It's November! This year celebrates 10 years of "Movember" in Canada and gives us another great opportunity to talk about a health concern that disproportionately takes the lives of men, suicide. While not always easy to talk about suicide, this threat is out there and it is real. To help address this concern I've invited a local expert, Shawna Percy, to answer some questions about suicide prevention.
Life Voice specializes in building suicide-safer communities through suicide prevention workshops such as safeTALK, ASIST, and "ASK" (Assessing for Suicide in Kids 5-14). Bereaved by suicide Shawna knows the impact of suicide from both a head and heart level. In her TEDxUW talk "Suicide in Preventable" Shawna explores what we can do to help those at risk of suicide help themselves stay safe. You can learn more about Shawna and Life Voice @LifeVoiceCanada on social media, or at www.LifeVoice.ca
When it comes to suicide prevention, I think, because this topic is so stigmatized, that many people think "this isn't going to happen to me" or that their friends and family aren't affected, but I'm sure that's really not true. How likely is it someone will confront someone with suicidal thoughts?
It's so true that many people think suicide or thoughts of suicide is something that happens to "other people." That's what I thought before life taught me that simply isn't true. Suicide is not a mental illness; it's a mental health issue. There's a difference. Suicidal behaviours are things that can be learned. However, individuals who have never been exposed to any suicide experience can also be at risk. I often describe suicide as being like a hostage-taker. People don't wake up in the morning and suddenly think to themselves "Perhaps I'll start toying with the idea of suicide today." Thoughts of suicide come on them and threaten to take their life. I also believe each one of us is hardwired with what I call a "life voice", and that life voice will fight to keep us safe. Sadly, it's not very likely that someone will talk about suicide if they think they're sensing their friend, family member, or co-worker is at risk. Not because they don't want to help. Often they fear they'll make things worse, and they have no idea what to say or how to fix a thing like suicide. That's where taking a workshop can be useful. People can explore their questions in a safe environment, and build their confidence to know how to help a person-at-risk.
Spotting Suicide Risk
As a clinician, I know what I'm supposed to do when I suspect someone may have suicidal thoughts but I wonder in the community, how might someone know if their friend or family member was contemplating suicide. Obviously, this needs to be something that is spoken about more openly in general, but, in your experience, when should you worry that someone you love is contemplating suicide.
First of all, I'm so glad to hear that you know what to do if someone is contemplating suicide. Sometimes even professionals do not have good training to know how to ask about suicide, and work with a person-at-risk to build a safeplan. To address your other comment about how one might know that someone in their circle is contemplating suicide, here are a few things to look for. Is there something that's changed with the person? For example, if they're always saying yes to everything, and suddenly they're saying no, and losing interest in things they love, what is that about? If they were naturally introverted and now they're signing up for sky diving lessons, and going to social events, and drinking a lot, what's that all about? The only way to know is to ask. Sometimes we have nothing more to go on than our gut instinct. It could be that everything looks perfect on the outside. We just saw the person this morning. They smiled and said hello. We asked them how they were. They said they were fine. Last week they seemed a little disheveled, had a hard time making eye contact, and were negative about everything. But suddenly things seem to have come together for them. A peace came over them. They look better. They seem to be thinking clearer. So that's got to mean they're doing better, right? Here's the thing. That's still a shift. So, we need to question what that is all about. Here's why.
Research shows us that commonly those who are thinking about suicide often talk in terms of feeling hopeless and helpless. A person at risk tends to misuse drugs and alcohol, give away their possessions, talk about escaping, or lose their appetite and ability to regulate their moods. However, I hear all too often in suicide bereavement circles that the person who died was the last person they would have suspected. They were a star athlete. They were always helping others. They never said anything was wrong. They seemed happy. And that is why we need to rely on our gut instinct. Not everyone's warning signs are going to fit what's statistically common. Sometimes that sense of peace we see is because that person made a decision to suicide. That peace is not because suicide is what they actually want to do. Often what they really want is an end to their pain; not their life. That peace is about them getting an element of power and control back over their life. Which is one of the reasons you'll never hear me say suicide intervention is about saving someone's life. No. When done right it's about helping someone save their own life. We need to find healthy ways to empower the person-at-risk so they are less likely to use an unhealthy option like suicide to meet that need.
The bottom line is if you think someone has the threat of suicide on their life, ask them about it. Ask as though you really want to know the answer. And ask them directly. Using questions like, "Are you thinking about suicide?" or "Are you thinking about ending your life?" are clear and direct. Direct questions communicate that you're willing to have that conversation. And that makes it safer for the person-at-risk to open up to you about suicide.
What to do.
Let's say you have a friend or family member who is openly expressing a desire to die by suicide. What's the one thing that if everyone knew to do first, would save lives.
Ask about suicide, in a genuine, compassionate, and direct way. If we don't open up the conversation around suicide then that leaves the person with that threat on their life in greater danger. When we ask we don't need to have all the answers. We don't need to fix the problems they may tell us about. So much of the pain they're in can be relieved when we make it okay to talk about suicide and listen to what brought them to this state. Traditionally, men have less emotional outlets than women. Which may be one reason why men are four times more likely to suicide than women. But this is more of a cultural phenomenon than a biological one. We can change that. When we enter conversation around suicide know that we don't need to have it all figured out. And, neither does the person-at-risk. What we do need is to ask about suicide, let the person-at-risk share with us, and then expand their circle of support by connected them with additional help such as HERE 24/7 in the Waterloo-Wellington Region.
If you want to improve your confidence in knowing how to respond if a friend, family member, or coworker finds their life threatened by suicide, consider arming yourself with training in how to respond. Just like physical first aid teaches you what to do if someone is chocking or having a heart attack, these trainings provide the skills you need to respond when someone is facing suicide. Life Voice offers a variety of workshops including:
- "ASK" Assessing for Suicide in Kids 5-14 workshop, November 18th
- safeTALK suicide awareness workshop, November 20th
- ASIST Applied Suicide Intervention Skills Training, December 7 & 8, or February 6 & 7