Until recently, suicide was something that people didn't talk about. Today, where statistics are available, suicide ranks as one of the ten most common causes of death. Girls tend to attempt suicide more often than boys; boys tend to follow through and complete a suicide more often than girls.
HIGH RISK INDICATORS FOR YOUTH
Loss: any type of loss: of a parent through death, divorce, or separation; loss of friends and familiar surroundings; loss of health; loss of respect; loss of a pet.
Family dysfunction: parents fighting with each other; parent - child conflict; unemployment; financial strain; abuse - physical, sexual, emotional, drug or alcohol abuse; parental depression; parents who have attempted or committed suicide.
Depression: not all depressed people feel suicidal, but if one of the symptoms expressed is hopelessness, then depression can become a suicide risk factor.
Pressure to succeed or conform - to family, peer, or self-imposed standards.
Low self-esteem.
Poor communication and socializing skills.
Alcohol and drug abuse: sometimes kids take drugs and/or alcohol to dull the pain of their problem(s) and to cope. Unfortunately, this coping technique can become a problem itself. It also lowers inhibitions and interferes with problem-solving and judgment.
Poor coping or problem-solving skills: when kids have trouble coping (limited resources) and have difficulty solving problems, suicide can become the only alternative solution they can see.
WARNING SIGNS OF SUICIDAL BEHAVIOR
Situations
- sexual or physical abuse
- divorce or separation of parents
- running away from home
- court involvement
- death of someone else
- dependence on drugs or alcohol
- failing grades
- almost anything, depending on how the person feels about it
- crying
- withdrawal
- quitting activities
- previous suicidal behaviour
- alcohol or drug abuse
- recklessness
- fighting & lawbreaking
- "tidying up" or giving gifts (preparing for death)
- lack of interest in appearance
- lack of physical energy
- no appetite
- disturbed sleep
- loss of interest in sex
- increase in minor illnesses
- talk of suicide
- planning for suicide
- worthlessness
- guilt
- helplessness
- loneliness
- escapism
- sacrificing
- scattered thoughts/tunnel vision
- sadness
- lethargy (no energy)
- apathy (no interest)
- distress
- anger
- hopelessness
- helplessness
- worthlessness
ASSESSING DANGER
Phase One
Is there a plan and the means to carry it out?
Risk factors (5 or more of the following = imminent danger!)
(Place a check mark in the boxes provided)
| Male | |
| Past attempt | |
| More than one attempt | |
| Antisocial behaviour | |
| Friend or family member who has committed suicide | |
| Drug and/or alcohol abuse | |
| Depression | |
| Social difficulties, especially family problems |
Phase Two
Can the person complete the following tasks (which are incompatible with suicidal states)?
- A written promise to abstain from suicidal behaviour for a specified time.
- Ability to compliment self and others.
- Ability to assess own emotional state.
- Capacity to plan ahead.
HOW LETHAL IS THE PLAN?
A 10-point scale, where 1 is low and 10 is high degree of lethality
- Pain killers & sleeping pills (least likely to result in death, but the most common way to die among suicide attempts).
- Gas poisoning.
- Attempting to drown when you can swim.
- Cutting or piercing non-vital areas of the body (slashing wrists, stabbing arms or legs).
- Poisoning (using rat poison, etc.)--poisons tend to induce vomiting.
- Attempting to drown when you can't swim.
- Hanging.
- Cutting or piercing a vital organ (stabbing in the stomach, abdomen, heart, throat, eyes).
- Jumping.
- Shooting oneself (gun in the mouth, hugging a grenade or stick of dynamite).
SIGNS THAT A CHILD MAY BE A SUICIDE RISK (GENERAL)
- Change in presentation- appearance, personality, behaviour style.
- Change in school performance.
- Depressed mood.
- Aggression/violent behaviour.
- Mood swings/emotional outbursts.
- Stealing.
- Sleep/eating difficulties.
- Somatic complaints/constant fatigue.
- Social withdrawal.
- Loss of interest in things.
- Inability to concentrate/complains of boredom.
- Risk-taking/self-harming behaviour.
- Sexual promiscuity.
- Running away/truancy.
- Satanic fascination.
- Substance abuse.
SIGNS THAT A CHILD MAY BE SUICIDAL
- Someone close has attempted or completed suicide.
- Previous threats/attempts.
- Conveys thoughts of helplessness/hopelessness.
- Suicidal ideation:
- Jokingly talks of suicide.
- Flippant remarks about suicide.
- Wonders about being dead.
- Indirect statements . . . "I won't be around anyway."
- Direct statements . . . "I feel like dying."
- Threatens suicide . . . "I'm going to kill myself."
- Has plan and means.
- Makes gestures or attempts.
TEACHERS: HOW TO HELP A SUICIDAL STUDENT
- Take it seriously.
- Listen and empathize. Don't discount, challenge, criticize, or moralize.
- Be stable, positive, and calm. The student is not in control, and you need to be in control - of yourself and the situation-like a good parent.
- Realize that others may back off from this person, so show your concern.
- Be candid and direct in assessing the risk.
- It's all right to ask, "Are you thinking of killing yourself?"
- Clarify the problem and explore options and strengths.
- Normalize the person's feelings.
- Side with the person's desire to live.
- Buy time if a suicidal plan is in progress - safety and survival are your main concerns.
- Depending on the risk involved, you want to go with the student for help or refer them for help.
- DON'T . . . ignore your intuition.
- DON'T . . . sidestep the issue. Suicide is serious. Take the threat seriously. It's better to be safe than sorry.
- DON'T . . . leave the student
- DON'T . . . lose patience or be shocked at what they are saying.
- DON'T . . . discuss whether suicide is right or wrong. Now is not the time.
- DON'T . . . promise confidentiality.
ADULTS-HOW TO HELP A CHILD YOU KNOW
If you suspect a child you know may be suicidal, the most important thing you can do is show him/her that you care and are interested.
Ask how she/he is feeling, or what has been happening at school or at home.
Get the parents of the child involved, if possible. For pre-adolescent children, who are still quite dependent on their parents, the more the parents are involved, the better the child will do. The younger the child, the more this is true.
Encourage the child and/or the parents to get professional help for the child.
It is important for the child to know you are still there and that you still care. You may have been the one person the child trusted enough to give a last chance for some understanding . . . or you may be the one who first noticed. Let him/her know you still care. It can be a real life-saver.
PARENTS: HOW TO HELP YOUR CHILD
Don't try to intervene yourself. When you're that close to the situation, it's hard to be objective. It's best to get professional help for your child and yourself - perhaps for the whole family. As parent(s) you are essential in helping your child get through this difficult time. Trying to deal with the situation alone can be too stressful and possibly counter-productive.
HOW TO HELP YOUR FRIEND
It's a positive sign if your friend wants to talk to you about committing suicide, so it helps to know how you can help.
Remember: while your friend is talking to you, your friend is undecided about suicide, so get on the side that wants to live. Time and talking are the main tools for dealing with a suicide crisis. The longer you can talk with the friend and keep him or her from carrying out the suicide, the better your chances of getting your friend to change his or her mind. So, don't be in a hurry. Don't push for decisions or pressure your friend to abandon his or her plan. Your main goal is the safety and survival of your friend, and to get help.
- Listen
- Encourage your friend to talk (ventilate):
- Explore the problem: what's been going on for the past 6-8 weeks.
- What led up to the present situation?
- Summarize the problem (narrow it down)
- Focus on the specific problem
- What's been tried so far to deal with the problem?
- What worked?
- What didn't work?
- Keep your friend's sense of the future positive. Find ways to emphasize your friend's strengths.
This reminds the person of past achievements and reinforces remaining strengths.
It introduces reality into the situation in a positive way.
It shows the person that she/he has coped in the past, that they have good points, and reminds them that things may not be as black as they feel.
It introduces reality into the situation in a positive way.
It shows the person that she/he has coped in the past, that they have good points, and reminds them that things may not be as black as they feel.
- Be supportive: let your friend know you're glad he/she is sharing feelings with you.
- "What happened to make you feel life isn't worth living?"
- "Can we talk about this?"
- "How do you feel?"
- "Have you thought about other ways to solve your problem?"
- "Is there someone in particular you'd like to talk with?"
- Evaluate: is your friend extremely upset but not suicidal?
- Suggest a course of action
- Emphasize that people care
- Say that counselling is available to help.
- Offer to help them get/find help/counselling.
- Concentrate on the immediate situation, problem, feelings.
- Your goal is not long-term change - it's prevention of a suicide.
- It's okay to ask, "Are you thinking of killing yourself?"
- Is the plan well thought-out?
- Does your friend have the means to carry it out (the weapons or other means)?
- How soon is the plan going to be carried out?
- How lethal is the plan?
- Try to get your friend to agree not to do anything before s/he talks to someone who can listen and help. Develop a suicide protection plan.
- Make it specific.
- Build in loopholes for failure ("If it doesn't work, what will you do?").
- Never laugh at or humiliate your friend.
- Don't promise anything you can't deliver.
- Don't keep the suicide threat secret. This isn't a test of friendship. It's a cry for help and should be treated as such. Get help for your friend.
PROTECTIVE FACTORS
Some factors that indicate stronger resistance to suicidal behaviour are:
Presence of an important person in a youth's life
Having an emotionally significant person to whom a youth can relate will decrease the likelihood of suicide. It could be a parent, teacher, close friend, or youth worker. The person has become the lifeline to the teenager.
Good coping skills
The more resourceful and skilled at problem-solving the person is, the more likely he/she can cope with stressful situations. Coping skills are generally related to personality rather than intelligence. A person who copes well may see a stressful situation as a challenge and an opportunity for change rather than an occasion for despair or grief.
A supportive and caring family
A warm, caring and understanding family is a good source of support for young people in distress.
Interests and activities
Group activities like scouts, church groups, team sports are socially acceptable ways to channel energy and frustration.
SOME FACTS ABOUT SUICIDE:
- Most people who commit suicide give clues that they want to kill themselves.
- People who kill themselves usually don't want to die. They just want to get away from the pain.
- Most teens who are suicidal can work it out by talking or occasionally going on medication, and they go on to live long, healthy lives.
