What makes someone vulnerable to suicide?
By having a conversation about suicide, listening without judging, offering support and encouraging people to get further help, you can make a difference to someone considering suicide. Suicidality is extremely complex. 3,318 Australian’s died by suicide in 2019. This is about nine Australians each day who die by suicide. (ABS, 2020)
Certain groups within our community are more vulnerable to suicide, including Aboriginal and Torres Strait Islander people, people living in remote or rural areas, veterans and emergency service workers, health care workers and people who identify as LGBTQIA+. Other circumstances may also contribute to a person’s overall level of risk.
Some factors increase risk of suicide, known as risk factors, or reduce risk of suicide, known as protective factors. It is important to look out for changes in someone’s behaviour, as those experiencing suicidal thinking may not always verbalise their thoughts or feelings.
As such, it is important to consider both verbal and nonverbal indicators.
Signs to look out for include:
How people may think….
• A sense of hopelessness – “There’s no future for me, I’m a failure”; “I just can’t do this anymore”
• Belief they are a burden to others – “They’re better off without me”
• Worthlessness – “I’m not needed anymore”; “I’m useless”
How people may feel…
• Guilty – “I’m a burden to others”
• Lonely and isolated – “No one understands me, no one cares”
• Afraid – “There’s no way out for me but to die”; “I don’t know what tomorrow holds in store”
How people may behave…
• Mood swings and irritability – “Leave me alone!”
• Engaging in risk taking behaviours out of character – “See, I’m not afraid to die”
• Talking about suicide – “If I died you wouldn’t miss me”
• Giving away possessions – “When I’m gone I want you to have this”
• Abuse of drugs and alcohol
• Self-harm such as cutting
There may be many different reasons that someone is considering suicide. They may want relief from overwhelming emotional pain and feel their situation is hopeless, they may feel worthless and believe that other people would be better off without them. They may also believe that suicide will provide a means to relieve unmanageable emotions and thoughts. However, regardless of the reason, we need to support them in every way we can and help them to consider other options.
How can I help someone at risk?
If you feel as if someone may be at risk, it is important to ask them questions to determine whether they are experiencing suicidal thinking. Be clear and direct when asking them questions to ensure unambiguity. You may feel uncomfortable starting the conversation. That’s normal. But talking is the best way you can be a good friend and support someone experiencing suicidal thoughts.
Remember, you don’t need to solve their problem or make them happy, you’re just helping them talk about what they’re going through and giving them some safe space to think, or simply to catch their breath – it is exhausting experiencing such strong emotions.
Examples of questions you could ask include:
• “A couple of things you have just said have concerned me. Can I ask whether you have had any thoughts about taking your own life?”
• “Have you been experiencing suicidal thoughts?”
• “Have you been having any thoughts of suicide?”
• Other people who have been through similar things to you have found themselves considering suicide as an option. Have you had suicidal thoughts?
Expressing care means showing them you understand. That’s empathy. Be careful not to express your feelings of being ‘sorry’ for them as it may increase their feelings of guilt. It is important to note that by asking the question, you are not making the person more likely to end their life. By asking the question you are demonstrating care and empathy for the person. You are letting them know that you are comfortable to have the conversation about suicide if they want to.
Many people with lived experience of suicidal thinking and/or crisis tells us that when someone actually asks directly about suicide, it is in fact a relief. They say it gives them permission to open up and talk knowing that the person is confident and comfortable to have the conversation with them It is also okay if your concerns about suicide are not right – even if they are not thinking about suicide, they may be experiencing other challenges that they need support managing. You will be in a position to have a conversation regardless.
When they are sharing their feelings with you, ensure you’re saying things to demonstrate you are really listening to what they’ve said, such as:
• “I can tell this is really tough for you”
• “It sounds like you’re feeling really low”
Resist the urge to interrupt or share your own opinions or try to fix the situation. Avoid judgment, arguments or offering solutions. Be careful not to minimise their problem. This is tough. Let them talk about it and listen openly.
Making a safety plan
If you think a person is considering suicide, ask them. If they are, you can help them develop a plan to stay safe. This is often referred to as a safety plan, and it may include:
• The practical steps to be taken to help the person regain a sense of control and ways to seek support.
This can include:
Names and phone numbers of people (try to have at least 5) they trust and can talk to.
Places to go that are safe for them
Techniques that they know are helpful to them to reduce the intensity of what they are feeling and thinking. (e.g. deep breathing or relaxation techniques, exercise or other activities)
A list of things that make life worth living to encourage hope and more positive emotion
Numbers for emergency services, helplines and health professionals to respond urgently if required
Reminders of how they have managed these intense emotions and thoughts in the past
If you think the person is at risk of self-harm, it is very important to stay with them until help arrives.