September is National Suicide Prevention Month. Our world has been rapidly changing, stress abounds and it’s taking a toll on some of the most vulnerable populations, including our youth and young adults. It is not only in the mental health community. Cases of suicide are on the rise across the board, which makes learning the warning signs more important than ever.
Mental illness does not discriminate as to race, background, religion, age, gender, or position in life. As an advocate and a survivor of mental illness and suicidal ideation, I thought it would be helpful to discuss this topic. IT IS OK TO TALK ABOUT SUICIDE. After all, if we do not, severe consequences could be ahead.
I want to discuss one part of suicidal ideation today – first contact. This can be done by either party, i.e. a loved one where the person is in crisis, or you, yourself can initiate the conversation. The topic is, the person struggling is thinking of taking their life. What is important is noticing when something seems ‘off’. When you have a close relationship with a person who lives with mental illness, it is important to sense when their symptoms are on the decline. They may stop eating, are secluding themselves or they may discontinue basic self-care. Warding off crisis mode is the most important thing. Once a person hits crisis mode, everything is exacerbated and much harder to deal with.
I picked up a phone call last year, not from a friend but an acquaintance. I had a casual relationship with her through work. She confessed to me she didn’t know where to turn at that moment. She didn’t want her personal life altered by reaching out. Uttering the word ‘suicide’ is a big thing. This can be a huge stumbling block in announcing “I feel suicidal”. She knew I was a mental health advocate and spoke openly as to the topic. I thank God she reached out to me.
The last thing the person wants to hear is, “oh you’ll be fine, you’re just having a bad day, snap out of it. Why don’t you do something fun like have an ice cream cone or hug a baby? Remember all the beautiful things you have in life to live for.” Platitudes and well-meaning surfacey sayings are not going to cut it here. You either move into the foxhole with the person, or, it can be make or break. The ultimate first step is getting them to reach out to the suicide hotline. The National Alliance on Mental Illness (NAMI) has installed a new number for just this topic. It is 988. You use it just like 911 to talk or text with a trained counselor.
If you are not able to handle the situation, please have the person dial that hotline number. Don’t send them to another family member, your priest, minister or friend. I am convinced, unless the person is trained in what to say, it can make the situation go south very quickly. There is no reason for you to feel guilt when there are trained personnel ready to deal with a crisis situation such as this.
Back to our story, the first thing I had this woman do was a ‘brain dump’ of everything she was thinking and feeling. I was prepared to hear her out, no matter how raw or vivid her words got. I stayed silent. I did not respond until she was done completely with dumping her feelings.
The next thing I did was affirm her. I said things like, “Susie, I completely understand why you could feel that way. It must be such a rough time for you right now. How long have you been thinking these thoughts? Have you held them in, journaled or talked to anyone else about what you’re feeling? Have you reached out to your therapist or psychiatrist?” I listened as she fed me more information. I did not respond or try to fix her.
Next I asked her, “Susie do you have a plan? Do you know exactly how you would go about it? Are the items necessary to do so in your possession currently? If so, where are they located? If not, how do you plan to get them?” I dove right into the point of access as to how serious she was. I let her walk through her words of how exactly she would execute her plan.
It is imperative that you do not get fearful in your voice or response. Try to keep as calm and monotone as possible without breaking a sweat and screaming “you can’t do that – what are you, nuts?” This is not about you. Your focus is totally on the other person.
Then, you make the issue third person. You say something such as, “let’s see if we can tackle this problem together. This problem needs addressing and I need your help to do that. Are you willing to take a few next steps with me to tackle it?” This way you separate the intimacy of the act and urgency of the feelings for the person.
You might say, “Susie, there is a new hotline number to call that will lead you to some more healthy options than what you’re currently thinking right now. Is there any reason why you couldn’t call that number and get back to me immediately after the call? I care very much about you and would hate for anything to happen. Let’s see what these trained professionals have to say and then discuss that next.”
You are leading the person through to the next step. You are letting them know you are not freaked out by what they are saying. You’re not judging what they are saying. Nor are you allowing yourself to try to be the answer. What you are being is a stable and safe place for the person to be able to talk through their feelings.
It is also important that you do not phone the nearest relative or friend and spill your guts about what Susie has divulged to you. Obviously she trusts you to hold things in confidence. Your spilling of Susie’s story to anyone that has gossiping ears and would love to hear this juicy tidbit, is off the board. If it gets back to Susie, you have lost her confidence, her trust in you and she loses her hope. That is what hangs in the balance here.
I want to share that my friend not only made it through her crisis moment, she is thriving and doing great as I write this. Please also understand that suicidal ideation, also known as suicidal thoughts, are a temporary and fleeting thing. It will not be followed through with unless the person does not reach out and/or gets a very bad response when they do.
This is why I felt led to make a blog on first contact. First contact is paramount in this situation. Chances are if they don’t get a great response from you, they are going to not pick up that phone again and will go further down the rabbit hole of suicidal ideation.
I remember when I was in my early twenties. I was married to my first husband and his father suffered severely with depression. He would come to our home as newlyweds and would tinker, fix things and have dinner with us. It was his way of keeping busy and not diving into his depressive feelings. He would talk constantly about his dark ideations. My ex and I were young and stupid. Very stupid. After months of this behavior went on, it was coming between our marriage. Finally, one evening, in a fit of rage and desperation, we both yelled at him, “Stop talking about it … if you’re going to do it, just do it!”
The next week he was found in a hotel room. He had done it all right. My ex came home from identifying his father. He looked at me and proclaimed, “you are responsible for this.” Needless to say that was the end of my first marriage. I would confess the incident has haunted me my entire life. I am at an age now, where I realize after much therapy and training from resources provided by the Mental Health Community, that I am not responsible for my ex-husband’s father’s death. I was young and naive and there were not as many options available as there are today.
My friends, anyone reading, this is how serious it is. Your reaction, your words, will either compel the person to continue to have hope, or repel them into thinking there is no way out.
I hope that this blog has enlightened some areas of darkness on this topic. My prayer is that you will not respond in panic or fear, should a person reach out to you one day. When a person suffers with heart issues, it is not a surprise if they suffer a fatal heart attack. When a person suffers with mental illness, a side effect could be that they choose to end their life. It is not odd. It is not something abnormal, that a disease of the mind would lead to such a fatal conclusion.
My prayer is that you take these things to Heart in all seriousness and act with compassion and understanding should you be put in the role of first contact. Thank you for reading.