*Trigger Warning:
The content we are discussing today may be triggering for some individuals.
*Your own level of training and comfort will determine how you move forward when working with suicide or suicidal ideation. This article is not met for training purposes or a substitute for receiving professional help.
Conversations surrounding suicide and suicidal ideation are often shy'd away from, and I understand why. They are uncomfortable and people are unsure what to say, there is a fear that we may say something wrong. I am hoping by taking time to talk about suicide and suicidal ideation, it will help lesson the stigma and normalize the discussion surrounding suicide. If you have any questions, please do not hesitate to reach out - I would be happy to connect.
Definitions:
Suicide is death caused by injuring oneself with the intent to die. A suicide attempt is when someone harms themselves with the intent to end their life, but they do not die as a result of their actions.
Self-harm is the act of purposely hurting oneself (i.e. cutting) as an unhealthy coping mechanism.
Suicidal ideation (or suicidal thoughts) is thinking about suicide with deliberate consideration or planning.
Myths and Facts:
Myth: Suicide only affects individuals with a mental health condition.
Fact: Many individuals with mental illness are not affected by suicidal thoughts and not all people who attempt or die by suicide have mental illness. Relationship problems and other life stressors such as criminal/legal matters, eviction/loss of home, death of a loved one, a devastating or debilitating illness, trauma, sexual abuse, rejection, and recent or impending crises are also associated with suicidal thoughts and attempts.
Myth: Once an individual is suicidal, they will always remain suicidal.
Fact: Active suicidal ideation is often short-term and situation specific. The act of suicide is often an attempt to control deep, painful emotions and thoughts an individual is experiencing. Once these thoughts dissipate, so will the suicidal ideation. While suicidal thoughts can return, they are not permanent. An individual with suicidal thoughts and attempts can live a long, successful life.
Myth: People who die by suicide are selfish and take the easy way out.
Fact: Typically, people do not die by suicide because they do not want to live—people die by suicide because they want to end their suffering. These individuals are suffering so deeply that they feel helpless and hopeless. Individuals who experience suicidal ideations do not do so by choice. They are not simply, “thinking of themselves,” but rather they are going through a very serious mental health symptom due to either mental illness or a difficult life situation.
Myth: Most suicides happen suddenly without warning.
Fact: Warning signs—verbally or behaviorally—precede most suicides. Therefore, it’s important to learn and understand the warnings signs associated with suicide. (We will go over these). Many individuals who are suicidal may only show warning signs to those closest to them. These loved ones may not recognize what is going on, which is how it may seem like the suicide was sudden or without warning.
Myth: Talking about suicide will lead to and encourage suicide.
Fact: There is a widespread stigma associated with suicide and as a result, many people are afraid to speak about it. Talking about suicide not only reduces the stigma, but also allows individuals to seek help, rethink their opinions and share their story with others. We all need to talk more about suicide.
Normalize Suicide - How to Ask About Suicide:
Engage the person in a serious conversation about how they are feeling.
– Connect with them in a personal way. It is important that the person feel comfortable sharing how they are feeling and what is happening in their life. Building that comfort level can happen quickly or it may take some time. Listen very carefully for any signs that might be an invitation to talk about suicide.
Ask about suicide.
– When you hear, see and/or sense signs of suicidal thoughts, you can normalize the association by saying something like: “I can see you are feeling very low and hopeless. Sometimes when people feel like this, they have thoughts of killing themselves. Are you thinking of suicide?”
Explore and assess the risk.
– Continue to ask questions and listen to what is happening with the person. Explore their reason for wanting to commit suicide but also reasons for wanting to live. Are they feeling unbearable pain or desperations? Desperation can increase the risk of suicide. What has changed to make them have thoughts about suicide now?
Ask if they have a plan for suicide.
– Ask them about any preparations they have made, such as how, when, or where they would attempt suicide? Have they collected the items they need to attempt suicide i.e. pills, a razor, rope, a firearm? Have they made arrangements for when they are dead i.e. cancelling deliveries, sending pets away, giving away personal items?
Ask about prior suicidal behavior.
— People are at greater risk of suicide if they have attempted suicide before or if anyone close to them has ever attempted or died by suicide. If they have past experience with suicidal behavior, ask if they need extra support to help protect against the risk or if there is a resource that has helped them in the past.
Ask about their supports.
— People who feel totally alone and without any resources are at greater risk of attempting suicide. Ask them: are you feeling alone and with no supports? What resources do you have to support you? Who do you think you could turn to for help?
*Any communication of suicidal thoughts or behaviours should be taken seriously. If you believe the person is an imminent risk of harming themselves (they have a plan and the means available and they have the intention), seek professional help immediately.
Engage the person in creating a safety plan.
Engage the person in creating a safety plan to keep the person safe and provide a sense of hope. The safety plan should be consistent and relevant to the person’s situation. When the person has a plan for suicide, work as cooperatively as possible to disable the plan. Try to ensure that the person does not have ready access to the means to commit suicide but keep your own safety in mind.
Connect them with appropriate professional help or other resources they trust and respect i.e:
Local crisis/distress lines.
Hospital emergency department
Social worker, psychologist or mental health worker.
Family doctor.
School counselling services
If it is an emergency call 911.
*Counsellors who work with suicidal clients develop a safety plan together that best supports the clients needs. Having your safety plan readily available is beneficial as people have trouble remembering coping strategies, supports, and resources during these situations.
Additionally:
Listen non-judgmentally.
Engage the person in a discussion about how they feel.
Remember, that these problems are no due to weakness or laziness – the person is unwell and is trying to cope.
Do not express frustration with the person for having and sharing symptoms.
Do not be critical.
Do not offer glib advice such as, “pull yourself together” or “cheer up”.
Avoid confrontation.
Do not try to fix their reasoning right away.
Do not rush the conversation.
Be present with the person.
Turning points comes from the person at risk, you cannot force it. (Turning points will be discussed).
Explore Invitations/Warning Signs
Actions: Giving away possessions Withdrawal (family, friends, school, work) Loss of interest in sports and leisure Misuse of alcohol/drugs Impulsive/reckless behavior Self-mutilation/self-harm Extreme behavior changes | Words: “All of my problems will end soon.” “No one can do anything to help me now.” “Now I know what they were going through.” “I just can’t take it anymore” “I am a burden to everyone.” “I can’t do anything right.” “I just can’t think straight anymore.” |
Physical: Lack of interest in appearance Change/loss in sex interest Disturbed sleep Change/loss of appetite/weight | Feelings: Desperate Angry Guilty Worthless Lonely Sad Hopeless Helpless |
Turning Points and Ways to Support Them:
Turning points/hope can be:
Fear of dying or pain.
Having something to live for. (This can be ANYTHING)!
Uncertainty.
Turning Point Examples:
Additional Support Statements:
“We can work together to help figure out what to do next.”
“What can I do to support you right now?”
“I can’t imagine what you are going through to feel this pain.”
“I appreciate you talking with me and being vulnerable. I can’t imagine how hard this must be.”
“Thank you for trusting me with this, I am here for you.”
Final Reminders:
Explore invitations.
Normalize the word suicide. It is not a dirty word.
Ask if they have a suicide plan. If yes, ask details i.e. how, where, when, access to materials needed in the plan. If no, ask if they have ever thought about how they would do it? How many times have they had these thoughts?
What brought on these suicidal ideations?
Ask, “what do you have to live for?” Do not judge their answers. If they are unable to answer this question, tell them it is ok and something that can be continued to be explored.
Ask when they felt suicidal in the past, what did they do to fight the suicidal ideations?
Ask what supports they have at school i.e. teachers, admin, friends, counsellor.
Ask what supports they have outside of school i.e. parents, siblings, extended family, counsellor, support group.
Validate and empathize with their feelings and reasoning.
Remind them, they are not alone.
Resources:
Specially trained staff are available to provide mental health and addictions crisis support in a safe and confidential manner. It's free and available 24/7.
Dial 811 to call Healthline.
Kids Help Phone offers professional counselling, information and referrals. You can phone, text or chat online. It's confidential, free and available 24/7.
Call 1-800-668-6868
Text CONNECT to 686868
Chat online at kidshelpphone.ca
Talk Suicide
You deserve to be heard. We’re here to listen.
Connect to a crisis responder to get help without judgement.
Call 1.833.456.4566 Toll free 24/7/365
Text 45645 4 p.m. – midnight ET
コメント