of that? Thanks for the suggestion, what a
great idea – I’ll go kill myself now.”
Someone contemplating suicide has dis-
torted thinking. Their real interest is not so
much ending their life as ending their pain. It
is also common for them to feel as if they are
broadcasting their feelings and intentions. An
unspoken verbal battle inside their head feels
like others can hear it. They are astounded that
no one has picked up on it or has responded in
a way that makes them feel heard.
Sometimes you need to ask the question,
“Are things so bad you are thinking suicide
is a solution?” Shortly after a training for a
group of attorneys, one of them contacted
me regarding a friend he was deeply concerned about. We talked about approaches. A
few days later he called to relay that his friend
told him he had been seriously contemplating
suicide and their conversation was a positive
turning point for him in wanting to live.
Suicidal thoughts often have both dangerous peaks and calmer valleys over time. A
situation can escalate to the tip of a razor’s
edge, precariously balanced between two
possible outcomes: de-escalation with the
choice to live and survive the struggle, versus
a permanent tragedy. Most often someone
who is distressed or depressed might be
talking about suicide in a less obvious manner, making it more difficult to determine if
there is a serious threat.
Listen to what the person is saying. If
they are having trouble being direct, listen
for underlying messages. Try to understand
their perspective on their life in the moment.
2. Be Honest
Try to avoid empty reassurances like
“everything will be fine.” Depending on the
circumstances, it is possible things may continue to get worse before they get better.
Be genuine. Find the part of you that genuinely cares about the outcome and respond
3. Share Feelings
Let them know you are worried about
them. It is okay (and a lot more honest) to let
them know you want to help but are not sure
how to do that.
4. Get Help
Do not try to fix it yourself. Try to find a
responsible person they trust. If not, find
one you trust and get them there immediately. This is no time for keeping secrets.
In an emotional health crisis, it is critically
important to provide a secure environment.
Anyone can call a suicide prevention hotline
for assistance in evaluating the seriousness
of a situation. Some cities have mobile crisis
units where they can dispatch someone to do
a lethality assessment. Most cities will send
police to do an assessment, and police are the
only ones who can legally transport someone
against their wishes in the interest of saving
their life from a threat of suicide.
HOSPITALIZATION IS SCARY.
DEATH IS TRAGIC
Sometimes a person who is actively harboring suicidal desires needs an emergency
emotional intervention. Thoughts of suicide
do not automatically mean mental illness
even though a person may be checked into
a psychiatric hospital.
Hospitalization is only necessary in a small
percentage of cases, providing a safety net
to prevent acting on the impulse while at
the top of the danger zone of the peaks
and valleys of suicidal thought. It can also be
a needed wake-up call to others to take this
potentially deadly emotional crisis seriously.
A psychiatric hospital is the only place that
can lock the doors and provide a necessary
degree of physical safety for someone who
is highly emotional and therefore at a critically low point of clear thinking.
Even though it is always the last resort,
individuals with a plan to commit suicide who
refuse to agree to not harm themselves can
be hospitalized against their will. It is seldom
a pleasant experience, but it can save lives.
People often feel the hospital should “fix” the
person. It does not work that way. Intervention, including hospitalization, is often just the
Think of a psychiatric emergency room in
the same manner as you would the medical emergency room. One handles emotional
emergencies and the other handles medical
emergencies. In both cases the patient who
SOME DO’S AND
WITH SOMEONE WHO MAY
• Be aware. Learn about the
• Get involved. Become available.
Show interest and support.
• Offer to go with them to talk to
• Ask if the person is thinking
• Be direct. Talk openly and
freely about suicide. Share
feelings, not judgments.
• Be willing to listen. Allow
expressions of feelings. Accept
• Be non-judgmental. Do not
debate whether suicide is right
or wrong, or if feelings are good
or bad. Do not lecture on the
value of life.
• Do not dare them to do it. • Do not give advice, make
decisions for them or tell them
to behave differently.
• Do not ask “why.” This
• Offer empathy, not sympathy. • Do not act shocked. This will
put distance between you.
• Do not be sworn to secrecy,
• Offer hope that alternatives are
available without offering glib
reassurances that everything
will be fine. It only proves you
do not understand.
• Take action. Remove items
they could use to harm
themselves. Get help from
persons or agencies specializing
in crisis intervention and