Understanding Suicide
Some things that drive people to think about suicide are:
- Personal catastrophes, such as being made redundant, the collapse of their own business, the break-up of a relationship or being refused access to children
- A persistent sense of worthlessness or failure; uncertainty about sexual identity or personal goals
- Good things happening to other people, such as friends getting married, going off to university or getting new jobs, and feeling left behind
- A combination of the above. A whole series of little setbacks can sometimes be more devastating than one big thing.
What we know
Someone may feel so low, or such emotional pain, that life seems unbearable. Or they may have suffered a loss or experienced life changing circumstances such as a relationship breakdown, loss of a job or be experiencing financial problems, that makes them feel that ending their life is the best solution. Experiencing something that overwhelms a person’s coping resources and safety such as abuse, assault, addiction, bullying can also lead someone to think about suicide. Someone thinking of suicide may have experienced personally meaningful stressors, sometimes over a prolonged period, and will often also be isolated in some or many ways.
Many people think about suicide at some point in their lifetime – research has found around one in five people think about suicide at some point in their life.
We know that some groups are more at risk of dying by suicide than others.
• Recovery is possible
• There are steps we can take to support someone to stay safe.
• With the right support they can start to feel more hopeful and in control of their life.
Worried about someone?
Talking about suicide
The safest way to support someone you are worried about is to ask them how they are feeling and to ask directly about suicide.
Ask in a non-judgemental and respectful way and use open-ended positively phrased questions. Don’t deny what they’re telling you, and don’t pretend you know how they feel. Try to keep the dialogue open by asking questions like, “How has that impacted you?” or “What’s that like?”
Ask about suicide with a direct question, with a yes or no answer. It can be as simple as asking clearly and neutrally, “Are you having thoughts of suicide?”
Sometimes, a more sensitive introduction supports the person to share their thoughts and experiences. For example, “It sounds like things have been quite difficult recently.” When in such challenging situations, many people will experience thoughts of ending their life. “Can you tell me, is this something you’re experiencing?”
Don’t be too quick to accept denials or joking responses.
Common fears
This is not the case. If a person is thinking of suicide, the idea is already there. If they aren’t suicidal, it won’t do any harm. Asking them about it provides a clear message that they are allowed to talk about it and evidence suggests that a person experiencing a compassionate response to sharing their thoughts can provide relief and hope in suicidal crisis. Asking about suicide is the first thing to do to reduce the likelihood of someone dying by suicide.
“What if I say the wrong thing? Could talking about suicide damage my relationship with the person?”
This is a misconception. Showing a person you care about them, and their wellbeing won’t damage your relationship. Asking and showing you care, could save their life.
Responding
Focus on listening to them in order to understand and validating their experience and show them that they aren’t alone with it. This might look like, validating and showing acceptance by repeating their experience back to them; and using phrases such as:
1. “You are not alone.”
2. “You are important, and I care about you and your safety.”
3. “I can’t imagine how painful this is for you, but I would like to try and understand.”
4. “That must have been difficult.”
Try to understand a bit more of how they are feeling and any actions they have taken, this will inform your next steps:
• How long they’ve been feeling this way?
• Whether how they feel fluctuates in intensity?
• Have they thought about ways to end their life?
• Have they made a plan to end their life?
• Is there a specific date or time they are planning to?
If they are in immediate danger, call for support and stay with them.
Seek to understand with them their current experience. Ask them about their reasons for dying, and their reasons for living/ or simply what matters to them and listen to the answers. This can support hope and self-efficacy.
Talk through steps they can take to stay safe, known as making a ‘Safety Plan’.
Support them to plan to access help (e.g. (additional) support from their doctor or named health professional, support from their family and social network, support from a charity or local group). This will involve talking with them about what form of support they would feel comfortable with accessing, any barriers they are facing and what help or support they need to seek this help. Clarify next steps for both them and you.
Get support for yourself. If the person is a patient, speak the situation through with your supervisor or team lead, as another perspective will help you to provide the best care for them. Supporting someone thinking of suicide or in suicidal crisis can give rise to a range of emotions, some of which are difficult to cope with and may impact on your wellbeing, particularly when under pressure or facing additional stressors. If you feel comfortable, speak these experiences through with your supervisor, a colleague, or in peer supervision.
Alternatively, there are services which offer confidential support to those providing care to people experiencing suicidal thoughts or crisis.
I can’t imagine how painful this is for you, but I would like to try and understand.
Possible warning signs
• Changes in behaviour (loss of interest/withdrawal, giving away possessions, getting affairs in order, seeking out means, engaging in risky behaviour)
• Physical indicators (changes in appetite, lack of interest in appearance),
• Expressing thoughts or feelings (Hopeless, sad, guilty, worthless)
• Words/language being used (“I can’t take it anymore”, “Everyone would be better off without me”)
• Perception of lack of social support (living alone, experiencing domestic abuse)
• Accessing suicide promoting websites or social media
But they might also appear to be doing well, or appear to have ‘recovered’.
It is important to remember:
They MAY be:
- Quiet
- Brooding
- Withdrawn or distant
- Not making eye contact
- Agitated
- Irritable or rude
- Drinking a lot
- Talking about suicide or saying it’s all hopeless
They may ALSO be:
- Busy
- Chirpy
- Living life as normal
- Going to work
- Laughing and joking
- Talking about future plans
- Telling you not to worry about them
Compassionate Language
It can be hard to know how to talk about suicide. Commonly used phrases such as ‘committed suicide’ contribute to stigma around suicide and can further alienate those affected. Suicide is a pressing public health issue, and we can all play a part in breaking down the stigma. It is also a devastating personal experience, and we can all ensure we speak respectfully and compassionately about the issue.
Below we have provided guidance on using factual, judgement free language that is sensitive and considered.
Language examples
Use: ‘Died by suicide’ or ‘Lost their life to suicide’
Instead of using terms like ‘Unsuccessful suicide’ or ‘Failed suicide attempt’
Use: ‘Attempt suicide’ or ‘Attempt to take their life’
Training
There are several different courses available which support staff to build their awareness and understanding, and to develop skills and confidence in responding to those considering suicide. These are offered at three levels. Most local training is free. Some training qualifies individuals to become an Orange Button holder in Somerset.
The Orange Button scheme exists to raise awareness of suicide in Somerset, break down the stigma around suicide, and identify members of our communities who are trained to listen to and support anyone experiencing thoughts of suicide. The Orange Button signifies that the person displaying it is:
- OK to say/hear the word suicide
- Can listen without judgement
- Can support people with signposting
Suicide can affect anybody and there isn’t a community in Somerset where people haven’t been touched by suicide.
If you would like to become an Orange Button holder, you will need to have completed at least three hours of quality assured mental health or suicide prevention training. This is to ensure you are equipped with the skills to listen and signpost people.
The Orange Button Scheme is linked to (but not limited to) many funded training courses through Somerset Public Health.
If you are interested in finding out more about the Orange Button scheme, or the free public health funded mental health or suicide prevention training courses, please have a look at Orange Button – Community awareness scheme – Healthy Somerset.
Safety Planning
What is a safety plan?
A safety plan is a concise plan that someone makes on their own or with help from someone they trust and find supportive, for keeping themselves safe when they experience distress and thoughts of self-harm or suicide. The plan includes personalised reminders, actions and strategies that will help the person navigate through to feeling safer and more comfortable. It will include steps the person can take to make their environment safer. It will also include the names of family and friends the person can reach out to, and contacts in professional and voluntary services. It is beneficial to encourage safety plans to be shared with others such as family or friends or carers.
Why is safety planning important?
A growing evidence base supports the use of safety planning to mitigate future suicidal behaviour and support treatment engagement (Ferguson et al., 2021; Nuij et al., 2021; Stanley et al., 2018). Safety planning takes a compassionate and recovery-oriented approach.
Practical support with safety planning
You can find brief guidance on how to safety plan with someone, and download a template, at stayingsafe.net.
The Stay Alive App is a really useful safety planning tool. It has space to upload meaningful images and reminders, strategies for keeping safe and feeling comfortable and services to contact for support.
Have you been affected by suicide?
Every one of us will have our own experience, either directly or indirectly, of suicide. It is a public health crisis that affects thousands of people across the UK. Each of us will personally know of someone who has died by suicide, know someone who has been affected by suicide, or both.
Mind in Somerset have developed a webpage and an Early Response Information Pack to provide information & support for living after a suicide.
Somerset Suicide Bereavement Support service
Somerset Suicide Bereavement Support service supports anyone that is bereaved by suicide, at any time during the bereavement.
All support is free.
- Support options include:
- 24/7 Helpline 0300 330 5463
- Specialist support worker sessions – For up to 3 months
- Specialist counselling provision sessions – Up to 12 sessions
- Bereavement Buddies – Trained volunteers who have lived experienced of suicide loss offering listening support.
- Practical information and support around issues such as the Inquest and funeral.
- Monthly peer support groups held in 4 locations (Taunton, Bridgwater, Street, and Yeovil) across Somerset.
More Support
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Mindline
Mindline is open 24/7. It is a confidential listening service which provides a safe place to talk if you, or someone you know, is in distress. Phone: 01823 276 892 or 0800 138 1692.
Survivors of Bereavement by Suicide
Support Line, 0300 111 5065 (Monday and Tuesday 9am – 5pm)
Mind
Provides information on bereavement, where to go for support, and suggestions for helping yourself and others through grief.
Support After Suicide
Developed with the help of both individuals with experience of being bereaved by suicide, contains practical information and find emotional support if you have been impacted by suicide.
Winston’s Wish
Provide specialist suicide bereavement support for children, young people and families following a death by suicide.
Gambling with Lives
Specific to those bereaved by gambling-related suicide. Provides support, raises awareness of gambling disorder’s devastating effects and campaigns for change.