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A sticky with information about suicide, prevention, lots of crisis lines for BC (Canada) residents, and other resources.


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Table of Contents:

- Post 1: Introduction <--- You are here.
- Post 2: Suicide article [copied over from previous sticky]
- Post 3: How to Cope/Deal With Someone Who is Suicidal [copied over from previous sticky]
- Post 4: BC Crisis Lines [2 seperate pamphlets]
- Post 5: Suicide Thoughts [pamphlet]
- Post 6: Are You Concerned About Someone Who is Suicidal? [pamphlet]
- Post 7: Living With Someone Who Is Suicidal [pamphlet]
- Post 8: Reserved
- Post 9: Reserved

How To Deal/Cope With Someone Who Is Suicidal


Taken from: http://www.onyourmind.net/qanda/suicide/whatisthebestwayto.htm

A: Talk openly with that person. Ask them what they are feeling. Support and validate the pain they are experiencing while talking about ways to get help. Get help from a counselor, teacher, or crisis line (1-800-SUICIDE).

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Taken from: http://www.counsel.ufl.edu/selfHelp/suicidalCrisis.asp

It?s 3:00 in the morning and you have just fallen asleep after studying for your exam. The telephone rings and your best friend is on the other end. Words that you never thought you?d hear come piercing across the line?"I just can?t do it anymore! The pain is too much to continue living?I know that I have got to end it ? I must kill myself!" You instantly feel the adrenaline surge through your body. With trembling hands and sharpened senses, the question looms through your mind: "What do I say?what should I do!"

A suicidal crisis is very difficult to deal with. It is usually unanticipated and requires the helper to mobilize a variety of skills and resources. Following is a list of suggestions should you face the challenge of preventing a suicide attempt.

1) Encourage the person to discuss what prompted "death" thoughts. The more the person is able to talk about the specific details of the experience, the better he or she is able to understand the source of the crisis. Once a source is delineated, a course of action and intervention can be developed.

2) Elicit the person?s feelings. Expressing emotions is a way for the person to vent frustrations while securing validation and support. Common probes and statements include; "how did you feel when that happened" or "I would have felt hurt if that happened to me".

3) Use the term "suicide", "kill yourself", and "suicidal plan" when talking about the threat. Oftentimes, people contemplating suicide envision the process from a distorted perspective. It may be even seen as a ?romanticized? escape?.a solution without notable consequences. Using these terms can bring the person into a sharper reality focus while enabling the helper to determine if a plan is in place. If the person has a reasonable plan to carry out the threat to end his or her life, the cry for help is more serious and warrants careful attention.

4) Assist the person in defining alternatives and options. Those who are contemplating death do not see life as having positive alternative solutions. Highlighting the fact that death is a permanent solution to a temporary problem can impart hope. Alternative solutions are available. With assistance, the person in crisis can have the option to select the best solution for the situation.

5) Involve professional resources as needed. Trained professionals can assist the person in crisis to deal more effectively with the problem and work to instill hope again. The challenge may be cultivating a sense of trust to include an outside person. In many cases, the suicidal person wants the helper to maintain confidentiality. It is important to emphasize that he or she came to you because of trust and confidence that you care to do the right thing. Encourage the person in crisis to value your decision to involve a professional counselor if needed.

6) Talk with someone after the crisis is over. Taking the time to share what it was like to be in the stressful situation is important. Venting your feelings and decision processes is crucial to re-stabilizing after your adrenaline surge. In addition, you may find yourself feeling ?guilty? or ?inadequate? for securing outside help. Remember that by bringing other helpers into the situation your intention was not to betray a confidence, but to save a life.

7) Realize the limitations of your responsibility. There are a number of ways to offer assistance in a crisis. Some include connecting the suicidal person with a crisis line counselor, accompanying the person to a counseling center, making an appointment with a psychologist, notifying his or her parents, or calling the police. If you have taken substantial measures to prevent someone from committing suicide and the suicidal person refuses help options, there may be nothing more that can be done. Anyone who is determined to end his or her life will find a way. Your responsibility as a friend or associate is to assist, support, and possibly refer. Once you have care enough to incorporate all resources humanly possible, your responsibility as a fellow human being ends.

If you currently know of someone dealing with suicidal thoughts, you are encouraged to consult with a professional counselor in your geographical area. Students at the University of Florida should contact the University Counseling Center. See the introductory web page for how to initiate services at the Center.

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Taken from: http://www.metanoia.org/suicide/whattodo.htm

1) Take it seriously.
Myth: ?The people who talk about it don't do it.?
Studies have found that more than 75% of all completed suicides did things in the few weeks or months prior to their deaths to indicate to others that they were in deep despair. Anyone expressing suicidal feelings needs immediate attention.

Myth: "Anyone who tries to kill himself has got to be crazy."
Perhaps 10% of all suicidal people are psychotic or have delusional beliefs about reality. Most suicidal people suffer from the recognized mental illness of depression; but many depressed people adequately manage their daily affairs. The absence of "craziness" does not mean the absence of suicide risk.

Myth: ?Those problems weren't enough to commit suicide over,? is often said by people who knew a completed suicide. You cannot assume that because you feel something is not worth being suicidal about, that the person you are with feels the same way. It is not how bad the problem is, but how badly it's hurting the person who has it.


2) Remember: suicidal behavior is a cry for help.
Myth: ?If a someone is going to kill himself, nothing can stop him.?
The fact that a person is still alive is sufficient proof that part of him wants to remain alive. The suicidal person is ambivalent - part of him wants to live and part of him wants not so much death as he wants the pain to end. It is the part that wants to live that tells another ?I feel suicidal.? If a suicidal person turns to you it is likely that he believes that you are more caring, more informed about coping with misfortune, and more willing to protect his confidentiality. No matter how negative the manner and content of his talk, he is doing a positive thing and has a positive view of you.


3) Be willing to give and get help sooner rather than later.
Suicide prevention is not a last minute activity. All textbooks on depression say it should be reached as soon as possible. Unfortunately, suicidal people are afraid that trying to get help may bring them more pain: being told they are stupid, foolish, sinful, or manipulative; rejection; punishment; suspension from school or job; written records of their condition; or involuntary commitment. You need to do everything you can to reduce pain, rather than increase or prolong it. Constructively involving yourself on the side of life as early as possible will reduce the risk of suicide.


4) Listen.
Give the person every opportunity to unburden his troubles and ventilate his feelings. You don't need to say much and there are no magic words. If you are concerned, your voice and manner will show it. Give him relief from being alone with his pain; let him know you are glad he turned to you. Patience, sympathy, acceptance. Avoid arguments and advice giving.


5) ASK: ?Are you having thoughts of suicide??
Myth: ?Talking about it may give someone the idea.?
People already have the idea; suicide is constantly in the news media. If you ask a despairing person this question you are doing a good thing for them: you are showing him that you care about him, that you take him seriously, and that you are willing to let him share his pain with you. You are giving him further opportunity to discharge pent up and painful feelings. If the person is having thoughts of suicide, find out how far along his ideation has progressed.


6) If the person is acutely suicidal, do not leave him alone.
If the means are present, try to get rid of them. Detoxify the home.


7) Urge professional help.
Persistence and patience may be needed to seek, engage and continue with as many options as possible. In any referral situation, let the person know you care and want to maintain contact.


8 ) No secrets.
It is the part of the person that is afraid of more pain that says ?Don't tell anyone.? It is the part that wants to stay alive that tells you about it. Respond to that part of the person and persistently seek out a mature and compassionate person with whom you can review the situation. (You can get outside help and still protect the person from pain causing breaches of privacy.) Do not try to go it alone. Get help for the person and for yourself. Distributing the anxieties and responsibilities of suicide prevention makes it easier and much more effective.


9) From crisis to recovery.
Most people have suicidal thoughts or feelings at some point in their lives; yet less than 2% of all deaths are suicides. Nearly all suicidal people suffer from conditions that will pass with time or with the assistance of a recovery program. There are hundreds of modest steps we can take to improve our response to the suicidal and to make it easier for them to seek help. Taking these modest steps can save many lives and reduce a great deal of human suffering.


WARNING SIGNS

Conditions associated with increased risk of suicide

- Death or terminal illness of relative or friend.

- Divorce, separation, broken relationship, stress on family.

- Loss of health (real or imaginary).

- Loss of job, home, money, status, self-esteem, personal security.

- Alcohol or drug abuse.

- Depression. In the young depression may be masked by hyperactivity or acting out behavior. In the elderly it may be incorrectly attributed to the natural effects of aging. Depression that seems to quickly disappear for no apparent reason is cause for concern. The early stages of recovery from depression can be a high risk period. Recent studies have associated anxiety disorders with increased risk for attempted suicide.

- Emotional and behavioral changes associated with suicide

- Overwhelming Pain: pain that threatens to exceed the person's pain coping capacities. Suicidal feelings are often the result of longstanding problems that have been exacerbated by recent precipitating events. The precipitating factors may be new pain or the loss of pain coping resources.

- Hopelessness: the feeling that the pain will continue or get worse; things will never get better.

- Powerlessness: the feeling that one's resources for reducing pain are exhausted.

- Feelings of worthlessness, shame, guilt, self-hatred, "no one cares". Fears of losing control, harming self or others.

- Personality becomes sad, withdrawn, tired, apathetic, anxious, irritable, or prone to angry outbursts.

- Declining performance in school, work, or other activities. (Occasionally the reverse: someone who volunteers for extra duties because they need to fill up their time.)

- Social isolation; or association with a group that has different moral standards than those of the family.

- Declining interest in sex, friends, or activities previously enjoyed.

- Neglect of personal welfare, deteriorating physical appearance.

- Alterations in either direction in sleeping or eating habits.

- (Particularly in the elderly) Self-starvation, dietary mismanagement, disobeying medical instructions.

- Difficult times: holidays, anniversaries, and the first week after discharge from a hospital; just before and after diagnosis of a major illness; just before and during disciplinary proceedings. Undocumented status adds to the stress of a crisis.


Suicidal Behavior

- Previous suicide attempts, "mini-attempts".

- Explicit statements of suicidal ideation or feelings.

- Development of suicidal plan, acquiring the means, ?rehearsal? behavior, setting a time for the attempt.

- Self-inflicted injuries, such as cuts, burns, or head banging.

- Reckless behavior. (Besides suicide, other leading causes of death among young people in New York City are homicide, accidents, drug overdose, and AIDS.)Unexplained accidents among children and the elderly.

- Making out a will or giving away favorite possessions.

- Inappropriately saying goodbye.

- Verbal behavior that is ambiguous or indirect: "I'm going away on a real long trip.", "You won't have to worry about me anymore.", "I want to go to sleep and never wake up.", "I'm so depressed, I just can't go on.", "Does God punish suicides?", "Voices are telling me to do bad things.", requests for euthanasia information, inappropriate joking, stories or essays on morbid themes.


A WARNING ABOUT WARNING SIGNS
The majority of the population at any one time does not have many of the warning signs and has a lower suicide risk rate. But a lower rate in a larger population is still a lot of people - and many completed suicides had only a few of the conditions listed above. In a one person to another person situation, all indications of suicidality need to be taken seriously.

Crisis intervention hotlines that accept calls from the suicidal, or anyone who wishes to discuss a problem, are (in New York City) The Samaritans at 212-673-3000 and Helpline at 212-532-2400.

Suicide Thoughts [pamphlet]


Everyone feels down at times. People can get overwhelmed by work or studies. They may have money worries. Relationships may end. A friend of family member may become ill or die.


It's Normal to Have Feelings

When difficult things happen, people may feel sad, anxious, angry, hopeless or frustrated. After a few days or weeks, most people begin to have moments when they feel ok again. After awhile, the times of feeling OK last longer than the times of feeling bad.

Thoughts about suicide are not a normal response to stress. If someone thinks about suicide a few times a week or almost every day, it's a sign of a serious health problem. Most people don't respond to stress or troubles in this way.

Thoughts about suicide are important signals. You wouldn't ignore having a high fever or severe stomach pain. People who have thoughts of suicide are getting an important message. Their bodies and brains are telling them that something needs to change.


What Causes Suicidal Thoughts?

People may think about suicide because:

- They're feeling great pain.
- They're having trouble finding solutions for their problems.
- They may feel they don't deserve the time or effort it would take to get help.

Suicide is not the answer. These things can be changed.


Suicidal Feelings Don't Last Forever

Thoughts of suicide are often due to several factors.

- People may have personal troubles.
- They may have physical or mental health problems.
- They may not be able to turn to others for help.

When these things happen at once, it can cause a crisis.

This is why health professionals take suicide thoughts seriously. When people who are thinking about suicide get treatment, and are prevented from harming themselves, things can change.


What Can You Do?

If you are having suicidal thoughts:

- Take it seriously. Treat it as you would severe physical symptoms.

- Don't try to "go it alone." It can be hard to tell these thoughts and feelings to others and ask for help. But it's very important to do so.

- Talk to a professional who can help:
-- A counsellor, therapist or campus counselling services.
-- A doctor or other health care provider.

- Talk to others who can offer support:
-- Parents or other family members.
-- Friends.
-- A teacher.

Choose people who trust, who don't judge you and will urge you to get appropriate care.

- Talk to clergy if you are religious or spiritual.

- Avoid alcohol or other drugs. They increase the risk you will harm yourself.




If a friend talks about suicide:

- Listen closely and without judgement. Remain clam. Treat the takl seriuosly. Show by your tone and manner that you are concerned.

- Acknowledge the pain and confusion your friend feels.

- Urge your friend to seek professional help. Offer to go along to a crisis centre or counselling appointment.

- If the person is in danger, don't leave him or her alone. Remove weapons (especially guns), or other means of self-harm. Call 9-1-1. Get someone else to help you.

- Tell a professional about the situation, even if it means breaking a confidence.

- Get support and take care of yourself. Talk to a counsellor, your friends, your parents, a crisis line, or others you trust.

When people who are thinking about suicide get treatment, things can change.


Does Treatment Really Help?

Yes! Treatment can:

- Protect the person from harm during the crisis.
- Provide support for strong emotions.
- Teach new ways to think so life events won't feel so overwhelming.
- Build skills for solving problems, resolving conflict, copying with stress and connecting with others.
- Build confidence and self-esteem.

When appropriate, medications can treat anxiety, depression, panic attacks, bipolar disorder or other conditions.




"I'm Not Thinking About Suicide, Exactly..."

Some people think about harming themselves, but not so seriously that they would die. They may wonder what would happen if they died. They might imagine killing themselves, even thought they don't really want to.

These thoughts can keep coming back. They may pop up unwanted and can be distressing. They can interfere with school, work, or relationships.

These thoughts can also be treated successfully. See a counsellor.


Have Hope

People who have had suicidal thoughts and gotten through the crisis give these reasons to be hopeful:

- It doesn't last forever.
- Treatment helps.
- Life can be better again.


[Nikolita Note: I've also been in this position, many years ago. If you've had suicidal thoughts or if you're considering suicide, please feel welcome to send off a PM my way and I'd be happy to talk to you. While it only lasted a few weeks for me during the year I spent depressed, I still remember those feelings and would be happy to discuss them with you.]


To Learn More

National Institute of Mental Health [American]

National Mental Health Association [American]


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The information in this pamphlet belongs to ETR Associates. I do not claim to own any of this information, nor am I trying to profit from it.

Living With Someone Who Is Suicidal [pamphlet]


Suicide Facts

You are not alone. While suicide may not have the same visibility as AIDS or cancer, you probably have a friend or relative who has lost someone to suicide.

- Suicide crosses all cultural, economic and social boundaries. Many people who die by suicide appeared to be functioning well prior to their death. It can happen to anyone.

- It is estimated that approximately 3 million Canadians are personally affected each year by the suicide death or suicide attempt of family, a friend, classmate, co-worker, patient, client, teacher or coach.

- Suicide is the second leading cause of death for youth and young adults age 15 – 24 years. Suicide is one of the leading causes of death for adults from ages 25 – 49, the primary parenting years. The rate for men over 65 is also high.

- Suicide consistently ranks among the major causes of “potential years of life lost” for both genders combined.

- Many suicidal people are struggling with a treatable mental health condition, with depression being the most common.

- Most people think about suicide at some point in their lives.


Why Do People Attempt Suicide?

When people are in a suicidal crisis, their view of the world is often distorted. They feel that they can no longer cope with the emotional pain they feel, and that suicide is the only way out.

Suicidal people often report feeling helpless, hopeless and worthless; unable to feel the love, support and acceptance of friends and relatives; unable to share their pain with those who care and those who can help.

Suicidal people frequently perceive life as a never-ending downward spiral. There may be a trigger incident prior to the attempt, such as a loss. Even if externally they seem to be doing well, internally they often feel unable to live up to their expectations of themselves, and what they feel others expect from them.


Is There Anything We Can Do?

Yes! The more we can do to develop networks of caring and support for the suicidal person and ourselves, the more likely the right help will be in place when the suicidal person has the courage to reach out.

Our direct actions may not appear to make a difference at first, but we don’t need to back away completely, nor should we. The situation calls for patience, knowledge, gentle guidance, and careful non-judgemental listening.


What Can We Do to Help?

1) Obtain immediate help for the person in crisis and for yourself.

When the person is in a suicidal crisis, telephone your local Crisis Centre or take the person to the Hospital Emergency Room. If you are not satisfied with the results, try another Crisis Centre, S.A.F.E.R, or another local agency, but keep trying.

If you find out about an attempted suicide long after the event via an old suicide note or a casual comment, the person who attempted suicide may no longer be in crisis – but now you are!

Either way, your “assumptive world” is probably shattered. Contact S.A.F.E.R. or a Crisis Centre to get immediate emotional support, to coach you on how to approach the suicidal person, and to help you find further support and information.

2) Develop a network of support.

Stigma often keeps both caregivers and the suicidal person from reaching for support and information. “Helpseeking” is difficult for people struggling with suicide. Break these cycles of silence by seeking out a caring community of health care professionals, friends and community “gatekeepers” who can advise and support you. Assist the suicidal person to find a caregiver with whom they can share their pain.

Be aware that suicidal behaviour can recur. Learn who to contact and what to do if there is another suicide attempt. Learn the suicide warning signs and the issues underlying suicide by exploring the resources below.

3) Get the person to a physician for a complete physical.

Suicide is complex. It emerges out of a dynamic interaction involving biological, social, psychological and spiritual factors. Physical ailments can be factors in depression and add to suicide risk. Simple things like undiagnosed diabetes, or a thyroid or iron deficiency can be factors, and may provide a non-threatening point of focus for getting the suicidal person to see the physician for a full physical and appropriate referral.

Suicidal people often confide more to close family/friends than to professionals, so prior to the exam, alert the physician to the potential suicide issue. Provide relevant family history, including mental health issues, the person’s own writing, comments by teachers, friends and employers, etc.

While confidentiality guidelines may limit what health care professionals can share with you, it is vital to report your observations to them.

S.A.F.E.R. can provide consultation to you, your physician, and other helping professionals.

4) Learn new ways to respond.

Living with a person who has attempted suicide can be challenging. They can be loving and “up” and fine, and maybe they are, but they can also seem happy even when they aren’t. They may “ask for help” by acting out or withdrawing, then rebuff your offers to talk or help.

You may feel like you’re walking on eggshells – you don’t know when to reach out, and when to stand back. You, your friends and relatives may have conflicting views about what to do. There may be difficult decisions to make.

Normal boundary setting or everyday decisions may not be terrifying. You need to act with safety in mind; erring on the side of caution. At the same time, giving in continually, ignoring the problem, or allowing yourself to become victimized is not healthy for you, nor helpful to the suicidal person.

You want to make the best choices for the circumstances at hand. Contact S.A.F.E.R. or other professional help to understand the options that are available and to learn new ways to respond.

5) Self-care is essential for someone living with someone who is suicidal.

Caregivers living in uncontrollable high stress situations such as this are themselves prime candidates for clinical depression, stress aggravated physical ailments (like arthritis, stroke and heart attack_ and have diminished ability to effectively manage family, relationship and work issues.

The better you can take care of yourself, the better you will be able to provide a support system for someone else in crisis. Attending to your own physical and emotional health is the first step in caring for the suicidal person.

Draw on the support of those close to you. Eat right, exercise, and try to balance work and play. Explore meditation, spiritual retreats, self-help courses, support groups, reading or music to find your inner strength and resources.

Share your situation with your family physician. Take advantage of community resources or your company’s Employee Assistance Program. This is what they are there for!

What is important during this time is not “who” or “how,” but finding safe places and safe people to support you on this difficult journey.


Tips from Professionals

- 4 out of 5 people who die by suicide have made a previous attempt. Don’t ignore the problem and don’t give up hope.
- The actual suicidal crisis is time limited, but is likely to recur if the underlying issues aren’t addressed.
- Many people who accept professional help following a suicide attempt can learn how to reduce the likelihood of further attempts, while also learning more about improving their overall mental health.
- While we can provide care and support, ultimately it is the suicidal person who has to reach for life instead of death. Don’t punish yourself with recriminating thoughts like ”I should have...” or other guilt-inducing negative self-judgements.


We Can Make a Difference

- Educate yourself about suicide. Treatment approaches are still evolving; the system still fragmented. People may dismiss your concerns, particularly if the suicidal person seems to be functioning well. Knowledge is your most powerful ally in obtaining help.

- A person in a suicidal crisis is ambivalent – things seem hopeless, but a part of them wants to find a better way to live. Look for opportunities when the suicidal person might reach for hope and healing.

- Many of those who initially refuse help after a suicide attempt accept help at a later date. Don’t give up.


Additional Support

For support outside Vancouver, British Columbia [Canada], contact the following agencies:

1) Family physician.
2) Public health.
3) Mental health centres.
4) Canadian Mental Health Association.
5) Mood Disorders Association.
6) Drug & alcohol services, if appropriate.


Web Sources

- Centre for Suicide Prevention: http://www.suicideinfo.ca
- Canadian Health Network: http://www.canadian-health-network.ca
- BC Ministry of Health Services – Mental Health and Addictions: http://www.healthservices.gov.bc.ca/mhd
- Mental Health Evaluation & Community Consultation Unit: http://www.mheccu.ubc.ca
- BC Partners for Mental Health & Addictions Information: http://www.heretohelp.bc.ca
- Centre for Addiction & Mental Health: http://www.camh.net
- Metanoia: http://www.metanoia.org/suicide
- Befriender’s International (suicide and crisis support for 40 countries, and in 12 languages): http://www.befrienders.org


Further Reading

Title: Suicide, Why
Author: Adina Wrobleski
Publisher: SAVE
Year: 1995

Title: Suicide – The Forever Decision
Note: Chapter 2 talks about suicide being illegal; this refers to certain states in the US, as suicide is no longer illegal in Canada.
Author: Paul G. Quinnett
Publisher: Crossroads
Year: 1993

Title: How I Stayed Alive When My Brain Was Trying to Kill Me
(includes an extensive section on Helping the Suicidal Thinker)
Author: Susan Rose Blauner
Publisher: HarperCollins
Year: 2002

Title: Choosing to Live: How to Defeat Suicide Through Cognitive Therapy
Author: Thomas Ellis & Cory F. Newman
Publisher: New Harbringer
Year: 1996

Title: A Parent’s Guide to Suicidal and Depressed Teens
Author: Kate Williams
Publisher: Hazelden
Year: 1995

Title: Helping Your Depressed Teenager
Author: Gerald D. Oster & Sarah S. Montgomery
Publisher: John Wiley & Sons
Year: 1995

Title: Prayers for Bobby: A Mother’s Coming to Terms With the Suicide of Her Gay Son
Author: Leroy Adams
Publisher: HarperCollins
Year: 1995


S.A.F.E.R. (Suicide Attempt Follow-up, Education & Research program)
#300 – 2425 Quebec St.
Vancouver, BC
V5T-4L6

Phone: (604) 879-9251


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The information in this post belongs to S.A.F.E.R., and Vancouver Coastal Health, copyright 2004. It was written as a collaborative effort between SAFER and P. Bonny Ball, a woman who lived with her suicidal young adult son. I do not claim to own any of this information, nor am I trying to profit from it.

Reserved.