Suicide Crisis Intervention

About 30,000 suicide deaths occur in the United States every year. The number one cause of suicide is untreated depression. Suicide is the culmination of a long process in which people try in various ways to reduce their profound emotional pain. They have contradictory desires to live and to die, and the balance between the two shifts back and forth.1

Indicators of depression are discussed separately. The following indicators suggest that suicide may be imminent.

• Pre-Suicide Statements: Direct or indirect statements about suicide, hopelessness or death.
• Final Arrangements: A person may put their affairs in order, change a will, give away possessions, or talk vaguely of going away.
• Sudden Elevated Mood: Paradoxically, a depressed suicidal person may suddenly appear better after making a decision to end their life. A burden has been lifted, as they no longer have to agonize over the decision.
• Risk Taking or Self-Destructive Behavior: This may represent a death wish. The person isn't ready to take their own life but tempts fate by taking an extreme risk, for example reckless driving.

Suicidal people often pick rescuers. Despite what they say, subconsciously they want these people to help them. If you suspect that someone may be contemplating suicide, ask them direct questions. Are you thinking of suicide? How are you going to do it? Do you have a gun, or enough pills for an overdose? When will you do it?

Contrary to popular belief, you are not putting ideas into the persons head if you ask them about suicide. Bringing the subject out into the open and discussing it is one of the most helpful things you can do. It also enables you to assess how likely a suicide attempt may be.

Another common misconception is that if a person is determined to kill him or herself, nothing is going to stop them. Even the most severely depressed person has mixed feelings about death, wavering until the very last moment between wanting to live and wanting to die. Most suicidal people don't want death. They just want the pain to stop. The impulse to end it all may be temporarily overpowering, but does not last forever.

The decision to commit suicide is not a rational decision, so don't expect to have a rational discussion in which you talk a person out of it. Be supportive by letting the person know you care. Listen to them with respect for their profound despair. Do not make moral judgments. Don't challenge or dare a person to commit suicide thinking you will shock them out of the idea.

Then get help. Do not worry about invading the person's privacy even though they try to get you to promise secrecy. This is not a test of friendship but a cry for help. Don't leave it up to them to get help on their own. See that arrangements are made for professional evaluation and treatment.

If the crisis is acute, do not leave the person alone. Call 911, a hot line, or take the person to a crisis center, hospital emergency room, health center, psychiatrist, or family doctor. If you wonder whether you should intervene, ask yourself what you would do if the person were having a heart attack? The suicidal person has an equally deadly illness.

Extensive information about suicide prevention is available on the Internet. Search under Suicide Prevention.

Related Topics: Depression, Preventing Violence.

Reference
1. This section is based upon information provided by Suicide Awareness/Voices of Education at their Internet site www.save.org. Copyrighted information is being used with permission.

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