What do you do when you fear a friend or family member may be suicidal? How do you assess the seriousness of your suspicion or their ‘suicidal comments’? The following assessment tool is from the mini-book HELP! My Friend Is Suicidal by pastor and police chaplain Bruce Ray.
Listen to Your Suicidal Friend!
Be willing to talk about suicide plainly. Many suicidal people want to voice their thoughts but their family and friends won’t let them! You don’t have to have all the answers; you just need to be willing to listen. Take your friend seriously. Don’t discount her concerns. Don’t say, “It’s not that bad…” To her it is! Don’t tell her what to do, but show her biblically what God wants her to do. Help her to take every out-of-control thought and bring it into submission to Jesus Christ. “We demolish arguments and every pretension that sets itself up against the knowledge of God, and we take captive every thought to make it obedient to Christ” (2 Corinthians 10:5).
When in Doubt, Ask!
If your friend’s intentions are not clear, ask him point blank: Are you thinking about suicide? It seems counter-intuitive, the opposite of what you think you should do, but asking will not push him to act. Talking about his thoughts and feelings may actually serve as a release-valve, thus buying more time. Learn as much as you can about his suicide plan. A suicide threat assessment tool that I find helpful is easily remembered by the acronym SLAP DIRT:
- Specific plan – has your friend thought about how, where and when he would commit suicide? A plan that is specific is much closer to being carried out than one that is only general: “I don’t know how, but I’m gonna do it.”
- Lethality – how deadly is the plan? I’m not overly concerned about a plan to overdose on Vitamin C, but if someone says they’re going to shoot themselves or jump from a freeway overpass, they have my full attention.
- Availability (of means) – does your friend have or can he easily get what he needs to carry out his plan?
- Proximity (of help) – How close help is can indicate determination. Fred moved in with his daughter and her family after his wife died. They were glad to have him there and Fred did much of the gardening. One evening he said he was going for a walk. He actually went to a park in a neighboring city. In the gazebo in a remote part of the park, Fred put a handgun to his head and pulled the trigger. He went to an isolated place so that there would be no one nearby who could interrupt what he had decided to do.
If there has been a previous attempt(s), add DIRT to the mix:
- Dangerousness – how dangerous were the previous attempts? Is there is a pattern of para- or pseudosuicidal attempts that were deliberately unsuccessful, and is your friend more determined now?
- Impression – whatever the actual danger might have been, what is your friend’s impression of how dangerous her previous attempts were?
- Rescue – how did your friend survive previous attempts? Did he use less than lethal means, or were there friends or other people who came to his rescue?
- Timing – some people attempt suicide expecting to be rescued. Linda rigged a vacuum cleaner hose from the tailpipe of her car in the garage into the passenger compartment, expecting her estranged husband to find her (and save her) when he came to pick up their children. She forgot he had a dentist appointment. As a result of that miscalculation, Linda died and almost killed her kids when carbon monoxide filled the house.
When depression is present, suicidal persons can send out conflicting signals. One of the most dangerous periods is on the way down, when they are unhappy with life and close to the bottom but still have enough energy to carry out a plan.
At the bottom of the curve, life is flat and depressed persons have little energy to do anything. This is when they don’t go to school or work, don’t seem to get anything done, and spend a lot of time unable or unwilling to get out of bed or off the couch. When they start to come out of the depression, that’s the next most dangerous period because they are beginning to regain energy and can again carry out a plan. Often friends are misled into thinking that the suicidal person is getting better: “He seemed so much happier the last few days….” That apparent happiness may be because the person has a plan and now has the energy to carry it out.
Don’t Try to Be a Hero!
Suicide intervention is risky. It places you in harm’s way, between a suicidal subject and the means of carrying out his plan. Your priority must always be your own personal safety first. Don’t try to be a hero, and don’t become a victim. Call for appropriate help from police, fire, or the local suicide crisis line.