Today, September 10 is World Suicide Prevention Day.
Suicide affects everyone: most directly the family and friends of the deceased, but many of us are impacted and saddened by the loss of life and the reality that it is possible to be so overwhelmed by circumstances. Many of us wonder, too often after an attempt or a death has occurred, what indicators could have been recognized as warning signs, and what could have been done to prevent a suicide or suicide attempt. Sometimes it’s hard to know if someone’s thinking about suicide, since so much of what’s going on happens beneath the surface, and sometimes it’s hard to ask or talk about it.
Things to know that can help:
# 1: Conversations that can help de-escalate potential suicidal thoughts and behaviors usually look like casual conversations between people that care about each other’s well-being. Be genuinely curious about how your friends, co-workers, and loved ones are doing, and their life in general. Simply knowing that someone cares and makes time to talk to them can reduce feelings of isolation and feeling unloved or invisible. Help people feel like they have meaning in your day and life, and that having them in your life is important to you.
# 2: Ideally the time to intervene and seek mental health services is before a crisis event happens, to de-escalate the acceleration of suicidal ideation and planning stages, and to provide more time for the person and a therapist or therapeutic team to work together toward improving coping skills and stabilization of the stressors.
# 3: Listen for the risk factors (below are some examples):
Feeling overwhelmed by responsibilities:
“I have no time”
“I work a lot”
“I am preoccupied with thinking about everything I have to do”
“If I don’t take care of these things no one else will”
“Everyone depends on me”
“I don’t have any family here/ I don’t feel close to any relatives here”
“I don’t have any real friends”
“I call my mother/sister/best friend/significant other multiple times a day”
“I’m not comfortable/ I don’t feel safe outside my home”
“I don’t trust anyone anymore/ I want to be left alone”
Feelings of Low Self-Esteem:
“I feel so stupid”
“I deserved it”
“I can’t do anything right/ I’m not good enough”
“I feel like nothing will help me”
“I’m afraid to try because I will just screw it up/ it won’t work”
“I barely eat anything”
“I eat when I am not hungry”
“I wake up at night and can’t go back to sleep”
“I sleep too much”
“I love a clean home, and my place is such a mess”
“I am always tired”
“I can’t make any decisions on my own”
“I forgot to take my medication again”
“I’m drinking /using substances more than I used to”
Feelings of Despair and a Wish to Die or Disappear:
“I’m going to kill myself”
“I wish I were dead”
“I wish I hadn’t been born”
“I want to leave this life in a big way”
“Yeah these things used to me important to me, but I don’t want them anymore. Do you want them?”
“Take care of these precious items/people for me.”
Anniversaries of Personal Losses and Tragedies:
In the United States, September 11, or 9/11, the day of the terrorist attack on New York’s Twin Towers and the Pentagon in Virginia, and an impending attack on Washington D.C. in 2001. Eighteen years later, many of us are still feeling the effects of this day. Families and first responders may need extra attention and support.
Persons who have lost spouses, parents, children, siblings, and other close family members and are exhibiting strong depressive signs, especially during the first year, but may last longer.
For information on how to cope with anniversaries see this article: “Anxiety and sadness may increase on anniversary of a traumatic event” by the American Psychological Association.
# 4: When someone is disclosing an imminent desire for suicide or is actively engaging in suicidal behaviors with an imminent danger of harm or death, call 911 or the telephone number for emergency services in your area.
#5: If there is no immediate threat of suicide, know where to refer people for help, support, and resources:
Offer to help the person call their insurance provider and locating a list of therapists in their area that accepts their insurance. Technology has made online therapy from the comfort of people’s homes as accessible as in person sessions in a therapist’s office. Some therapists offer a sliding scale for people concerned about costs, and a free consultation. Others may qualify for services under the Employee Assistance Program offered by their employers and may not have to pay at all for a certain number of sessions.
If the person is a student you can refer them to their guidance or college counseling office to meet with a counselor, which are typically free services for enrolled students.
Keep a list of hotlines handy or look some up together. These are some listings, but there are more, of hotlines available in New York City:
National Suicide Prevention Lifeline (1-800-273-8255) or text the Crisis Line at 741741
NYC Well: 1-888-NYC-WELL (1-888-692-9355) ***Interpreters are available for 200+ languages!
Samaritans 24-Hour Crisis Hotline (212) 673-3000
There are also Walk-In and Drop-In centers, as well as Hospitals and Crisis clinics, but you might need more time to search for where all the currently active places are and call ahead to confirm before going or referring people to go there.
Mental Health care and support has increased a lot in the last few years. Chances are, many people know of someone who has been in therapy, with good results. Some people though, can still be shy or skeptical. Some people may accept your suggestion to see a therapist. Others may not, and among their reasons they may ask: “What can sitting in a room talking to a therapist do for me?”
The simplest answer to give is this: “Go, and find out.”
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Questions or comments can be directed to Maria Constantinou, LMFT at [email protected]