The following is provided only as information and is not intended to substitute for assistance from a trained and licensed mental health professional, nor is it intended to suggest that you are being provided with such training.

WHAT TO LOOK FOR

Distress can lead to the development of unhealthy behaviors.  People closest to the person experiencing psychological or emotional difficulties (friends, family, co-workers) are in the best position to recognize changes due to distress and to provide support.

Look For:

• Comments that suggest thoughts or plans of suicide.
• Rehearsal of suicidal acts.
• Giving away possessions.
• Obsession with death, dying, etc.
• Uncharacteristic behaviors (e.g., reckless driving, excessive drinking, stealing).
• Significant change in performance.
• Appearing overwhelmed by recent stressor(s).
• Depressed mood; hopelessness.
• Withdrawal from social activities.

WHAT TO DO

It is best for a mental health or medical professional to assess and manage suicidal person, but there may be times when you find yourself talking with someone you believe is thinking about suicide.  In any situation, if someone threatens suicide, take him or her seriously, and call 9-1-1 to enlist immediate assistance.  You may have very limited time and only one chance to intervene.  The most important thing to do is to take action.

If you suspect that someone is thinking about suicide, here are some things that you can do:

By Phone:

• Establish a helping relationship (get your foot in the door).
• Quickly express that you are glad that he or she has called you.
• Immediately get the telephone number that he or she has called from in case you are disconnected.
• Find out where he or she is located.
• Get as much information as possible about the individual’s plans, access to means of self-harm, and intent.
• Listen and do not give advice.
• Keep the person talking as long as possible until help can reach him or her, but avoid topics that may agitate him or her (i.e., his or her supervisor , cheating spouse, etc.)
• Follow up and ensure the person is evaluated by a licensed mental health professional.

In Person:

• Find out what is going on with the individual.
• Use open-ended questions such as: “How are things going?” or “How are you dealing with…?”
• Share concern for his well-being.
• Be honest and direct.
• Listen to words and emotions.
• Repeat what he or she is says using his words.
• Ask directly about his or her intent, i.e., “Are you thinking about suicide?” This will not put new ideas in his or her head.
• Keep the person safe –DO NOT leave him or her alone; have a capable person with him or her at ALL times.  Take steps to remove potential means of self-harm including firearms, pills knives, and ropes.
• If he or she expresses intent to harm self and/or others, call for immediate assistance to 9-1-1 and ensure that the person is evaluated by a qualified mental health professional.
• If psychiatric hospitalization is required, talk to the mental health staff about what assistance is needed (e.g., arranging for necessary belongings, child care, or pet care).
• Monitor the person until you are convinced that he or she is no longer at risk.
• If the individual is not expressing suicidal and/or homicidal thoughts, but you believe that he or she is nevertheless at risk (based on your prior knowledge of the person), call a mental health professional for advice on whether to call an ambulance or transport the person yourself to a hospital.  If the advice is to transport him or her in your vehicle, a person must sit at each door to prevent the potentially suicidal person from exiting the moving vehicle.

What to Avoid

• Do NOT minimize the problem.  Do NOT ask, “Is that all?”
• Do NOT overreact to the problem.
• Do NOT create a stigma about seeking mental health treatment.
• Do NOT give simplistic advice such as, “All you  have to do is…”
• Do NOT tell the person to “suck it up,” or “get over it.”
• Do NOT make the problem a source of gossip.  Involve others only on a need-to-know basis.
• Do NOT delay a necessary referral to a mental health professional. 

References:

Adapted from TA-060-0107