TALKING ABOUT IT

STARTS HERE.

Suicide Prevention starts with a Question

Here is an example of how to talk to someone about suicide using the TALK steps from the safeTALK training. The information is not intended to replace the fundamental understandings and practical applications of the TALK steps learned in safeTALK. It is strongly recommended to attend a safeTALK training session to have a complete understanding of the TALK steps principles and application.

ARE YOU READY TO ASK IT?

Asking someone and talking about suicide can feel scary. Breaking the silence however sends a powerful message to someone that it is okay to talk about what they are feeling and thinking, that they are not alone, and that you care. When someone is feeling suicidal, it is often less about wanting to die, and more about feeling that they have run out of options and hope. The fear and shame surrounding these feeling keeps people isolated and cut off from accessing help, which allows their fear, hopelessness, and embarrassment to grow bigger and bigger.

Asking about and giving people permission to talk about suicide is the first step towards hope and almost always helps reduce the risk.

Asking someone about suicide doesn't put the idea in their head, it gives them the chance to let their fear out and talk about other options. Breaking the silence surrounding suicide increases realistic opportunities to save lives and to reduce suffering.

Here is an example of how you may approach and about suicide using the TALK steps from the SafeTALK educational program (LivingWorks, 2007):


T-TELL: We would like the person to tell us openly and directly that they are thinking about suicide but often this does not happen. Instead we may need to tune into more subtle "invitations" to begin the conversation about suicide and inquire if thoughts of suicide are present.

The "invitations" may be things we see, hear, sense, or learn about the person, such as:

SEE: The person may be weepy or crying, unkempt in appearance, withdrawn or not communicating, giving away their possessions or those of the loved one who died by suicide (normal for people grieving but may also be something you see in people at risk of suicide).

HEAR: The person may use statements such as: "I understand why my loved one died the way they did", "I can't take this anymore", or "I hope others understand when I am gone" (these statements may be subtle messages of distress and hopelessness that needs to be explored).

SENSE: The person may have a range of emotions like feelings of hopelessness, despair, anger, numbness (common reactions in grief but also may be present when people are thinking about suicide).

LEARN: The person may share information with you about the trauma of losing other loved ones to suicide or other life events that have happened recently or in the past. (Life events that may put people at greater risk of suicide include rejection, loss, abuse, and their trauma experiences).

The above "Invitations" give us a starting point to inquire about suicide in a more conversational way.

A-ASK: It is okay to ask openly and directly about suicide.
This is not always the easiest question to ask but if the person is thinking about suicide it is important to do.
How can you ask?
Here are some ways to ask about suicide after you have connected with the person and have seen, heard, sensed or learned about the person in your brief conversation.
Ways to ask about suicide:
Ask Directly - It is a yes or no response and we need to be okay talking openly about suicide so that the person has permission to disclose their own thoughts of suicide to us:

"You have been through a very difficult experience; I need to ask, are you thinking about suicide?"
"Are you having thoughts about killing yourself?"

Summarize - It may feel more natural to restate to the person what we have seen, heard, sensed or learned about them and then ask about suicide:

"You look very sad and have told me that you can't take it anymore, sometimes when people are feeling this way they are thinking about suicide, are you thinking about suicide?"

Another example of a summary might be: "You seem very overwhelmed and this is understandable given your tragic loss, sometimes when people have a loved one die by suicide they think about suicide themselves, are you?"

By asking about suicide you are validating the person's pain and trauma and then taking the risk to check out how bad it is for the survivor, "Is it so bad for them that they are thinking of killing themselves?"

If the answer is yes, acknowledge that this is serious. Your next steps should be to:
L-LISTEN: Allow the person to share with you more about how they are doing and what has them thinking about suicide. By listening you are showing empathy and understanding, building rapport with the person so you can express your concern about needing to get help to keep the person safe.

K-KEEPSAFE: You need to get resources or helpers that can do a suicide intervention involved today to support the survivor so that they can keep safe.

Here is what you might say to introduce the topic of getting help: "You shared with me that you are having thoughts of suicide, this is serious and I am concerned about you... we need to get other people involved, can I share with you some options of helpers/resources who support people thinking about suicide?"

Encouraging the use of other supports: "Who else have you told or who else can you tell about your thoughts of suicide so you have support?" This last statement is about natural supports such as friends or family who can perhaps stay with the person after your conversation with them ends.

It is important that a person with thoughts of suicide is not left alone and that they are connected to a helper or resource that can do a comprehensive suicide assessment and intervention today. (LivingWorks Canada, 2007)

If you would like more information on being suicide alert or to develop skills in suicide intervention please visit: www.livingworks.net to find SafeTALK and ASIST trainings offered in your area.



*SOURCE: Information was adapted with permission on February 12, 2013, from original sources:
Source: SafeTALK Trainer Manual (2007) Lang, W., Ramsay, R., Tanney, B., Kinzel, T.
Suicide Alertness for Everyone. LivingWorks Education. SN1659 03/2007

Source: A Guide for Early Responders Supporting Survivors
Bereaved by Suicide / Winnipeg Suicide Prevention Network