majority of people who attempt suicide literally do or say something to let others know their intentions before they act, it is important to take all talk of suicide seriously.
Get Involved and Be Responsive
People who receive care and support from those around them get through difficult times with better outcomes. Talking to someone who is suicidal does not give them the idea to take their own life. Being accessible is the key. Do your best to provide the person you are responding to with an environment that is quiet, private and where you will not be interrupted.
Establish Rapport and Trust
Be respectful, listen carefully to what the person has to say without immediately expressing your own opinion. The focus should be on what the person is thinking and feeling. The more comfortable a person feels, the more we can learn about their situation and the greater the likelihood they will allow us to help.
Identify Warning Signs and Risk Factors
Recognize the circumstances and environments that can increase an individual’s risk for suicide; the behaviors and states of mind that are warning signs of suicide; and the behaviors, environments and relationships that reduce that person’s risk. Focus should be on noticeable or abrupt changes in that person’s behavior, including eating and sleeping patterns, self-destructive behavior, preoccupation with death and violence, feelings of helplessness and hopelessness, increased isolation, etc.
For more information on how to recognize the warning signs and risk factors associated with suicide, click here.
Assess and Determine Suicide Risk
There are different methods that you or a health professional can use to determine the extent of a person’s depressive and/or suicidal feelings. These include depression screening tools that can measure the “severity” of an individual’s depression and risk assessment models that can measure the individual’s “intent” to attempt suicide, capability to act on that intent, how much he or she has visualized the act, etc.
Don’t be afraid to ask: “Has it gotten to the point that you feel suicidal?”
If the answer is “Yes,” continue “suicide risk assessment” questions: If the person has a plan, the means available and has set a specific time, consider that person “high risk.” Also find out if the person or a member of their family has ever attempted suicide before.
Do not leave a person who is “High Risk” alone, for even a moment
Most people can get through their moment(s) of crisis, if they have someone who will spend time with them, take them seriously and provide ongoing support. To do this, you must expand your own support network, engage professional help and access appropriate resources.
If the person has taken some form of life-threatening action, get help
If a person has taken any action that you believe could be considered life threatening, do not hesitate to get that person to a hospital yourself or call an ambulance or emergency service.
Explore Available Resources and Options
Utilizing professional, familial, spiritual and other resources increases the likelihood of maintaining an ongoing level of care and support for the person who is in distress or crisis. Resources may include referrals for ongoing clinical care, immediately accessible crisis response services like hotlines and mobile crisis units, support groups, etc.
For information that will assist you in identifying appropriate resources and referrals to help the person you are responding to, click here.
Engage Professional and Other Appropriate Help
Determine the professional and other forms of help that will most benefit the individual in distress. Assist the individual in making contact with the practitioner or program but, if that is not possible, engage that person or service yourself and seek guidance on the best way to proceed.
Provide Ongoing Support
Responding to a person who is in distress or suicidal is often an ongoing process that requires a consistent level of followup, support and utilization of resources. For the benefit of the person you are helping as well as yourself, do not go it alone. Implement a multi-faceted team approach consisting of family, health professionals, members of the community, colleagues, etc. to ensure the best results and reduce your own stress and, possible, burnout.
If the person you are responding to is significantly depressed or has thoughts of suicide, identify and remove all access to lethal means (including guns, controlled substances or any materials that could be used to harm oneself), engage professional help and additional support.
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For additional resources to help you respond to someone in crisis, click here.