Suicide Awareness and Training for Caregivers: Outline & Take-Home Points

Suicide Awareness and Training Overview

  • Anyone can think about suicide, even young children.
  • Activities such as sports and volunteering can create a sense of community and meaning, which can help to protect against suicide.
  • Teammates and group members can help look out for others and for signs of suicide.
  • Certain groups are more at risk for suicide such as veterans and military personnel.
  • Follow up and take action if you notice anything that may be concerning.
  • Trauma and violence can increase the risk of suicide.
  • Those who work in stressful workplaces can look out for others and their safety from suicide.
  • EMS is often the first to respond when called for help related to suicide and help to de-escalate the situation.
  • Despite the stigma surrounding suicide, there are ways to talk about suicide openly – in-person and virtually such as in the media.
  • Finding activities that are meaningful can help to improve one’s well-being.
  • Life changes such as new roles may increase one’s risk for suicide.
  • Being prepared to respond to someone in distress can help make a difference.
  • Certain communities, e.g., rural, have been more affected by suicide. Specifically targeted programs can help to reduce suicide deaths in these communities.
  • There is a potential for people to think about suicide through all stages of life.
  • Family members can be educated about suicide to keep loved ones safe.
  • Family relationships can work both ways: help protect members from suicide, but also can increase the risk.
  • There are both national and local resources for suicide, depending on where you live.
  • Pets and social contact can be protective factors against suicide.
  • Healthy habits are important such as diet, activity, hobbies, and self-care for one’s well-being.
  • Those who are thinking about suicide may not know that they need to get help.

Suicide Warning Signs

  • Learn to watch for the Suicide Signs
  • Follow your instinct and look, listen, and sense if something is not right.
  • Signs may also be feelings and situations or traumatic events that have happened to the person, e.g., abuse, death, loss of a job, bullying, or relationship problems.

Examples of Warning Signs

  • Substance use and abuse
  • Withdrawal or isolation
  • Behavioral or personality changes
  • Being moody
  • Unusual behavior
  • Giving away one’s possessions
  • Talking about death, suicide, not caring, being alone, escaping, being overwhelmed with problems, and not having a purpose.
  • Feelings of sadness, depression, hopelessness, guilt, or shame.

There was no evidence of an iatrogenic effect of asking about suicide. Neither distress nor suicidality increased among the entire population of surveyed students or high-risk students who were asked about suicidal ideation or behavior. On the contrary, the findings suggested that asking about suicidal ideation or behavior may have been beneficial for students with depression symptoms or previous suicide attempts.2

Communication Techniques

  • Listen to the other person and ask what is going on; encourage the other person to share and talk.
  • Ask the person directly if they are thinking about suicide – be direct, calm, clear, and non-judgmentally. You won’t know if you don’t ask.
  • How NOT to ask: “Are you thinking of harming yourself?”; Instead: “Are you thinking of suicide?”
  • Myth: Asking ‘puts the idea of suicide in someone’s head’. False. It’s likely that nobody has ever asked them about suicide despite yet they are thinking about it.[1]Bender, T. W., Fitzpatrick, S., Hartmann, M. A., Hames, J., Bodell, L., Selby, E. A., & Joiner Jr, T. E. (2019). Does it hurt to ask? An analysis of iatrogenic risk during suicide risk … Reference List[2]Gould, M. S., Marrocco, F. A., Kleinman, M., Thomas, J. G., Mostkoff, K., Cote, J., & Davies, M. (2005). Evaluating iatrogenic risk of youth suicide screening programs: a randomized controlled … Reference List
  • Thank the other person for sharing their answer.
  • Avoid sharing your own experience and stories.
  • Avoid giving advice.
  • Don’t be dismissive or invalidate their feelings.
  • Throughout the conversation, repeat or rephrase what you heard the other person say. This shows that you care and that their thoughts of suicide are to be taken seriously.
  • State how serious the situation is if the person is in fact considering suicide; do not dismiss the person.
  • Offer to continue and provide help especially if they want to be alone and step away from the conversation. Do not leave a person with suicidal thoughts alone without help.
  • Ask the person if there’s more they want to share. Learn more about what may have led to their suicidal thoughts. When did it begin? LISTEN more than talk. This helps you to provide and connect the person with more specific resources that may be of help.
  • Ask if there have been any actions taken toward suicide. This will let you know if you would need to contact emergency medical services for immediate help.
  • Share that you can provide the person with resources to get help.
  • The person should agree that they need and want to get help, even in the current moment (not sometime in the future).
  • Have the person add these contacts to their phone themselves at the moment; offer to help them do it for them.
  • Review the resources with the person so they know which is best for their situation.
  • Initiate a phone call with one of these resources for this person while you are still with them. In-person help is best, but otherwise, texting or other means is okay.
    • Police or EMS if the person is in immediate danger, otherwise…
    • A helpline, family doctor, counselor, or clinic.
    • Leave contact information: it is also helpful to share a resource list with the person to have for their own.
  • If the person is reluctant to connect with a suicide resource, ask about it. They may be more comfortable connecting with another resource instead.
  • Offer to provide continued support in the future.
  • Rehearse and practice these skills in preparation for should someone need your help.

Resources (USA)

Examples of resources to connect the person with: crisis hotlines, text-chats and Apps, physicians, counselors, therapists, healthcare workers, spiritual leaders, cultural supporters, or employee wellness support programs.

References

References
1 Bender, T. W., Fitzpatrick, S., Hartmann, M. A., Hames, J., Bodell, L., Selby, E. A., & Joiner Jr, T. E. (2019). Does it hurt to ask? An analysis of iatrogenic risk during suicide risk assessment. Neurology, Psychiatry and Brain Research, 33, 73-81
2 Gould, M. S., Marrocco, F. A., Kleinman, M., Thomas, J. G., Mostkoff, K., Cote, J., & Davies, M. (2005). Evaluating iatrogenic risk of youth suicide screening programs: a randomized controlled trial. Jama, 293(13), 1635-1643.