When it Comes to Suicide Prevention, Direct is Best
I turned to the woman sitting next to me in the church hall in Clinton, and, even though it felt incredibly awkward, I asked her, “are you thinking about killing yourself?”
She wasn’t. We were both role playing at a Mental Health First Aid USA training session. I asked her. She asked me. And, even though we had both been through the same training and it was just practice, it was hard to get the words out of my mouth. Like many people, I had always wondered if asking someone who was troubled, putting words to my fears, might put the idea in someone’s head and make them feel awkward and pull away, or otherwise make a bad situation worse.
What I learned that day, and what mental health professionals would like you to know, is that it is OK to ask, and that they can give you the words to help you ask, and that they can recommend resources for you to access after you ask. They don’t want you to be the therapist; you don’t have to diagnose and solve the problem. But you can act as a bridge for someone who needs help.
That by doing that you might save someone’s life is one of many messages they will be trying to get out to the public during Suicide Prevention Week, Sunday, Sept. 9 to Saturday, Sept. 15.
In advance of that week, on Thursday, Sept. 6 at 6 p.m., the Henry Carter Hull Library, 10 Killingworth Turnpike, Clinton is offering a guided discussion with Clinical Psychologist Megan Warner, PhD and Licensed Social Worker Alissa Goldberg, LMSW, both of Guilford.
Focusing on How to Help
The free talk, open to all, at the Clinton library will focus on statistics relating to suicide, the difference between self-harm and suicidality, the difference between suicide ideation (thoughts that life isn’t worth living) and an urge for suicide (a desire to make an attempt), the difference between premeditated suicide attempts and impulsive attempts, suicide triggers, risk factors, and more. And they will focus on what people can do to help.
“Asking creates a space that lets people speak openly,” Warner says. “It’s a myth that asking about suicide will trigger the idea. There is a list of five steps you can take if you are worried. We will go through those.”
Here are the five steps for helping someone who is in emotional pain that Warner and Goldberg obtained from the National Institute of Mental Health:
1 Ask: “Are you thinking about killing yourself?” It’s not an easy question, but studies show that asking at-risk individuals if they are suicidal does not increase suicides or suicidal thoughts.
2 Keep them safe: Reducing a suicidal person’s access to highly lethal items or places is an important part of suicide prevention. While this is not always easy, asking if the at-risk person has a plan and removing or disabling the lethal means can make a difference.
3 Be there: Listen carefully and learn what the individual is thinking and feeling. Findings suggest acknowledging and talking about suicide may in fact reduce rather than increase suicidal thoughts.
4 Help them connect: Save the National Suicide Prevention Lifeline’s number in your phone so it’s there when you need it: 1-800-273-TALK (8255). You can also help make a connection with a trusted individual like a family member, friend, spiritual advisor, or mental health professional.
5 Stay Connected: Staying in touch after a crisis or after being discharged from care can make a difference. Studies have shown the number of suicide deaths goes down when someone follows up with the at-risk person.
Warner said the conversation could help determine whether the person really wants to be dead, or whether they are just in a lot of pain.
Look for Something Not Typical
“Most people will say they just don’t want to be in pain anymore,” she says. “If they say they don’t want to be alive, that’s a bigger problem that needs to be dealt with.”
Risk factors for suicide can be complicated and can include hopelessness, mood disorders, challenges controlling emotions that swing to extremes, isolation and withdrawal, and changes in behavior.
“You’re looking for something that is not typical,” she says. “Maybe they are sleeping a lot or not at all. Maybe they are retreating or not interacting. Changes in patterns are meaningful.”
She also said there is such a thing as “suicide euphoria,” that can make it seem like someone is suddenly getting better when in fact they have made a decision to kill themselves or have made a plan.
“They feel relief, so they seem like they are getting better,” Goldberg says. “And that can be confusing for loved ones.”
Goldberg says that while it’s not easy to ask someone if they are thinking of killing themselves, studies show it will not increase the risk of suicide. Warner adds that between 2- to 10 percent of the population have experienced ideas of suicide. It’s more common than most people might think.
What can make people more comfortable with asking is knowing that help is available, they said. And it is.
“Things can get better. This stuff can be treated. It’s possible to find providers and get started with the therapy process. It can feel daunting, but getting help is absolutely worth it,” Warner says. “It’s the bravest thing you can do. It can give you your life back. It’s well worth it.”
Seeking Help, Next Steps
One of the most valuable resources in Connecticut is calling 211, says Goldberg.
“If you press Option 1 on the main menu, if a caller is in crisis, someone will answer the phone and talk you through what you should do,” she says. “They will tell you next steps. This is a great resource for individuals in crisis, or someone trying to help someone in crisis. A parent can call it for a child, or a parent and child can call it together. Or the child can call it themselves. Once you are identified as a caller in crisis, your call gets prioritized.”
For those who are not in immediate crisis, but want to learn more about how to help, there are several options.
Goldberg recommends a resource called Family Connections that can help someone with a family member who suffers from what she calls “emotional disregulation.” This is a 12-week course that provides family members with education, resources, coping skills, and tips on how to interact with the family member who is suffering.
“It’s a free course and I wish everyone knew about it,” she says.
More information about it is available at www.borderlinepersonalitydisorder.com. Goldberg says not to worry about the fact that it includes “borderline personality disorder” in the title, that the lessons apply to a wide range of emotional and mental health challenges.
Several Mental Health First Aid USA sessions, like the one I took in Clinton, are coming up as well, several of them taught by Nikita L. Joslyn, LMSW, a training and staff development specialist at The Connection in Middletown.
“People who attend this course will learn about some of the most common mental health disorders, warning signs, and how to respond appropriately to a mental health problem or crisis,” Joslyn says. “You won’t be trained to be a clinician or therapist, just a first aider to help someone going through a challenge make a connection to more advanced help.”
The training will help people help others who may be thinking of suicide.
“It will help you assess and, from there, how to follow up and direct someone to help,” she says.
More information about these classes is available at www.mentalhealthfirstaid.org. In addition to the courses listed, Joslyn says custom training is available for individuals and organizations interested in that by contacting her supervisor, Michele Klimczak at email@example.com.
Warner also encourages family members concerned about someone to make sure all lethal means are removed from the home.
“Get rid of lethal items and opportunities,” she says. “The thing about firearms is that you can’t change your mind. Get rid of guns, the meds out of the medicine cabinet, razor blades, knives. This is particularly true of households with young people who are struggling. Their frontal lobes don’t develop until they are in their mid-20s. They are more apt to do something on impulse.”
Warner and Goldberg both said finding a therapist who specializes in dialectical behavior therapy (DPT), which identifies and helps change negative thought patterns, can provide long-term help.
“We’ve been kind of on a tear trying to educate people about this,” Warner says. “It can really help people control these emotions.”
Another foundation concept is mindfulness, she says.
“The whole point of mindfulness is being in the present,” she says. “If you’re future focused, it can create anxiety. If you’re in the past, it can create depression. Or for some people, it’s the other way around. But if you can turn your mind to the present, you can find your way through. We need to teach people how to turn their minds to the present.”