Identifying someone at risk of suicide and what to do
The Zero Suicide Alliance have a great 30 minute free Online training Course Save a Life – Take the Training -giving practical advice on how to start the conversation. It may be all you need to know. Take the course yourself and encourage as many people as you can to do it too. Our Get Help page provides links to some key services.
Understanding more about suicide
Information regarding how you may identify someone at increased risk of suicide is useful but it is important to recognise that some people may not show these signs yet still be at risk. There may be many reasons why the person wants to keep their personal crisis private and so will work hard at hiding their thoughts and feelings. This short Owen Jones interview “Why do so many men die by suicide” gives one young man’s insight into the problems they face.
Helping Early Before Things Become Overwhelming
Looking after your mental health is as important as looking after your physical health. They can affect each other. Being mentally unwell can sometimes lead to physical symptoms. Being physically unwell can sometimes affect you emotionally.Things you do to keep well physically also help your mental wellbeing: eating well, getting plenty of sleep, doing some exercise and watching how much you drink.
In addition there are 5 things you can do to take care of your mental wellbeing; sort of like a mental health equivalent of the physical health “5-a-day”. These are Connect. Be Active. Take Notice. Keep Learning. and Give. The Action for Happiness Website provides an explanation of the principles behind this with its GREAT DREAM acronym and gives you some ideas to think about what you can do.
Taking time to understand ourselves – our strengths, what we value in our lives, what makes us feel happy, how well we connect with our emotions and how we express them- is essential. This not only helps us to understand and manage our own emotional health needs but also helps us appreciate how complex and different we all are and how dangerous it can be to assume that you understand someone else’s feelings without them telling you.
Emotional First Aid suggests simple tips to help deal with common emotional “bumps and scrapes.”
We can’t always predict or control what life throws at us but we can learn a range of skills to help us respond more flexibly, deal with challenges more effectively and bounce back more quickly as a result. Mind have a number of resources explaining how to manage stress, become more resilient, manage pressure and anger. Student Minds have good information to help deal with exam stress. mentalhealth.org.uk also have a range of downloadable brochures offering practical advice including how to sleep better. Mastering the skill of quick stress relief suggests some ways to identify things that may help you manage stress anytime, anywhere.
A number of different apps are now available to help maintain mental wellbeing. Some require registration and some have to be bought but links to a collection of free apps have been pulled together on the Brighton Mind website. The Australian Reach Out site has a Toolbox of apps for your brain and body with a quiz that helps you identify your goals.
Some people may communicate through Facebook when they can’t talk about their feelings directly. Facebook and Samaritans have put together a leaflet which gives some advice on noticing worrying posts and what to do to help your friend.
Encouraging people to talk about their feelings is an important part of maintaining mental wellbeing and helping them cope with the SToRMS of their everyday life. Gaining these skills early, and keeping in practice, may prevent problems becoming overwhelming further down the line. Helping others to do this is something we can all do and the good news is that this doesn’t need any specialist training. Just being a good friend may be all that is needed most of the time. Everyone can help by taking time out of their busy lives to #AskListenSupport if they are concerned about a change in someone’s behaviour.
Some good points to bear in mind are:
- When emotions take over it can be difficult to see any situation clearly. People need to feel listened to, understood and valued as well as cared about. By providing these you will help them to become calmer and better able to look at their problem in a different light.
- Be kind. Remind them that you are always there for them.
- If you notice a change in their behaviour, try starting the conversation yourself by telling them what you have seen. ” I can see that you are unhappy/ angry/ xxxx. What can I do to help?”. Some people struggle to start conversations about how they feel. Try to avoid “How are you?” as the conversation is often shut down by a socially acceptable response of “Fine”.
- ASK. Accept that they may not want to talk at first but tell them you will see how they feel about talking later. Don’t forget to go back and ask again. If they come to you, and are wanting to talk, try to take advantage of the opportunity but if it is not a good time for you, arrange a time that’s good for you both and stick to it.
- Give them your full attention. Put down your phone and your own issues.
- LISTEN calmly to what they say, without interrupting or judging. Perhaps just nod to show you are listening. Be aware of your body language.
- Don’t make any assumptions. Let them tell you. Ask them questions if you are unclear about something they have said. Reflecting back to them what they have said makes it clear you have heard them.
- Ask “Open” questions starting with “What” or “How” eg “How do you feel about…?”. This will help to prevent conversations getting stalled by Yes and No answers.
- ACKNOWLEDGE the way they feel “That sounds really upsetting” or “You must be feeling really confused”.
- Don’t play down or dismiss their feelings or criticise the actions that may have led to these feelings. Instead try to understand what they must be feeling, and reassure them it’s OK to feel that way. VALIDATE.
- It is OK and normal to feel angry about things. It’s how you handle that emotion, without hurting yourself or others, that is important. It is important to understand that when someone is angry it is usually as a result of another emotion such as fear, frustration, guilt, shame etc. Try not to react to the anger but instead find out what is the primary emotion and root cause, as you would do if someone were obviously sad or anxious etc.
- Don’t immediately jump in with your own solutions. By letting them talk you are giving them time to reflect on what they have said and understand it better. This may enable them to come up with their own solution. If this does not work you may feel some help is needed to get the process started. Asking “What do you want to happen?” helps you understand what they need. Followed with “What could you do to help that happen?” leaves them in control, helps them think about solutions and which option(s) they could try.
- Don’t gossip. Keep their confidence unless you are worried about their safety (see last point). You may think they should also talk to someone else they trust who may be able to help. If so, talk to them about this but make it clear you are still there for them.
- Look after yourself. Think about how listening to their problems is making YOU feel. Can you bear to listen? If not, it’s OK ,but try to recognise it so you can give them honest feedback and let them know you can be there for them in other ways but that they’ll need to find someone else to talk to on this one.
- If you are worried they may harm themselves ask them if they are considering taking their own life. This will not encourage them to do so. It is likely to be a relief for them to be able to talk to someone about these feelings. PAPYRUS provide advice on how to start this difficult conversation with a young person. If you do not feel able to ask them about possible suicide, be honest with them. Let them know you are concerned and that you will help them to access support.
Reach Out and Epic Friends give more information about what we can do to communicate more effectively with our friends. Student Minds have a good resource covering most aspects of helping a friend, with general advice applicable from school age onwards. It also includes specific advice for university students from coping with Freshers week to leaving and looking for jobs. Plenty of information around helping friends with specific diagnoses. The Mix also provide excellent advice and support for issues affecting young people. Samaritans provide good information on how to prepare for these conversations (from providing a safe environment through to recognising your own needs) and some good example questions for checking out if they know how to get help.
Supporting Someone Who Has (Or Has Had) Suicidal Thoughts
If you are concerned for any reason about someone you know please take them seriously, offer them support and give them the opportunity to talk with no judgement. Often you don’t have to make a grand gesture, just the offer of a film or takeaway or even just a hug. It is crucial that the person at risk realises he/she is loved, supported, and valued. Sometimes this may not be enough, and in that case please contact any of the helplines listed above or encourage the person to go to their GP. If you feel that a suicide attempt is imminent, please do not hesitate to call 999 or take him/her to A&E.
Supporting someone who is experiencing suicidal thoughts can be challenging. Even if they are receiving help from Mental Health services they will still need your support. The suicide prevention charities listed above provide information to help you if you are worried about someone.
Specific information for parents about childrens’ mental health and resilience
Many parents feel that raising their family is one of the most important and rewarding parts of their lives. It can also be a source of anxiety, confusion and frustration when things aren’t running smoothly. Often parents put their own needs to one side to concentrate on their children but it is important to look after their own mental wellbeing too. Not only are their children more likely to pick up these good habits but it will also make it easier for the family to manage difficulties that arise.
The widely held belief that “you just know” how to be a good parent means that early signs of problems may go unrecognised and information is often sought only when things become unmanageable. There is a lot to be said for adopting a more proactive approach, whether to confirm you are doing all the right things or to identify and avoid the common pitfalls that may impact your children now or later in life.
Talking and listening to your child, encouraging them to understand and express their emotions from an early age is crucial to their future health and wellbeing. 10 minutes a day, where you are there just for that child doing an activity with them that they have chosen and enjoy, creates the security and space for proper communication to happen. It can be difficult to get this “us time” with teenagers but this is when they are likely to need it most. Look for innovative ways to keep communicating.
Parents now have access to more information that ever before but navigating the often conflicting advice in books, newspapers and online can add to the confusion. MindEd resources, developed by Department of Education in partnership with Health Education England, provide reliable and evidence based information to help parents understand and cope with a range of issues in all age groups. The approach is quite formal and there is a prompt to log in to the site but it is possible to progress through the sessions without this.
For a more informal approach, some suggestions are:
- Educating For Happiness and Resilience: Dr. Ilona Boniwell . This video gives an accessible, basic insight into the importance of resilience and happiness and how to start building these in children.
- The Aha!Parenting and The Child Development Institute (US) websites aim to promote positive parent child relationships and provide user friendly advice for age groups from birth to teens.
- This leaflet from Canadian organisation Beststart helps parents to understand resilience and how to start building it in young children.
- The American Psychological Association provides further information for parents on how to foster resilience in children at various stages of their lives.
The Young Minds website has reliable information for parents and carers about common mental health and behaviour concerns in children and young people aged 0-25. Find out about symptoms, possible causes and what you can do to help, with links to further information, resources and other organisations you can contact for support.
Sheffield Children and Adolescent Mental Health Services (CAMHS) in association with Sheffield Childrens Hospital have put together the Epic Friends website in response to the fact that “12% of Sheffield secondary pupils say they feel very sad or depressed most days”. The Epic Friends website provides mental health information in a way that young people are likely to understand and relate to and may provide a good starting point.
Interchange Sheffield is a local charity supporting the emotional wellbeing of young people up to age 25 in Sheffield. Their website has useful information about mental health, local support and counseling services.