How You Can Help

 

How You Can Help an Individual or Yourself?
Know the Warning Signs and What to Do about Them

People who attempt suicide often send out warning signs before they actually make an attempt. These signs may be loud and clear, or low-key and subtle. Knowing how to recognize these signs is the first step in taking action that could save someone’s life.

Ten Warning Signs of Suicide

1. Preoccupation with death and dying
2. Drastic changes in behavior or personality
3. A recent severe loss (such as a relationship) or threat of a loss
4. Unexpected preparations for death such as making out a will
5. Giving away prized possessions
6. A previous suicide attempt
7. Uncharacteristic impulsiveness, recklessness, or risk-taking
8. Loss of interest in personal appearance
9. Increased use of alcohol or drugs
10. Sense of hopelessness about the future

What to Do if You Spot the Signs

Ask directly. Asking someone directly if they ever think of suicide lets them know that you take the situation seriously and want to help. It may be a real relief to someone to know that it's all right to talk about it openly.

Evaluate whether the danger is imminent. If someone admits thinking about suicide, follow through by asking questions that can help you determine how high the risk is that it will happen. Find out if he or she has thought about how and when to do it and if the means are available. If there's a plan for what to do and when and how to do it, the risk of suicide is very high. Consider the San Francisco Suicide Prevention crisis line's "PlaidPals" list of things to watch for:

Plan - Do they have one?
Lethality - Is it lethal? Can they die?
Availability - Do they have the means to carry it out?
Illness - Do they have a mental or physical illness?
Depression - Chronic or specific incident(s)?
Previous attempts - How many? How recent?
    Alone - Are they alone? Do they have a support system? Are they alone right now?
    Loss - Have they suffered a loss? Death, job, relationship, self-esteem?
    Substance abuse (or use) - Drugs, alcohol, medicine? Current? Chronic?

Get an agreement. If it seems likely that the person could act on thoughts of suicide, do not leave the person alone and try to get their verbal agreement to get help from a mental health professional. You can also call 911 for a mental health deputy or officer to transport a person if danger is imminent and/or take the person to the nearest hospital emergency room. Many local MHMRAs also have crisis mental health mobile outreach teams that may be available to provide help wherever you are.

Call for help. Get in touch with your local crisis line for resources and immediate help. Nationally, Call 1-800-273-TALK (8255) to be connected to the nearest crisis center or go to the Texas Department of State Health Services Web page at http://www.dshs.state.tx.us/mhservices/default.shtm to search by county to find the crisis center in your area or to the Texas Council of Community Mental Health Centers web site at http://www.txcouncil.com/crisis.html to find the crisis number for your area.

Save a Number / Save a Life.  Enter the Lifeline phone number in your cell phone - it's too hard to remember a phone number in a crisis: 1-800-273-TALK (8255).

Source:
San Francisco Suicide Prevention crisis line. http://www.sfsuicide.org
"Understanding and Helping the Suicidal Individual," American Association of Suicidology. http://www.suicidology.org

How You Can Help Your Community Prevent Suicides

Join a Group

Suicide is a preventable public health problem and many communities have organized groups to address the issue, such as the local coalitions of the Texas Suicide Prevention Council, chapters of the American Foundation for Suicide Prevention, affiliates of Mental Health America, National Alliance for Mental Illness, or Depression Bipolar Alliance.  Join one of these groups, if there is one in your area.

http://www.texassuicideprevention.org/volunteersection.asp

Start a Coalition or Add Suicide Prevention to an Existing Group

If your community does not have an organized group, you may want to start one, or add suicide prevention as a priority to an existing group. We have found that adding suicide prevention to already established mental health group, such as a local mental health task force, is often more successful than starting a new group.

The Texas Suicide Prevention Council has 15 local coalitions statewide and we can help you establish one in your area. Contact Merily Keller, hodgekeller@yahoo.com

For more information on taking action and best practices for your community, see Chapters 3 - 6 in "Coming Together to Care, A Suicide Prevention and Postvention Toolkit for Texas Communities," http://texassuicideprevention.org/docs_pdf/24215-Mental_Health_09_Suicide_Prev_Book_Complete_FINAL.pdf 

What You Can Do After a Death by Suicide to Help Prevent More Suicides

            Postvention becomes prevention when after each and every suicide people follow practical guidelines to prevent more death of vulnerable, at-risk youth.

The Grief Process

As with any sudden or unexpected death, those who have lost a loved one to death by suicide (often called survivors of suicide) have not had time to say goodbye. This suddenness, coupled with the violence of a death by suicide and common misunderstanding and stigma surrounding the death, can greatly intensify, complicate and extend the time of the grief process. It is important to remember and know that it may be normal for survivors to face guilt about being unable to save the life of their loved one and spend time asking "why" their love one took their own life before being able to move forward in the grief process. It is also important to know that survivors may be at increased risk of death by suicide themselves so that professional mental health support is readily available if needed. Anyone who believes or suspects that they are facing Complicated Grief and/or Post Traumatic Stress Disorder is encouraged to get professional mental health support. 

Postvention Goals for Family and Friends

1. Provide support for normal grief process and minimize complicated grief and guilt reactions
2. Reduce the risk of further suicidal behavior
3. Connect family and friends to health and mental health providers if needed and to community resources
4. Education and information about steps family and friends can take to help prevent suicide clusters and contagion in the immediate aftermath of a suicide in the way that they approach funerals and memorial services and long term in community suicide prevention and postvention activities

For more information on postvention for family and friends, see Part 3B in "Coming Together to Care, A Suicide Prevention and Postvention Toolkit for Texas Communities," http://texassuicideprevention.org/docs_pdf/24215-Mental_Health_09_Suicide_Prev_Book_Complete_FINAL.pdf 

Postvention in the Community

Due to the inherent vulnerability of many youth in response to suicidal behavior displayed by others, it is important that every school and community have a postvention response plan in place. Too many times a school has found itself caught in a wildfire of suicidal behavior resulting in preventable deaths, injuries due to attempts and lives that are forever altered. Prevention is the key, and incorporating suicide prevention programs is the first level of preventative measures. Once suicide behavior has occurred, postvention protocols should be implemented immediately to prevent imitative suicide behavior among at-risk youth and other individuals in the community.

Community Postvention Goals:

1. Reduce the risk of further suicidal behavior
2. Avoid glorifying or sensationalizing the suicide
3. Avoid vilifying the decedent
4. Identify youth who may represent a high risk for suicidal behavior
5. Connect at risk youth with mental health resources
6. Identify/alter environmental factors that may be influencing the process of contagion
7. Provide long term surveillance and analysis

For more information on what communities can do after a death by suicide, see Part 3 of  "Coming Together to Care, A Suicide Prevention and Postvention Toolkit for Texas Communities," http://texassuicideprevention.org/docs_pdf/24215-Mental_Health_09_Suicide_Prev_Book_Complete_FINAL.pdf 

Another resource for community postvention guidelines from the Centers for Disease Control:  www.cdc.gov/mmwR/preview/mmwrhtml/00001755.htm

Media Coverage Caution

Regarding media coverage of suicide death, Dr. Scott Poland warns, "Well documented in the research is the fact that teens are the most susceptible to suicide contagion and that media coverage - especially front page coverage - of a youth suicide, details of the method used, simplistic explanations of the cause of suicide, and printing photos of the suicide victim are key contributions to contagion. The literature also contains numerous references that one a community has experienced one youth suicide that the chances of a second occurrence increase greatly."

For more information on best practices for media coverage after a death by suicide, see Part 4D of  "Coming Together to Care, A Suicide Prevention and Postvention Toolkit for Texas Communities," http://texassuicideprevention.org/docs_pdf/24215-Mental_Health_09_Suicide_Prev_Book_Complete_FINAL.pdf 

Another resource from the American Foundation for Suicide Prevention and the American Association of Suicidology Annenberg Policy Center, "Reporting on Suicide Recommendations for the Media,"  http://www.sprc.org/library/media_guide.pdf