How You Can Help Someone At Risk for Suicide by Lisa Firestone, Ph.D.
One of the scariest things you can experience is the fear that someone you know may be suicidal. When a friend, family member or associate shows some of the warning signs for suicide, it is essential to intervene and take action to get that person to the help they need. When someone is suicidal, they are in a disassociated state in which they are experiencing extreme self-hatred. How can you lift a person out of this state? Below you will find steps showing what you can do to help a person who is in the midst of a suicidal crisis and put them in touch with the help they need.
1. ENGAGE:
Engage the person at risk in a personal way; let the person know you are paying attention and make the person feel accepted. Maintain eye contact. Let your personal reactions show on your face. Sit forward, lean toward the person, and don’t get distracted. For example, convey empathy, try to see and feel things from the person’s perspective.
2. IDENTIFY:
Ask whether the person is thinking about suicide. Be direct but sensitive. It gives the person permission to talk about suicidal thoughts or plans.
3. INQUIRE:
If the person is considering suicide, ask about their reasons. Reflect back in your own words what you are hearing to help the person feel that he or she is being understood. With understanding you can then work together to find ways other than suicide to resolve the situation.
4. ASSESS:
Ask if the person has a plan. For example “Have you thought of how you might kill yourself”? Is there a gun in the house? How soon are you planning to do it? Ask whether the person has attempted suicide before. If you have any doubts about the level of danger, err on the side of caution. In a situation where a person’s life is at stake, it is better to do too much then not enough. You ask about where, when, and how they are planning on doing it…You are also looking for any positive things that light them up. You want to support any coping strategies that they show are working for them. And you might even ask them; in the past when you felt bad how have you dealt with it? What’s helped?
5. DEVELOP AN ACTION PLAN:
This task involves you and the person at-risk coming to an agreement and putting a plan into action to prevent the immediate risk of suicide.
Be specific: Be sure the person is able to play back the plan to you to show that he or she clearly understands it. You want to commit to doing things, and you want them to commit to doing things. Play the plan back to them, and make sure they are really understanding it. It is important to provide structure for them; to make it simple, direct and with structure, because people at risk are feeling fragmented. They feel like they’re coming apart…and you need to provide the structure.
Limit objectives: The action plan is not meant to be a total solution for all the person’s problems. Be realistic. Do not make false promises or resort to phony statements.
Confirm the commitment: The person at-risk agrees not to engage in any self-harming behavior for an agreed-upon time period. Ask the person to repeat the agreement out loud. Both of you will experience a feeling of relief. If you don’t experience a feeling of relief, get them to help immediately.
Develop crisis control: Make arrangements for emergency support if the steps of your plan for action cannot be carried out. For example, have the person or their parents call the local or national suicide hotline. Lastly, what you want to do is make up a back up plan with them. What are they going to do if they get overwhelmed with suicidal thoughts or feelings between now and when you are going to do the next step of your plan or the next time you are going to see them? You want to make sure that they have both the local and the national Hot Line Numbers so that 24 hours a day they could reach another trained person at the end of the line that can help talk them through it. You also want them to be able to contact you, but if they can’t get a hold of you, you want to make sure that they have those numbers.
Spell out the follow-up: After assistance is obtained, follow up to see how they are doing.
Lastly, it’s really important that we reach out and act kindly toward everyone in our lives, people we come across, that we smile at people; you know that we take the time to talk to somebody who looks distressed and ask them what’s wrong. Make the effort because some people are just waiting to be stopped, to be interrupted, to be helped. Go ahead and ask, it couldn’t hurt. GO ahead and smile at somebody, it doesn’t take a lot for you, it doesn’t cost you anything. It could really save a life.
GET HELP:
IF YOU OR SOMEONE YOU KNOW IS IN CRISIS OR IN NEED OF IMMEDIATE HELP, CALL 1-800-273-TALK (8255).
This is a free hotline available 24 hours a day to anyone in emotional distress or suicidal crisis.
International readers can click here for a list of helplines and crisis centers around the world.
Click here to locate a therapist in your area
For more Suicide Prevention Advice and Resources visit our Suicide Prevention Advice Page
Related Articles:
Coping Suggestions for the Suicidal Person
The Do’s and Don’ts of Suicide Prevention
Helper Tasks – How You Can Help Someone Who’s Suicidal
Suicide: The Warning Signs
Busting the Myths About Suicide
“Something to Lose”
Download the Brochure:
“Save a Life”
Helpful Websites:
www.suicidology.org
Lisa Firestone , PhD, is the Director of Research and Education for The Glendon Association. Since 1987, she has been involved in clinical training and applied research in suicide and violence. In collaboration with Dr. Robert Firestone, her studies resulted in the development of the Firestone Assessment of Self-Destructive Thoughts (FAST) and the Firestone Assessment of Violent Thoughts (FAVT). Dr. Firestone has published numerous professional articles, and most recently was the co-author of the books: Sex and Love in Intimate Relationships (APA Books, 2006), Conquer Your Critical Inner Voice(New Harbinger, 2002), and Creating a Life of Meaning and Compassion: The Wisdom of Psychotherapy (APA Books, 2003).
VIDEO: Watch Dr. Lisa Firestone discuss topics of self, intimacy and parenting at PsychAlive’s Video Center
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