A Therapist's Thoughts on Suicide Prevention

Michael Driscoll, LPC

 

 

 

 

 

 

 

 

 

 

 

 

 

2020.  Ah, what a year.  It feels like Murphy’s Law has been in full force.  In the midst of a global pandemic of historical proportions, our nation has faced increasing political turmoil, competing ideologies locked in civil conflict, an economic downturn not seen since the Great Depression and, of course, murder hornets.  As we do our best to get through these societal and environmental challenges, we must not lose sight that suicide remains the tenth leading cause of death in the United States - seventh in Colorado.  Given the recent and long-term problems faced by our country, this issue may be more prevalent than ever. 

Suicide is a difficult topic to discuss and often related to a mental health issue such as Major Depressive Disorder, unbearable mental anguish and pain.  Depression is a disease like any other.  It can occur with sudden rapid shifts in a person’s life or with a prolonged chronic health condition lasting months or years.  No one chooses to develop a disease, but we attempt to deal with it in the best ways we can.  Depression is no different. People with depression respond well to social connectedness and conversations supported by empathetic understanding.  Loneliness and isolation are common precursors to depression symptoms. 

In an article “The Social Cure” published in Scientific American, one study of some 1400 people indicated that loneliness was often a big predictor of depression, occurring in about one in four older adults.  On the flip side however, depression and anxiety plummeted the more social connectedness the person felt, such as engaging in multiple group activities.  Even better, it didn’t matter what kind of groups the person was involved in … could be sports, birdwatching, painting, behavioral health groups, or just about anything.  The more groups and social connectedness, the better the participants felt.  This speaks strongly to the power of social connection and its healing impact on depression, loneliness, and suicidal thinking.

We need to talk

As friends, co-workers, family-members and as a community, we need to start having weekly, if not daily, conversations with each other about suicide if we are ever to move the needle on suicide prevention and intervention.  We must break through the stigma and discomfort of discussing this topic with others.  The journey out of suicidal thinking can be greatly assisted by a caring person or a group of acquaintances.  Offering a gentle, non-judgmental curiosity to the conversation, as well as just thirty minutes of empathetic listening, can go a long way.  It’s okay to ask even when there is no indication of suicidal thoughts, because contrary to common opinion, asking will not place the idea in their head and will open the door to future conversations.  Starting the conversation is easier than you think.

Try to remain relatively quiet, calm, and non-judgmental for approximately ten minutes, only repeating back what you heard them say in your own words.  Do this several times to help convey that you understand.  It’s critical for the person to feel heard, understood, and validated, as this provides a release for them.  Recommend contact with their therapist, family/friends, or crisis services if indicated, and identify two coping skills they can use to calm down and wait out the ideations, as suicidal thoughts are time limited and usually pass.  Help them to identify their reasons for living, and who would be impacted by their death.  Call 911 or drive them to your nearest behavioral health crisis location if they cannot be safe on their own.  You might not be able to change their mind, and remember the decision is ultimately not yours.  A person must decide to help themselves in a moment of crisis. 

We need to listen

As the listener, reactions to suicidal discussions can feel overwhelming, anxiety producing, and difficult to sit with.  The best advice that I can give is to remain calm and take deep breaths, signaling that it is okay to talk about this subject.  Becoming comfortable with this subject will take time and practice.  Understand there is a significant difference between suicidal thoughts and imminent risk.  If we can help them identify their coping skills for triggers and occurrences of suicidal thoughts, then they take a step toward early intervention, resiliency building and resources at their disposal as well as strengthen their crisis prevention skills for imminent risk.  Finally, as a helper, please do not make the mistake of taking responsibility for someone else’s decision.  Ultimately the individual must make a choice.  Outcomes will vary in all situations. 

Thankfully, around ninety-five percent of suicide survivors report later in life they are glad they lived and that someone was there to listen to them and provide support when it was needed.  They remembered they are never truly alone if they ask for help.  Most survivors have common themes in describing their experience, whether they were interrupted by other persons or lived through the experience, and that is they are incredibly grateful for their connection with another human being during their darkest moments.  Many in this state of mind wished that a stranger on the street had asked them how they were doing.  The innate human need and desire for social connection is powerful - equally incredibly healing and potentially very damaging.  One human connection at the right moment in space and time can alter the life path of an individual forever.  How will you choose to act in that moment?

Finally, many of the previously mentioned issues can generate huge disruptions to people’s lives, creating shifting circumstances suddenly and dramatically, so be on the lookout.  Sadly, suicide is never fully predictable, but the least we can do is ask and check in with our friends, family, and co-workers.  Hindsight provides us data regarding the precursors and indicators of suicidal behavior, so we know what to watch for in people.  Take a few moments right now to research the common symptoms of suicidal behavior, as it just might be that you are in the right place at the right time one day.  If someone you know has had a major life change recently, it doesn’t hurt to ask them how they are doing, and if recent changes have led to recent suicidal thoughts.  And plug 1-844-493-8255 (Colorado Crisis Services) into your phone.

Some resources:

www.NAMI.org  National Alliance on Mental Illness

https://coloradocrisisservices.org/   Colorado Crisis Services

https://suicidepreventionlifeline.org/    Suicide Prevention Lifeline

Denver based therapist Michael Driscoll is a Licensed Professional Counselor and Supervisor of Staff for the Thornton Outpatient Therapy team of Community Reach Center.  He has been working in the field of mental health for over 16 years, has been an outpatient therapist for more than 10 years and specializes in the treatment of PTSD, Major Depression, Bipolar and Schizophrenia disorders.  Michael is a certified EMDR therapist, a facilitator for Assessing and Managing Suicide Risk (AMSR) trainings and is the lead for Community Reach Center’s Suicide Prevention Committee. 

 

National Suicide Prevention Awareness Month

September is National Suicide Prevention Awareness Month. It is an observation that draws attention to what a pervasive problem suicide is. It also highlights the fact that there are behavioral health resources available from places like Community Reach Center’s crisis center in Denver for people who are considering ending their life and for family members and friends of people who are at risk of attempting suicide or who have completed suicide.

According to the American Foundation for Suicide Prevention:

  • Suicide is the 10th leading cause of death in the U.S.
  • Nearly 45,000 Americans die by suicide each year
  • For every person that dies by suicide, there are another 25 who attempt suicide
  • Suicide costs the U.S. $69 billion annually

However, there are things that loved ones can do to help prevent suicide. First and foremost, it is important to recognize the indicators that some is at risk.

Signs a Person May be Considering Suicide

While not everyone who attempts or completes suicide exhibits observable behaviors before they take action, many people do. These behaviors may include:

  • Talking frequently or passionately about death, dying, self-harm or suicide
  • Attempting to obtain the means of suicide such as firearms or other weapons, drugs, chemicals, rope, etc.
  • Expressing feelings of hopelessness or helplessness
  • Withdrawal from family and friends, and avoiding activities previously enjoyed
  • Expressing feelings of self-hatred or guilt
  • Reckless actions, such as abusing drugs or alcohol, driving carelessly, etc.
  • Getting affairs in order such as selling or giving away possessions
  • Saying goodbye to loved ones as if they won’t be seen again
  • Demonstrating sudden calmness as they come to terms with the action they are about to take 

It is important to treat any of these behaviors as issues that should be addressed and not a “phase” that the person is going through.

The Right Response is to Take Action

If you have any suspicion that someone is considering suicide, the right response is to take action. If it turns out you have misunderstood their behavior, you can apologize and move on. However, if you are correct, your intervention may save their life.

It is a common belief that talking with someone who is considering suicide may cause them to move forward with their attempt. However, providing an opportunity to talk about what has them on the brink of ending their life can help relieve some of the pressure they are feeling and give them a chance to consider alternative actions including getting help from a crisis center in Denver like Community Reach Center.

When talking with someone you think is at risk of attempting suicide, keep these tips in mind:

  • Be honest. Don’t try to hide the fact that you are worried about them attempting suicide. It is important that you be truthful about your fears for them.
  • Take them seriously. If a person says that they “just can’t go on,” you should take them at their word and not be dismissive about their situation.
  • Be understanding even if you can’t relate. It may be that suicide is something that would never cross your mind. However, what matters is that it appears to be on theirs.
  • Be a good listener. Generally what people in crisis need is not advice but an opportunity to express themselves. 
  • Provide hope. The mental health conditions that lead people to consider suicide are treatable and a better life is possible.
  • Promise support. In many cases, simply knowing that they have someone who will stand by them as they seek treatment can make all the difference.

If at any point before, during or after a conversation you feel a suicide attempt is imminent, seek help immediately. Transport the person to a hospital or mental health center if they will allow it and you are able to do so. If not, call 911, prevent access to any means of suicide, and stay with the person until help arrives.

How to Talk with Suicide Loss Survivors

Like a person who is at risk of attempting suicide, suicide loss survivors also need the support of loved ones. Here some recommendations on how to talk with them:

  • Avoid saying “I know what you’re going through.” Even if you are a suicide loss survivor yourself, you can’t fully understand their situation.
  • Don’t imply or assign blame to them or to anyone.
  • Know that just being there for them can be helpful, even if a few words are spoken.
  • Don’t ask questions about how the person died.
  • Offer whatever assistance you are able to provide.
  • Don’t make statements that minimize the pain of the situation like, “He’s in a better place.”
  • Don’t place value judgments on the act, such as saying it is selfish, a sign of weakness, etc.
  • Be patient with them.
  • Check in often.

Assistance is Available

Talking with a behavioral health counselor can help a person keep from getting to the point where he or she is considering suicide. Learn about our crisis center in Denver at communityreachcenter.org or contact us by phone at 303-853-3500 to learn more about our services. We have centers in the northside Denver metro area of Adams County including the cities of Thornton, Westminster, Northglenn, Commerce City and Brighton.