It was 4.30pm on a Friday afternoon when the phone rang. I had started packing up for the day and my mind wandered to my weekend plans. Automatically I reached for the phone “Hi, you have reached…” my words faded as I listened to the sobs on the other end. “Hello,… hello? Can I help you?” I asked? In the next few moments between the sobs, I learned it was a client and he had just attempted suicide. My mind and heart raced as I thought about what to say next.
Fortunately conversations like this do not happen every day. But from time to time we are all faced by the crisis of another. What do you say in a moment like that? Who do you call? I have listened to people share how they fumbled their way through conversations like this hoping that they were saying the right words, while fearing they were making it worse.
Although there is no magic answer, there are some good principles to follow. Firstly understand that for suicide to become a very real option for someone the following 3 beliefs must be held strongly: the current situation is unbearable; it is unlikely to change; and I cannot get help to manage this. The last one may be for a number of reasons, such as I don’t have the resources, I don’t know where to go, or I don’t deserve help. More often than not, in those moments people also believe that others or the world will be a better place without them.
The following lists – “What to look out for” and “What to do” come from the Australian Government Department of Health "Living is for Everyone" - Fact Sheet 23 (for a full list of fact sheets click here).
What to look out for?
People at risk of suicide usually give clues by their behaviour. These may include:
• Previous suicide attempts
• Being moody, sad and withdrawn
• Increasing their use of alcohol or other drugs
• Talking of feeling hopeless, helpless or worthless
• Taking less care of themselves and their appearance
• Losing interest in things they previously enjoyed
• Finding it hard to concentrate
• Being more irritable or agitated
• Talking or joking about suicide
• Expressing thoughts about death through drawings, stories or songs
• Saying goodbye to others and/or giving away possessions
• Leaving organised group activities such as social or hobby groups or study; and/or
• Engaging in risky or self-destructive behaviour.
What to do?
Act immediately to respond to the person by following these steps:
1. Do something now. Take warning signs seriously and ask the person if they are considering suicide and if they have any plans. Reaching out could save a life. Seek urgent help if it is needed by calling 000 or take the person to an emergency department of a hospital.
2. Acknowledge your reaction. You might panic or want to ignore the situation. If you are struggling, enlist the help of a trusted friend.
3. Be there for them. Spend time with the person, encourage them to talk about how they are feeling, identify who they can call on for support and encourage the person to agree to get further support.
4. Ask if they are thinking of suicide. Talking about suicide will not put the idea into their head but will encourage them to talk about their feelings. Don’t agree to keep it a secret since the person’s safety is your main concern.
5. Check out their safety. Ask how much thought the person has put into taking their own life. If you are really worried, don’t leave the person alone. Remove any means of suicide available, including weapons, medications, alcohol and other drugs, even access to a car.
6. Decide what to do. Discuss together what action to take. You may need to enlist the help of others (partners, parents, close friends or someone else) to persuade the person to get professional help. Only by sharing this information can you make sure the person gets the help and support they need.
7. Take action. Encourage the person to get support from local health professionals such as:
– counsellors, psychologists, social workers
– Aboriginal Health Workers
– school counsellors, youth workers, sports coaches – religious leaders
– mental health services
– community health centres
– telephone and web-based counselling services (see list)
8. Ask for a promise. Ask the person to promise they will reach out and tell someone if suicidal thoughts return. This will make it more likely they will seek help.
9. Look after yourself. It is difficult and emotionally draining to support someone who is suicidal, don’t do it on your own. Find someone to talk to, maybe friends, family, or a health professional.
10. Stay involved. Thoughts of suicide do not disappear easily. The continuing involvement of family and friends is very important to the person’s recovery.
Most importantly remember that your job is not to be their counsellor or psychologist. Just like you would perform CPR in a health crisis while calling the ambulance. So in a mental health crisis, be supportive while contacting their treating GP, Psychologist or other health professional who will be able to take over and provide appropriate treatment.
Want to learn more?
If you are struggling yourself, worried about a friend of family member, or would like to know more about helping someone, please contact our office on 02 9186 2544. Our friendly staff will be able to direct your questions to the right person.
Join me and let's start the conversation, "Are you ok?"
By Lidija Balaz
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