By Dammy Damstrom-Albach
Many people do not realize that suicides can be prevented. Yet there are a number of realistic measures that communities, provinces and the country as a whole can take to reduce the risk, including:
• limiting access to means (e.g., pesticides, medication, guns)
• treating people with mental illnesses or disorders (especially depression, alcoholism and schizophrenia)
• providing follow-up to those who have made suicide attempts
• encouraging responsible media reporting
• training primary health care workers
• engaging in mental health promotion and stigma reduction
Take threats seriously
At the individual level, it is important in fact, courageous to ask for help when struggling and to offer it if someone seems distressed. Only a few suicides happen with no warning. Most people who die by suicide give definite signs of their intentions. Therefore, all threats of self-harm should be taken seriously. In addition, research shows that most people who attempt suicide are ambivalent rather than entirely intent on dying. If there are any indications that a person may be overwhelmed then ask about suicide clearly and directly. Signs include changes in behaviour, appearance or mood; increased use of alcohol or drugs; appearing depressed, anxious, numb or increasingly irritable; withdrawal, isolation or recklessness; and expressions of hopelessness, helplessness and talk of suicide or wanting to die, or of feeling trapped or like a burden. If someone says they are thinking about suicide, stay calm and listen as the person talks about their feelings and circumstances. Take any threats of suicide seriously and stay with the person until you can connect them with additional support or community resources. This might include calling 1-800-SUICIDE (a BC-wide 24/7 distress line), a family physician, a walk-in or mental health clinic, the nearest hospital emergency room or 911.
safeTALK is a workshop program that prepares people over age 15 to recognize when someone may be thinking about suicide. We talk about how to ask a person directly about their intentions, and how to connect them with further help should they indeed be feeling overwhelmed or at risk. Our work is grounded in the understanding that most people with thoughts of suicide do not truly want to die, but are struggling with pain in their lives and may not be able to see a way to deal with it. Underlying this is the belief that suicide prevention is everybody’s business and that anyone can learn to be a suicide-alert helper. safeTALK participants learn to:
• notice and respond to situations where suicidal thoughts might be present
• move beyond the common tendency to miss, dismiss and avoid talk of suicide
• apply the TALK steps: Tell, Ask, Listen and Keep safe
• know community resources and how to connect someone with thoughts of suicide to them for further help
Another available program is Applied Suicide Intervention Skills Training (ASIST), which focuses on suicide first-aid training. Delivered to more than one million people since 1983, ASIST teaches participants to recognize when someone may have thoughts of suicide and to work with them to create a plan that will support their immediate safety. Over the course of the two-day workshop, participants learn to:
• understand the ways that personal and societal attitudes affect views on suicide and interventions
• provide guidance and suicide first aid to a person at risk in ways that meet their individual safety needs
• identify the key elements of an effective suicide safety plan and the actions required to implement it
• appreciate the value of improving and integrating suicide-prevention resources in the community at large
• recognize other important aspects of suicide prevention, including life promotion and self-care
Save a life
Everyone should know what to look for, and how to ask and respond to someone who may be at risk of suicide. Every life is precious. Know that you are just as likely to encounter people at risk among colleagues, friends and family members as you are among customers, clients or patients. To learn more about, find or schedule a safeTALK or an ASIST program near you, go to cmha.bc.ca/types-programs-services/suicide-prevention.
Dammy Damstrom-Albach is the manager of suicide prevention gatekeeper training for the Canadian Mental Health Association, BC Division, in Vancouver.