Suicide Intervention
Introduction
Suicide is perhaps the most tragic cause of death because it leaves behind so many conflicted and uncomfortable emotions. Those coping with death of a loved one by suicide will experience the standard feelings of grief and bereavement that accompany any loss, but also may feel confused, hopelessly curious as to why the deceased chose such a fate, skeptical toward religion or spirituality, angry at the deceased for abandoning them, and guilty about feeling angry at someone who was suffering and is no longer living. Fully dealing with this kind of loss and reaching a place of acceptance or peace for these conflicting feelings can be a lengthy process. The process can be more difficult when the cause of death is kept a secret by those close to the deceased. Though the motive might be to offer privacy and protection from judgment out of respect for the deceased, secrecy can isolate loved ones from the support that they need—and limit the potential to learn from the experience and prevent other tragic losses. Thankfully suicide awareness is growing; whispers and speculation have turned into dialogue and research, which allow for improvements to assessment and intervention. Suicide is tragic, but it is also preventable through knowledge. This article offers information for the average person on how to identify and intervene with people who may be at risk for suicide.
Goals of Suicide Intervention
Some people may feel immune to suicide, as if it could not possibly touch their lives. They themselves could not imagine taking their own lives, so how could anyone else? While it might be unfathomable to most, according to the U.S. Centers for Disease Control and Prevention, suicide was the 10th leading cause of death for all ages in 2010. This translated to an average of 105 deaths by suicide each day. This staggering figure does not include nonfatal suicidal thoughts and behavior; a survey of adults ages ≥ 18 found that there is one suicide for every 25 attempts (Crosby, A.E., Han, B., Ortega, L.A.G., Parks, S.E., Gfoerer, J., 2011). This data suggests that, while suicide is a major problem facing our nation, it is also a problem with warning signs, potential clues to its prevention. The goals of suicide intervention at the level of prevention are to increase awareness to identify who is at the greatest risk.
When is Suicide Intervention Used?
The U.S. Centers for Disease Control and Prevention found that women are 2-3 times more likely than men to attempt suicide. However, men are 4 times more likely to complete suicide. This is because men are more likely to use lethal methods, such as firearms, in a suicide attempt. Individuals under 25 years old, over 65 years old, American Indians, Alaska natives, and Hispanic females are most likely to attempt suicide. Outside of demographics, risk factors include prior or current alcohol and / or substance use, a family history of suicide, previous suicide attempts, a history of childhood abuse or trauma, major mental illness, such as bipolar disorder or depression with psychotic features, perception of a limited support system, and a recent loss, such as a divorce or firing. A suicide intervention should be used if more than one of the above risk factors is present.
How Suicide Intervention Works
Certain behavioral indicators of suicidality, particularly within the foregoing sub-populations, should be taken very seriously. The most concrete indicators are suicidal statements. These might be passive, such as “I wish I wasn’t here,” but should never be brushed off or ignored. One might assume that the other person is speaking concretely rather than metaphysically, but it is important to clarify. Other indicators include giving away personal possessions, engaging in self-harm, establishing a suicide plan, drafting a suicide note, and refusing to engage in planning or future orientation. Paradoxically, a sudden elevated mood, unaccounted for by any obvious changes to the person’s circumstances, can be cause for concern. The person may be experiencing a momentary sense of calm about having deciding to end his life. Once you have identified someone who might be at risk, do not be afraid to question him directly—and do not be afraid to use the word “suicide.” Concerned individuals may shy away from using the word for fear that bringing it up might put the idea in the other person’s head. However, there is no support for this theory. In fact, having someone acknowledge the extent of your despair can be validating for individuals suffering from depression.
Criticisms of Suicide Intervention
Take all statements about suicide seriously, even if you get the sense that the other person is being “dramatic.” But do not try to be therapist. As a concerned individual who has identified some risk factors, your goal should be to get the other person connected to a mental health provider. You may experience resistance, which could make you feel helpless. Depending on the circumstances, you might enlist the help of other loved ones or family members. If you’re unsure about how to get the suicidal individual connected to resources, a good place to start would be the National Hopeline Network (1-800-784-2433) or the National Suicide Prevention Lifeline (1-800-273-8255). Most importantly, take care of yourself. Concern for another person’s safety can be overwhelming; do not take on more than you can handle and do not neglect your own emotional needs as caretaker. Together we can tackle suicide, but we need to work together and rely on one another for support!
References
Centers for Disease Control and Prevention, National Center for Injury Prevention and Control. Web-based Injury Statistics Query and Reporting System (WISQARS). Available from www.cdc.gov/injury/wisqars/index.html
Crosby, A.E., Han, B., Ortega, L.A.G., Parks, S.E., Gfoerer, J. (2011). Suicidal thoughts and behaviors among adults aged ≥ 18 years- United States, 2008-2009. Morbidity and Mortality Weekly Report Surveillance Summaries, 60 (13).
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