You stop to talk to your neighbor after a long time; the usual things, children, the traffic and so on. Quite unexpectedly, after some initial hesitation, she shares her thoughts about life not being worth living. What do you say or do next? Can you do anything to help?
Taking the time to listen, reach out, to ask and show that you care is the most important thing you can do in a situation like this. Any expression of suicidal thoughts is something to take seriously as a ‘call for help’. You may worry that asking about suicidal thoughts may push someone toward suicide, or introduce a thought that wasn’t there in the first place. Actually talking about it openly could be most helpful. Take a small step by telling your neighbour that you are concerned. Listen to her story calmly with compassion and acceptance. This could make her feel that she is not alone and that help is available. You could say something like, “I may not be able to understand exactly how you feel, but I care about you and want to help.” Or you could ask, “When did you begin to feeling like this? Did something happen that made you start feeling this way?”
Sometimes, in an effort to help the person change her mind, we may give quick advice, compare, or criticize with statements like, “You have so much to live for,” or “Your suicide will hurt your family” or “People have bigger problems” or “ You are being selfish and weak”. While we may mean to help, these remarks could do more harm than good. Can you step into her shoes and see things from her perspective? Real conversations, where we try to understand and support without judging, can be safety nets for someone in distress. Take the time to reach out to someone who needs help.
What can you do next? Your neighbour may reveal that she has been thinking about suicide for a long time and has even considered different methods. At the same time, she may try and convince you that it’s not really serious, she will manage on her own and so you must not share this information with anyone. Never promise to keep your discussions a secret and do not take complete responsibility for changing how she feels. Be proactive and do everything you can to get her the support and help she needs. If you are talking to someone who has specific ideas about how to end their life and a suicide attempt seems imminent, then do not leave the person alone. You could contact her family members and gently share your concerns. Suggest that they call a crisis helpline or get her to see a mental health professional. She may resist and feel that there is no hope, but you may need to persist.
Theory-based models of suicide prevention and the findings of mental health professionals and local and international research studies reinforce the importance of entering into a compassionate dialogue with a suicidal person. Suicide is an important public health issue, and research studies using community-based interventions have documented downward trends in suicide rates. Lifeline, an Australia-based crisis support service emphasizes the importance of training members of the community in relationship building and communication skills beyond just knowledge and awareness about suicide rates, risk factors and early identification. School, college and workplace-based suicide prevention programmes in India and across the globe also focus on training teachers, peers and co-workers in empathetic listening, talking and reaching out to vulnerable persons.
You may not be able to help everyone, but if you reach to one person, you can save a life.
Dr Poornima Bhola is associate professor, department of clinical psychology, NIMHANS