We must speak about the unspeakable: Suicide
Some people may become at risk of suicide after periods of depression or other mental health issues. Others may have thoughts of suicide after a major life trauma. Most people with mental illness never attempt suicide. However, 87 per cent of people who take their own life have mental illness. It is often a complex combination of life events as well as mental illness that increases risk, so there is no time frame.
Losing hope is a sign that things may have worsened. Other risk factors you might notice include:
- Saying they want to die (directly or indirectly talking about “things being too much” or they “can’t see any way out”)
- Putting affairs in order, that is, giving away possessions, especially those that have special significance
- Writing about death or suicide, a suicide note or goodbye letters
- Withdrawal and isolation from family and friends
- Withdrawal from activities or commitments that were previously important to them
- Uncharacteristic risk-taking or reckless behaviour
- Suicidal thoughts or attempts
- Self-harming behaviour
- Suicidal plans — when or how they may do it — take this risk very seriously
It is considered an emergency when someone has moved on from thinking about it, to making actual plans. In this case call for immediate support.
If you have any intimation that a person may be having thoughts about suicide, take it seriously and try to talk with the person and seek help and advice from a service such as the Suicide Call-Back Service, 1300 659 467.
Responding to an employee or colleague who may be at risk of suicide
Mental health issues and suicide risk are complex and individual experiences. There are no quick fixes, and the right approach to recovery is an individual experience. If you’re worried about someone potentially being at risk of suicide, the way you respond is incredibly important.
An Employee / colleague might say a general statement like “I can’t cope, it’s too much and I can’t go on” without ever explicitly saying “I want to kill myself”. Some people will come out and say it, but many will dance around to test out if they can trust you enough to tell you. It is a very vulnerable space to be in and not everyone will respond appropriately.
People will sometimes respond to someone with unhelpful comments such as: “Oh, you wouldn’t do something stupid like kill yourself? Don’t be so ridiculous – there are people out there with far worse problems than you. Plenty more fish in the sea. You’ll find someone new and it will be okay.”
These dismissive platitudes are extremely unhelpful. If they are at this level of distress, then there is the risk that they will disengage further and be less likely to seek help. Your goal is to connect with them and then to help seek the support they need.
In this conversation with an employee / colleague you don’t want to say “Hold it!” and pick up the phone to call for help. You do not want to force the help on them unless that is the only option. Firstly, you need to try to get them to agree to seek the support they need. For example you could say:
“Thank you so much for trusting me by telling me how you are feeling. I need to check that I’m on the right track. Are you talking about wanting to kill yourself?”
“Are you talking about ending your life?”
“Are you talking about suicide?”
Ask the question that clarifies that you are actually hearing where they are at. The reason you ask that question is because if you don’t ask it and you then begin to jump towards action, you may overreact when all they were meaning was that they felt overwhelmed that day.
Importantly it shows a level of confidence you have in helping them and respecting that it’s real for them. Many people have the experience where they’ve been told: “Oh don’t do that, it’s too selfish” or “You can’t do that, it’s a horrible thing for you to even think about”. These statements risk disengaging the person because they minimise the validity of what the distressed person is experiencing.
Therefore, the first step in terms of suicide intervention is to ask the person that direct question: “Can I check that we’re talking about the same thing – that you’re maybe wanting to end your life?”
Then follow it with: “Thank you so much for telling me that’s how you feel. I know it must be a big thing for you to share with me. I really want to help you get some help. You trusted me to tell me this, so now will you trust me to help you get some support?”
You are building on that relationship to then connect them with the professional supports. You can’t hold this situation and this person by yourself. You can’t be everything for a person at this level of distress. It’s about using the trust they have with you to say: “I know you may not want to tell anyone else, but you trusted me and I can’t help you by myself. I don’t have the skills and knowledge, but I know that sometimes people feel this way and I know there is help available.”
Do not try to rationalise their reasons for dying or living because if they could simply be rationalised or easily fixed then they would have already done so. Respect that their perceptions are real for them. Saying “I don’t understand how it feels, but I believe that is how it feels for you and that is what I want to help you with” is far more helpful. Don’t leave them alone. Connect them immediately with professional support and if he refuses then ring yourself to get professional advice.
Suggest where they can seek help:
- your organisation’s EAP provider
- a GP
- a suicide support helpline
Ask which one of these services they’d prefer to talk to and ring them together. If they’re not comfortable to talk with them then you do the talking and let him listen to what you say.
If possible you can connect today and help today, but if they refuse that help then you can ring the helpline for immediate advice. You will then need to consider appropriate disclosure, such as to your own manager and your Human Resource team to determine whether any other supports can be offered at this time. Ensure that any disclosure is appropriate and necessary to keep Employee / colleague safe, and is not just gossip.
It is important to recognise that supporting someone through a situation like this can take a toll on you as well, so you need to seek support from your EAP or employee counselling service as well.
If an employee has lost someone to suicide in their personal life, then ensure that they are also offered supports.
If at any point you have concerns about an employee’s immediate safety or risk of suicide then you should seek urgent crisis support.
In an emergency (in Australia, or your local mental health crisis line internationally):
Mental Health Emergency Response Line: 1300 555 788
Suicide Call Back Service: 1300 659 467
Lifeline: 13 11 14
When a person threatens suicide regularly they are in need of support. Take all indication of suicide risk seriously and connect with a mental health professional to determine how to support them ongoing, as well as during times of crisis. Never keep suicide risk a secret and never feel you are responding alone, call a help service and they can advise you, help assess the risks and determine what action to take.