Supporting someone with suicidal thoughts

When we came home with our son after his first suicide attempt we felt completely out of our depth. We knew we loved him and wanted to look after him but had very little idea of what the most helpful things to do would be. It was like taking a new born baby home and our emotions were all over the place which meant that we really could have done with some guidance.

Pat, a service user’s parent.

What is suicide?

Suicide is when someone intentionally ends their own life.

What are suicidal thoughts?

Suicidal thoughts or suicidal ideation means thinking about or planning suicide. Thoughts can range from a detailed plan to a fleeting consideration.

What are some of the common myths about suicide?

Myth

Talking about suicide will give someone the idea to do it.

Fact

• Talking about suicide does not make it more likely to happen.
• Talking about suicide not only reduces the stigma, but also allows someone to tell you how they feel.
• People who have felt suicidal will often say what a huge relief it is to be able to talk about what they are experiencing.
• Once someone starts talking they’ve got a better chance of discovering other options to suicide.

Myth

People who talk about suicide aren’t serious and won’t go through with it.    

Fact

• People who take their life by suicide have often told someone that they do not feel life is worth living or that they have no future. Some may have actually said they want to die.
• While it’s possible that someone might talk about suicide as a way to seek the support they need, it’s vitally important to take anybody who talks about feeling suicidal seriously.

Myth

You have to be mentally ill to think about suicide.

Fact

• Not all people who die by suicide have mental health issues.
• Two in three suicides are by people who are not under mental health care services.
• Around one in five adults say that they have thought about suicide at some point in their life.

Myth

If a person is seriously thinking about taking their own life, there is nothing you can do.

Fact

• Suicide is not inevitable – it can be preventable.
• Most people who experience suicidal thoughts don’t go on to take their own life.

Why does someone have suicidal thoughts?

Thoughts of suicide can affect anyone at any time.

People might think about suicide for different reasons. Often there isn’t one main reason why someone is thinking about taking their life, it can be a result of problems building up to the point where they feel unable to cope and see suicide as the only option to escape from what they are experiencing.

Some of the problems that might increase the risk of someone thinking about suicide include:

• the recent loss or the breakup of a close relationship
• an actual and/or expected unhappy change in circumstances (e.g. education, employment, housing, social, financial)
• bullying or social isolation
• physical illness
• heavy use or dependency on alcohol or other drugs
• depression
• previous suicide attempts or self-harming behaviours
• history of suicide in the family.

How will I know if someone is experiencing suicidal thoughts?

There is no exhaustive list of signs, some can be obvious and some more subtle.

A significant number of people with suicidal thoughts may try to keep their thoughts and feelings a secret and show no signs that anything is wrong.

There are some things to look out for which may be a sign that someone is struggling to cope and is feeling suicidal:

• feeling or appearing to feel trapped or hopeless
• feeling intolerable emotional pain
• having (or appearing to have) an unusual preoccupation with violence, dying, or death
• having mood swings (happy or sad)
• talking about revenge, guilt, or shame
• being agitated or in a heightened state of anxiety
• experiencing changes in personality, routine, or sleeping patterns
• consuming drugs or more alcohol than usual (or starting drinking when they had not previously done so)
• engaging in risky behaviour such as driving carelessly or taking drugs
• getting their affairs in order and giving things away
• getting hold of a gun, medications, or substances that could end a life
• experiencing depression, panic attacks, impaired concentration
• increased isolation
• talking about being a burden to others
• saying goodbye to others as if it were the last time
• seeming to be unable to experience pleasurable emotions from normally pleasurable life events such as eating, exercise, social interaction or sex
• severe remorse and self-criticism
• talking about suicide or dying, expressing regret about being alive or ever having been born.

Most importantly pay attention, look out for small changes in behaviour and follow your instincts. If you feel they are ‘not right’ tell the professionals and ask them to reassess the person you are supporting.

What can I do to help?

Often people report that they find it difficult to support someone who has attempted suicide or is experiencing suicidal thoughts because they feel they don’t know what to say.

It can be hard to find the right words when you’re feeling overwhelmed and emotional yourself.

There are several things you can do to help someone who is suicidal and you may find these suggestions below helpful.

Be there for them and listen

Spend time with the person and express your care and concern. Ask them how they are feeling and listen to what they say without judging. Let them do most of the talking. Offer support rather than advice and help them to think about other options.

Ask direct questions about suicide

The best way to know if someone is thinking about suicide is to ask. It can often be a relief for people to be asked what they are feeling. Asking can sometimes be very hard but it shows that you have noticed things, been listening, that you care and that they are not on their own. If you are concerned someone is thinking of ending their life, ask them honestly and directly whether they have suicidal thoughts and whether they have a specific plan. Not only will it help you find out how best to support them, but by being direct you will be taking away some of the shame and secrecy around suicidal feelings, which can also reduce their impact. Don’t agree to keep their suicidal thoughts or plans a secret.

The following suggestions may serve as prompts:

• Do you feel life is not worth living?
• Do you feel like ending your life?
• Do you ever feel so bad that you think of suicide?

Check out their safety

If a person is considering taking their life it is important to know how much thought they have put into this. It is helpful to ask about the following:

• Have they thought about how and when they plan to kill themselves?
• Do they have the means available to carry out their plan?
• What support can they access to stay safe and get help?
• How can you help them to draw on the links and support from family, friends, pets, religious convictions, personal coping strategies and strengths?

Seek professional help

The person can get help from a range of professional and supportive people:

• General Practitioner (family doctor)
• Support organisations such as the Samaritans, Papyrus (see Support for information about how to contact these services)
• Counsellor, psychologist, social worker
• School counsellor, youth group leader
• Priest, minister, religious leader
• For urgent access to services phone your local mental health crisis service, ring 111 – 24hrs a day, 365 days a year

Ask to see their safety plan

People in receipt, or previously in receipt of mental health services, who have been identified as having suicidal thoughts may have developed a safety plan with the support of staff, their family and/or carers.  This plan will give information on how you can support the individual.  You can request a copy of this plan.  Wherever possible we will share this with you (Please see L854 – common sense confidentiality leaflet) and emergency services can access these plans.

If there is an immediate risk

If someone you know, is in immediate danger of serious harm (for example, if someone has taken an overdose or in the process of carrying out their suicide plan), go to your nearest accident and emergency department or call 999 for an ambulance immediately.

Do not leave the person alone, remove any means of suicide available, including weapons, medications, alcohol and other drugs, even access to a car.

Give as much information as possible to the 999 operator and be as clear as you can when giving your address and telephone number.

If there is a risk of physical violence or if the person is at risk of self-harm or of causing harm to someone else, it may be necessary to contact the police directly by calling 999.

Our crisis and home treatment teams work closely with the acute hospitals / accident and emergency departments to make sure that the person you know can be supported for their mental health needs when required.

Call 999 if you, or someone you know, are seriously ill or injured and their life is at risk whether that is a medical emergency or a mental health emergency.

Alternatively if the person has not harmed themselves in any way that requires immediate medical attention it is best to contact your local Crisis Team or if known to mental health services, their named worker first.

Looking after yourself

If you are supporting someone who is considering suicide, make sure you take care of yourself. It can be difficult and emotionally draining to support someone who is suicidal, especially over an extended period.

Below are some things to consider to help look after your own wellbeing:

• Ensure you eat and drink
• Set small goals and celebrate them together
• Continue to do the things that you enjoy
• Don’t do it on your own. Find someone to talk to, maybe friends, family, religious leaders, GP, professionals
• Ask for help if you need it – be specific in your request so people know what is useful
• Contact a support organisation – even if you don’t know where to start; they will be able to give you more guidance (details are available at the end of this information)
• Don’t try and remember everything – write down any information you are given so you have something to refer to.

Support

The following organisations provide a range of free support and advice:

• NHS Choices
• Rethink
• Connecting with People
• Staying Safe
• Zero Suicide Alliance
• The Royal College of Psychiatry
• The CALM zone
• Young Minds
• The Recovery College Online