What If Someone Is Suicidal?

The information provided below is from the Mental Health First Aid website 

Please refer to question on what to do in Mental Health Crisis. Most people who have committed suicide have done so when they have been alone. The risk of suicide is greatly increased if the person has been drinking, is alone and/or has ready access to means (gun, prescribed and non prescribed medication/drugs). In this state, the person may act impulsively:

  1. Assess or ask directly if the person is at risk of suicide.
  2. If situation is life threatening or dangerous, call 000 for emergency services or call your local Mental Health Crisis Team or take the person to a Hospital Emergency Department.
  3. If help has been called, stay with the person until help arrives.
  4. If emergency services are not needed, encourage/assist person to get appropriate professional help.
  5. Encourage the person to talk - listen without judgement. Be polite and respectful.
  6. If the person is consuming alcohol or drugs, try to help him/her from consuming any more.
  7. Try to ensure the person does not have ready access to the means to take their life.
  8. Give reassurance about the short term nature of suicidal feelings.
How can I tell if someone is feeling suicidal?

It is important that you know the warning signs of suicide. Signs that a person may be suicidal include:
  • threatening to hurt or kill themselves
  • looking for ways to kill themselves: seeking access to pills, weapons, or other means
  • talking or writing about death, dying or suicide
  • rage, anger, seeking revenge
  • acting recklessly or engaging in risky activities, seemingly without thinking
  • feeling trapped, like there's no way out
  • increasing alcohol or drug use
  • withdrawing from friends, family or society
  • anxiety, agitation, unable to sleep or sleeping all the time
  • dramatic changes in mood
  • giving away valuable items, money etc
  • no reason for living, no sense of purpose in life
How should I talk with someone who is suicidal?

It is important to:
  • tell the person that you care and that you want to help them
  • express empathy for the person and what they are going through
  • clearly state that thoughts of suicide are often associated with a treatable mental health condition. This may give the person a sense of hope for the future.
  • tell the person that thoughts of suicide are common and do not have to be acted on.
Suicidal thoughts are often a plea for help and a desperate attempt to escape from problems and distressing feelings. Encourage the suicidal person to do most of the talking, if they are able to. They need the opportunity to talk about their feelings and reasons for wanting to die. It may be helpful to talk about some of the specific problems the person is experiencing. Discussing ways to deal with problems which seem insurmountable at the time can be helpful, but do not attempt to "solve" the problems yourself.

How can I tell if the situation is serious?

Firstly, you need to determine whether the person has a definite intention to take their life, or whether they are having vague suicidal thoughts such as "what's the point of going on?". To do this, you need to ask the person if they have a plan for suicide. The three questions you need to ask are:
  • have you decided how you will kill yourself?
  • have you decided when you will do it?
  • have you taken any steps to secure the things you would need to carry out your plan?

A higher level of planning indicates a more serious risk. However, you must remember that the absence of a plan is not enough to ensure the person's safety. All thoughts of suicide must be taken seriously.

Next, you need to know about the following risk factors:

  • has the person been using alcohol or other drugs? The use of alcohol and other drugs can make a person more susceptible to acting on impulse.
  • has the person made a suicide attempt in the past? A previous suicide attempt makes a person more likely to make a future suicide attempt.
  • once you have established that the risk of suicide is present, you need to take action to keep the person safe.
How can I keep the person safe?

A person who is actively suicidal should not be left on their own. If you can't stay with them, you need to arrange for someone else to do so. Give the person a contact who is available at all times (such as a telephone help line, a friend or family member who has agreed to help, or a professional health worker).

It is important to help the suicidal person think about people or other things that have supported them in the past, and find out if these supports are still available. These might include a doctor, psychologist or other mental health worker, family member or friend, or a community group such as a club or church.

Do not use guilt and threats to prevent suicide. For example, do not tell the person they will go to hell if they die by suicide, or they will ruin other people's lives if they kill themselves.

What about professional help?

During the crisis.....
Mental Health professionals advocate always seeking professional help, especially if the person is psychotic. If the suicidal person has a weapon or is behaving aggressively, you must seek assistance from the police in order to protect yourself. However, the person you are helping may be very reluctant to involve a professional and, if the person is close to you, you may be concerned about alienating them. In fact, some people who have experienced suicidal thoughts feel that professional help is not always necessary.

After the crisis has passed.....
After the suicide crisis has passed, ensure the person gets whatever psychological and medical help they need.

What if the person makes me promise not to tell anyone else?

You should never agree to keep a suicide plan secret. However, you should respect the person's right to privacy and involve them in decisions regarding who else knows about their suicidal intentions.

The person I am trying to help has injured themselves, but insists they are not suicidal. What should I do?

Some people injure themselves for reasons other than suicidal intent. This may be to relieve unbearable anguish, to visualise their pain, to stop the feeling numbness, or for other reasons. This can be distressing for others to see. There are guidelines in this series entitled First Aid guidelines for deliberate self-injury which can help you to understand and assist in this situation.