10 Ways to Approach a Conversation About Suicide with Brittney and Meredith

Written By Thea Varley

To help educate us on this subject are two guests, Meredith Sears, Ph.D. — a clinical psychologist who specializes in suicide prevention and serves as the President of the Board of the American Foundation for Suicide Prevention (AFSP), and Brittney Elko — an AFSP board member who shares her personal story of loss, and her expertise as a 988/TALK crisis line volunteer and organizer of ASFP's Healing Conversations program. 


1. Don’t be afraid to use the word suicide 

When speaking to someone you are concerned about, don’t be afraid to use the word suicide. Often, it's a burden for them to bring it up because of the stigma associated with suicide. Help them break through the stigma, so they don’t have to worry about breaking through it themselves. The less we use the word, the less likely they will say they need help. Using euphemisms causes us to beat around the bush and makes people unable to talk about their suicidal thoughts. People can often feel like they are in a prison of silence.

2. Try using the phrase “died by suicide” instead of “committed suicide.” 

So many of us don’t realize that our language around suicide can be harmful. Brittney spoke about how it wasn’t until her involvement with AFSP and working on the crisis line, and going through lots of training that they tell you, you need to say, died by suicide, because committing implies, it was a criminal act. We don't really want people we love and lose to be viewed in that way.

3. Know the difference between suicidal ideation and crisis

A Crisis is when someone wants to take action or attempts to take their life. Note that crises don’t last forever and are usually really short. Research shows that a suicidal crisis is under an hour and, in most cases, under 10 minutes. You can help someone in crisis by using skills like breathing exercises, calling 988, or going for a run, and actively direct them through these exercises. If they can get through the other side of that 10-60 minutes, they can usually get to a much better cognitive and calmer state and then can start focusing on getting more help to create a life worth living. 


Ideation is when people have intrusive thoughts about suicide and how they want to do it but aren’t actively pursuing it at that moment and its a way of coping with the pain they are feeling. If you're feeling like they're just asking for attention, or they're being selfish, a lot of times that's more about our frustration about how people communicate their pain, people don't always communicate it most effectively or understandably. Whether it's effective or not, in terms of how they're communicating it, that probably means they've tried other things that haven't worked and are really struggling. 


No matter what, always take people seriously and no matter how they're communicating. Take it seriously regardless of whether they mean it or whether this is how they cope. And we're going to do what we need to to give you some support.

4. Come from a place of caring instead of a place of panic.

With all the questions you ask someone when they have suicidal thoughts, the suicidal person wants to know that who they are talking to cares about the answer vs. coming out of a place of panic. Even immediately jumping to problem-solving can be overwhelming, the most impactful thing to do is show someone you care in this situation by actively listening and letting them know how much you care.

5. How to respond to “I have tried everything” 

This is a common feeling when it comes to dealing with suicidal thoughts. Know that in most cases, people are not receiving their full dosage of help, whether that's quitting therapy or meds before it makes a difference. It’s important to remind our loved ones that healing takes time, but it doesn’t mean the treatment of choice is not working. There are also many new alternative methods out there, like recent studies with phsycadelilcs and ketamine, and you can help someone find that help if they aren't feeling able to do that themselves. 

6. Support by asking and identifying how you can help someone struggling 

Sometimes even just making a phone call or doing laundry can feel overwhelming when someone struggles with suicidal thoughts or depression. It can be really helpful for loved ones to call 50+ care providers on someone's behalf if they have permission to find them professional support. Or even cook them a nice meal. Remember that sometimes a person struggling doesn’t even know what they need, so just ensuring they are getting the basics, like food, water, sleep, exercise, and a shower, can be supportive. 

7. Ask yourself: “What do I need to know to support this person?

Are they angry, sad, depressed, or even suicidal themselves? Brittney talks about her experience with survivors of suicides. People will often be angry at the person they lost or call them selfish. One piece of advice she likes to give is to try not to define the person you’ve lost or even understand. They weren’t in a logical place when they made that decision, and you can't think through what they were thinking and call them selfish.


Also, when talking to someone who has survived suicide loss, you don’t need to know the means of the suicide of their loved one or the details, only the coroner needs to know that. Let the person speak about their loss and try not to pry. Focus on the person who has lost someone, and it’s okay not to know what to say and even say that nothing I can say will help, but we miss them, and this sucks. 

8. Be patient with anyone in your life you are worried about.

Think about a painful time in your life (i.e., labor, breaking a bone, etc.). Most likely, you couldn’t answer easy questions like where the hospital is, but on any other given day, you would be able to. Meredith explains that mental distress functions the same way as physical distress, so it's important to be patient and not keep pushing someone. The goal is to help them get out of distress to get to a place of cognitive functioning, which can take time. 

9. Know that suicide is never someone's first choice 

One of the most common feelings is people feeling stuck and in tremendous pain. If one touches a hot stove, they don’t keep their hand on it, they want to take it off. When you are going through intense emotional or physical pain, the brain wants to escape it. There are many ways the brain tries to escape pain before suicide, but if you can’t see a way through the problems that are causing you pain, whether it's a longstanding mental health condition that's going on and on and you haven't found a solution to help you feel joy again or at peace. Or if you have intense problems going on in your life that don’t feel like they are going to be resolved or you don’t feel like you have the capacity to resolve them, that's when the mind starts looking for other escape routes.

10. Think ahead about safety from lethal means

Studies have shown that people are 5x more likely to die by suicide if a firearm is in the home, and 90% of people will survive from suicide attempts when firearms aren’t involved. Meredith specializes in lethal means safety in her work as a therapist and says taking away firearms from people is like taking away keys from someone who has been drinking. If you can find a way to ask if there can be reduced access, the odds of someone dying by suicide are far less likely. 


Remember to take care of yourself! Whether you are a survivor of suicide loss, supporting someone who struggles or attempted or have your own struggle, it's really important to take care of yourself, and there is no shame in asking for help. Even therapist supporting people thinking about suicide need support. Many resources are available, and you can always call the 988/TALK crisis line. Check out below and head to the AFSP website for more information.


Resources:

Thea Varley
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