Managing Risk

Is someone you care about thinking about suicide? It can be very distressing when we are worried about the safety of somebody we care about.

Disclaimer: This blog is written as a guide only for managing suicidal ideation. Please follow the advice of your GP and health professional.

Although they may require professional support, there are things you can do to help your loved one in the short term. Having an open and direct conversation can show them they are seen, heard and not alone.  Let’s have a look at some key areas to address when having these conversations.

Warning signs

It is important to be aware of verbal and non-verbal cues that may indicate somebody is thinking about suicide. Look for any of the following:

  • Talking about suicide or wanting to die
  • Saying that they don’t have anything to look forward to
  • Saying that they feel like a burden to others
  • Social isolation
  • Excessive or impulsive behaviours (including but not limited to alcohol and drug abuse)
  • Changes in personality
  • Decreased care for personal appearance
  • Giving away of personal possessions
  • Severe sadness
  • Insomnia

Having the conversation

It can be tricky to know what to say to somebody you are worried about. Choose a time and a place where you can talk with no interruption. The first thing you need to do is to show them that you are here for them. Conversation starters can look a little something like…

  • “I’ve noticed that you seem a little down, is everything okay?”
  • “How have you been feeling lately?”
  • “I can see it’s been a difficult week for you. Would you like to talk about it?”

Next, listen. Listen like you’ve never listened before. Use non-verbal cues such as eye contact and nodding while they are talking. Then, simply validate their experience by rephrasing what you have just heard. For example…

  • “It sounds like you’ve been having a really difficult time. I’m here for you.”
  • “Having feelings like this is never easy. Thank you for talking to me about it.”

Exploring the potential risks

It’s important to identify whether the person is at imminent risk of suicide. Although it can feel daunting, you will need to ask four direct questions:

  • Are you currently thinking about suicide?
  • Do you have the intention to end your life?
  • Have you made a plan to end your life?
  • Do you have access to the means you would use to end your life?

A “yes” answer to any of these questions certainly indicates that the person has a desire to die and/or take their emotional pain away. But, the answer to each question will tell us about the likelihood that the person will take their own life.

For example, experiencing suicidal ideation (i.e., thoughts about ending one’s life) without suicidal intent (i.e., the intention to end one’s life) or a plan (i.e., decision about the time, place and means one would use to end their life) suggests a passive desire to die. However, it also indicates that there is currently little risk that the person will act upon their desire at the current time.

What we do next is dependent upon the person’s answers to the above questions.

Managing suicidal ideation on its own

In this case, it will be important to continue to provide emotional support and remind your loved one that you are here for them. Regular conversations about their well-being will be helpful. The person will also likely require some form of professional support. This is a great time to organise an appointment with a professional, such as a GP or a Psychologist.

Managing suicidal ideation with intent and/or a plan

In this case, more immediate support will be necessary. If the person reports that they have access to the means that they would use to end their life, their access will need to be removed (i.e., remove access to sharp objects, medication etc). If you are unable to remove their access, an ambulance should be called immediately. At the hospital, they will be assessed by a mental health nurse who will determine the level of risk and referrals to other services will be made where appropriate.

Once access to means is removed, getting the person in touch with the support that they need at this time is crucial. Telephone support lines such as Lifeline, Beyond Blue or Kids Helpline can be a good first point of call as they can provide immediate emotional support and advice for keeping safe. Alternatively, we can contact Mental Health Triage who can talk to us and/or our loved one, assess risk over the phone and provide advice around what to do next.  The Mental Health Triage team can refer you to the hospital, connect you with community workers or recommend services to assist.

We know that it can be very distressing when we are worried about the safety of somebody we care about. We hope that this blog can provide some assistance as to what we, as family and friends, can do to help. And remember, now is the time for us to listen. Listen like we’ve never listened before.

Support numbers

Lifeline: 13 11 14

Beyond Blue: 1300 22 46 36

Kids Helpline: 1800 55 1800

Mental Health Triage: 13 14 65

Emergency services: 000

Better Self Psychology specialises in helping children, teenagers, and young adults.

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