Hello everyone! Today Paula Stokes has come on on blog to talk about what to do for someone if they are considering suicide. Hope you all enjoy this post!
Trigger warning: Suicide discussed heavily.
What to do if you’re worried that someone is thinking about suicide.
Hi everyone 🙂 I’m honored to be here on Fafa’s Book Corner to talk about a really serious subject: What to do if you’re worried that someone is thinking about suicide. I’m American, so I’ll be using terminology and websites for the United States in this post, but similar sites exist in most countries and many of these tips should be applicable worldwide. All the graphics and statistics are from the American Foundation for Suicide Prevention website.
I suggested this topic because I’ve been volunteering on a crisis hotline for ten months and this is one of the most common types of calls, I get. I’m going to share some of the same strategies that I typically share with callers, but please note that this isn’t meant to be an exhaustive source of information about what to do. Every person is different, and every crisis comes with its own set of circumstances that are impossible to predict ahead of time, so when in doubt call your local or national mental health/suicide hotline for additional information or 911 for immediate assistance in life-threatening situations.
How to best respond to someone else’s mental health crisis is going to depend on several factors, including whether the situation is a life-threatening emergency, whether the person is willing to seek treatment, and what you can do to assist the person in need.
If the person is in imminent danger, for example, on the edge of a building or a bridge, or alone with a firearm or other means of self-harm, and they tell you they’re going to act on their thoughts of suicide, that’s a life-threatening emergency. The recommended course of action for life-threatening emergencies is to immediately call 911. When calling 911, be prepared to give the dispatcher the person’s name, age, location, psychiatric diagnoses (if they have any), and whether they have access to weapons. It’s fine if you don’t know all of that, but the more info you can provide the better. The makeup of professionals who will respond to a welfare check/possible suicide call is going to depend on where you live and the specific situation, but you should be prepared for at least one police officer, and probably more than one. Other types of professionals who might be part of the team include paramedics, firefighters, and mental health professionals.
I recognize that asking cops to respond to mental health emergencies sometimes leads to bad outcomes, especially when it comes to certain marginalized groups. I completely understand people being hesitant to involve the police, but before you opt not to call 911, consider whether you have any other realistic options and how much risk the person might be in if you don’t send someone to intervene. Here’s a short post from NAMI about calling 911 and dealing with police in mental health emergencies.
If the person is someone you feel comfortable with and they are willing to seek treatment, an alternative to calling 911 would be for you to transport them directly to a psychiatric facility or the emergency department of any hospital, where they can then receive an assessment from a mental health professional. Note that doing this might reduce certain risks but increase others. (There are cases on record where suicidal people have jumped out of cars and ran into traffic on the way to treatment).
The best thing you can do is talk clearly and directly to the suicidal person so you can try to gauge how much risk they are in. It’s fine to ask directly if they’re thinking about suicide, if they have a plan to hurt themselves today, if they have the means to hurt themselves today, whether they have a psychiatrist or therapist they see that you could reach out to on their behalf. It’s also best to involve the suicidal person in any intervention—if you’re going to drop by their apartment or call 911 and request a welfare check, tell them so they don’t get surprised by someone showing up to their home unannounced. When in doubt, trust your gut. If your gut isn’t sure, you can call 1-800-273-TALK in the U.S. or the local or national suicide prevention in your country to get additional advice from a trained staffer or volunteer. If you’re not sure whether a situation is an emergency, treat it like it is.
Let’s say you’re really worried about someone, but you know they’re safe for the time being. There are several different options you can take in these situations, and again it depends on whether the person is willing to seek treatment. If they’re not, you can call your local (usually county in the U.S.) mental health hotline and ask about the possibility of a visit from a mobile crisis team. Mobile crisis teams are equipped to do assessments, safety planning, and referrals in neutral settings or private residences. A team will generally include at least one trained counselor or social worker but is likely to also have a police presence. Mobile crisis teams don’t operate 24-7 and take longer to respond than 911, so if you call and ask for a mobile crisis team and the dispatcher thinks it’s an emergency situation, they’re probably going to send a team of first responders.
If the person is willing to seek treatment, consider taking them to a walk-in clinic. In the U.S., most counties have walk-in mental health clinics where a person in distress can go without an appointment and without having to worry about payment. These clinics are usually not 24-7, so you could also consider taking someone to a regular urgent care clinic, a psychiatric hospital, or an emergency room for an assessment if a walk-in clinic isn’t available.
You might also want to get another family member or friend involved. Supporting a suicidal person can be physically and emotionally difficult, and you should never feel like you must figure things out all by yourself. Again, it’s best to include the person-at-risk in all the decisions, so that way you don’t end up involving someone who might make things worse. At the nonprofit where I volunteer, call workers will reach out to people-at-risk on behalf of friends and family members, but due to privacy issues, we’re not able to leave messages if the person doesn’t answer and we’re not able to update you if we do get a hold of them. Still, that’s one more option you can consider if you don’t feel comfortable talking to the person directly, but you think they might be willing to talk to an anonymous stranger.
PASSIVE SUICIDAL IDEATION:
Suicidal thoughts should always be taken seriously, but there are differences between a person who is actively suicidal and one who sometimes wishes they were dead but has no plans to end their life. As this excellent article points out, passively suicidal people can live for months to years with recurrent thoughts of suicide. Supporting them is often more about listening and offering to help find resources.
The best thing you can do for anyone who is emotionally struggling, whether they’re suicidal or not, is to LISTEN. Don’t take my word for it—watch this four-minute animated video that explains it more eloquently than I could ever dream of. Not only does listening help a person-at-risk process their emotions safely, if you do a good job of it, you’ll make them feel less alone, which can have a huge impact on their current mental state. If you can do nothing else but listen—without trying to fix the problem or cheer the person up, two well-meaning strategies that often backfire—you’ve actually done a lot.
In addition to be a supportive listener, you can also encourage the person to reach out to their primary care doctor, psychiatrist, or counselor if they have one to let them know how they’re feeling. Sometimes all it takes is a dosage adjustment or a new medication to make someone who has been struggling feel better. Other times all they need are a couple extra counselor visits to get them through a disruption in their life.
If they’re not currently seeing a mental health professional, encourage them to seek one out in a supportive, nonjudgmental way. Example: “Hey, I’m here to listen and support you, but what you’re dealing with is really hard. How do you feel about reaching out to a professional who is trained to assist in these situations? I can help you look for someone.” The Psychology Today website has search functions for finding therapists, psychiatrists, treatment centers, and support groups. You can search by city or zip code and scroll through the providers to find ones who accept insurance or take sliding scale fees for the uninsured. (A sliding scale means that the cost of the appointment depends on the client’s income. Unemployed people might pay just a few dollars. Low-income people might pay something like $20). You can also search “low-cost therapy [city]” for options. And if the person-at-risk is a student, they should be able to access free therapy via the school counselor or student services department of their college or university.
**NOTE: It is neither safe nor appropriate for a friend or family member to expect you to serve in the role of counselor for them. If someone is leaning heavily on you but is resistant to talk to a counselor or crisis line, the right thing to do is to tell them kindly that you want to support them but you’re not a trained mental health professional and you’re not able to provide the level of assistance they need. You could mention that you’re struggling with issues of your own or that worrying you won’t be able to meet their needs is causing you some anxiety. A line I like to suggest is “What you’re going through seems really difficult. You deserve someone to help you who is trained in handling these situations.” Never feel guilty for not being able to be a person’s entire support network. That’s too much to ask of anyone.
If the person you’re worried about is a stranger on social media, you can reach out to them directly if you feel comfortable. If you do that, you might want to tell them you can see that they’re really struggling, and you want them to know they’re not alone. Offer to listen (if you feel comfortable and have the time) or send them the number for a crisis hotline in their country. If you’re not comfortable reaching out, you can report the post to the site and/or call a crisis hotline yourself and let them know about the post. A lot of nonprofits have staffers who man social media accounts and reach out to strangers who appear to be in crisis.
As mentioned above, supporting a person with suicidal thoughts can be difficult. I’m always buoyed by the number of people who call the crisis lines because they want to help others. It renews my faith in humanity. At the same time, I always make sure to check in with the callers to see how they’re doing. If you’ve been supporting someone in crisis, be sure to check in with yourself and gauge how it’s affecting you. If you’re feeling a lot of sadness or anxiety, you might want to also reach out to a crisis line or mental health professional to talk through some of your feelings. If nothing else, be sure to engage in some self-care activities to reduce your stress level.
There is no one-size-fits-all strategy for handling mental health emergencies, but I hope this post has given you some new information and resources to use when it comes to helping people in crisis. If you are struggling yourself, you can find treatment options on the AFSP website, NAMI.org, or Psychology Today. In the U.S., you can call 1-800-273-8255 or text HOME to 741741 for immediate assistance. In Canada you can find help on the CASP website or call 1-833-456-4566 to talk to a crisis worker. Reaching out for help is a hard thing to do, but it’s also very brave.
Paula Stokes is an author, editor, mental health nurse, and crisis hotline volunteer. Her novels include Hidden Pieces, Girl Against the Universe, and Liars Inc. Paula loves kayaking, hiking, reading, and seeking out new adventures in faraway lands. She also loves interacting with readers. Find her online at authorpaulastokes.com or on Twitter and Instagram as @pstokesbooks