So, September is World Suicide Prevention Month. Related hashtags have been all over my Twitter feed this month, especially a few days ago, as it was World Suicide Prevention Day.
It’s hard to read a person’s personal experiences with suicidal thoughts and attempts, but it is something we cannot ignore. Ignorance – especially intentional ignorance – leads to neither understanding nor compassion.
You know that I’ve struggled with suicidal ideation from time to time, which has resulted in over a dozen admissions to psych units over the years. But that’s not what this post is about. I’m not going to give you a rundown of my worst moments.
Instead, I’d like to share some tips for dealing with people when you think they might be in one of those very low, strange, scary moments.
First off, if you’ve never been suicidal, thank the gods for sparing you that terror.
Listen to the person and be comforting, not confrontational. Make sure the person feels like they’re being heard. You may be surprised by how much they have to say.
Please don’t compare your suffering to their suffering, unless you have also survived suicidal ideation. Comparing can come across like you’re not listening, or it may sound like you’re making it all about you instead of the person in need of help. Someone I know says, “Oh, I get depressed sometimes, too…” Well, I know her very well, and no she doesn’t. She gets sad, which is very different from depression and cannot be compared to suicidal thoughts and feelings.
Don’t be afraid. Have compassion for the person. Try to imagine what it would feel like to be where they are right now and go from there.
90% of people who attempt suicide have a diagnosable mental illness. If someone you care about has a mental illness or shows signs of one, do not dismiss their feelings (well, never dismiss anyone’s feelings). Mood swings, which often happen without warning and for no discernible reason, have a way of catching us off-guard. Sometimes, suicidal thoughts pop into our heads at the drop of a dime. Other times, it is the result of a gradual slide down a slippery slope.
Educate yourself. You don’t have to write a thesis on mental illness or suicide, but if someone in your life struggles with their mental health, for heaven’s sake, do a little research. All you have to do is Google “depression” or “schizophrenia” or “warning signs of suicide” or whatever. You need to know what you’re dealing with.
Know the signs. If you know this person well, chances are you might notice changes in their personality or behavior when they’re struggling. Then again, you might not, because many of us are experts at keeping our feelings and thoughts to ourselves, wearing masks to keep other people safe from the vortex of our minds. But if you do notice changes, ask the person if everything is okay. (Even if they seem okay, you can still ask once in a while. It shows that you care.) If you’re afraid for their safety, you can ask them if they’re having thoughts of suicide. It’s okay, really – asking does not cause suicide. It starts a meaningful conversation about what’s going on with them and you can help them in the way they need.
Know what to do in case of a mental health emergency. It seems simple, doesn’t it? If someone is threatening suicide, just call 9-1-1. But that might not be the best idea. Depending on the situation, you might rather call your county’s Mental Health Crisis Team. Where I live, in Hennepin County, MN, it’s called COPE. You call and they come out almost immediately to assess the person. If they need to be hospitalized, COPE will help you both get that figured out. If some other kind of treatment is indicated, they will help with that, too.
On the other hand, if you feel the person is in imminent danger or is a threat to others, handle the situation with great care. Either take the person to your local Emergency Room, call your local crisis team, or call 9-1-1. Try to keep the person safe until the professionals intervene. But don’t put yourself in harm’s way!
An unfortunate side note that cannot be ignored: A very small, very ill subset of people want to die, but they don’t want to do it themselves. They may get ahold of a weapon and act irrationally so that you (or someone else) call 9-1-1. Occasionally, a person who is very sick and desperate may become dangerous and act violently, so that the police have to defend themselves (or an innocent bystander). This is called “SBC”, or suicide by cop. By the way, this can also happen with people who are out of their minds on drugs. It is important to note that, though it happens, this is very rare. We’ve all read or heard about these situations, and we all wish the outcome would have been different. This is why your local crisis response team is so important. They are trained to deal with mentally ill folks and can often talk the person down without resorting to violence.
Have a list of important phone numbers handy. This includes your local mental health crisis response team (like COPE, as mentioned above), the phone number to your local police department (rather than 9-1-1), the numbers to your loved one’s psychiatrist/ general practitioner/therapist/social worker/case manager/spiritual guide/whomever, and other people on the person’s support team. It might help to have a safety plan in place, which would already have this information on it – just in case.
Know which local hospitals have psychiatric units. Not every hospital is equipped to handle psychiatric emergencies, and not every hospital has a psych unit. What happens is they will hold the person in an isolated, safe room, under close watch, and then arrange for an ambulance to take him or her to the nearest hospital that has a bed open in their psychiatric unit. That can be very taxing on both you and your loved one, because it can take a long time (I’m talking a day or two) – and time is very valuable during an emergency. (Trust me, you get little to no psychiatric care while you’re waiting for a bed. Ironic, I know.) For instance, there are two hospitals in my area where I will go if I am having a psychiatric emergency. I’ve been in both units before, and I definitely prefer one over the other, but I know I’ll be safe in either place. If I go to a place that’s an ER/Urgent Care, they will have to make arrangements to transfer me to a hospital with a psych unit, which is frustrating for all involved and time-consuming. Sure, they’re probably trained in mental health emergencies, but it’s not the same thing.
TAKE CARE OF YOURSELF
Debriefing is your friend. If you’ve just witnessed a loved one have a psychiatric emergency, you may want to talk to someone about it. This can be a mental health professional, a trusted friend or family member, or anyone. I generally recommend that, if you have a loved one with a mental illness, you might want to get a little counseling for yourself. This could be short-term or long-term; it’s up to you. But it can be very frustrating, confusing, difficult, and maybe a little scary to live with someone whose behaviors and thoughts you don’t always understand. A professional counselor, therapist, or psychologist can help with that. Food for thought.
You may need to get a little extra rest. Us mentally ill folks can take up a lot of your patience, understanding, compassion, and time. Make sure you get adequate sleep and the time you need to rest after an emergency.
Take a personal day off at work if needed. You don’t need to give the specific reason if you don’t want to, but if you have sick, vacation, or PTO stored up, take a day or two so you can get that rest and maybe talk to a counselor. If you don’t work, you still need to give yourself time. Try to create a couple days free from too much activity, and try not to make any important decisions during this time.
If you do work, check to see if your employer offers an Employee Assistance Program (otherwise known as an EAP). Many employers offer such a program, and they can be invaluable in taking care of yourself. The details differ, depending on the contract, but generally speaking, EAPs offer (at the very least) three or four free, confidential counseling sessions to employees. There are other perks, too, but I don’t know them by heart. Many programs allow immediate family members to use this resource, as well.
Mental health emergencies are scary. But if you know what you’re dealing with and know who to call for help, you and your loved one can get through it together. Know the signs of mental illness and suicidal ideation, and make sure the person is safe. Then, get help. The rest will fall into place.
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A version of this post was previously published on DepressionWarrior and is republished here with permission from the author.
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