Preventing Suicide *

David A. Gershaw, Ph.D.

After someone has commited suicide, we can look back and see possible signs of suicide potential. Then we often regret our own lack of insight and courage to attempt to prevent such actions. What cues are there for you to detect someone who might attempt suicide? How can untrained persons prevent a potential suicide?

No behavior or warning signs are displayed by all people who attempt suicide. However, several signs are commonly found with suicidal people. First, many people indicate verbally that they "want to die" or "can't bear to live anymore." Some people refer to how others will feel after their deaths. A second warning sign is self-injurious acts, even if the acts do not seem serious at the time. Other warning signs include giving away cherished possessions, setting one's affairs in order, or suddenly making a will these behaviors may indicate that the person has decided to act. Suicide is typically preceded by depression, which may be caused by injuries that prevent a person from functioning the way they previously did accidents that mutilate the person, or notification that the person has cancer, AIDS, or another seriously debilitating illness.

What most suicidal people need is a good listener.

If you feel that a person fits some of these warning signals, what can you do? The best thing to do is to listen with empathy. Listening with empathy means trying to step into another person's shoes and see the world through their eyes trying to understand why they are considering suicide. Empathetic listening also includes temporarily withholding both judgment and advice. Saying "Chin up" or "Things aren't as bad as they seem" is not effective when a friend or family member expresses suicidal thoughts.

A common myth states that asking people if they have thought about suicide will give them suicidal ideas that they did not have previously. There is no support for this myth. You can ask the person directly if they have had suicidal thoughts or intentions. If they express such intentions, the seriousness of these intentions may be indicated by their plan for suicide and how available the means are for this plan. For example, if the person intends to use a gun, owning a loaded gun is much more lethal than planning to buy or borrow one.

After you ask about suidial intentions, if you listen with empathy, your concern and your willingness to discuss an otherwise taboo subject may act as a deterrent. The person may feel a renewed closeness to another human being, which reduces the probability of suicide.

One short-term way to deal with a suicidal person is to elicit a promise that they will not harm themselves for a specific time period. For example, they may promise not to do anything, until after you talk to them at lunch the next day. This can serve two purposes. First, many people are unwilling even when they are desparately depressed and considering suicide to break their promises. Second, since this approach delays suicidal action and the situation may change or the depression may lift, this delay could save the person's life. Even among those who have unsuccessfully attempted suicide once, only ten percent kill themselves at some later time.

Finally, providing information about crisis or suicide telephone counseling, mental health centers, or therapists may be helpful. It is even better if you can get them to contact one of these sources of help while you are with them. Fostering such a contact both postpones the suicide attempt and gets them in touch with professional help.

If you follow these guidelines, and the person attempts or completes suicide, you will have helped as best you could. Nobody can be expected to do any more than their best. If a friend or family member has attempted or committed suicide, you may find this quote helpful:

Remember, whoever you may be professional helper, friend, or lover we cannot solve the problems of others, nor can we make decisions for them. We can only respect and care for them, offering ourselves as a calm, stable fellow traveler who reaches out to their own core of stability. Given this much, they will do the rest, usually (though not always) choosing life.

* Adapted from Simons, Irwin and Drinnin's Psychology: The Search for Understanding, West Publishing, 1987, pages 542-543.

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