First Aid for Suicidal Thoughts and Behaviors
How to tell whether a young adult is suicidal
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Threatening to hurt or kill themselves.
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Seeking access to pills, weapons, or other means to kill themselves.
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Talking or writing about death, dying, or suicide (including in schoolwork, creative writing, and artwork).
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Expressing hopelessness, no reason for living, or having no sense of purpose in life.
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Having rage, anger, or seeking revenge.
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Acting recklessly or engaging in risky activities, seemingly without thinking.
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Feeling trapped.
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Increasing alcohol or drug use.
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Withdrawing from friends, family, or society.
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Having a dramatic change in mood (may even be a shift from being sad and depressed to happy, with a sense of resolve; often with no clear indication of how or why the shift in mood occurred).
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Sleeping all the time or being unable to sleep.
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Being anxious or agitated.
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Giving away prized possessions.
(From Mental Health First Aid USA)
There are multiple other external factors or triggers that may result in suicidal thoughts and behaviors:
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Death of a family member by suicide
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Death of a close friend by suicide
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Recent suicide in the community
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Major traumatic incident
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Death of a person of a similar age
How to assist
Safety is the first priority for you and the young individual, especially for you.
For young people, any family/primary caregiver is the last line of defense for suicide. When a person is suicidal or presents signs of suicidal thoughts, they should ALWAYS seek professional help.
If the individual presents any of the warning signs, it is ok to communicate with them about your concerns. You should let the person knows that you are worried and care about them. It is important to ask the young person directly about suicidal thoughts; also it is very important to ask in a respectful, caring, non judgemental manner. You should ask the individual following questions:
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Do you have any specific plan of how to kill yourself?
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Have you decided when you would do it?"
Not everybody is going to tell you the truth about their feelings, but it is important for them to know that someone cares for them and they always have someone for them who they can reach out to. It's crucial to keep observing any changes in their behavior.
"Suicidal thoughts are often a plea for help and a desperate attempt to escape from problems and distressing feelings."
(From Mental Health First Aid USA)
Encourage the young individuals to talk. You do not need to provide any immediate solution for their problems, but you should encourage the individual to do most of the talking if they are willing to. Do not be forceful or aggressive, ask open-ended question, let them lead the conversation. Consider the big question, Why?
How should I talk with a young person who is suicidal?
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Tell the person that you are concerned and that you want to help.
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Express empathy for the young person and what they are going through.
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Respect the culture of the young person and respond in ways that demonstrate this respect. For example, consider issues such as eye contact, physical space, and language as well as the role and relationship of the first aider with the young person.
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Clearly state thoughts of suicide are common and that help is available to discuss these thoughts, because this may instill a sense of hope.
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Tell the young person that thoughts of suicide do not have to be acted on.
(From Mental Health First Aid USA)
How can I tell how serious or urgent the situation is?
Answers from those 2 questions are critical:
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Do you have any specific plan of how to kill yourself?
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Have you decided when you would do it?"
All suicidal thoughts should be taken seriously; however, higher level of planing generate greater risk. It is critical to determine whether the young individual has definite intentions to take their life, or whether the young person has been having more vague suicidal thoughts.
Next, you need to know about the following extra risk factors:
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Has the young person been using alcohol or other drugs? The use of alcohol or other drugs can make a person more susceptible to acting on impulse.
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Has the young person made a suicide attempt in the past? A previous suicide attempt makes a person more likely to make a future suicide attempt.
(From Mental Health First Aid USA)
As soon as you established that there is an actual risk for suicide, intervention should be taken immediately. The young individual should receive mental health intervention as soon as passable. (Such as Emergency room with Psychiatric service) The individual should not be left unattended. However, your own safety is always the priority. It is very important to connect the individual with someone who they trust completely - ideally someone who has helped or supported them before (Friend, family, teacher, coach...), as well as professionals (suicide hotline numbers, 988). Do not use guilt or threats to prevent suicide. Suicide always take priority in Medicine.
Information that the emergency department personnel need to know:
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Access to a gun, medications, or other means of suicide.
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Stopped taking prescribed medicines.
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Stopped seeing a mental or behavioral health provider or physician.
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Written a suicide note.
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Given prized possessions away.
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Been in or is currently in an abusive relationship.
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Recently suffered a loss or other traumatic event.
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An upcoming anniversary of a loss.
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Started using alcohol or drugs.
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Recovered well from a previous suicidal crisis after a certain type of intervention.
(From Mental Health First Aid USA)