One of the most difficult jobs of a mental health clinician is dealing with someone who is suicidal. Being a layperson with family members, co-workers or friends who want to kill themselves is even scarier. At least we have training in what to do and not do. Here are some things to consider when dealing with people who say they’re suicidal or who you think might be. (“Suicide rates on the rise: know the signs, ask the right questions to help them stem the tide” by Alison Lauria, Social Work Advocates, 10-11/18, pp. 13-20).

You may believe that suicide is a rare occurrence, but the fact is that, “Nearly 45,000 Americans age 10 and older died by suicide in 2016, making it one of the leading causes of death in America. And the suicide rate is rising…more than half—54%—of those died by suicide did not have a known mental health condition” (p. 14). So, toss out the belief that it’s just depressed people who take their own lives or that we can always tell if someone is planning to do so. Not true. And that’s what makes it so scary for clinicians, those who think about ending their lives prematurely, and loved ones alike.

When dealing with someone who might be suicidal, Kimberly H. McManama O’Brien, LCSW, PhD, advises not using the word “commit” because it sounds punitive or “successful” or “unsuccessful” when asking about attempts.” Rather, she recommends using “kill yourself” or “die by suicide (p. 15).” The goal is not to say the perfect thing that will bring someone back from the brink, but to not use words that might push him or her over the edge. I would add that you never want to tell people that they shouldn’t or don’t feel that way, implying that it’s morally wrong and that they are bad for doing so.

One important point to remember is that people often don’t want to stop living; instead, they simply wish to be out of emotional pain and haven’t found another way to do so. Although no one can ever promise to stop someone’s pain, we can provide hope that this will happen. Sometimes people experience just one stressor too many, and that feels like overload to them, when it might not to someone else. When dealing with someone who’s suicidal, it’s imperative not to judge or be critical.

What helps is expressing genuine concern. When evaluating or talking with clients who are actively or passively suicidal, I usually go from a more general statement about how they’re feeling to asking directly if they’re thinking of ending their life. I’d rather know that they’re not, than not ask if they are. By the way, no one has ever gotten upset with me for asking. Usually, they’re grateful that I care enough to make the effort and understand how much courage it takes for someone to reach out and ask hard questions.

Best,

Karen

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