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Suicide Prevention: When There’s Help, There’s Hope

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Every 10th of September, we celebrate World Suicide Prevention Day to highlight the fact that suicide is a global issue that needs to be addressed. On this day, we emphasize the idea that those at risk of suicide are not a lost cause. When there’s help, there’s hope. At the end of the day, it is human beings who can prevent the suicide of another human being, and it all starts with awareness of how to help them.

For the years 2024 to 2026, the International Association for Suicide Prevention (IASP) has announced that the theme of World Suicide Prevention Day is about changing the conversation surrounding suicide. What does this mean?

The call to action encourages everyone to start the conversation on suicide and suicide prevention. Every conversation, no matter how small, contributes to a supportive and understanding society. By initiating these vital conversations, we can break down barriers, raise awareness, and create better cultures of support.
Pan American Health Organization

So how do we initiate a conversation about suicide prevention? In the previous article on the theory and warning signs of suicide, the three-step theory of suicide, also known as the ideation-to-action framework, was discussed, as well as the IS PATH WARM mnemonic that represents the indicators of suicide. In this article, we move on to opening up the floor to the discussion of suicide prevention.

There are many models of suicide prevention available, but the five action steps for communicating with individuals with suicidal intent are noteworthy because it is supported by evidence in suicide research. As the name implies, there are five steps to suicide prevention, as follows:

  • Ask.
  • Be there.
  • Help keep them safe.
  • Help them connect.
  • Follow up.

In the next few sections, these five action steps will be discussed.

Asking about suicide can be nerve-wracking, but it is important to initiate a dialogue with the person who is exhibiting suicidal behavior so that they have the time and space to express their thoughts, feelings, and intentions.

Another way of looking at this step is that it is an informal form of assessment. In assessment, there are a few basic principles to take note of.

Asking about suicide

The following are some guidelines that lay the groundwork for suicide assessment:

First of all, when asking about suicide, your questions and statements should be clear, unambiguous, direct, and nonjudgmental. It is crucial that there is no room for interpretation in your assessment; otherwise, their responses will be open to interpretation as well.

It has long been a belief that bringing up the topic of suicide might result in the person taking their own life. This is probably why some people are afraid to start this conversation with a person at risk of attempting suicide. However, it is not really the case that they will be driven to attempt suicide. When we ask the person about whether they want to end their life, we are allowing them to communicate the distress behind their possible suicidal intentions. For many people, being given this space to talk about their feelings more often than not goes a long way.

It has long been a belief that bringing up the topic of suicide might result in the person taking their own life. This is probably why some people are afraid to start this conversation with a person at risk of attempting. However, it is not really the case that they will be driven to attempt suicide. When we ask the person about whether they want to end their life, we are allowing them to communicate the distress behind their possible suicidal intentions. For many people, being given this space to talk about their feelings more often than not goes a long way.

Unfortunately, it is not an automatic outcome that a person who is willing to talk about suicide will not attempt to take their own life. Thus, it is imperative that we ask, or assess, their intentions so that we know exactly how to reduce the risk of them attempting suicide.

In suicide assessment, there is more or less a step-by-step procedure on how to go about it. Simply ask the following:

  • Suicidal ideation: Have you thought about taking your own life?
  • Suicidal intent: Have you formulated a plan to end your life? How do you plan to go about it?
  • Access to means: Do you have any access to the methods you plan to use for your suicide attempt? If yes, what are they, and where are they?
  • Stressful events and coping: Have you been experiencing anything especially stressful lately? How have you been coping?
If we find a high risk of lethality, then we have a direct admission to save the individual’s life.
D. Williams

The following are some things to take note of when asking about suicidal intent:

listening in suicide prevention
  • Don’t forget to listen when they answer your questions.
  • Take their answers seriously.
  • Help the person zero in on their reasons for living, not your reasons for them to continue living.

What does being there look like? Being there could entail any of the following:

  • Being physically present for them
  • Speaking with them on the phone or chatting with them
  • Following through with your word on how you plan to support them
providing support for suicide prevention

Recall that in the three-step theory of suicide, connectedness was deemed a protective factor among individuals at risk of suicide. This is because connectedness mitigates the feelings of pain and hopelessness.

With that said, fostering an at-risk individual’s connectedness to others or to some things can reduce their feelings of isolation, which in turn, can prevent suicide. Thus, being there can somehow satisfy the person’s need for belonging and affiliation.

In this step of suicide prevention, you can intervene once suicidal ideation has been established. In suicide intervention, there are some things that you need to know first to make sure that they are safe. The following are some considerations:

  • Have they already tried to hurt themselves before talking to you?
  • Do they have access to their planned method?
  • What is the time frame of their plan?

Take note that the answers to these questions are critical in determining your next steps. If their risk is considered high and severe, then you might need to urge them to call for emergency help or go to the hospital, or you might even offer to drive them to the emergency department. You will know that hospitalization is warranted if they meet the following criteria:

  • They have a suicide plan.
  • They have a means of carrying out the plan.
  • They are exhibiting a poor ability to control their actions.
  • Their judgment seems impaired.
  • They lack social support.

An important principle of suicide prevention is to transfer and not refer. In other words, when connecting them to more skilled, experienced mental health providers or crisis hotlines, you will have to keep them company while waiting for the referral contact to get back to the person in crisis. There are a number of things you can do while waiting for them to connect to a mental health professional. One of them is to collaborate with them to develop a safety plan.

calling for professional help in preventing suicide

In suicide intervention, working with the person who is at risk of suicide to create their own safety plan is highly encouraged. But what is a safety plan? A safety plan is a written document that the individual can refer to whenever they are in crisis. This safety plan serves as their go-to guide for what to do and what not to do when they are suffering from severe distress.

The following are the components of a crisis response and safety plan:

  • Warning signs: How do they know that they are in crisis?
  • Self-regulating activities: What can they do to soothe their emotions and thoughts?
  • Distractions: Who are those people who can provide a distraction? Where can they go to distract themselves?
  • Loved ones: Who comprise their support network? Whom can they talk to about their feelings and problems?
  • Mental health services: Whom should they contact for professional help when they are in crisis?
  • Reducing access to lethal means: What can they do to prevent themselves from utilizing lethal means to end their life? What objects should they avoid or remove from their environment?
  • Reasons for living: What are their reasons for living? What do they look forward to in their life, and who or what are good motivations for them to stick around?

Last but not least, once you have connected the individual to the proper support systems, make sure to check up on them to see how they have been doing since your last conversation. A simple message, text, or call will do. Following up serves as an opportunity for you to provide them with more emotional support.

Continued availability of support can increase the individual’s sense of connectedness. It reminds them that your concern for them did not exist in isolation; by following up, you can reduce their suicidal intentions because this cultivates the perception that they are not alone.

The steps we can take to completely eradicate the incidence of suicide may not take effect overnight. Maybe it is the case that absolute suicide prevention can only be accomplished through systemic changes. However, your help, effort, and support to minimize the risk of suicide among individuals still matter. It is the small acts of kindness that buid up and culminate into a world where suffering is alleviated and where distress is addressed and not ignored. To celebrate World Suicide Prevention Day, don’t just remember these five steps of suicide prevention; embrace it, live it, and take action as well.

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