Suicide is the 11th leading cause of death for individuals 15-24 years old. So why don’t we talk about it? Initiating a conversation about suicide is uncomfortable and it is difficult to feel equipped to hear the response. But asking the question “Are you thinking about killing yourself” is the one question that can save a life.
How do you know someone might be suicidal? The American Association of Suicidology uses the acronym “IS PATH WARM”.
I Ideation (are they thinking about suicide?)
S Substance Abuse (drugs and alcohol lower inhibitions)
T Trapped (do they feel unable to change their situation?)
W Withdrawal (Are they secluding themselves? Selling possessions?)
M Mood Changes
If you notice any of these signs, initiate the conversation. Ask “Are you thinking about killing yourself?”
Tips for an Uncomfortable Conversation
When you notice the warning signs in someone or they tell you they’ve thought about suicide, believe them. Often times the first inclination is to “fix” the problem or use logic to “talk them out of it”. We might want to say things like “It’s not that bad”, “Time heals everything” or “You wouldn’t actually follow through with it”.
Even though well intentioned, those responses close the door to an important conversation. Responses like “Oh really, tell me more about that”, or “I can really tell you’re hurting right now, let’s talk to someone” validates the person and allows them to feel safe talking to you.
Initiate the Conversation
The biggest fear in asking someone if they’re considering suicide is the belief that you’re going to “give them the idea”. This is one of the biggest and most dangerous myths about suicide. Even young kids have heard about suicide. If you ask someone if they’ve thought about suicide, it will not give them that idea!
Starting the conversation can be difficult. Start with letting them know you care and then be direct in asking. Phrases you could use: “You have seemed down recently. I’m worried about you. Are you thinking about suicide?” or “Could we talk a minute, I’ve heard you make a few comments about feeling hopeless recently. Are you thinking about suicide at all?”
Be direct. Don’t talk around the subject. Don’t ask if they feel like “hurting themselves”. Ask specifically about their current thoughts about completing suicide. When we avoid using the word ‘suicide’ it can create a sense that it’s not okay to talk about it, or show them you’re too uncomfortable with suicidal thoughts to openly discuss it.
Show the person you’re talking to that you care and are willing to listen. Take time to ask questions about their feelings and experiences. Avoid cutting the other person off or offering advice on handling the situation. Give the person an opportunity to open up.
Be genuine in how you respond. The biggest fear many people have in asking someone about suicide is the fear of doing or saying the wrong thing. If you listen and respond with genuine care and concerns, you will not do more harm in the situation.
Help minimize their access. If someone is having active thoughts about attempting suicide in the immediate future try to minimize their access to weapons, guns, medications, or vehicles. Get them help immediately by calling 911. If it is someone in your household that is considering suicide, lock medications in a cabinet, put all guns and knives in a locked safe, and limit driving privileges if necessary.
Assist the person in seeking help. Sit with them while they call the hotline 1-800-273-TALK (8255), take them to a local hospital or call 911 if you need immediate assistance.
Simply asking, listening, and offering genuine supports are truly the keys to saving a life.
Suicide vs Self Harm
Often suicide and self-harm are talked about interchangeably but they are two very different experiences that serve two very different purposes. Self-harm is the use of self-inflicted pain to release or distract from emotions that are unpleasant; it is an unhealthy way to cope with negative feelings. Suicide serves to allow the person to escape a situation or feeling completely. While some people who self-harm may eventually attempt suicide, they are not interchangeable experiences.