Isn't suicide solely about the person wanting to die?
People who have thoughts of suicide are often in intense pain arising from their emotional distress. They may want to end or escape their pain, and in the moment, view death as a viable option. Thoughts of suicide are an indicator that the person feels lonely, hopeless, helpless, and can’t think of another way to make things better.
If I try to intervene with someone who looks distressed, will I be putting the idea in their head?
Asking someone if they’ve had thoughts of suicide isn’t likely to plant the thought in their head. On the contrary, it could give them an opportunity to acknowledge and share what they’re going through. A study conducted with over 2000 teenagers in New York showed that asking them whether they had thought of suicide didn’t increase emotional distress or suicidality, even among students with depression or those at risk.
People with suicidal thoughts want to die - is there anything I can do to change their mind?
People with thoughts of suicide want to end their pain, and not necessarily die. Several survivors of suicide attempts have said they felt instant regret after they jumped off the Golden Gate bridge.
People with thoughts of suicide may have reached out in different ways, or even attempted to deal with the thoughts using different coping mechanisms. Gatekeeper intervention followed by professional mental health support are known to help. Prevention is possible, and one can help by being on the lookout for red flags and by not seeing the person’s death by suicide as inevitable.
How can I tell the difference between a thought (“Oh, I’m so sick of it all”) as an expression of frustration, or as an indication of something more serious?
Not every person with a thought of suicide will go on to attempt it. There are three factors that determine whether thoughts of suicide are indicating a crisis or emergency: frequency, intensity and control.
The greater the frequency and intensity of thoughts, and the lesser the control over them, the more critical the situation. In addition, making concrete plans and acquiring tools may indicate a greater urgency.
If you hear someone express their frustration or a wish for things to end, you can attempt to understand whether they’re at risk by asking these three questions:
How often do the thoughts occur?
Are you able to push the thoughts away and focus on something else?
How much control do you experience over the thoughts when they occur? Are you able to manage them or do you feel helpless?
However, it’s essential to remember that whether the person is at risk of suicide or not, a thought of suicide is probably an expression of their emotional distress. A trained mental health professional is likely to be able to make an accurate assessment and offer them the support they need. If you know of someone who has thoughts of suicide, you could refer them to a mental health expert and encourage them to seek help.
Can I really prevent a suicide?
For someone who has thoughts of suicide, it may sometimes be just a conversation with a trusting, caring and empathetic person that prompts them to rethink their decision to take their life. That said, it’s important to remember the limits of your own resources. If you’re not a mental health professional, it is recommended that you have an initial conversation and then accompany or refer the person to a trained mental health professional who can help them deal with their emotional distress. As a gatekeeper, your additional support in terms of finding a professional they can consult, checking in on them and asking how else you can help can make a difference to the person.
Most importantly, remember that no gatekeeper is completely responsible for the actions of the person they are supporting. A gatekeeper’s job is to help the person who is contemplating suicide by pointing them to the right mental health support. It is not the gatekeeper’s job to make sure that the person is able to face all their challenges; the gatekeeper is the bridge between the person and the mental health practitioner, who will help the person build their resilience.
With inputs from Dr Divya Kannan, clinical psychologist; Kamna Chibber, consultant clinical psychologist and head - mental health, department of mental health and behavioral sciences, Fortis Healthcare; Paras Sharma, counselling psychologist and founder, The Alternative Story; and Scherezade Sanchita Siobhan, psychotherapist, The Talking Compass.
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