Best Evidence Based practices in dealing with persons ideating suicide

[Deleted User]Bles (deleted user)
edited April 2020 in General

The physical and social distancing practices in place now has many feeling beside their usual selves. It also has a few feeling fatalistic about their lives and existence.

One person posted thoughts of suicide recently. And I have been receiving messages from people asking for a hug to feel less depressed and/or prevent themselves for going over the edge.

I have done what I was taught to do by my training and very personal experiences on the job and privately. Give hotline numbers to call and online resources I have collated over the past 10 years or so.

But I'm feeling inadequate to handle it despite my knowledge, understanding and experience. And the number of folks feeling depressed and potentially ideating ( expressing or thinking) suicide is increasing. In the past week alone I have received 3 such messages from different individuals. And it truly bothers me.

One part of me wants to have nothing to do with it. So I ignore it. I delete and move on.

Another part of me wants to help. But my knowledge, understanding and experience tells me there are many effective ways to handle it. In addition to giving the person resources at a moment when they're really crying for help and seeking understanding and acknowledgement for what ever it is they're dealing with. What else can a lay person do ?

This is especially unique because of the nature of what this community purports to offer. What does connection really mean in the context of someone feeling desperate and/or daring enough to post thoughts of wanting to end his life?

We can speculate all we want on why the person did so. It could be so many variables.

But as a community it may be useful to empower ourselves on how to respond to and engage meaningful conversation on how we approach this situation.

What are the best available evidence of the practices and approaches that work when dealing with persons who express such thoughts?

It might be useful to list them here for the benefit of all whether you're a health care professional or not. We have all encountered such situations at one point or another in our lives.

Let's be respectful, thoughtful and understanding. These are difficult times.

Comments

  • Be positive, Be caring let the person know they are not alone and that this too shall past, Get them to think back to happier times. I wish our leaders could be more compassionate in their tone when they are holding these press conferences.

    Practice boundaries, self-care. The same concepts that we use in our platonic cuddling experiences can be applied here.

  • Suicide: What to do when someone is suicidal
    When someone you know appears suicidal, you might not know what to do. Learn warning signs, what questions to ask and how to get help.

    By Mayo Clinic Staff
    When someone says he or she is thinking about suicide, or says things that sound as if the person is considering suicide, it can be very upsetting. You may not be sure what to do to help, whether you should take talk of suicide seriously, or if your intervention might make the situation worse. Taking action is always the best choice. Here's what to do.

    Start by asking questions
    The first step is to find out whether the person is in danger of acting on suicidal feelings. Be sensitive, but ask direct questions, such as:

    How are you coping with what's been happening in your life?
    Do you ever feel like just giving up?
    Are you thinking about dying?
    Are you thinking about hurting yourself?
    Are you thinking about suicide?
    Have you ever thought about suicide before, or tried to harm yourself before?
    Have you thought about how or when you'd do it?
    Do you have access to weapons or things that can be used as weapons to harm yourself?
    Asking about suicidal thoughts or feelings won't push someone into doing something self-destructive. In fact, offering an opportunity to talk about feelings may reduce the risk of acting on suicidal feelings.

    Look for warning signs
    You can't always tell when a loved one or friend is considering suicide. But here are some common signs:

    Talking about suicide — for example, making statements such as "I'm going to kill myself," "I wish I were dead" or "I wish I hadn't been born"
    Getting the means to take your own life, such as buying a gun or stockpiling pills
    Withdrawing from social contact and wanting to be left alone
    Having mood swings, such as being emotionally high one day and deeply discouraged the next
    Being preoccupied with death, dying or violence
    Feeling trapped or hopeless about a situation
    Increasing use of alcohol or drugs
    Changing normal routine, including eating or sleeping patterns
    Doing risky or self-destructive things, such as using drugs or driving recklessly
    Giving away belongings or getting affairs in order when there is no other logical explanation for doing this
    Saying goodbye to people as if they won't be seen again
    Developing personality changes or being severely anxious or agitated, particularly when experiencing some of the warning signs listed above
    For immediate help
    If someone has attempted suicide:

    Don't leave the person alone.
    Call 911 or your local emergency number right away. Or, if you think you can do so safely, take the person to the nearest hospital emergency room yourself.
    Try to find out if he or she is under the influence of alcohol or drugs or may have taken an overdose.
    Tell a family member or friend right away what's going on.
    If a friend or loved one talks or behaves in a way that makes you believe he or she might attempt suicide, don't try to handle the situation alone:

    Get help from a trained professional as quickly as possible. The person may need to be hospitalized until the suicidal crisis has passed.
    Encourage the person to call a suicide hotline number. In the U.S., call the National Suicide Prevention Lifeline at 800-273-TALK (800-273-8255) to reach a trained counselor. Use that same number and press "1" to reach the Veterans Crisis Line.

  • A friend who worked in the Nuclear industry, told me they have a "chirp" alarm, which makes a chirp noise at regular intervals, to advise that all is well. An alert would sound the normal alarm, but also turn off the chirp, and the latter worked even if all communication was lost.

    The parallel is that we probably need to keep in regular contact with people, in order to know something is amiss.

  • edited April 2020

    Use the same interpersonal communication skills you would use for someone dealing with grief whether from death, divorce, addiction, mental illness, etc. It's important they feel heard and in our case, touched.

    Also, look into Kevin Briggs. He is a Highway Patrol officer known for talking over 200 jumpers off the Golden Gate bridge. One technique; If they did not have plans for the next day, he'd try to make plans with them, inviting them to come back to the bridge if their plan did not work out at the end of the day.

  • My best friend and soul-mate committed suicide many years ago. I don't think there is anything you can do or say that will prevent it in the long term. She had been in therapy for years and was on medications. She had also attempted before. The medications themselves can trigger suicidal thoughts independent of any other factor. In this case, she stopped taking the medications and then took them all at once at a time she knew she would not be discovered.

  • [Deleted User]Bles (deleted user)
    edited April 2020

    Thanks to all who have contributed so far. Please keep the posts coming.

    @pmvines for the instructive comprehensive textbook recommendations. Standard in the field.
    @PeopleLikeUs for the reminder of the priceless value human touch and thoughtful empathetic interpersonal relation
    @UKGuy for a poignant reminder of the reverse effects of antipsychotic medications on the chemical structure of the brain resulting suicide ideation.
    @geoff1000 for visually and pointedly reminding us to keep in touch with each other and be aware of what is normal baseline behavior for our loved ones.
    @WKCuddles for the encouragement and reminder of the importance of empathy and understanding regardless of how we may feel or what we may think.

    All very useful and interesting approaches. Including the standard evidence based ones used in the field.

    Thanks again. And keep posting your perspectives. For the benefit of all in this community. For we are never alone.

  • Friedrich Nietzsche wrote :
    "It is always consoling to think of suicide: in that way one gets through many a bad night"

    I think he was trying to say that the theoretical contemplation of it, may be OK for some people ; as I think @PeopleLikeUs said Kevin Brigg suggested, something one might do "tomorrow".

    My father often repeated the advice "Measure twice, cut once", recognising that cutting the material is an act that can rarely be undone. Suicide is the ultimate irreversible decision, and so deserves proportionate reasoning.

    The repeated analysis of whether it is a good idea, combined with people's natural procrastination, may be enough to put it off long enough for their circumstances to change.

  • Not a single person I know in real life even has a clue.

  • @BigGuyGa
    There are very few people who try to commit suicide, but fail, that we can ask what would have helped.

    There are also as many different situations as there are would-be suicides, that each one needs a different approach. Most people will never encounter the situation, so can't learn for next time.

    Still, if we can identify methods that might help a few percent, that is a big number.

    The trick is probably early intervention, before the person even gets that far. We cannot know how many times we and others have saved lives by something "ordinary" we have done ; like the hand-washing after a grocery store trip, that cut a Covid-19 transmission chain.

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