Everyone can help prevent suicides because:

• About 80% of the time people who kill themselves have given definite signals or talked about suicide
• Most suicidal people don’t really want to die – they just want their pain to end

So, all one needs to know is:

• How to identify someone at high risk (Warning signs)
• What to do. (Intervention)

Warning Signs:

• Observable signs of serious depression
  • Unrelenting low mood
  • Pessimism
  • Hopelessness
  • Desperation
  • Anxiety, psychic pain, inner tension
  • Withdrawal
  • Sleep problems
• Increased alcohol and/or other drug use
• Recent impulsiveness and taking unnecessary risks
• Threatening suicide or expressing strong wish to die
• Making a plan
  • Giving away prized possessions
  • Purchasing a firearm
  • Obtaining other means of killing oneself
• Unexpected rage or anger

DSM – V – Suicide Assessment Dimension

High level of concern:

1.Living alone, chronic severe pain, or recent (within 3 months) significant loss

2.Recent psychiatric admission/discharge or first diagnosis of MDD, bipolar disorder or schizophrenia

3.Recent increase in alcohol abuse or worsening of depressive symptoms

4.Current (within last week) preoccupation with, or plans for, suicide

5.Current psychomotor agitation, marked anxiety or prominent feelings of hopelessness

What to do?

Three Basic Steps:

1. Show you care
2. Ask about suicide
3. Get help

• Step One
  • Show You Care: Take ALL talk of suicide seriously
  • If you are concerned that someone may take their life, trust your judgment!
  • Listen Carefully
  • Reflect what you hear
  • Use language appropriate for age of person involved
  • Do not worry about doing or saying exactly the “right” thing. Your genuine interest is what is most important
• Be Genuine : Let the person know you really care.
• Talk about your feelings and ask about his or hers.
  • “I’m concerned about you… how do you feel?“
  • “Tell me about your pain.“
  • “You mean a lot to me and I want to help.“
  • “I care about you, about how you’re holding up.“
  • “I’m on your side…we’ll get through this.”
• Step Two

Ask About Suicide

Be direct but non-confrontational

Talking with people about suicide won’t put the idea in their heads.

Chances are, if you’ve observed any of the warning signs, they’re already thinking about it. Be direct in a caring, non-confrontational way.

Get the conversation started.

• You do not need to solve all of the person’s problems – just engage them. Questions to ask:
  • Are you thinking about suicide?
  • What thoughts or plans do you have?
  • Are you thinking about harming yourself, ending your life?
  • How long have you been thinking about suicide?
  • Have you thought about how you would do it?
  • Do you have __? (Insert the lethal means they have mentioned)
  • Do you really want to die? Or do you want the pain to go away?

• Ask about treatment:
  • Do you have a therapist/doctor?
  • Are you seeing him/her?
  • Are you taking your medications?

• Step Three
  • Get help, but do NOT leave the person alone
    • Know referral resources
    • Reassure the person
    • Encourage the person to participate in helping process
    • Outline safety plan

Referral Resources

• Resource sheet: Create referral resource sheet from your local community
  • Psychiatrists/Psychologists
  • Other Therapists
  • Family doctor/pediatrician
  • Local medical centers/medical universities
  • Local mental health services
  • Local hospital emergency room
  • Local walk-in clinics
  • Local psychiatric hospitals
• Hotlines : Samaritans : 116123 ; NHS: 111

Reassure the person that help is available and that you will help them get help:

• “Together I know we can figure something out to make you feel better.”
• “I know where we can get some help.”
• “I can go with you to where we can get help.”
• “Let’s talk to someone who can help . . . Let’s call the crisis line now.”

Encourage the suicidal person to identify other people in their life who can also help:

• Parent/Family Members
• Favorite Teacher
• School Counselor
• School Nurse
• Religious Leader
• Family doctor

 Outline a safety plan

Make arrangements for the helper(s) to come to you OR take the person directly to the source of help – do NOT leave them alone!

Once therapy (or hospitalization) is initiated, be sure that the suicidal person is following through with appointments and medications.

While doing all of this, remember to take care of yourself. xxx