Our society doesn’t talk enough about suicidality. Somehow it’s still considered taboo to do so even though suicidal ideation impacts so many of us. For that reason and so many more, it’s important to talk about what you can do to help someone who may be suicidal.
My perspective comes from my lived experience with suicidality (though thankfully it’s been a very long time since I’ve seriously considered killing myself). It also comes from my experience as a phone counselor at a crisis and suicide line. Like most of us, I’ve also been personally touched by the suicide of loved ones. May you find these seven pieces of guidance helpful and relieving in a situation where you may not know where to start.
1. Be there.
My toddler watches a lot of Sesame Street, and one of my favorite things is Super Grover 2.0 You know what Super Grover 2.0’s super power is? “He shows up.”
Showing up, whether that means physically or virtually, can make a huge difference for someone. Being there is so underrated and so important.
So many people I talk to on the suicide hotline feel isolated and like no one is there for them. It’s amazing how much difference it can make for me to listen to them talk for ten minutes and try to empathize with them. Often times I say little more than “mm hmmm” and other minimal encouragers to let them know I’m listening. And if talking to a stranger over the phone who barely says anything is helpful, think of how much help a close friend who can actually be there with them in person can be. Even an email or Facebook message can make a huge difference.
2. Talk about it.
One of the remarkable things about working at a suicide hotline is how easily “Do you feel like killing yourself?” rolls off the tongue. Talking about suicide will not “put ideas into someone’s head” or other such nonsense. Asking someone about whether they may kill themself lets them know that talking about suicidal feelings is on the table and that they don’t have to hide how they’re feeling.
People who are feeling suicidal will often be scared to talk about it with friends for fear of freaking them out or driving them away. It is always okay to ask the question if someone is suicidal. And if they’re not, they will just tell you they’re not and you can move on to listening to them talk or cry about whatever is going on.
It may be hard to ask the question — and make sure you say “kill yourself” instead of “hurt yourself” so there is no confusion — but it can make all the difference. It lets your loved one know they can come to you and talk about things that sometimes feel unspeakable.
More Radical Reads: Learning to Live with Wanting to Die
3. Get the person appropriate help.
It’s no secret that the mental health system in this country is awful. With increased health insurance there may be better options for people now, but it’s still super hard to find quality practitioners to help with mental health stuff. Many people have had bad experiences with therapy in the past and are now reluctant to seek that kind of help. I do think it’s important to remember that therapy is like dating: you need to find the right therapist that will work for you, and sometimes it takes work to make a “match.”
Medications also take a long time to start working, so that is also no magic bullet, though so many people’s lives have been saved by appropriate psychiatric medication.
In the end, people can make whatever treatment decisions they want, but as a supporter, you can make it as easy as possible for them to seek help. For example, a lot of times severe depression makes it hard for people to do anything, let alone all the insurance wrangling and hit-or-miss phone conversations it takes to make an initial therapist or psychiatrist appointment. If they are willing, you can take over this task and the logistics that may be too hard for them. You can even drive them to their appointment. Anything that makes it easier for them to access help makes it more likely that they will.
4. Get yourself support from others.
Being close to someone who is in a mental health crisis can also be traumatic. You should try to get support for yourself so you can have the endurance, compassion, and patience necessary to be as present as possible.
I hope this is obvious, but go to other people who are less close to that person to process your feelings. The person who is suicidal does not want to hear about how their mental health crisis is stressing you out (though it is fine to talk about how sad you are about how they are feeling, how much you value them, and so on). But especially with a friend who has a lot of mental health crises, you want to be able to have a place to vent and process so you can bring your full self to your friend without underlying resentment or hostility. Your own therapist is a great place to do this, but also friends you may have who are less close with the person in crisis.
Important caveat: check with people first before talking about suicidality, because so many of us have our own histories with it that it can be easily triggering for folks.
5. Create a safety plan.
Safety planning is a way to help someone who is suicidal stay safe. For example, after you ask someone if they are suicidal and they say “Yes,” ask them if they have a plan to kill themself. If they do have a plan, ask them what it is. Once again, all of this is hard to say to someone if you’re not used to it, but remember that you won’t be saying anything they haven’t already thought about.
So, if someone says they’re planning to take an overdose of pills, ask them if you can have the pills or get rid of the pills. You want to try to do what you can to make suicide more difficult than staying alive.
Other safety planning involves coming up with activities that help the person cope. For example, a lot of people feel better after writing in a journal. When we are in the thick of a mental health crisis, we may often forget the simple ways we usually cope. Helping someone to think about “what has been helpful when you’ve felt this way before” can help them get through the suicidal feelings.
More Radical Reads: On Wanting to Leave: Suicide and the Black Community
6. Get emergency help.
This part is really complicated to write about, because most people’s idea of emergency help is calling 911. 911 usually means police, and police can often exacerbate people’s trauma. Especially for people of color, undocumented immigrants, and tons of other marginalized folks, even in emergencies calling the police can do more harm than good.
Police will often eventually bring folks to an inpatient psychiatric unit and/or the emergency room. Inpatient units vary widely and depend on a lot of factors. Some people have decent experiences and some people have awful experiences. Hospitals can be good for medication stabilization and keeping someone safe from killing themself, but they can also be hotbeds of trauma, involuntary holds and treatment, and other things that make the situation worse.
If they have been there before and know the risks and are willing to go to inpatient treatment, then that can often be the best bet for someone who is imminently suicidal. Ideally you will have their cooperation for any interventions you both decide on.
I wish I had easy answers for this part. The fact is, there aren’t any easy answers. If you call a suicide hotline, they will likely tell you to call 911 because they prioritize keeping someone from killing themself and (in my opinion) don’t tend to acknowledge that fact that police way too frequently kill people of color who are going through a mental health crisis.
Unfortunately, there are not simple alternatives to calling 911. One of the main things that emergency services and inpatient do is to physically watch the person so that they can’t kill themself. It’s a very complicated and nuanced thing to think about. I especially urge fellow white folks to really think about white privilege regarding police and, if your friend is a person of color, to weigh as best you can the potential costs and benefits of calling the police. Also know that suicide hotlines will call 911 if they feel that someone is in imminent danger or in the process of killing themself.
7. Know it’s not your decision in the end
One of the biggest feelings loved ones have after someone kills themself is guilt. Guilt because they feel like they should have done more or could have done something to stop it. Suicide is a last resort that people turn to when living is too much hell. As supporters, we can try our best to make it less of a hell for them, but in the end we can’t control anyone but ourselves. That doesn’t mean we shouldn’t try as hard as we fucking can to be there and help and listen, but it also means that if we can’t save someone, it’s the fault of their illness and not a failing of ours.
Suicide is hard for us as a society and individuals to talk about it. However, younger generations are making strides in talking more about mental illness and suicide. In the end there is only so much we can do, but sometimes what we can do is a lot.
[Feature Image: Grey scale close-up photo of a person’s face and shoulders. They have light skin, dark hair, and are looking downwards with a serious expression on their face. Source: Wasfi Akab]