BY: Dr Moumita Nandy
Most people can be helped in getting through their moment of crisis if they have someone who will spend time with them, listen, take them seriously and help them talk about their thoughts and feelings. Almost every suicidal crisis has at its center a strong ambivalence: “I can’t handle the pain anymore,” but not necessarily, “I want to be dead forever!” What most suicidal people want is not to be dead but some way to get through the terrible pain they are experiencing and someone they can turn to during those terrible moments of fear and desperation.
Having someone to talk to can make a big difference. However, you may need to be persistent before they are willing to talk. Talking about suicide or suicidal thoughts will not push someone to kill themselves. It is also not true that people who talk about killing themselves will not actually try it. Take any expressed intention of suicide very seriously. While you may not be able to solve these problems for a friend or classmate, you may be able to help the person find someone who can help.
HOW TO RESPOND TO A PERSON WHO IS POTENTIALLY SUICIDAL
1. Recognize the warning signs of depression and suicide risk.
Research suggests that the majority of people who attempt suicide give out warning signs, to let others know their intentions before they act. These ‘warning signs’ consist of personal behaviors, verbal and non-verbal communications. Mental and emotional illnesses such as depression and bi-polar disorders are often tied to suicidal feelings. The risk of suicide may be greatest as the person’s depression begins to lift.
2. Take suicidal statements seriously and trust your instincts.
50 to 75 percent of all suicides give some warning of their intentions to a friend or family member. Imminent signs must be taken seriously.
3. Get involved and use ‘active listening’.
By listening to what the person in crisis has to say and by asking direct and open questions, we show our willingness to talk about anything with that person, including his/her feelings about suicide.
Start by telling the person you are concerned and give him or her examples.
Do not attempt to argue someone out of suicide. Rather, let the person know you care, that he or she is not alone, that suicidal feelings are temporary and that depression can be treated. Avoid the temptation to say, “You have so much to live for,” or “Your suicide will hurt your family.”
4. Encourage the person to seek professional help.
Be actively involved in encouraging the person to see a physician or mental health professional immediately.
Individuals contemplating suicide often don’t believe they can be helped, so you may have to do more. Help the person find a knowledgeable mental health professional or a reputable treatment facility, and take them to the treatment.
5. While directly asking about suicide can be scary, the person you’re concerned about needs you to ask, “Do you feel so badly you are thinking about suicide?”
Almost everyone thinks about suicide at some point in their life. By listening and observing the ‘warning signs’ of suicide and asking direct questions, we demonstrate our willingness to talk about anything with the person in crisis, including his/her feelings about suicide. He or she is likely to feel understood. It can be a great relief to the person if his or her suicidal feelings can be brought out into the open and discussed freely without shock or disapproval; it shows that you are taking the person seriously.
6. If the answer is “Yes,” take the person’s response seriously and continue the ‘Suicide Risk’ assessment questions.
“Do you have a plan to take your own life?” or “Have you thought of how you would do it?”
“Do you have the means or materials available to act out your plan?” If so, “What and where are they?”
“Have you set a time?” or “Have you decided when you would do it?”
If the answer is still “Yes,” ask:
“Have you ever attempted suicide before?”
“What happened then?”
If the person has a definite plan, the means are available and the time is set and immediate, you should consider the person to be high risk for suicide.
7. Do not leave a person whom you feel is ‘high risk’ for suicide alone, even for a moment.
If a person has expressed suicidal feelings, has a plan, the means available and has a time set, you should always take him or her seriously. A person who is ‘high risk’ for suicide should not be left alone. Keep talking to that person, stay with him or her or arrange for another party (someone who that person trusts and feels comfortable with) to stay with them. Remove from the vicinity any firearms, drugs or sharp objects that could be used for suicide.
8. If the person in crisis has taken some form of life-threatening action, get help immediately.
If a person has taken any action that you believe could be considered life-threatening, don’t hesitate to get that person to a hospital yourself (if practical) or call an ambulance or emergency services.
ADDITIONAL SUGGESTIONS
Be direct. Talk openly and matter-of-factly about suicide.
Be non-judgmental. Don’t debate whether suicide is right or wrong, or whether feelings are good or bad. Don’t lecture on the value of life.
Get involved. Become available. Show interest and support.
Don’t dare him or her to do it.
Don’t ask ‘why’. This encourages defensiveness.
Offer empathy, not sympathy.
Never promise to keep suicide a secret. Seek support.
Offer hope that alternatives are available but do not offer glib reassurance.
Do not counsel the person yourself, seek professional help.
Don’t pretend you have all the answers. The most important thing you can do may be to help them find help.
Don’t be afraid of being wrong. It is difficult for even experts to understand who is at serious risk of suicide and who is not. Many of the warning signs for suicide could also indicate problems with drug or alcohol abuse, domestic violence, depression, or another mental illness, which still need professional intervention.
About the Author and Psychologist – Dr Moumita Nandy
Having completed my MSc in Clinical Psychology from Pune University I have been associated with Cancer Institute Chennai and Tata Medical Center, Kolkata for psychological morbidities in cancer care. I had also worked part time with an NGO named Reach Out For Life, Pune where I specially worked on Suicidal Awareness, Abuse and Addiction in all age groups. Furthermore, I pursued advanced Diploma in forensic psychology and criminal profiling & integrated clinical hypnotherapy. I am also trained as an expressive therapist and strong believer and practitioner of Mindfulness and EFT. Trained in CBT and REBT , I have been a consultant clinical psychologist for 6 years . Being associated with Mind Vriksha, a psychiatry clinic and as motivational speaker with Santulan . I have also done many workshops on Anxiety and Depression with several corporate house like pantaloons, Sunlife . I am also an active member on the ecell panel of TISS. I am currently associated with a government Sponsored projects such as, national helpline for transgender community and alongside with Netram and ministry of social empowerment. Senior consultant at Mind Vriksha clinic. I am currently pursuing phd in clinical psychology with a vision to increase awareness in the field of mental health across the country and executing the same via channels and initiatives.