What Do I Say When…?
Someone is Talking about Suicide
Suicide can be an anxiety-provoking topic. Often, the simple act of just seeing or hearing the word spikes personal and societal fears. The idea of a colleague, friend, or loved one talking about killing themselves or “wanting to die” can be even more overwhelming and scary. This article will help to alleviate some of the unknown and answer common questions about how to manage the difficult topic of suicide.
Talking about suicide is not a call for attention, rather a cry for help.
There are two different types of situations you may experience with people having suicidal thoughts – passive and imminent. Both should be taken very seriously, though likely handled a bit differently. In either case, do not be afraid to ask detailed and difficult questions. Asking about suicide does not increase their risk of an attempt. Instead, it decreases the stigma, alleviates feelings of isolation, and increases support – decreasing the likelihood of death by suicide.
Passive:
This situation occurs when someone is speaking more vaguely of wanting to die - maybe they have considered suicide or state that they feel they simply cannot go on like this.
- Start with validating that person’s emotions and expressing your own genuine concern. Showing empathy and emphasizing that the person’s feelings matter can go a long way. “It sounds like you are really struggling. Can you tell me more about it? I’d like to listen and help where I can.”
- Try your best not to argue with the person’s negative statements, no matter how dire they may sound. You can use positive reinforcement, while still acknowledging that their current emotions are real and fair. “You feel hopeless right now; we will get you the help you need together. You are not alone.”
- Encourage the person to seek professional help and offer to help them identify and contact resources (see resource list below).
- Safety Plan – Speak with the person about who they will contact if their suicidal thoughts and depressive symptoms begin to escalate. This list will likely include close friends or relatives, a professional, and a 24-hour suicide hotline.
- Ask the tough and detailed questions. “Do you have a plan?” “Have you ever attempted before?” “Do you feel as if you could do something to hurt yourself today?” “Are you scared to be alone right now?”
Imminent:
Someone who is expressing a desire to die in the near future is in imminent danger, particularly if they have established a plan, means, or timeline.
- Call 9-1-1 or the nearest emergency services unit.
- Do not leave the person alone. Make sure they are escorted by a trusted person to the nearest Emergency Department or mental health crisis center.
- Ensure that all means are removed from the person’s access. This might include guns, knives, medications, alcohol, and poisons. If this person is not a close friend, be sure to alert someone who will have the ability to remove means.
Work/Life Connections-EAP psychologist Chad Buck created a helpful acronym for keeping some of the tips mentioned above in mind: BELIEVE.
- Believe that suicidal comments or gestures are serious
- Engage in conversation about thoughts and feelings
- Listen without judgment or arguing
- Investigate intent and access to lethal means
- Express empathy for the person and situation
- Validate how difficult and painful this is for them
- Encourage them to seek support and escort the person to access help
Supporting those with mental health issues can be incredibly tough, and you should not have to walk through it alone. Vanderbilt’s Work/Life Connections – Employee Assistance Program is a no-cost, confidential benefit for all employees, faculty, physicians, and their spouses. If you are wondering if counseling is for you, I encourage you to call 615-936-1327 and schedule an appointment to speak with one of the licensed clinicians on our team.
If you are a Vanderbilt student, call the Vanderbilt Psychological and Counseling Center at (615) 322-2571.
We are here for you.
Additional Resources:
Crisis Lines:
National Suicide Prevention Lifeline - 1-800-273-8255
Tennessee State-wide Crisis Phone Line - 855-CRISIS-1 (855-274-7471)
Walk-In Crisis Centers:
Mental Health Cooperative
275 Cumberland Bend, Suite 237
Nashville, TN 37228
615-726-0125
Vanderbilt 24/7 Behavioral Health Access
1601 23rd Ave. S.
Nashville, TN 37212
615-327-7000
References
National Alliance on Mental Illness. (2017). Preventing Suicide. Retrieved from: https://www.nami.org/Find-Support/Family-Members-and-Caregivers/Prevent…
National Institute of Mental Health’s Science Writing, Press & Dissemination. (2015). Suicide in America: Frequently asked questions. National Institute of Mental Health. Retrieved from: https://www.nimh.nih.gov/health/publications/suicide-faq/index.shtml
Smith, M., Segal, J., & Robinson, L. (2017). Suicide Prevention: How to help someone who is suicidal and save a life. HelpGuide.org in collaboration with Harvard Health Publications. Retrieved from https://www.helpguide.org/articles/suicide-prevention/suicide-preventio…
Maggie Reynolds – Clinical Counselor
Vanderbilt Work/Life Connections - Employee Assistance Program
