When it gets risky

It can be very hard to know when you have done all you can and things are now getting out of hand. This article explains some of the key things to look for. These can be different for suicide and self-harm, so here I will just deal with the warning signs of suicide as this is the thing we really want to try and stop happening.

*** If you have recently been bereaved by suicide, you may find this article difficult as you might feel very guilty that you hadn't taken some of these things seriously. We would suggest you read another article in the site first such as this testimony of someone else who has been bereaved by suicide.

This list of things that may warn of suicide is compiled by SAVE. Basically, the more plans a person is making, the more likely they are to go through with them. Another big factor is a past attempt at suicide that was almost successful.

- Talking about suicide.
- Statements about hopelessness, helplessness, or worthlessness.
- Preoccupation with death.
- Suddenly happier, calmer.
- Loss of interest in things one cares about.
- Visiting or calling people one cares about.
- Making arrangements; setting one's affairs in order.
- Giving things away.

If you think a person is seriously contemplating suicide, then you need to try and talk to them about it - please do not ignore it. Talking about suicide does NOT increase the chance of them doing it. In fact, keeping it a secret is often worse. You do not have to be an expert to ask the first couple of questions: try simple things like:

- 'Do you ever feel so badly that you think of suicide?'
- 'Do you have a plan?'
- 'Do you know when you would do it (today, next week)?"
- 'Do you have access to what you would use?'

These questions will help you know if you need to act very quickly or if you have a bit more time. A good place to start is making an appointment to see your GP: even if the person will not come you can still go instead. If it seems more urgent, then there are a number of options like going to A&E, calling NHS direct or 999.

This will put you in touch with professionals who will be able to take a lot of the burden off you. However, please do not think that your role is over. Although professional risk asessment is needed, the thing that most suicidal people actually want is someone to sit with them and just be there.

Self-harming behaviour such as cutting or taking a small overdose is not the same as an attept at suicide, but there is a link and some people who only mean to self harm will accidently go as far as suicide. This leaflet about helping someone who is suicidal from 'Mind' explains the difference well. They also have a separate booklet called 'Understanding Self Harm.

Mike Bush, 24/07/2008