Last week, in response to local and national news of suicides, I shared with you some . Undoubtedly these statistics are shocking: for many of us, it’s hard to relate to and understand the extent of despair felt by those who attempt to take their lives. Today I’d like to share with you some information about how to speak with those who may be considering suicide. Although we are not and cannot be responsible for preventing suicide, we can fill our proverbial toolbox with skills in the hopes that we feel empowered to try and intervene.
One question that I frequently hear is, “How do I know if someone is contemplating suicide?” According to the American Foundation for Suicide Prevention, there are some observable warning signs in the form of changes in mood, language, and behavior. Their mood and language indicate pessimism, desperation and hopelessness regarding things ever improving. While depression and anxiety are common conditions in our society, the combination of depression with anxiety can be particularly dangerous. In addition, those considering suicide may use language that includes direct statements regarding the wish to die, or how the world would be a better place without them in it.
Behavior also may dramatically change for suicidal people. Their alcohol and substance use may accelerate, and they may make impulsive choices which seem risky. They may be uncharacteristically quick to anger, which could result in outbursts of rage that seem disproportionate to the situation. You may notice that they are giving away belongings which once seemed precious to them. And you may hear or see that they have acquired a firearm, poison, or other means of completing their suicide act.
If you notice this behavior in a friend, colleague, or loved one, please do not ignore it. Understandably, you may feel confused, scared, and paralyzed by witnessing someone you know experience suicidal thoughts and behaviors. To help counteract your powerlessness, I’d like to summarize a training program from the QPR Institute for non-clinicians. The QPR training is designed to help those who see the potential for suicidality in someone and gives them guidance on how to intervene. This training does not take the place of counseling or critical care—rather, it helps you offer hope and alternatives through action rather than inaction.
“QPR” stands for Question, Persuade, and Refer. According to the QPR Institute, the first thing to do when wondering whether or not someone you know may be suicidal is to question them about it. You might consider saying, “Hey, I notice you’ve mentioned being down and that you’ve been talking about suicide lately—are you considering suicide?” People who are considering suicide typically discuss it when confronted with direct questions, and asking does NOT increase the risk of suicide.
Once the person acknowledges their suicidal thoughts, the next step would be to persuade them to get help. This includes hearing what they say, letting them know that you are listening, and that you want to help. At this point, do not ask or encourage them to consider help—it’s more effective for you to exercise control by imperatively stating “Let me help,” “I will help you,” or “Come with me.” Do not promise to keep their feelings a secret—this is not a time for loyalty to anything other than the person’s safety and life.
The last step is to refer the person to a helping professional. For most people, a telephone is an easily accessible means of reaching help, and there are many hotlines focused on preventing suicide. One easily memorized number is 1-800-SUICIDE (784-2433), which is the hotline for the Kristen Brooks Hope Center. Another hotline is 1-800-273-TALK (8255), which is the National Suicide Prevention Lifeline. It is also important to know that local psychiatric stabilization hospitals like The Ridgeview Institute offer no-cost evaluation services to assess the appropriate level of care for someone. Sitting with someone as they call a helping professional or driving them to provider's office is much more effective than leaving them alone to do it themselves.
Approximately 36,000 lives per year are lost to suicide in the United States. Those of us who are left to make sense of what happened often ask ourselves the question, “Could I have done something else to prevent this?” While we may never know the answer to this question, utilizing the Question, Persuade, and Refer method in response to someone’s suicidal behaviors may make the ultimate difference.
Brandy Smith is a Licensed Professional Counselor at Avanti Counseling Services, Inc. in the Oakhurst District of Decatur. For additional information about this post or about services available, please visit www.AvantiCounselingServices.com.