Bluntly Ask About Suicide

Image courtesy of Calaveras County Government

We are losing too many people to suicide. The National Institute of Mental Health (NIMH) reports that more than twice as many people in the United States killed themselves (47,173) in 2017 as were murdered (19,510). It was the second-leading cause of death of people aged 10–34 and the fourth-leading cause for people aged 35–54.

This problem is actually more serious than the number of completed suicides. According to that same report, nearly 10 million people in the U.S. reported serious thoughts of committing suicide. Nearly 3 million made serious plans. Nearly 1.5 million actually attempted suicide. From 2001–2017, the overall suicide rate in this country jumped up 31%.

Veterans especially suffer in this regard. Despite the oft-quoted statistic that we are losing 22 veterans a day to suicide, the actual number, according to the Department of Veterans Affairs, is actually more like 17. That’s still too many.

Current service members fare no better. According to this report from the Department of Defense, deaths by suicide in the military outpace deaths by combat. Reservists and National Guardsmen have a higher rate than the active component; enlisted personnel under age 30 account for the majority of completed suicides.

People come to a choice about suicide from a multitude of different paths. One thing we do know is that suicide does not discriminate. It crosses boundaries of age, gender, race, religion, professional occupation, and any other demographic you can think of. The numbers are climbing year-over-year and it seems like a hopeless cause. It’s not. Here are some things we can do.

Learn to recognize risk factors.

Risk factors are facts and circumstances of someone’s life that may suggest at-risk status for suicide or suicidal ideation. These include:

  • Previous suicide attempt
  • Depression
  • Substance Abuse
  • Family history of mental disorder or suicidal activity
  • Victim of physical or sexual abuse
  • Severe medical conditions

These do not necessarily mean someone will think about, attempt, or complete a suicide. These are trends that suicidal people tend to present.

Learn to recognize warning signs.

While risk factors are facts and circumstances, warning signs are actual behaviors that may indicate someone is on the road to suicide. These include:

  • Making fatalistic statements about hopelessness, emptiness, or not having a reason to live — social media is a common place for this.
  • Talking about being a burden to others
  • Excessive substance abuse, especially when feeling depressed or hopeless
  • Withdrawing from family or friends
  • “Checking out” on life responsibilities, e.g. work, finances, etc.
  • Taking risks that could lead to death, e.g. reckless driving
  • Giving away important possessions
  • Saying goodbye to friends and family

Ask the question.

Be blunt. Don’t ask, “Are you thinking of hurting yourself?” or “Are you thinking of doing something stupid?” The former is too broad — hurting oneself certainly needs to be addressed, but not all forms of self-harm necessarily lead to suicide. The latter is invalidating. If someone is already in a place where they don’t feel anyone understands them or cares about them and they want to die, then calling them or their thoughts “stupid” is the opposite of what you need to do here.

Straight-up ask, “Are you thinking about killing yourself? Or maybe, “Are you thinking of suicide?” The direct approach quickly focuses on the situation and gets you the answer you need immediately.

I have asked that question before, and many times I get a surprised response. One guy told me that he had felt down for a long time, but he didn’t realize how bad it had gotten until I asked the question. He told me that he wasn’t actively thinking about suicide, but he couldn’t swear that he wasn’t headed in that direction. Another was surprised because he was planning to commit suicide and he thought no one would care enough to even notice.

Refer them to the proper resources.

Once you are able to get someone talking about suicide, encourage them to seek the help they need. Unless you are a licensed mental health professional or a medical doctor, you need to realize that your job is to refer.

Be prepared to address the subject of stigma — either social or professional. We have come a long way in our understanding of just how many people are hurting, but we still have a long way to go in our willingness to help, as well as our willingness to seek help.

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I came into work one morning having not slept a wink all night. My dog kept me up with his allergy-fueled idiosyncrasies, and I was dragging. Also, I had not had my morning coffee yet. I guess it must have showed, because no fewer than three people asked me if I was okay.

As I settled into my office to begin my day, one of my employees came in and closed my door behind me. He looked troubled, so I sat up straighter and tried to mentally prepare myself for whatever issue he was bringing to me.

“I’m concerned about you,” he said. “You made a statement earlier about wanting to go away somewhere and not think anymore. That sounds like one of those statements you trained me to pay attention to.”

It was my turn to give the surprised response.

“I…wow. Ok,” I stammered. “So, I’m not suicidal at all. I just meant that I need some off time to decompress and not think about work. Also, coffee.”

He grinned at me and left my office satisfied that I was okay, but that he had done the right thing.

This stuff works.

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Frank Vaughn is a writer, photographer, and military veteran from Little Rock, Ark. He is grateful for people who care enough to ask.

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