“Suicide prevention is hope” said Steven Karaiskos, PhD, Senior Director of Community Education & Outreach at Samaritans, Inc., in a recent training seminar for Springwell employees.   Dr. Karaiskos is a social learning expert, a suicide prevention advocate, an educator, and a long-time suicide loss survivor. He has spent years supporting those affected by suicide and suicide ideation and working with community outreach programs to help further educate people on suicide prevention.

Dr. Karaiskos advocates for reframing the conversation of suicide under the entire mental health umbrella, including joy, compassion, gratitude, and positive psychology. It helps to create the understanding that suicide prevention is not just about crisis–it’s about helping people find hope.

There are many factors that can put someone at risk of suicide. Suicide is the 11th leading cause of death across all ages. Risk factors and warning signs are often layered and subtle. Someone who is experiencing suicidal thoughts might not share all warning signs with one person.

When going through the warning signs, you might think: “what did I miss?”. Dr. Karaiskos suggests reframing this to “what do I know?”.

If you know someone with risk factors or warning signs, the best thing to do is think and act proactively. If someone has risk factors, talking to them long before a crisis might occur is a proactive way to lower their risk.

There is a common misconception that asking someone about suicide will make them feel angry or isolated, or put the thought inside their head. The truth is, asking someone about suicide directly may make them angry at first because of the stigma, but direct (empathetic) confrontation has been shown to reduce risk and help them feel more connected. It can lower intent and anxiety, as well as open up the conversation.

CONVERSATION BEST PRACTICES

It can be challenging to talk to someone about suicide as it is complex and confusing. Many people don’t understand how someone starts thinking about suicide and others are frightened by the idea of bringing it up.

There is also a stigma around the topic, and that stigma comes from language. This is why it’s important that we shape the language surrounding suicide.

How do we talk to someone who may be at risk, or someone who has confided in us?

Saying you’d like to talk to someone who you are concerned about or listening to someone who comes to you overwhelmed are both great ways to begin a conversation. Once you are engaged in conversation, active listening will be one of your best tools.

First, put away any distractions; show that you’re present through body language, physical affirmations, and verbal affirmations.

Listen with your heart and not your words. Sometimes just having someone to listen to can be more helpful than trying to fix it.

Listen with the intent to understand. Allow them to express their emotions without judgment, and without minimizing their feelings. Don’t try to tell them that what they’re feeling will pass. Try instead to validate their feelings.

Sometimes we try to relate to them through sharing our own experiences. While this may seem helpful, it can actually make them feel diminished in their experience. Try instead to engage with their experience by asking questions such as: “what are you feeling right now,” “what do you think you need right now?”

It can be difficult to understand how to respond to someone when having these complex conversations. Reflecting by communicating that you’ve heard them is one way to make them feel heard. It’s also a good idea to cautiously validate their emotions (not their situation). For example, “it’s normal to feel…,” “it makes sense to feel…”; rather than saying “yeah that’s a terrible situation to be in”.

Try using open ended questions rather than asking “why.” Using clarifying questions helps to narrow the focus of the conversation. It may seem counterintuitive but steering them into the pain can be a useful tool. We don’t want to avoid it. Instead, we want to create a safe space without judgment or fear.

TALKING TO SOMEONE WHEN YOU ARE CONCERNED

Talking to someone with suicidal thoughts can be difficult, but if you have cause for concern don’t wait. Be sure to talk to them privately and approach the conversation gently. If you are struggling to ask them, you can do so indirectly.

Be cautious of your language and tone. Don’t ask “you’re not suicidal, are you?,” “you wouldn’t do anything stupid would you?” This perpetuates the negative stigma around suicide and can make them feel worse. Instead, gentle, direct questions like, “Have you been having thoughts of suicide?” are a better way to introduce the topic and your concern.

If the person says yes, make sure to manage your reaction and stay calm. Ask them if they have a plan, access to means and a timeframe. This can help you determine how immediate the risk is, and if immediate action is needed. If you can’t help them, that’s okay. Get someone who can. You don’t have to have all the answers and know that there are others to support you.

When getting help, try involving them: “will you go with me to get you help?” or “will you let me get you help?”

If someone is in imminent danger, you may need to call 911.

There are other support and helplines available if 911 is not the right option.

988 is a new all-inclusive support resource that will direct you to the help you need. It is not 911. You can also reach out to Samaritans, a 24/7 helpline with text available. Hey Sam, is a peer-to-peer helpline for young people to text for support from trained people of similar ages.

Calling 988 will direct you to one of those resources, or a variety of others to best suit your needs.