Finding the Right Tool for (the Job) of Suicide Prevention
Have you ever heard the saying “it’s like using a sledgehammer to crack a nut?” While a sledgehammer will certainly open the nut, it will also smash it to bits when there are better tools for the job. This points to the issue of how we respond to someone who reveals that they are thinking about suicide.
If you have ever been in this position, you know how difficult it can be. The fear of saying or doing the wrong thing, or not enough, can be overwhelming. The safest response might seem like calling 911. While this is true in some situations, in others a less drastic response may be more helpful.
Below are some considerations for finding the right tool for the job. Sometimes the best way to identify what steps to take is to ask the person what they think will help keep them safe. You can find reassurance in the knowledge that most suicidal crisis last for a brief period of time. Therefore staying with the person (as long as the scene is not unsafe) and connecting them to resources and ongoing support when the situation has calmed down might be the most effective course of action.
When is a call to a crisis line the right tool?
Crisis lines are designed to quickly assess the level of risk in a situation and get the caller to the appropriate services. If you are calling the National Suicide Prevention Lifeline or one of its member crisis centers in California, the call will be answered by someone trained in assessing suicide risk and conducting a phone-based intervention designed to reduce their risk. Many Lifeline/crisis center calls are life-saving interventions, and they are equipped to call 911 on the person’s behalf if they believe a suicide attempt has occurred or the person’s life is in imminent danger.
Crisis lines are useful in a range of situations, from direct intervention to someone in an acute crisis, to calling yourself to talk about how you might help someone you are concerned about. Crisis lines can also help you or the person in crisis to find a mental health provider in your community.
The National Suicide Prevention Lifeline (1-800-273-8255) is available 24/7 and answered by trained counselors who are skilled in intervening with those who are acutely suicidal, as well as individuals who are concerned about someone else. Chat services are also available online: https://suicidepreventionlifeline.org/chat/. Individuals can also text EMM to 741-741.
The Suicide Prevention Lifeline can also connect callers to the Spanish language network through a prompt or by calling directly (1-888-628-9454). There is also an option for the deaf and hard of hearing: 1-800-799-4889. Callers to the Lifeline can also choose a prompt to connect with the Veterans Crisis Line, which can also be reached by texting 838255 or through an online chat service.
When is a call to 911 the right tool?
Calling 911 connects the situation to first responders, such as law enforcement, firefighters and EMTs. If you suspect that someone is about to or has already harmed themselves and requires medical attention, or if you are in danger, this is the right tool.
But it may not be the right tool in every circumstance. More often than not other tools in the community can help avoid the potential trauma of a 911 response. For example, crisis hotline staff have the skills to assess and intervene to help someone who is acutely suicidal. Imagine someone being in emotional pain and rather than emotionally stabilizing on the phone or in-person with a caring and compassionate, friend, family member or mental health professional, they are potentially hand-cuffed and transported to the nearest Emergency Room in a police car, only to experience long wait times or hold for psychiatric assessment. This experience might deter them from seeking the appropriate help later.
How do I know if I should be worried about someone?
Becoming familiar with warning signs and resources, being willing to listen, and ready to take steps to reduce access to lethal means are tools you can always have in your toolbox.
Know the Signs: Pain isn’t always obvious, but most suicidal people show some signs that they are thinking about suicide. The signs may appear in conversations, through their actions, or in social media posts. If you observe one or more warning signs of suicide, especially if the behavior is new, increased, or seems related to a painful event, loss, or change, step in or speak up. Visit the Know the Signs section of www.suicideispreventable.org to learn the warning signs of suicide.
Find the Words: “Are you thinking of ending your life?” Few phrases are as difficult to say to a friend or loved one. But when it comes to suicide prevention, none are more important. Visit the “Find the Words” section of www.suicideispreventable.org for suggestions to get the conversation started. Having the conversation is less about persuading someone not to end their life, and about showing that you are concerned, helping the person to find hope and remember their reasons for living.
Reach Out: You are not alone in helping someone in crisis. There are many resources available to assess, treat, and intervene. Crisis lines, counselors, intervention programs and more are available to you as well as to the person experiencing the emotional crisis. Visit the “Reach Out” section of www.suicideispreventable.org to find a list of resources in your county, as well as state and national resources, to help you connect and prepare.
Instinct and compassion: two tools you can always count on
There is no foolproof process for knowing exactly the right thing to do. Trust your instinct if it tells you something is wrong. Leading with compassion can help create safe spaces for people to talk about their pain and this is one of the most helpful things you can do.
Many people who have lost someone to suicide don’t feel the same compassion from others that those who have lost a loved on another way experience. Some of this is because people are uncomfortable talking about suicide. Consider reaching out to someone who has lost a friend or loved one to suicide. Ask them about how the person they lost lived rather than focusing on the way they died.
The more we talk about suicide and suicide prevention, the more we can reduce the stigma around the subject and infuse our communities with hope and healing.