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Suicide is a tough topic to talk about so don’t go forward in this article if you feel triggered. ***Please note, this article is not a substitute for emergency mental health care, these are simply best practices. When in doubt about what to do always, always consult a mental health professional!!!***
What to do when you don’t know what to do
The first thing to know when a friend confesses to you that they want to end their life is this: it’s totally okay if you don’t know what to do. Most of us aren’t trained to handle such an emotionally charged situation.
The heavy emotional lifting can and should be done by a mental health professional.
If you choose to help, you can provide a little Mental Health First Aid. From there you can get your friend to the correct resource as soon as possible. (Side note, you can actually get certified in Mental Health First Aid by going to https://www.mentalhealthfirstaid.org/)
Here are a few things to do if a friend comes to you talking about ending their life
Ask the Right Questions
The first thing to understand is that the desire to commit suicide exists on a spectrum. (Find out more about this here: https://www.huffingtonpost.ca/adele-mcdowell/spectrum-of-suicide_b_16631596.html)
On the mild side of suicidality are thoughts of self harm, not wanting to exist, and/or the desire to disappear. This is mostly thoughts and thoughts without action are less dangerous.
On the severe side lies the gestures and actions. These are when suicidality gets very dangerous. This includes activities associated with planning to end your life such as writing a goodbye letter or giving away your belongings.
Asking questions to determine where your friend is on the Suicidality Spectrum will help you figure out the best possible resource for them in the moment.
*** Note here: All Suicidal Ideation should be taken seriously no matter where it is on the spectrum. Ideation is a maladaptive thought process and needs to be attended to by a mental health professional ***
- Do you have a plan (written or otherwise) to kill yourself? Having a suicide plan is the number one sign your friend needs professional intervention immediately.
- Do you have any weapons in the house? (This includes guns, knives, pills, razors, ropes, etc.)
- Is there someone in your immediate area that you can talk to? If not can you stay on the phone with me? (Getting the person out of isolation is key here. Even if they just go and sit in a room with another person that’s better than being alone and suicidal.)
- Do you want to die or do you want to take a break from the pain? (I know, it’s a tough question to ask but it’s extremely important to know the distinction between the two options. More often than not, people overwhelmed by negative emotions see no other way out but suicide. This is a totally different situation than being convicted to end your life)
Make Decisions Based on the Answers
If your friend answers yes to questions one and two – they are in imminent danger. This would be the point where it would be appropriate to alert the authorities, your friend’s family members, and/or their mental health professional if applicable.
On the other hand, if your friend doesn’t have a plan then you can try to talk to them a bit more to figure out what’s going on.
Keep them talking Until Help Arrives
At this point it’s important to encourage them to lock up/hide any weapons they have, to get themselves out of isolation, and for them to contact a suicide hotline like 211.org.
If they don’t feel capable of doing any of that ask them to stay on the phone/text with you until they are feeling a little more calm. After that you can encourage them again to call a suicide hotline or a counselor. If they still don’t feel like talking to a person a good alternative is the Crisis Textline.
Keep them talking until the proper authorities are reached or a responsible caregiver can take over.
The key here is to keep your friend distracted and out of isolation long enough to let the strong emotions subside a little bit. This will help them make more rational decisions.
Have backup and Set Boundaries
It’s really important to remember that unless you’re a trained professional, handling a friend’s suicide attempt is an emotionally heavy endeavor. It’s a not a good idea to take on this responsibility alone.
If you’re part of someone’s support network you can alert the other members to the issue so they can offer their help. You can take turns checking in on your friend.
If you are your friend’s only avenue of support continuously encourage them to reach out to a hotline or mental health professional. When they’re calmer make sure to gently remind them while you’re here to listen you’re not trained for this.
In addition, I highly recommend providing your friend support over the phone or internet. Not in person! This is for everyone’s safety since it’s an emotionally charge situation where one or both of you can be harmed if things escalate.
It may seem selfish to set a boundaries like this with someone who is clearly upset. However keeping a wise emotional and physical distance is better in the long run for everyone involved. You can only help as long as you stay calm and safe.
For more info on this part, check out MSB’s guide on How to Help Without Hurting.
Provide After care
Even after the crisis has passed, it’s important to check in on your friend often.
Things that can help:
- Take them to doctors appointments
- Listen to them and/or just hang out doing low pressure activities like video games, drawing, or taking a walk
- Regularly encourage them to seek help if they haven’t already
- Bring food or go grocery shopping for them
- Call/text more frequently than you normally would
- Tell them how much you care about them
Friends don’t let friends suffer alone.
If you’re concerned, tell your friend even if they get upset. It’s better to have them alive and pissed off at you than to have them dead.
Most likely though, they won’t even be mad.
Most people I know would appreciate that someone cared enough to check on them. So if you see something, say something especially now that you have these new tools at your disposal. You might just save a life.
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