Preventing Suicide

If Brad’s suicide was prevented, then he would be in the photo of this post…probably standing behind me with his hand on my shoulder. And he would have ripped it up on the dance floor after our nuptials!

When I think of preventing suicide – the first thought that comes to mind is PREVENTION. Then the second thought is CRISIS.  When I recall my brother’s situation, I don’t think any of us were paying close enough attention to know what was happening (or wanted to accept what was happening) until we entered the crisis stage.

In October 2002, we had a get together with Brad and we tried to convince him to think differently.  Looking back and knowing what I know now, I would have asked questions instead of speaking. I took a Suicide First Aid course called, Applied Suicide Intervention Skills Training (ASIST), and it promoted a three step approach to helping someone with suicidal thoughts.

The first step was exploring invitations – noticing if their actions are calls for help.  What does a call for help look like?  According to my ASIST training, calls for help can be seen in action, thoughts, feelings, or physical changes. Someone contemplating suicide might give their belongings away, stop hanging out with people or doing the hobbies they used to love.  Or they could drink too much and get in a car and drive like my brother Brad, or another form of substance abuse with reckless behaviour. Self harm, impulsive behaviour, or just changes in their behaviour are also signs of help.  Someone thinking of suicide might say, “I just can’t take it anymore”; “I wish I were dead”; “People would be better off without me”; “All of my problems will end soon”; “No one can do anything to help me now”; “I won’t be needing these things anymore”; “I just can’t keep my thoughts straight”.  Brad expressed being called by God and he did try to take a spoon to his throat to hurt himself.   Near the end, Brad’s physical appearance – lack of hygiene, disrupted sleep, loss of appetite, body aches, and the look in his eyes that showed emptiness, sadness, and hopelessness were all signs that he was near the verge of his suicidal ideation. To prevent Brad’s suicide, I wish I would have listened to what he was saying instead of trying to change his mind.

The second step of of the ASIST training was to review the risk of suicide.  My understanding today, is that if someone is going to take their own life, their risk factors outweigh their protective factors…meaning the reasons why they want to die are greater than the reasons why they want to live.  Because I didn’t listen to Brad, I didn’t know the reasons why he wanted to die.  At the time, I didn’t know what questions to ask and I didn’t know what to say.  So I didn’t ask.   Hard conversations are scary.  Am I going to say the wrong thing. What if I do…is it going to make him kill himself?  I don’t believe talking about suicide will make someone attempt suicide.  In fact, I think talking about it and allowing them to express how they feel, does the opposite.  It’s like popping a zit!  It releases the pent up feelings caused by the irrational thoughts swirling in their head.   Yes, asking the following questions seems blunt, hard, and scary.  In my opinion though, if someone is thinking of killing themselves, the discomfort and awkwardness I feel when asking direct questions and listening to the responses, is a better option than the discomfort of the grief I felt after Brad died by suicide.  So what would I have asked him?

Are you having thoughts of suicide? 

  1. Plan: Do you have a plan?  How would you do it? Do you have the items to carry it out?  When do you plan on doing it?
  2. Pain: Do you have pain that at times feels unbearable?
  3. Resources: Do you feel like you have anyone or anything to support you?
  4. Previous Attempts: Have you ever attempted suicide before?
  5. Help: Are you receiving or have you received mental health care?

If he would have responded with YES to any of the previous questions, then it would have meant that he was feeling:

  • Suicidal
  • Prepared
  • Desperate
  • Alone
  • Familiar with Suicide
  • Vulnerable

So the next step would have been to develop a contract for safety.  

  • details to disable the suicide plan
  • details to ease his pain
  • specific phone numbers, addresses, and visits to resources within my family and the community (including emergency and health care workers)
  • methods to protect against the danger of previous suicide attempts/ highlight previous survival skills or protective factors.
  • connect him to a health worker in the community
  • follow through to ensure that all members of the plan fulfill their commitments.

Yes this is a lot of information. It’s scary to think … what if I made a mistake? Would I have caused him to carry out with his plan.  In my opinion, Brad was contemplating suicide and felt alone/shameful, was drowning in his past, and saw death as an option.  And he was thinking that in his head – alone. No one was talking honestly with him about what was in his head. If I had noticed one of his calls for help and CONNECTED with him – directly – like those above questions, then maybe he would have shared with me that he had the gun and was thinking of doing it on the Wednesday.  I would have been there with him in the storm….no matter what decision he ultimately made, he would not have been alone.

For more information about how to and how not to talk to someone, please read this pamphlet from Mental Health First Aid International.

Even if I didn’t feel comfortable doing any of the above, I could have called a community suicide line and asked them to help me so I could help my brother.  In my community, there is a 24/7 suicide help line, and there is a mobile crisis unit that would come to our house to help us help him. I could have sought out my own therapist.  I could have talked to my doctor or asked the hospital to tell me what to do!  But… I didn’t know these things.  I sure wish that asking someone about where to go to help someone with suicide was as easy as asking someone where to go to grab a good burger!    Really…they are both just as common …

More importantly, I sure wish we didn’t have to get to the crisis point.  I wish that PREVENTION was the primary approach as opposed to reaction. For instance, people take their car in for service in the spring and fall or when they hear sounds that are weird.  We don’t question servicing our vehicles.  And we don’t question going to our doctor when we have a cut that won’t heal or when our breathing sounds weird.  So why do we question getting help if our thoughts are sounding weird or if our spirit is broken and won’t get better. Yes, we can’t make people get help either.  And some people wait until the last minute.   But talking or trying to talk is at least something – which is better than nothing.

So what does prevention, rather than crisis response, look like to me? That’s a whole other post – several in fact.  I can’t wait to share my ideas with you…so stay tuned!

Lots of love,

Julie

 

Please note:
The information contained in this blog is provided as an information resource only and is not to be used or substituted for professional diagnosis and treatment. Please consult your health care provider or local hospital before making any decisions. Journey with Julie expressly disclaims responsibility, and shall have no liability, for any damages, loss, injury, or liability whatsoever suffered as a result of reading the information contained in this site.

 

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