You Can Play a Role in Suicide Prevention
Reach Out to Save a Life
EDITOR'S NOTE: This article summarizes some of the lifesaving techniques taught in several suicide-prevention training programs. It is not intended as a replacement for in-person participation in one of these programs. Please immediately call 988, the national suicide and crisis lifeline, if you or someone you know is having thoughts of suicide.
When rural North Dakota resident "James" drove by his neighbor "Bob" sitting in his vehicle near a field, something seemed off -- the time and place for Bob to be there were unusual. James immediately turned around and went back to ask Bob if he was all right. A long conversation revealed Bob was facing a great deal of stress and struggling emotionally. James persuaded Bob to get help, and thanks to that assistance, Bob's situation improved. Later, Bob admitted to James he probably wouldn't be alive if James hadn't stopped to ask him if he was OK.
This real story is an example of how the simple act of reaching out to someone who is struggling emotionally and having thoughts of suicide can potentially save that person's life, says Katie Henry, a family and community wellness Extension agent with North Dakota State University (NDSU).
Henry is a certified trainer for a suicide-prevention program called "QPR," which stands for "Question. Persuade. Refer." The program -- and others like it -- teach people how to recognize the signs of mental health distress and empower them to provide lifesaving assistance.
The key message of these training programs is that, like many other health issues, suicide is preventable. Each program takes a slightly different approach to giving help, but at their core, all focus on the same basic principles: recognizing the warning signs that people may be considering suicide, reaching out to them and connecting them with the appropriate mental health help.
WATCH FOR WARNING SIGNS
The education program "Talk Saves Lives" teaches that the first step in preventing suicide is recognizing the warning signs that someone is struggling, explains Becky Wiseman, a clinical social worker and family consultant case supervisor for Cornell University's New York FarmNet Program. In a recent Rural Minds webinar on rural suicide awareness and prevention training, Wiseman said suicide warning signs are typically displayed in three ways: through a person's talk, behavior and mood.
Examples of things people might say if they're considering suicide are they're feeling trapped, they have no reason to live, they feel they are a burden to others, they're in unbearable pain or they're thinking about ending their life, Wiseman says.
Behavioral warning signs may include an increased use of alcohol or drugs, sleeping too little or too much, acting recklessly, withdrawing from activities they normally participate in, isolating from family and friends, looking for a way to kill themselves or giving away possessions, she adds.
Moods that may be warning signs could include depression, apathy, rage, irritability, impulsivity and anxiety. "We all have ups and downs in our moods, but if you notice something that's changed, (and) it's uncharacteristic or concerning, it's really important that you speak to that person about what's happening and what you're noticing," Wiseman says. "And, then trust your gut; our gut really tells us what we need to do."
If you're on the fence about whether to reach out to someone, Wiseman stresses you should always assume you are the only one who is going to do it. "In too many instances, people talk about their concerns for someone amongst themselves, but they hesitate to reach out to that person directly."
HOW TO REACH OUT
Often, the hardest thing to do is ask people if they are considering suicide. A common fear is that asking someone whether the person is thinking about suicide could put the thought in that individual's head or make the person more likely to follow through. That fear is unfounded, mental health experts say.
"We know that asking somebody directly if they're having (thoughts of suicide) actually lowers their anxiety and opens up that critical line of communication between you and that person, and gives them an opportunity to ask for help," says Madeleine Smith, an NDSU Extension agent and certified QPR trainer, who participated in a recent QPR training webinar sponsored by NDSU.
Wiseman recommends talking to the person privately if you suspect someone might be suicidal. "Listen to their story, express concern and caring, and ask directly. Don't be afraid to ask, 'Are you thinking of ending your life?' 'Are you thinking of suicide?'â??" she says.
Don't worry about saying the wrong thing, she and other experts agree. The fact that you ask the question is more important than how you word it.
After a conversation has been started, listen to the person, Wiseman continues, without offering solutions to the issues that may have led the person to consider suicide.
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GETTING A SUICIDAL PERSON HELP
If you suspect someone has a plan to end his life soon -- especially if it comes up in a conversation -- don't leave the person alone, Wiseman explains. Stay with the person and help the individual connect with professional help. If the person is in immediate danger of self harm or of harming others, call 911. If the danger is less immediate, urge the person to call 988, the national suicide and crisis lifeline, or offer to call the line with the person. Experts also recommend offering to take the person to a mental health professional, a clergy member or someone the person trusts.
If the person doesn't have an immediate plan to end his life and can't get into a mental health professional right away, the next best thing to do is get the person to commit to accepting help, and make the arrangements to get that help. And, then follow up soon afterward to make sure the person is getting help.
REDUCE ACCESS TO LETHAL MEANS
Another potentially lifesaving action people can take is to reduce a suicidal person's access to lethal means, such as firearms or medications, according to mental health professionals.
People who attempt to kill themselves usually choose a means they are familiar with and already have access to, said Tara Haskins, Total Farmer Health director for AgriSafe Network, in a recent "Counseling on Access to Lethal Means" (CALM) webinar. CALM is another training program aimed at preventing suicide, primarily through reducing access to lethal means.
Most suicide attempts involve medications, Haskins explains. However, 55% of deaths from suicide in the United States involve firearms, she says.
Because the thought of suicide is often spontaneous and brief, putting time and distance between someone who is suicidal and access to lethal means can sometimes allow the suicidal thoughts to pass, she says.
"Individuals usually consider suicide not necessarily because they want to die," Haskins explains. "In fact, we know from interviewing individuals that have survived a suicide attempt or that have had suicidal thoughts, they also admit to having thoughts of ambivalence. That's what we're trying to capitalize on are those ambivalent thoughts."
She suggests focusing on the person's safety and the safety of family members and making the person a collaborative partner. Ask questions such as, "What do you think we can do to help make you safer?" or "Can we think about steps to keep you safe until things get better?"
If a suicidal person has access to firearms, the best option is to collaborate on temporary off-site storage, such as at a friend's or relative's place, a gun range, a self-storage facility or a pawn shop. The next best option is in-home storage, where firearms are locked and unloaded, and stored in a safe or lockbox. Another option could be to add trigger or cable locks to the firearm for added time in gaining access to them. Or, the keys or combination to a locking device could be given to a trusted person.
If a suicidal person has access to medications, CALM training recommends limiting the amount of medications available to only what the person needs immediately. Some options include safely disposing of any out-of-date, unused or excess medications and over-the-counter remedies or using a lock box to secure any lethal and additional medications.
It's difficult to reduce access to every form of lethal means, Haskins says, but if a person considering suicide mentions something specific, it's important to take steps to help the individual remove, limit or disable it. Follow up on a plan for safety and assist the person with getting professional help.
SIMPLE ACTS CAN SAVE LIVES
Chad Reznicek, a behavioral health state specialist with the Colorado AgrAbility Project, has worked for 20 years as a licensed professional counselor and has done thousands of suicide assessments. Through his work, he says, he has witnessed firsthand the power of reaching out to people who are struggling.
"Many of the assessments we did (on people who had considered or attempted suicide) would ask questions such as, "Had you ever had a plan to complete suicide and something or someone stopped you?," and the number of times that people reported some small, caring gesture, some simple act of human kindness as being the thing that allowed them to hit the brakes on their suicidal intent that day and keep going has given me a tremendous amount of hope and optimism," Reznicek says.
SUICIDE PREVENTION TRAINING
Several suicide-prevention training programs are available that teach how to recognize the warning signs that people may be considering suicide, how to talk to them and how to connect them with appropriate mental health help.
Here is a list of some of these programs:
-- CALM (Counseling on Access to Lethal Means)
This program teaches people how to collaborate with those at risk of suicide to implement safe storage of firearms and dangerous medications.
-- COMET (Changing Our Mental and Emotional Trajectory)
https://medschool.cuanschutz.edu/…
Developed by the High Plains Research Network Community Advisory Council (a grassroots group of ranchers, teachers, small business managers, students, retirees in rural eastern Colorado), rural mental health professionals and health researchers, COMET teaches people how to intervene when they encounter someone who is in a "vulnerable space" and help shift the person's mental health trajectory back to a place of wellness instead of proceeding toward a mental health crisis.
-- QPR (Question. Persuade. Refer.)
Created in 1995 by Paul Quinn, QPR (like CPR) is an emergency intervention for someone experiencing a life-threatening mental health crisis. The program teaches participants to be able to recognize the warning signs of suicide and question, persuade and refer people at risk for suicide for help.
-- Talk Saves Lives
This program covers the general scope of suicide, the research on prevention and what people can do to fight suicide.
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-- If you are someone you know is in crisis, please contact the 988 Suicide and Crisis Lifeline. Call or text 988. Chat at https://988lifeline.org/…
-- You may email Anthony at anthony.greder@dtn.com, or reach him on social platform X @AGrederDTN
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