Suicide prevention month is in September, so it seems like I should write something about it. Nothing strikes a greater fear than thinking someone you love might consider suicide, attempt it, or worst of all, complete it. Some people plan theirs over a long time and give clues along the way, others do it impulsively as the method was readily available.
As therapists, there are all kinds of indicators we look at to see if someone is at risk. It is also important to remember that someone can be at risk, but give no clue or indication that they are thinking along those lines.
Assess thoughts/plan for suicide
Ask if they are having thoughts of suicide
On the intake paperwork it asks if suicide is a concern for the person in the moment. I also directly ask them during our initial session if they are having thoughts of suicide.
Some people fear that if they ask someone if they are having thoughts about it, then it will put the idea in the persons head. This is not true. Everyone knows that suicide is an option. Having an open conversation and hearing what the person has to say can be one thing that prevents it. It helps to have someone to talk to about dark and scary thoughts. Providing a safe place or a being a safe person to talk to can give the other person hope, that they can get through their difficulties.
If someone is having thoughts of suicide, we ask them to share those thoughts as it can give us an idea of how serious the person is contemplating it.
Do they have a plan?
We ask if they have thought of a plan. That is, how would they do it if they did do it. Having a plan makes it a little more serious. If we know they have a plan, we ask them to get rid of the means. What this refers to is getting rid of the gun(s) in the house if that is what they plan on doing. If they would take an overdose of pills, we ask someone to either get rid of those pills, or lock them up. If the client needs those pills, that someone else would need to be responsible for doling out their medications.
Risk factors for suicide
Active alcohol/drug problem
Being drunk or high decreases a person’s inhibition. Perhaps they would not attempt a suicide if they were sober, as all the consequences and fallout of it can make the person decide against it. If a person is having thoughts of it, then having alcohol and guns in the home greatly increases the risk of a completed suicide.
Recent death of a loved one
Losing someone you love is devastating. Most of us grieve, yet are able to move forward with our lives. If someone is already depressed and considering suicide, this can be the thing that pushes the person over the edge. The thing that is so challenging about all of this is that no one can predict if someone will commit suicide, we can only consider the risk factors.
Past suicide of friend or family member
This seems to give someone who is contemplating suicide permission to do so. Suicide is considered taboo. Yet when a person hears of someone else doing it, it can make the option even better. This can occur if it is a friend or family member who completes it, or a movie/rock star who is then idolized.
Helpless/hopeless
If someone feels that there is no hope for his or her current situation and struggles, then suicide can become a viable option. These are often symptoms of depression. Most situations will get better over time. If the person feels helpless and alone, that is not good.
Protective factors against suicide
Support system
Knowing that you have people you can talk to and will be there for you no matter what provides a safety net. This can be a friend, family member, religious figure, therapist, etc. Just having someone to talk to makes you feel less alone. Having your feelings validated and know that person will be there for you can help you get through your struggles.
Goals for the future
If the person has goals for the future such as going to college, starting a business, traveling, getting engaged, etc., they are less likely to commit suicide. Obviously doing so will get in the way of those plans.
Pets
At times a persons pets may be the only thing keeping them alive. To some people that might sound silly. Yet if that person believes that no one else can take care of their pets, then the person may feel a responsibility for keeping that pet alive.
Pets are wonderful for mental health. They provide love, attention and fun to a persons life.
It important to know that just because someone has these risk factors does not mean that they will commit suicide. On the flip side, just because they have protective factors, does not mean that they will not commit suicide. Obviously, if there are risk factors there, talking to someone and getting help are important.
For information or crisis call
National suicide hotline 1-800-273-TALK(8255)
Legacy Community Health clinics 832-548-5000
Menninger Clinic Houston 713-275-5400
Trevor Lifeline (under 25 LGBT population) 1-866-488-7386
Trans Lifeline (for transgender population) 1-877-565-8860
Please give me a call at 713-304-6554 if I can help.
Take care,
Debbie
