What if the person doesn’t do anything to feel better? What if he or she considers suicide? The fear that someone we care about might choose to end their own life is probably one of the worst fears that we can have. While we may feel frightened and distressed to know that someone we care about is considering suicide, we can still do something helpful. We can help the person – who thinks that they are better off dead and who feels hopeless and distressed – to know that their feelings make sense; their thoughts are just thoughts and may not be helpful; what they believe (e.g. that they would be better off dead) may not be true, and that there are always, always alternative options to suicide.
How do we do that? By really knowing that:
1. Just because someone thinks that they are better off dead does not mean that they are suicidal.
2. Just because they think that they are suicidal does not mean that they have to do it: There are always other options.
3. Just because someone has a diagnosis of depression does not mean that suicide is an inevitable outcome. There are many, many people who have depression or have had depression, and who are still alive and do not choose suicide.
Stay alert for warning signs of suicide.These may include:
- Talking about suicide in a way that describes it as a release and/or a solution
- Withdrawing from social contact such as family, friends and work
- Getting the means to carry out suicide
- Excessive mood changes
- Conversations centred on how helpless and/or hopeless the person feels
- An unexplained lift in mood that may indicate that the person has decided on suicide as an option
- Giving away belongings or getting affairs in order when there is no logical reason for doing so
- Saying ‘goodbye’ to people as if they will not be seeing them again
- A preoccupation with death
- Giving birthday or Christmas presents very early
- Increased use of drugs and/or alcohol
Remember that sometimes there are no obvious signs that a person is considering suicide. If you are concerned that this may be a possibility please discuss your concerns with a medical professional and a trusted friend/family member.
If you are concerned that someone you care about may be seriously considering suicide please:
- Talk to them about your concern. Ask if they have had thoughts about suicide. If they have, explain that such thoughts can be normal though very distressing. Ask if they have made plans and pay particular attention to how they answer – having a detailed plan may indicate a higher likelihood of their actually attempting to take their own life.
- Get and take help. Discuss your concerns with a GP, another family member, a friend. If appropriate contact the person’s doctor and/or medical health professional to inform them of your concerns.
- If you are clear that the person is at immediate risk of suicide call the emergency services and ask for an ambulance or go immediately to A&E.
- Make sure that the person is in a safe environment and remove things that could be used to harm themselves.
- Ensure that someone trusted stays with the person until professional help arrives.
If a person has been treated through A&E and is being discharged, it is important to enquire with one of the medical team about a follow-up care plan. For example, will there be a referral to mental health services and what is the likely process/time frame? It is also essential that the individual makes an appointment to see their GP as soon as possible.