SUICIDE AND HOW TO HELP
A person who engages in self harm could be at risk of suicide, but there are others who may engage in a pattern of self-injury over weeks, months or even years and not necessarily be suicidal.
In 2007, the National Survey of Mental Health and Wellbeing found that 3.2% of Australians aged 1685 had attempted suicide at some time in their life and 0.4% attempted suicide in the last year.
In 2007, 3,128 Australians died of suicide. This is higher than the number of deaths from motor vehicle accidents.
Males account for 75% of suicides and approximately 87% of people who die from suicide have a diagnosable mental illness at the time of death.
Common reasons for attempting suicide:
- Feeling a need to escape or release themselves of unmanageable emotions and thoughts. The person feels unbearable emotion pain. They believe their situation is hopeless, they feel worthless and thinks that the world would be better off without them.
- A sense of control or influence over another person. The suicidal person wants to communicate how they feel to others, change how others treat them or uses suicide as a way to ask for help.
- People are at a greater risk of suicide if they have:
• A mental illness
• Poor physical health and disabilities
• Previous history of self-harm or suicidal tendencies
• Experienced pain and struggle in close relationships or their health
• Been physically or sexually assaulted as a child
• Been exposed to suicide by someone else.
Important signs that a person may be suicidal:
• Threatening to hurt or kill themselves
• Researching ways to die – seeking access to pills, weapons or other means
• Talking or writing about death, dying or suicide
• Rage, anger, seeking revenge
• Recklessness or participating in unsafe, risky activities
• Feeling tapped with no way out
• Increasing drug and alcohol use
• Withdrawing from friends, family or society
• Easy agitation, anxiety, insomnia or chronic lethargy
• Dramatic mood swings – including sudden improvement in mood following an episode of
- Having no sense of purpose for life or living
People may show one or many of these signs and some may show signs not on this list. If you are worried that someone may be at risk of suicide, you need to approach them and have a conversation regarding your concerns.
Preparing yourself and approaching the person:
Be conscious that your ability to provide assistance may be impacted by your own personal beliefs and attitudes regarding suicide, e.g. beliefs that suicide is wrong or that it is a rational opinion. If you feel unable to ask the person about suicidal thoughts, find someone else who can.
Act fast if you think someone could be contemplating suicide and even if you only have a mild suspicion.
Anyone could potentially have thoughts of suicide and if you think someone you know might be, avoid assumption and ask them directly. You could ask: “Are you having thoughts of suicide?” or “Are you thinking about killing yourself?” Avoid asking about suicide in ways that might sound judgemental, e.g. “You’re not thinking about doing anything stupid, are you?”
Be mindful that the person may not want to talk, and that’s okay. In this instance, you should offer to help them find someone else to talk to.
Sometimes people are reluctant to ask directly about suicide because they think they will put the idea into the person’s head. This is not true. Similarly, if a person is suicidal, asking them about suicidal thoughts will not increase any risk of action.
Instead, asking about suicidal thoughts will allow the person a chance to talk about their issues while showing them that you care. It’s more important to be supportive, rather then to say ‘all the right things’
It common to feel shock or panic when someone discloses thoughts of suicide, do your best to appear calm, confident and empathetic in the face of suicide crisis. Avoid expressing negative reactions. This will have a reassuring effect for the suicidal person.
Demonstrate appropriate language when referring to suicide by using the terms ‘suicide’ or ‘die by suicide,’ and avoiding use of terms to describe suicide that promote stigmatising attitudes, e.g. ‘commit suicide’ (implying it is a crime or sin) or referring to past suicide attempts as having ‘failed’ or been ‘unsuccessful’ (implying death would have been a favourable outcome.)
Ask the suicidal person what they are thinking, feeling and their reasons for wanting to die. Reassure them that it’s okay to talk about things that might be painful, even if it’s hard. Let them know you want to hear whatever they have to say, actively listen to them and allow them to fully empty out.
They may express feelings of anger, cry or even scream. Allow them to do so. A suicidal person may feel relief being able to do so.
Remember to thank the suicidal person for sharing their feelings with you and acknowledge their courage.
• Be patient and calm
• Listen without expressing judgement, accept what they are saying without agreeing or
disagreeing with their behaviour or point of view
• Ask open-ended questions and questions that can’t be simply answered with ‘yes’ or ‘no’ –
this allows you to learn more about the suicidal thoughts, feelings and problems
• Show you’re listening by summarising what the person is saying
• Clarify important points to make sure they’re fully understood
• Express empathy
Assessing an urgent situation.
Take all thoughts of suicide seriously and take action. Do not dismiss the person’s thoughts as ‘attention seeking’ or a ‘cry for help.’ Determine the urgency or taking action based of the warning signs listed previously.
Enquire about issues that affect their immediate safety by asking the suicidal person:
• Whether they have a suicide plan
• How they intend to do it and where specifically
• Have they decided when they will do it
• Whether they have already taken steps toward their plan
• Ask if they have been using drugs or alcohol – intoxication can increase the risk of a person
acting on suicidal thoughts
• Ask if they’ve ever attempted or planned suicide previously
If the suicidal person says they are hearing voices, ask what the voices are telling them. This is important as the voices are relevant to their current suicidal thoughts.
It is useful to find out what supports are available to the person by asking:
• Whether they have told anyone about how they’re feeling
• Whether they have been changes in their employment, social life or family
• Whether they have received treatment for mental health previously or are they taking any
Be aware that people who have the highest risk of suicide in the near future are those who have a specific suicide plan, resources to carry out their plan, a time set and an intention to do it. However, the lack of a plan is still not enough to ensure safety.
What not to do:
• Do not argue or debate with the person regarding their thoughts
• Do not discuss whether suicide is right or wrong
• Do not use guilt or threats to prevent suicide, e.g., saying they will go to hell or ruin their
loved one’s lives
• Do not minimise the person’s problems – the problems are real and extremely painful for
the suicidal person
• Avoid phrases such as “Don’t worry,” “Cheer up,” “You have everything going for you” or
“Everything will be alright.”
• Do not interrupt with your own personal stories
• Do not attempt to give the suicidal person a diagnosis of mental illness
How can you keep the person safe?
Once you have established that risk of suicide is present, you need to take action to keep the person safe. A person who is suicidal should not be left alone. If you suspect an immediate risk of the person acting on suicidal thoughts, act quickly, even if you are unsure. Work collaboratively with the suicidal person to ensure their safety, rather than acting alone to prevent suicide.
Remind the person that suicidal thoughts need not be acted on. Reassure that there are always solutions to problems and new strategies for coping.
When talking with a suicidal person, focus on the things that will keep them safe for now, rather than the things that put them at risk. To help keep them safe, develop a safety plan.
Engage the person to fullest extent possible in decisions about a safety plan. However, no not assume that a safety plan by itself is adequate to keep the person safe.
Although you can offer support; you are not responsible for the actions or behaviours of someone else, and cannot control what they might do.
If the person has a specific plan for suicide, or if they have the means to carry out their suicide plan, call a mental health centre or crisis telephone line and ask for advice on the situation If the person has a weapon, contact the police, inform them that the person is suicidal to help them respond appropriately. Make sure you do not put yourself in any danger while offering support.
A safety plan is an agreement between the suicidal person and the first person that involves actions to keep the person safe. The safety plan should:
The safety plan should:
• Focus on what the suicidal person should do rather than what they shouldn’t
• Be clear, outlining what will be done, who will be doing it, and when it will be carried out
• Be for a length of time that the suicidal person can easily cope with, so that they can feel
able to fulfil the agreement and have a sense of achievement
• Include correct numbers that the person agrees to call if they are feeling suicidal, e.g. the
person’s doctor or mental health care professional, a suicide helpline or a 24-hour crisis line,
friends and family members who will help in an emergency.
Find out who or what services have supported the suicidal person previously, if any, and whether these supports are still available. Ask the person how they want to be supported and if there is anything you can do to help, but do not try to take on their responsibilities.
3 key actions for helping a suicidal person
- If you think someone is suicidal, ask them directly.
- Work together to keep them safe for now
- Connect them to professional help
Always encourage the person to seek appropriate professional help as soon as possible.
Find out information about the resources and services available for a person who is considering suicide, including local and online services that can assist in response to people at risk of suicide such as hospitals, mental health clinics, mobile outreach crisis teams, suicide prevention helplines and local emergency services. Provide this information to the suicidal person and discuss help-seeking options with them.
Don’t assume that the person will get better without help or that they will seek help on their own. People who are feeling suicidal often don’t ask for help for many reasons, including stigma, shame and a belief that their situation is hopeless and that nothing can help
If the suicidal person refuses to seek professional help, call a mental health centre or crisis telephone line and ask for advice on the situation.
What to do if the person wants to promise not to tell anyone?
Never agree to keep a plan for suicide a secret. If the person doesn’t want you to tell anyone about their suicidal thoughts, you should not agree but give an explanation why, e.g. “I care about you too much to keep a secret like this. You need help and I am here to help you get it.
Treat the person with respect and involve them in decisions about who else knows or should know about the suicidal crisis.
You may need to breech their confidentiality in order to ensure their safety if the person totally refuses to give you permission to disclose information about their suicidal thoughts.
Be honest and tell the person who you will be notifying. Be prepared for the suicidal person to possibly express feelings of anger and betrayal.
Try not to take it personally and keep in mind that it is much better to have the suicidal person angry at you for sharing their suicidal thoughts without their permission, in order to obtain help and avoid losing the person to suicide.
Take care of yourself
After helping someone who is suicidal, make sure you take appropriate self-care. Providing support and assistance to a suicidal person is exhausting and it is therefore important to take care of yourself.
If life is in danger call 000
LIFELINE 24/7 Support