Vajra Blue

Mindfulness and Compassion. Understanding trauma in young people.

Don’t pass me by – you might just save my life.

“On the parable of the Good Samaritan: “I imagine that the first question the priest and Levite asked was: ‘If I stop to help this man, what will happen to me?’ But by the very nature of his concern, the good Samaritan reversed the question: ‘If I do not stop to help this man, what will happen to him?” 
Martin Luther King.

The parable of the Good Samaritan is a teaching from the Christian faith about kindness. More importantly, it is about everyone being a part of the same world, and how, as social creatures, we cannot afford to be indifferent to our fellow human beings. Status, rules, or any other artificial barriers that we place between ourselves and others, are often the excuses that we give to ourselves for not getting involved.

It is their choice, someone else will stop to help, I don’t know what to do, I am going to be late. Similar justifications may come to us as reasons to explain our choice not to become involved.

When the immediate risk of suicide is high, getting involved saves lives.

The first step in acute suicide prevention is to stop and choose to get involved. To make a decision not to just walk on by.

When someone we care about, or know, is struggling we need to get involved, and to see if we can help. We can make a difference.  If we are concerned that someone is going to kill themselves, we need to act now. We cannot assume that they will improve or that they will seek help off their own bat. People with mental health problems, or those who are simply overwhelmed by their present circumstances, do not have the necessary energy or ability to seek help. When contemplating suicide many people see it as the only way out of their current predicament, and are unable to see any other alternatives.

So act. Right now.

Ask them how they are.

Ask what can I do to help?

Making human to human contact can relieve the isolation and the pervasive sense of aloneness that many people have in this situation. If someone asks how you are, this can break into the belief that no one can possibly understand me or help. Perhaps suicide is not the only way.

Having a mental health problem does not mean that you will inevitably have thoughts of suicide.  Many people who have a diagnosis do not contemplate killing themselves, and many who do think of suicide do not have a diagnosis.  Mental health difficulties however, do affect how we see our world and react to the new situations that we encounter. We can become bogged down in the negative features of our experience at the cost of the positive.  This has serious implications for our motivation and ability to seek help on our own. It can affect our ability to think clearly, and without a negative bias. The presence of a mental health problem subtly increases vulnerability to both having, and acting upon, suicidal impulses.

We will need to acknowledge our own feelings about the situation.  When we find ourselves cast in the role of the knight in shining armour, there are several understandable responses that we might expect.

  1. Panic.  Help, I have no idea what to do. What if I make it worse?
  2. Someone else will help, please someone else help. It is someone else’s problem not mine. They should do something about it.
  3. Instant solution finding. Do anything to make them feel better.
  4. Perhaps I should try to jolly them out of it, or tell them not to be so silly, that they don’t really mean it. trivialising their condition or dismissing them out of hand.
  5. Criticise them or blame them for their feelings and predicament.

These reactions are normal and common, so it is important to take a moment to take stock. Take the time to listen to their story, and to think carefully before responding or acting.  If we are really struggling, we can always get another friend or family member to help.

It is important to spend time with the person who is suicidal.  This is a very effective way to demonstrate that we care and are concerned. Check  how they are feeling, let them tell us the story of their pain, and listen to what they are thinking about at the time. Importantly, let them do most of the talking.

Ask them directly if they are thinking of suicide.  Unless we ask, we will not know if this is the case.  To ask can be very difficult, but it is the best way to demonstrate that we have noticed how they are feeling, and to demonstrate that they are not alone, and others can bear to be with them and to share their pain.

There is a myth that talking about suicide will put the idea into another person’s head.  Nothing could be further from the truth. By asking, we encourage the other person to talk about their feelings, and this can bring a great sense of relief.  Someone else is prepared to listen, and talk about their darkest and most secret thoughts.

Next we need to do what we can to make them safe. This may mean not leaving them alone, even for a moment.  We should remove any lethal means that might be at hand. Hiding guns or other weapons, removing tablets, drugs and alcohol.  Investigate their suicidal thinking.

  • What is their plan?
  • Is it detailed?
  • Is it practicable?
  • What method?
  • Have they taken steps to acquire a lethal means?
  • Have they written a note, or made some other final act?
  • What safety measures can be put in place?
  • What other supports are available to them?
  • What social or family connections do they have that can be used to increase their safety?

Use this information as a guide as to what to do next. The more significant the risk, the faster we might need to act. Find help as quickly as possible. Perhaps call a suicide helpline (In Australia Lifeline on 131114) or the Samaritans. If the crisis is very acute call the police or ambulance 000, 999, 911 or whatever the local emergency number is in you area.

Discuss the steps that we need to take with the person concerned, Making their safety a paramount concern. Do not agree to keep their mental state quiet, or a secret.  We may need to enlist the help of other people in order to persuade the suicidal person to accept help, or at least to start the process of making themselves safe.

It is only through sharing this information that we can assure that the person will get the help that they need.

Making sure that they are safe should be the first priority.

There are a variety of services that can be called upon to help.

  • Emergency services.
  • Emergency departments.
  • GPs.
  • Counsellors, psychologists, social workers.
  • Community health centres.
  • Helplines.
  • Crisis support lines and services.
  • Priests or other religious and community leaders.

It can be helpful to assist the distressed person to prepare what they will say, as many people find it very difficult to communicate their suicidal ideation. Perhaps offer to accompany them to appointments and make sure that they have discussed their symptoms.

It is important to get the best care and help that we can, remembering that we can’t force them to accept the help on offer.

Ask for a promise that they will seek help should the thoughts return. A promise to someone else makes it much more likely that this will happen.

Providing a written list of supports and the numbers needed to access them is helpful.  With younger people actually putting the numbers into their phone may be a sensible step..  Removing as many obstacles as we can from their ability to seek help is vital.

If we are involved in the ongoing care of someone who is suicidal it is also necessary to look after ourselves.  If we are unable to cope we will be of little help to our friend or family member.

  • Don’t attempt to do the whole thing on your own.
  • Engage other people in helping, whether this is a friend, relative or professional.
  • Contact any local carers’ support or other groups.
  • Try to have as normal a life of your own as you can.  Enjoy your usual activities and pastimes.
  • Make sure to see your friends.
  • Avoid drugs and alcohol as a support mechanism.

Suicidal thinking and intent does not go away immediately and often fluctuates for some time.  the continuing involvement of family and friends in the care of a suicidal person is very important.

  • Access to some form of support 24 hours a day, and a written record of who, where, and when is useful.
  • Accompany them to appointments and other meeting,s as this helps with motivation, and ensuring that any treatment is of a suitable intensity.
  • If we are the primary carer who is responsible, we need to form  close relationships with the professionals involved with both planning and carrying out the treatment. Our input is helpful and vital to reliable care.
  • Act as an advocate for the person concerned.  This may involve finding out about other services and expediting access to them.
  • Help to reduce stress and triggers in the person’s life, and discuss with them what kind of things will help to reduce their risk.
  • Be supportive but not to the extent of disempowering them.
  • Help to formulate a safety plan, outlining a step by step approach of helpful actions that they can take to improve their safety. As well as a list of those they can access to help in times of stress.

Bur mostly reach out to those who seem to be in distress, a simple question can save a life.

If you, or someone you know, has been affected by suicide, the following links may be helpful

If you, or someone else that you know, is feeling down and is contemplating suicide, please seek help from a mental health professional as soon as possible.

Author: SandySB

Child and adolescent psychiatrist. Parent. Blogger.

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