Knowing that someone we care about is feeling suicidal can be emotionally and physically draining. It is important to look after your own health and to make time to get support and advice for yourself too.
Attempted suicide is far more common than most of us realise. In England and Wales, thousands of people are admitted to accident and emergency departments each year because they have tried to kill themselves.
Although most people who attempt suicide survive, a few remain at high risk of taking their own life for quite some time afterwards. This means that any suicide attempt, however minor it appears to be, should be taken seriously.
Suicidal thoughts can coincide with times of change - whether these changes are 'good' (like getting married or starting a new job), or 'bad' (such as someone dying or the end of a relationship). Quite often two or three different things will have happened, each of them causing considerable stress.
For some people there may be no apparent reason for these thoughts.
The circumstances leading up to a suicide attempt are different for everybody, and the reasons may never be fully explained or understood.
Often those who think about suicide are depressed. Usually very sensitive people, they may have been in despair, feeling hopeless about the future and unable to think straight. Everyday worries have become totally out of proportion, and dark thoughts may have left no room for anyone or anything else.
Turning thoughts about suicide into action is sometimes done on impulse, perhaps following an event that is seen as 'the last straw'. This is especially true of young people.
Others, however, may have been making plans about suicide for some time. Some speak openly about this whilst other people may make every effort to hide their intentions and appear to function as though nothing is wrong.
Using alcohol and/or other drugs can make things worse. They take away the inhibitions which would otherwise stop someone from attempting to take their own life.
It's hard to talk
Talking about fears and feelings is difficult - even to those we know love and care about us. This can prevent other people from recognising the distress and being able to help in a crisis.
Words are often totally inadequate to convey the amount of pain a person may be suffering.
It is easy to understand that someone is hurting if they have been badly injured or are physically ill. Emotional pain cannot be seen, but it can be just as unbearable.
Sometimes attempting suicide may be the only way to show other people how bad things are.
'When your back is up against the wall, suicide can seem to be the only way out.'
a) Ask them how they were feeling before it happened and how they are feeling now. Talking about suicide does not make it more likely to happen. Try to be patient if they are angry or refuse to talk. If they won't talk to you, maybe they would talk to a friend or sibling. It may be that writing things down is an easier way for them to communicate with you.
b) Listen - this is the most important thing you can do. Treat them with respect, and try not to be judgmental or critical. Is it important to try to raise their self-esteem.
c) Empathise by showing that you really do care about them, no matter what, and are trying to understand things from their point of view. Words don't always matter. The touch of a hand or a hug can go a long way to show that you care.
d) Reassure them that desperate feelings are very common and can be overcome. Things can and do change, help can be found and there is hope for the future. People do get better!
e) Try to give practical support, and help them to cope with any extra pressures. It may not be possible to deal with all the things that are troubling them, but between you agree on what you will do if a suicidal crisis happens again.
If they are living away encourage them to come home for a visit or go to see them yourself. This will give you an opportunity to assess the situation.
f) Be clear there are always other options:-
For example, if they are at University they can:
Put them down or do things that might make them feel worse. A suicide attempt suggests that self-esteem is already very low.
Abandon or reject them in any way. Your help, support and attention are vital if they are to begin to feel that life is worth living again. Don't relax your attentions just because they seem to be better. It doesn't mean that life is back to normal for them yet. They may be at risk for quite a while.
Nag - although it may be well meant. Nobody wants to be pestered all the time. Don't intrude - try to balance being watchful with a respect for privacy.
Ignore what has happened
Criticise their actions - however you may be feeling about their suicide attempt, try to remember the pain and turmoil that they were, and may still be, going through. Don't take their behaviour personally - it was not necessarily directed at you.
The doctor (GP) should always be the first port of call. He or she may decide to refer on to a specialist mental health service; Child and Adolescent Mental Health Services (CAMHS) or Adult Mental Health Services. Some GP practices have onsite counsellors.
Counselling services can be accessed through the NHS or privately. Many schools and colleges have their own counsellors.
The young person may be reluctant to seek help. Offer to go with them or suggest that someone else could go instead. You may want to talk to them about confidentiality beforehand to ascertain whether they are prepared for you to be involved in the sharing of information.
If the young person has been admitted to a hospital Accident and Emergency department a psychiatric assessment should take place.
Treating depression: suicidal feelings may be linked to being depressed. Depression is a serious illness but can be successfully treated with anti-depressant medication and/or 'talking and listening treatments'. Further information about depression and its treatment can be obtained from Depression Alliance.
If you feel that the situation is getting worse rather than better, and you are worried about another suicide attempt, trust your instinct and share your concerns straight away. Contact the GP, or any health professional who has already been involved. Unless the young person has given permission, these people may not be able to discuss confidential details with you, but they will want to listen to what you are saying as your input may play a vital part in the young person’s recovery.
Call the PAPYRUS helpline: HOPELineUK 0800 068 41 41.
HOPELineUK is a free confidential telephone helpline service providing support, information and practical advice to anyone concerned that a young person they know may be at risk of harming themselves.
The helpline staff are trained professionals who can discuss your needs when coping with someone who is feeling suicidal. They can help the young person who is in distress too.
The advisors have access to a comprehensive database and can give contact details of other sources of help should they be required.
The helpline is open every day of the year; on weekdays from 10am - 5pm and 7pm - 10pm and during the weekends from 2pm - 5pm.
A callback service is in operation if the helpline is busy or if you need to call outside our opening hours.