The purpose of this article is to discribe the methods used by mental health professionals in order to intervene in a possible suicide attempt.

This is not an article about the morality of suicide or a guide on how to "make someone" choose not to kill themselves if they are truly set on it.

A Few Statistics

Worldwide, suicide is the third-leading cause of death.

One death from suicide occurs every 40 seconds.

There are 25 suicide attempts for every actual completion, so, just because someone tries and does not succeed, this doesn't mean that they are necessicarily "through the worst."

Approximately five million living Americans have attempted suicide.

SAD PERSON Lethality Test

SAD PERSON is a lethality assessment that can help you determine the risk for a suicidal person. It is related here merely food for thought, not as the be-all, end-all judge of what kind of person will actually kill themselves, or, more importantly, what kind of person will not. You should evaluate each situation on an individual basis and go with what your gut tells you over any statistic.

In order to score the test, give the potential suicide a "point" for each of these characteristics he or she possesses. If they score between 1 and 3 points, the suicide completion risk is relatively low. Between 4 and 6 is a medium risk, and between 7 and 10 is a high risk.

Sex: If the caller is male, he has a statistically higher chance of committing suicide.

Age: The high risk ages groups are for people under the age of 19 or over the age of 45.

Depression: Depression is the leading cause of suicide.

Previous Attempts: Between 65 and 70% of people who commit suicide have made attempts prior to the completion.

Ethanol: (or alcohol) Ethanol is associated with 65% of successful suicide attempts. If someone has been suicidal in the past, alcohol may lower their inhibitions and make them more likely to follow through on their feelings.

Rational Thinking Loss: People with psychoses can be more likely to commit suicide.

Social Support Lacking: People without friends or family to help them cope with their feelings are statistically more likely to commit suicide then those with a support circle.

Organized Plan: If the person has a plan made, they automatically have a high risk of lethality.

No Spouse: People who are widowed, separated, divorced, or single are at a higher risk than those who are married.¹

Sickness: Chronic, debilitating illness can be a factor that drives people to suicide.

Symptoms of Depression

The leading cause of suicide is untreated depression. Depression can be caused by a combination of factors, both external and internal including illness, medications, substance abuse and alcoholism, money or job problems, and relationship trouble.

Some possible symptoms of depression include feelings of sadness and loneliness, trouble with sleeping, tiredness, loss of enjoyment during normally pleasant activities, low energy levels, feelings of guilt and uselessness, and thoughts of suicide.

Warning Signs of Suicide

There are several behaviors that are commonly shown by people contemplating suicide. These include the characteristics of depression listed above. Feelings of disinterest in academic or extracurricular activites are common. Other behaviors include self-imposed isolation, drastic changes in eating and sleeping patterns, remarks about an impending absense (ie: "I won't be around for very much longer") or threats of suicide, collection of weapons or drugs with which to kill themselves, giving away objects that used to be precious to them, writing a suicide note, and previous suicide attempts. However, there is no sure fire method of determining whether someone is suicidal other than to ask

The Methods of Intervention

If someone confides that they are contemplating suicide, they are actually asking for options, such as reminding them of all of the people who love them and letting them know that there are people out there who are equpped to help them deal with their feelings if they choose to do so. These resources may include a local Emergency Respose Team or hospital, a Call for Help intervention line, a mental health facility, a school councelor, or a religious leader.

It is recommended that one think about whether or not he can promise "not to tell anyone" about their feelings, keeping in mind that, if the suicidal person become dangerous enough, he might have to break their confidentiality.

Diffusing Attempts

If one come upon an attempt in progress, these steps can help to bring the attempter back into a calm frame of mind and guide them to help.

Establishing personal contact: If you don't know the person, then be sure to give them your first name and ask for theirs. You want them to feel connected to something. Allow them to steer the conversation and give positive reinforcement for continuing to talk.

Allowing them to vent all of their feelings: Provide alternative ways of getting out emotions, such as yelling or deep breathing relaxation. Put yourself into their shoes and evaluating every possible solution... even evalutate suicide as an option. Don't just immediately dismiss it. This way you can find a better solution together. Try and help them to evaluate the perceptions they have of their problems and bring gigantic troubles back down to manageable size.

Finding out if they have a plan: If so, determine how lethal the method is and if the tools to use this method are accessible to them.² You must ask these items directly because they are very important.

The most common method in the United States is firearms. They account for 61% or all completed suicides there. Another method that is commonly used is overdosing on paracetamol or Tylenol. Despite its over-the-counter status as a drug, it can be quite lethal if taken in large doses... and the death is quite a painful one. (Nothing for a day and then a slow death due to liver and kidney failure over the next four to five days.)

If they do have the resources to carry out their plan, ask them to get rid of them (dump pills in the toilet, unload a gun, throw away a knife, etc.) or to move away from them. You may want to try a "No Suicide Contract" to be in effect for the next month, week, even day. You want to extend the timeline available to them for as long as possible.

Reassuring them and let them know that you are available for as long as they need you.

Playing up positive actions (like getting rid of the tools they've chosen) and hopeful thoughts. Try and get them the talk about the meaningful parts of their life.

Avoiding reflecting thier feelings back at them (repeating back what they say to show you are listening) This can sound superficial. Focus on moving toward the solution.

As soon as possible, introducing the idea of getting into contact with your local emergency response team. If they don't want to do it themselves, offer to do it with them or even for them, depending on how dangerous the situation is.

Above all, letting them know that you are there for them. Keep them grounded and focused on moving forward towards a solution.

Don't forget your own needs. It can be tough dealing with a loved one who wants to commit suicide. Talk to a family member, a toll-free hotline, or a family doctor if you are feeling down.

"Cries For Help"

A "cry for help" is a deliberately botched attempt at suicide or threat not actually meant to be acted on.

Treat all threats of suicide and suicide attempts as real and life-threatening. You can never know when a "cry for help" will turn into an actual suicide attempt.

Online Resources

One great place to head if a friend, family member, or if you yourself are suicidal is The Befriender's Website. The befrienders are an international suicide prevention organization, including The Samaritans (A suicide prevention group in the UK). Their website features an online directory of suicide help lines for 41 different countries and can be viewed in 14 different languages.

You can also send an e-mail to the befrienders. It is guaranteed to be kept confidential and you will recieve a response within 24 hours barring technical problems.

Also, all e-mails and replies are kept for up to 30 days and you can ask for them to be deleted prior to then if you like.

For Those Left Behind...

If a loved one does commit suicide, the most important thing to remember is not to blame yourself. You cannot determine the course of another person's life.

Allow yourself the all the time you need to heal... And it may take a long time. There is no "set amount" of grieving time people should or shouldn't go through. Everyone is different in this regard. Don't listen to people who say that "you should be over this by now."

If possible, put off any life-altering decisions until you are well along in the greiving process.

Seek out people who will listen and talk about what you are feeling. A lot of the same "professional" resources used during suicide prevention can be helpful to survivors. You can also look into various support groups for the survivors of suicide.

Other Ways to Help

If you want to have the chance to help people deal with depression, anxiety, and suicide, contact your local emergency response team or a mental health facility. You can volunteer to be a peer counselor or to receive calls on an intervention hotline.

Sources

The Illinois Chapter of the Mental Health Association

www.befrienders.org

www.save.org