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Suicide Prevention: Ask the Question Directly to Save a Life

by Michael Day, Psy.D.

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Suicide remains a major taboo subject in our society – a forbidden, uncomfortable conversation no one wants to have. Yet it is the second-leading cause of death among 15-34 year-olds and the tenth leading cause of death for all ages in the United States (Centers for Disease Control, 2013). Worldwide, it is the seventeenth leading cause of death (World Health Organization, 2015).

It can be intimidating and even frightening to encounter a depressed and possibly suicidal individual in the course of daily ministry. Most people considering suicide do not want to die; they are just looking for a way to end their pain. Learning more about suicide can help us build the courage to face this issue head on, ultimately saving lives and helping heal those we serve.

Risk factors for suicide
  • Undiagnosed or untreated depression
  • Substance (drug or alcohol) abuse
  • Isolation and feelings of hopelessness
  • Environmental factors such as financial problems or family conflict
  • Family history of suicide or child maltreatment
Warning signs of suicidal behaviors
  • Verbal cues – statements such as, “ I wish I could go to sleep and never wake up.”
  • Behavioral clues – giving away prized possessions, reckless behavior, increased alcohol or drug use, isolating from family and friends, saying goodbyes
If you suspect someone is considering suicide

Sometimes we might avoid asking about a person’s intention to attempt suicide because it might  “give them the idea” or be interpreted as encouragement to act. The reality is that a person considering suicide may have had suicidal thoughts and plans for a long time, even years. Being candid and direct about your concerns can validate the desperate feelings, reduce the anxiety and secrecy and create an opening for dialogue.

What should you do when you suspect a person is considering self-harm? Ask. Be direct, respectful and concerned: “Are you thinking of killing yourself?”

This might sound frightening, and it can be an extremely difficult question to pose, but it is the only way to find out. Do not try to soften the question by framing it differently, such as, “You aren’t thinking about killing yourself, are you?” This may put the person on the defensive or discourage him or her from opening up to you.

If the person responds yes, listen empathically to the story, encourage him or her to get help and make a referral to a qualified mental health provider. Make sure you have ready access to resources such as the National Suicide Prevention Lifeline, as well as contact information for a mental health provider you trust.

Finding the courage to ask this important question can mean the difference between life and death.

  • National Suicide Prevention Lifeline: (800) 273-8255
  • American Foundation for Suicide Prevention: https://afsp.org/
  • Question, Persuade and Refer: www.qprinstitute.com
  • Mental Health Crisis Text Line: Text “HELLO” to 741741