Helping A Friend or Family Member who is Suicidal

Suicide Help

This chapter in our suicide series is designed for friends and family members who are interested in helping someone who is suicidal. We make the assumption that you have already read the background information on suicide included in our introductory chapter, so we will not repeat that information here. If you have not yet read the introductory chapter on suicide, and you have a few moments to spare, please do so by clicking here.

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Suicidal ideation can be precipitated by drug abuse and addiction. If you are struggling with a drug addiction and feel suicidal, help is available.

Alcohol use disorders have been frequently implicated in exacerbating suicidal behavior and/or suicidal tendencies.

The risk of suicidal behaviors is also exacerbated in the case of intravenous drug use, like heroin and prescription opiates.

Marijuana use and suicide may be associated--particularly for adolescents--although mental health factors strongly mediate the relationship.

If the person that you are trying to help is in serious danger right now (i.e., if they are acutely suicidal), please take the following steps right away:

• Take the person to the nearest hospital emergency room and tell the admitting staff there that he or she is "acutely suicidal".
  • Your use of the term "acute" tells the staff member who you're speaking with that your friend or family member is in danger of committing suicide right now, and that immediate action is necessary to keep the person safe.
• If you cannot get your friend or family member to the emergency room, call the emergency operator (911 in the United States).
  • Tell the operator that you are with someone who is acutely suicidal and that you require immediate help. Stay with the suicidal person until help arrives.
• If your friend or family member has existing relationships with mental health professionals, contact those professionals so that they are aware of what is happening.
  • This will help ensure continuity of care and make the process slightly less terrifying for the suicidal person.

If you are currently suicidal yourself, please call 911 or a suicide hotline, such as: 1-800-SUICIDE (1-800-784-2433) or 1-800-273-TALK (1-800-273-8255) in the United States.

What You Can Do

Here are a few things you can do while waiting for professional assistance:

Attention

Give all of your attention to him or her.

• Actively listen to what that person has to say and actively watch what he or she does.
• Do not try to multi-task; do not take phone calls (except from professional helpers); do not try to do anything other than to be present with this hurting person.
• If you have responsibilities that cannot be delayed (e.g., child care), make alternative arrangements so that someone else can handle those duties.

Put your own ego aside for a moment.

• Find it within your heart to care about the suicidal person you are with.
• Let him or her know that you care, but be genuine about it.
• Better not to go there if you aren't feeling it.

Empathy

Do your best to relate to and empathize your friend or family member's pain. Don't minimize feelings or shame someone for his or her thoughts.

• In other words, don't say stuff like, "Is that all that's bothering you? I can't believe that's upsetting you this much!" This may be how you really feel, but sharing such an assessment with someone in pain is cruel, as well as conveying a lack of empathy on your part.
• If you cannot relate to the person's situation, at least don't say anything that is likely to be viewed as insulting or demeaning.

It's easy to start feeling frustrated and even angry at a friend or family member who "refuses to put things into proper perspective" (i.e., to see things the way you see them). Anticipate that you might become frustrated and do your best not to lose your cool. Save your emotions for later- the focus of the present situation is not about you. The focus should be on the hurting person in front of you.

Is There a Suicide Plan?

Ask whether there is a suicide plan. If there is, draw out the details of that plan as best you can. Remember, though, that this is not meant to be an interrogation.

• How will the suicide take place?
• What means will that method of death require?
• Are the means easily available or at hand?
• Is there a time when the suicide will occur?
• Is there a place where the suicide will occur?

Listen

Continue to express your willingness to listen.

• However, do not force the suicidal person to talk. If your friend or family member doesn't want to talk, that's okay.
• To the extent that it is appropriate in the context of your normal relationship, consider holding hands, or touching the person on the shoulder as a gesture of support.
• If you would not normally touch this person, then make your support clear via verbal means.

Other things you can do

• Repeatedly suggest to your friend or family member that suicidal crises are temporary things. Waiting for a while and getting help can allow the suicidal crisis to pass.
• Don't agree to keep secrets for a suicidal person; or at least, don't agree to keep the fact that someone is suicidal a secret. In the same vein, do not agree that you will not call for professional help.
• Never challenge your friend or family member to carry out his or her suicidal plan, even if you privately think that the person is playing a game in order to attract attention. Even half-hearted suicidal gestures can result in a completed suicide.

What if you aren't sure whether someone is having an acute suicide crisis?

Sometimes you may suspect that someone you care about is suicidal even though he or she tells you that this is not the case. Go with your gut feeling in this situation.

• If you believe that your friend or family member will not be safe (despite whatever assurances are made) then go ahead and follow the steps described above to ensure that he or she gets help. It is better to err on the side of caution with regard to suicide.
• If you aren't sure one way or another regarding safety, err on the side of calling professional help. Let the suicidal person know what you are doing, however, so that there are no surprises.

A very likely outcome of reaching out for professional help is that your friend or family member will be brought into the hospital as a psychiatric patient for a few days, until the immediate crisis passes. Reassure the suicidal person that while no one looks forward to going to the hospital, doing so will help keep him or her safe, and may make the difference between living or dying.

If your friend or family member is not acutely suicidal, but still needs and wants someone to talk to about suicidal thoughts and feelings, please encourage him or her to contact his or her doctor or therapist, or to call a suicide hotline such as 1-800-SUICIDE (1-800-784-2433) or 1-800-273-TALK (1-800-273-8255) in the United States. Encouraging your friend or family member to speak with an impartial (objective) third party who has been specifically trained to talk with suicidal people can be very helpful.