When she was in her sophomore year of college, Mary Grace Donaldson's roommate admitted to her that she had thoughts of suicide. "She had been unhappy, homesick, struggling to learn English, and in a bad relationship to that point," Donaldson, a blogger, said of her roommate.
Donaldson called her own counsellor, who sent campus security to their unit to bring her roommate to the emergency room. Her roommate was hospitalized for a few days before being released, and in the following months she ended her relationship, saw a counsellor, and worked with other university staff who helped her recover.
The story has a happy ending, but Donaldson says she was initially unsure if calling for help had been the right thing.
But many similar stories don't have a happy result. About 4,000 Canadians die by suicide every year, according to the Canadian Mental Health Association, and it is the second-most common cause of death for young people. And some groups are at particular risk: Indigenous people in Canada, LGBTQ people, seniors, and middle-aged men all die by suicide or attempt suicide at higher rates, according to the Canadian Association for Suicide Prevention.
About 4,000 Canadians die by suicide every year, according to the Canadian Mental Health Association.
Donaldson's uncertainty about how to help her friend is not unusual. Friends and family members often find it hard to identify the signs that someone is suicidal, one 2011 study found. And harmful, outdated stigmas — that a truly suicidal person won't discuss their plans, for example — contribute to misunderstanding and silence that prevents lives from being saved.
If a friend or family member is expressing suicidal thoughts, or if you believe they might be struggling with suicidal ideation, these pieces of advice may help you get them the support and medical care they need.
Know the warning signs
It can be hard to signal out specific warning signs for suicide because there are so many, and all people are different, says Jay Westbrook, a grief and loss counsellor with Recovery.org. "These can include anything from a spiraling depression, withdrawal, isolation, giving away possessions that have meaning and/or value, to saying farewells, to lightness, joy, or a sense of relief, and almost anything in between," Westbrook says of some of the known signs.
Don't mistake an absence of the better-known risk signs for suicide as proof that someone is not experiencing suicidal ideation — but knowing how to recognize some of the more common ones can help you realize there is a problem.
Take them seriously
Never dismiss discussion of suicide as merely a joke or blowing off steam, and always take depression and other mental illnesses seriously. "One of the most over-looked signs is probably the most clear one: that is, actually telling people that they are thinking about killing themselves and want to do it," says counsellor Michele Moore. Listen in particular for signs like details of a time, place, or method of suicide, Moore says.
One of the most over-looked signs is probably the most clear one: that is, actually telling people that they are thinking about killing themselves and want to do it
People are often reluctant to start a conversation about suicide with a loved one. The subject is a difficult one, and there can be a fear of saying the wrong thing or pushing someone into a conversation they are not ready for. But speaking up, and doing so quickly, is key, Westbrook says.
"I'm a big believer in saying something, and a big believer in saying it now," he says. "There is always the potential for a bad outcome if nothing is said or if one puts off saying something until 'later.'"
Think about how you say it
The act of speaking up itself is important but the words you choose and the way you convey your message also matter, Westbrook says. "Saying something in a way that normalizes it can help," he says — for example, pointing out that suicidal ideation is something many people struggle with.
The act of speaking up itself is important but the words you choose and the way you convey your message also matter.
The Mayo Clinic advises being sensitive, but asking direction questions like, "Are you thinking about dying?" and "Have you ever thought about suicide before?"
Watch for changes in behaviour
This will not be present in all cases, but in some cases a sudden calm or happy mood in someone who has been struggling with depression, anger, or anxiety can be a sign of suicide risk. "Experts often call this the 'calm before the horror,'" Larsen says. "If someone you love suddenly or gradually becomes very calm when talking about suicide, this is a red flag. People who have a 'flat affect' when talking about harming themselves or others must always be taken very seriously."
If someone you love suddenly or gradually becomes very calm when talking about suicide, this is a red flag.
Reach out for help
A supportive friend can play a huge part in someone's recovery from suicidal ideation, but it's not a replacement for professional help. "Listening can be very healing to someone who simply needs a shoulder to lean on, but doesn't necessary help someone considering suicide unless it is paired with action," Moore says. Direct someone to medical help, via a 911 call or a trip to the emergency room if necessary.
Never keep someone's suicidal ideation or plans a secret. Losing a friendship or relationship is better than losing the person themselves. "This is not the time to remain silent," Larsen says. "Circle the wagons, tell friends, family members, and other loved ones about the situation so that they can appropriately support this person during this difficult time."
Offer to physically be there for support
Many of the first steps in getting help for mental illness are daunting: calling to make an appointment, going to see the counsellor, seeking help through medication, and so on. And for people who are experiencing clinical depression or an anxiety disorder, the task of picking up the phone simply to make an appointment can seem terrifying or exhausting.
Offer practical advice and in-person support where you can. You can help someone take those first steps by offering to research therapists, call to make appointments, accompany them to the ER, pick them up to bring them to appointments, and even sit in appointments if they wish.
Share information about crisis centres
There are 24-hour telephone suicide crisis lines available across the country. Share these with your friend: print the number and place it somewhere easily accessed, so the information is available quickly if they feel they need it.
Take care of yourself too
Supporting a loved one who is struggling with suicidal ideation can be draining and frightening. Make sure you support yourself as well, Moore says. Seek out a support group, call a hotline, and address your own physical and emotional needs as well. "Often caregivers become so depleted that they burn out, and they need to realize that they need to keep their own tanks full in order to continue to help someone else," she says.
Are you in a crisis? If you need help, contact your local crisis centre. If you know someone who may be having thoughts of suicide, visit suicideprevention.ca to learn how to talk about suicide with the person you're worried about.
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