How to help someone who you think may be suicidal

Individuals who are having thoughts about suicide are not always forthcoming about these thoughts, due to their very personal nature. There may be ways, however, to detect if a colleague is having thoughts of suicide. Below is a list of some of the warning signs.

COMMUNICATION WARNING SIGNS

Talking or writing about, or expressing in any way, the following concepts:

• unbearable pain
• wanting to die
• feelings of despair and hopelessness
• inability to find reasons to live
• perception of being a burden to others
• intense shame or guilt
• feeling trapped
• seeking revenge

BEHAVIORAL WARNING SIGNS

• No longer caring about hygiene or personal upkeep
• Withdrawing from friends, colleagues, family and/or activities
• Visiting or calling people to say goodbye
• Giving away prized possessions
• Increased use of alcohol or drugs
• Behaving recklessly or seeming not to care anymore
• Rage and inability to control oneself
• Online searches for methods of suicide, guns, poison, bridges, tall structures
• Hearing voices that command one to harm oneself or others

Take the following steps, if someone you know shows warning signs, but has not openly referenced thinking about suicide:

If a colleague shows warning signs, but has not openly referenced thoughts of suicide

1. Express care and concern to the colleague. Do not promise to keep secrets.
   Example: “I am really worried about you. It sounds like you are dealing with so much.”
2. Show empathy and spend time asking about how they are doing.
   Example: “It seems like you have been really overloaded in the last weeks. How are you managing on a personal level? I am asking not to pry, but rather to see if I might be of any support or help with connecting you to the right sources of support.”
3. Ask how you can be of help.
   Example: “I would like to support you however I can. Is there anything that I might do to support you? Your wellbeing is very important to me.”
4. Strongly make the offer to connect them to resources. Make a warm transfer.
   Example: “If it’s okay with you, I would like to introduce you to one of the counselors that we work closely with from our staff care program. This is a confidential resource and a place for you to speak candidly, and get the help you need from someone external to the organization.”
5. Follow up regularly. Depending on the circumstance, this might mean daily until help is sought, and later on a weekly or monthly basis.
   Example: “I am writing to check in to see if you were able to make contact with the counselor. Of course, I don’t need any details, but was hoping that you were able to connect.”

If a colleague makes vague references to suicide

If a colleague makes vague but concerning statements, ask further questions. Do not promise to keep secrets. Examples of vague questions include:

“I just don’t see the point anymore.”
“I don’t want to do this anymore.”
“I’ve lost all hope.”
“There’s no point.”

1. Ask about specifics.
   Example: “When you say there’s no point, can you clarify what you mean? No point to what?” “You don’t want to do what anymore? Are you referring to living or something else?”
2. Ask directly about thoughts about suicide.
   Example: “Are you having thoughts of suicide?” “Are you thinking about killing yourself?”
   Note: Asking about harming oneself is a different question. There are individuals who self-harm, (i.e. cutting, burning), but do not have the desire to kill themselves.

If a colleague specifically confides in you that they are having thoughts of suicide

If someone has confided in you that they are suicidal, it means they are interested in being helped. While it can be nerve-wracking and even frightening to support an individual in such a despairing place, there are many steps that you can take to help them.

1. Respond in a caring yet centered tone rather than a panicked one. Use self-regulation skills like abdominal breathing to keep yourself calm. Do not promise to keep secrets. Example: “I’m so glad that you are telling me this. I’m here to support you however I can.”
2. Gather information.
   Example: “Can you provide some background? I am really worried about you and want to understand the different factors impacting you so that I may try to support you.”
3. Ask specifically about the thoughts.
   Example: “When did these thoughts begin? What are the thoughts specifically? What do you think about doing? How far have you gotten with these thoughts? Do you think you will move forward with this plan? What is your timeline?”
   
   

   Some individuals talk about a means that is not accessible. For example, if a person cites walking off into the ocean, and they are in a land-locked region, this is not very accessible. If they talk about poison, it is important to ask if they have made efforts to obtain poison. The more lethal and accessible the method, the greater the risk, and higher the need for immediate help.

   Some individuals may cite events that are important to them and may envision taking their life after specific events or time has passed.

4. Make a judgment call about whether you need to consult immediately or whether you can wait.
   
   

   If the individual states a clear plan to kill themselves and expresses the desire to act on the thoughts, you should not leave them alone unless you are in immediate danger. In this situation, you can let them know that you need to consult and will be calling in your supervisor or seeking consultation with a mental health provider. You may email or use your phone to get in touch with the right people. Ask for help from your manager or appropriate colleagues to coordinate a plan.

Self Care

It is also vitally important that you take care of yourself when supporting colleagues having thoughts of suicide.

• Check in with colleagues and both share how you are doing and ask how others are doing.
• Find ways to decompress and release the stress of the day.
• Take time to reflect on what you have been contending with and reflect on its impact on you.
• Consult with a counselor from the staff care program to review the way in which you responded and to process your emotional reactions.
• Make sure you engage in rejuvenating activities.
• Drink water, eat well, sleep, and socialize.