Saroja was late to work that morning. She looked upset and her eyes were swollen from weeping. On gentle probing, she revealed that her husband had come home drunk and created a big scene in front of the kids. The situation had become so bad that she had even contemplated ending her life several times in the last month.
I realized that Saroja was feeling helpless and overwhelmed. The next ten minutes, I left all the other work I had, and listened to her with empathy, which helped her unburden.
I pointed out her strengths – she was kind, a great worker and very honest. Most of us who had employed her, valued her a lot. I volunteered to refer her to a doctor for advice regarding her husband.
I might not have solved any of her problems but she went home with a lighter heart and promised that if she ever felt suicidal again, she would reach out for help.
Suicide is a cry for help. It is difficult to explain why some people take this decision, while others in a similar or even worse situation do not. People who have attempted suicide often say that they had mixed feelings about the act before attempting it. While there was an urge to get away from the pain of living, there was also an undercurrent desire to live. Most people with suicidal intentions may not really want to die, it is because they are so overwhelmed by their situation that they feel helpless. Like in the story above, if we show support and empathy , the wish to live increases and the risk of suicide, usually declines.
A person who is contemplating suicide will at some point give definite warnings of their intentions. It is here that each one of us can act as a gatekeeper.
Who can be a gatekeeper?
A 'gatekeeper' is someone who believes that suicide can be prevented and is willing to give time and energy for this cause. It maybe a teacher, hostel warden, parent, neighbor, employer, watchman, bus conductor, shopkeeper or a community leader. As a gatekeeper, you have to keep a watchful eye and be able to sound the alarm when you identify someone who is very distressed, provide initial emotional support and then refer them to a mental health professional. If you think that the person may be suicidal, a question like – “Do you sometimes get thoughts that life is not worth living?” may help a person discuss his suicidal thoughts with you. Contrary to what most people think, asking such a question never induces suicidal thoughts. In fact, it makes it easier for the person to reveal such thoughts. Often a person who is getting suicidal thoughts is also ashamed of such thoughts and feels relieved about being able to talk about it without being judged or labeled weak.
What should the gatekeeper do?
Listen to the person with warmth, treat them with respect, empathize with their emotions and care with confidence. Do not judge, blame or make the person feel alienated further. Do not use phrases like – suicide is a sign of weakness. Do not get angry with the person or ignore their problems. Focus on the person’s strengths and encourage them to think of the good things in their life. Remember to remove means for suicide (such as sharp objects, medicines, pesticides) and ensure that the person is not left alone till the crisis passes.
With a little training, you can become a gatekeeper too.
Padmavathy is a psychiatric nurse at NCWB and Dr Prabha Chandra is a professor of psychiatry at NIMHANS.
Gatekeeper training program in suicide prevention is conducted every alternate month at the NIMHANS Centre for Well Being (NCWB) at BTM layout, Bangalore.
If you want to be trained as a gatekeeper, you can contact NCWB on 080-26685948 / 9480829670.