Suicide Intervention Skills
Updated: Feb 28, 2021
I recently attended a 2 day course on suicide intervention. And whilst it would not be possible or responsible of me to squeeze 2 days of learning into a single blog post, I do think we all need to have an understanding of what to do if someone we know or meet is having suicidal thoughts.
You may be naïve enough to think that you will never be in that position. I am sure the family and friends of the 6057 people recorded as suicide deaths in 2018 said things like “I didn’t see it coming” or “I knew they were down, but I had no idea it was this bad!” And actually 6057 deaths doesn’t even come close to the true figure! Did you know for example, that unless a coroner can prove without doubt that the person died from suicide, that the cause of death goes down as something else such as inconclusive. This means that all of the deaths of people that made the spontaneous decision to end their pain and suffering, who do not leave a note behind, are not recorded as suicide. It is believed that these unreported suicide deaths would add a further 25% to the total recorded each year. And the number would be up to 40 to 100 time’s greater still, if you then included those with suicidal behaviours. And let’s not forget, a whopping 3.33 million people in the UK suffer with suicidal thoughts.
So let me ask that question again. Are you really naïve enough to think you won’t know somebody who is at least thinking about suicide?
A whopping 3.33 million people in the UK suffer with suicidal thoughts
This blog is intended to give you some skills to prepare you for a suicide intervention. To discuss what are realistic and unrealistic expectations. Because if you are talking to someone you love, there is a real desperation to fix this for them. But people don’t move from a position of happily living, to suicidal overnight. And so it is important to remember that it is not possible for them to transition back to the happily ever after we would like for them that quickly either.
I would recommend everyone going on an ASIST training course to fully prepare you, as we all have a responsibility to safeguard those around us. However, in the meantime, please, please share this post to help me to build a foundation knowledge on what you can do, to help somebody to stay safe. It really is a matter of life and death.
So let’s start by addressing a common misconception surrounding suicide - those who do it want to end their life. Most the time, this is not the case. They may want to end their pain or suffering. They may want some peace from their own thoughts. They may be so exhausted that they just can’t see another option. Very rarely is it about wanting to die.
Identify When Someone is Struggling
So the first step is simply to recognise somebody’s struggle. Are they behaving differently? Are they quiet and withdrawn or manic and erratic? Are they using terms such as “I just don’t know how to cope” or “I just want it to end”? Are they going through a big life event that may tip them off kilter? If this is the case, ask them how they are doing? Give them your time to listen. And if you have concerns, it's time to talk about suicide.
It is always good to link any questions around suicide to their behaviour or things they’ve said, such as “You say you are struggling to cope. Sometimes when people struggle to cope, they may start feeling suicidal. Are you feeling suicidal?”
Anything other than a 'No, I'm not suicidal', is almost certainly a 'Yes, I am'!
Do not use phrases such as “You’re not thinking of doing anything stupid are you?” The double negative in that phrase alone makes it so much harder for the person to overcome that to say yes. And referring to it as stupid belittles how they are feeling. It is best to instead be direct. It is important to remember that anything other than a definite "No, I'm not suicidal" is almost certainly a "YES I am"!
Get Them Talking and Listen to What They Have to Say
If a person is having thoughts of suicide, ask them how they are feeling. Ask them to talk to you about what they have been going through. Ask them about their struggles. And just listen to them. Give them your time and your empathy. Do not offer them false reassurances such as “I’m sure it will all work out”. You can’t know that. And don’t emotionally blackmail them by reminding them of all the people or things they have to live for. That just won’t help and they could just come back with, "They would be better off without me." They need to talk about what is wrong and to be heard. They need to find their own reason to live. Just offer them acceptance, such as “I can see why you would find that hard” or “you have been dealing with such a lot recently.” This is the most important stage. Just being heard makes such a massive difference when you’re not coping.
As they talk, it is likely they will offer a glimmer of hope. Some unfinished business. Someone that is their world. Or simply just uncertainty that this is what they want. Chances are, if they were sure about suicide they would have already done it and so the fact that they have put themselves in a position to be talked out of it, is evidence enough this is not what they want. Whatever glimmer they give you, use it! “You seem unsure this is what you want, so shall we work on a plan to keep you safe for now?”
Keeping Safe for Now
And safe for now really is all that they can commit to at this stage in their mental health. That’s not a failing on you. I know how desperate it can feel when someone you love is this unwell but knowing that you have given them some breathing space to work on their issues is actually a massive win. And it tells them that if they feel at risk again in the future they can talk to you free from judgment, allowing them to see that there are other options.
Next, find out if they have a suicide plan. If they do try to disarm it. Ask them to safely dispose of any pills or knives. You may think it is unrealistic to ask them to throw away all their kitchen knives, but the chances are, that they will have planned it with one knife in particular. Throwing away that one knife is enough to disable their plan.
The final stage is simply to ensure they have a network of support. This could be asking them to talk to other friends and family, their GP and giving them the number of helplines such as Mind (0300 123 3393) and The Samaritans (116 123). You cannot be available 24/7 and so you need to be sure that at any time of the day or night, they have someone they can call if they feel unsafe.
Suicide is a final act to a temporary problem. They need to know there are other options. That these feelings will pass. That their story does not need to end here.
Please share. Let’s get this message out into the world. It really could save someone's live.
“Sharing a post about mental health, does not automatically tell the World that you are struggling. Instead, you are telling the World that you support Mental Health.”