Every day in Australia, eight adults die by suicide, six of which are male.
For every death by suicide, it is estimated that a further 30 people attempt to end their lives.
Every life lost to suicide can have devastating consequences for the families, friends and colleagues left behind.
While there have been positive advances in awareness of mental health and suicide in recent years, suicide remains a leading cause of death – and it is increasing.
We all have a part to play recognising the signs that those around us are not well.
We all have a responsibility to educate ourselves about how to have a conversation with someone we are concerned about.
Recognise the signs
- Have they had a significant life change recently? This could include: a relationship break-up, lost their job, death of a loved one, or a recent diagnosis for a serious health issue?
- Do they have a current mental health diagnosis?
- Has someone else in their life recently attempted or completed a suicide?
- Have they made direct or vague comments about wanting to die? This might sound like ‘I wish I wasn’t here’, ‘I’d like it to just end’, ‘I want this all to be over’, ‘I am such a burden’, ‘I want to go to sleep and never wake up’, ‘My family would be better off without me’.
- Are there any signs of recent self-harming?
- Have they previously tried to complete a suicide?
Prepare for the conversation
If you’ve noticed that someone doesn’t seem themselves and you’re worried, plan to have a conversation with them about it. Some things to consider before you speak to them:
- Are you in the right headspace to have a conversation with someone about this?
- Have you factored in enough time to have this conversation?
- Are you prepared that they may disclose that they aren’t doing well, and have you thought about how you might respond?
- Have you accepted that you cannot ‘fix’ someone and that it’s not your responsibility to become this person’s counsellor, or solve their problem?
- Are you going into the conversation with an open mind, and ready to listen to the person and understand their point of view?
- Do you have some resources and referral information (GP, EAP, Lifeline) that you can give to them?
- You don’t need to be an expert in mental health to have this conversation. Anyone can talk to someone they’re concerned about and get them help.
Please note, if you don’t feel able to talk to the person right now, confide in someone who also knows the person you’re worried about (a family member, close friend, the person’s manager) and tell them your concerns as they may be able to have the conversation now instead.
Talking about suicide
If you’re prepared to have the conversation, some phrasing suggestions to consider are below.
It’s important to ask directly about suicidal thoughts and what suicide plans the person has.
Talking about suicide won’t put the idea in their head but will encourage them to talk about their feelings in a safe environment.
- I’ve noticed you don’t seem yourself recently. I’ve noticed that [list the behaviour change you’ve seen] I’m a bit worried about you and just wanted to check in on you to see how you’re doing?
- Are you sure? Because you don’t seem yourself and honestly, I’m concerned about you. I’m here to listen and I won’t judge… how are you really doing?
- That sounds really difficult. How long have you been feeling like this for?
- Can you tell me more about how it’s been for you?
- Are you feeling so bad that you’re thinking about killing yourself?
- How much have you thought about this, do you have a plan in place already of how you would do this?
- It sounds like you’re having a really difficult time. Have you felt like this before? What helped you feel better then?
- Is there someone you think might be able to help? Did you know you can go to the GP and get up to 10 sessions with a psychologist? We could call and make the appointment together?
- I’ll check in again in a few days to see how you’re doing and how you got on seeing the GP.
Throughout the conversation, listen with an open mind and try not to disagree with them if they’re saying things you think are untrue.
Instead, empathise and clarify any points you’re unsure of to make sure you’ve understood what they’re saying.
Remember, you don’t need to solve their problem, you just need to give them to opportunity to open up and then support them in getting professional help.
The actions you may take to support the person may include some, or all, of the below:
1. Act immediately
Take warning signs seriously.
If you’re concerned that they’re thinking of harming themselves now or in the near future, call 000 or take the person to an emergency department of a hospital.
Also remove any means of suicide available, including alcohol and other drugs including medications, weapons, and even access to a car, if needed.
2. Acknowledge your reaction
You might panic initially or want to ignore the situation.
Don’t ignore the signs though, instead get support from others if needed.
3. Write a safety plan
This is a list of printed written steps for if/when the person is feeling low or suicidal again.
You, the person in need, and others close to the person, can make this safety plan together.
The instructions begin with healthy, self-soothing activities that usually make the person feel good.
This might include taking a bath, going for a walk, reading a book, having a massage, or even going to sleep.
This should not be an unhealthy coping mechanism (such as alcohol or drugs).
- Step 2 could be calling a nominated friend or family member who is involved in supporting the person and has agreed to be a contact on the safety plan
- Step 3 could be a list of 24/7 helplines to call if they’re feeling low
- Step 4 might include taking themselves to the emergency room or calling 000 for themselves (see below)
4. Facilitate professional support
Along with the help of another individual who the person trusts (their partner, parents, close friends or colleagues), facilitate getting the person professional support as soon as possible.
This could be from a GP, the EAP, a psychologist, school counsellor, or community mental health services.
There are usually face-to-face, phone and online options available, many of them 24/7/365.
You might suggest making the call together to book an appointment, or you may even offer to accompany them to see their GP.
Supporting the person to get professional help is an important step to getting them on track to becoming well again.
5. Ask for a promise.
Ask the person to promise that they will reach out and tell someone (one of the people on their safety plan) if suicidal thoughts return.
This will make it more likely they will seek help in the future.
6. Stay involved
Thoughts of suicide do not disappear easily.
The continued involvement of family and friends is very important to the person’s recovery.
Check in regularly to see how they are and remember to keep asking directly about thoughts of suicide.
7. Look after yourself
It is difficult and emotionally draining supporting someone who is suicidal.
Make sure you find someone to talk to so that you are supported as well.
Misconceptions about suicide
People who talk about suicide don’t do it
Reality: Talking about suicide can be an appeal for help. Most people usually communicate their intentions of suicide to another person, either directly or indirectly.
Once a person decides to complete suicide, there is nothing anyone can do.
Reality: The suicidal crisis can sometimes be a cry for help rather than a wish to die. Usually, part of the person wants to live, and part wants to die. With help, the person can be encouraged towards life.
Suicide happens without any warning/are spontaneous acts/people keep their plans to themselves.
Reality: Research suggests that the majority of people give warning of their intention to suicide beforehand. More often, this intention is not recognised by others, rather than hidden.
Talking openly about suicide increases the risk. It is important not to avoid asking about suicide.
Reality: Raising the issue sensitively and asking directly about suicidal thoughts gives the person permission to speak about their distress and shows that you care.
If someone asks me to keep their suicide thoughts/plans a secret, I must keep that promise.
Reality: Avoid secrecy pacts. If there is a chance the person may harm themselves, confidentiality cannot, and should not, be maintained. Instead, encourage the person to make a list of people they would be comfortable getting support from.
Call us at any time if you are worried about someone and would like support.