What To Do When A Friend Suggests They Are Considering Suicide

“As an active DBSA member, many of my acquaintances suffer from mood disorders.  One of my friends recently mentioned to me that she was considering suicide.  As a member of society, as well as a person with a mood disorder, what are my moral obligations in a case like this?  I understand what happens if I call the police, but what should I do as a friend?  Call the police?  Call some mutual friends for support?  Or what?”

Thank you for this most important and thought provoking question.  Whenever a family member or friend gives you information to even suggest that they are considering suicide, you cannot help but feel overwhelmed with the disclosure.  It can be a very scary time for you.  I refer you to an excellent resource, the website for the American Foundation for Suicide Prevention:  www.afsp.org.  This particular site has a wealth of information about suicide. I have taken much of my following answer about suicide recognition, treatment and prevention from the AFSP website.

According to the American Foundation for Suicide Prevention, It is important to note that over 90 percent of people who kill themselves are suffering from one or more psychiatric disorders.  In fact, between 25 and 50 percent of persons who do kill themselves, have made a previous attempt.   In other words, those who have made suicide attempts are at a much greater risk for actually taking their own lives.  This information offers clues as to the assessment of suicide risk.  Does your friend have a psychiatric disorder?  Has she made a previous attempt and has she given some warning signs to family or friends?

With these facts in mind, what can you do to help your acquaintance?

First of all it is crucial to recognize some of the warning signs of suicide.  While some suicides occur without any outward warning, most people who are suicidal do give warnings.  Actually, there are a number of warning signs to be particularly tuned into. These warning signs may include a low mood, pessimism, hopelessness, desperation, anxiety, withdrawal, sleep problems, increased substance abuse, recent impulsiveness and taking unnecessary risks, suicide threats or expressing a strong wish to die, giving away prized possessions, sudden purchase of a firearm and obtaining other means such as poisons or medications.

Since 50 to 75 percent of all suicides give some warning of their intentions to a friend or family member, these signs must be taken seriously.  You ask about a “moral” obligation.  If your feelings are to preserve life at all costs, you would probably be aggressive in your reaction.  If you believe that a person has a right to take their own life, you would be less concerned about their actions.  However, the most important question to be addressed is:  What can you do?  The most important thing you can do is listen.  Tell the person that you are concerned and give her examples from her behavior.  Don’t be afraid to ask if she is contemplating suicide.  Ask if she has a plan.  Ask if she is seeing a psychiatrist for medication and also seeing a therapist.  Do not attempt to “talk her out of it” or tell her “how much she has to live for” or other such platitudes.  While it may seem extremely difficult, just listen and let her know she is not alone.

If the situation is an acute crisis, do not leave her by herself. Remove all firearms, drugs or sharp objects that could be used for suicide.  As noted above, take the person to an emergency room or walk-in clinic at a psychiatric hospital.  If none of these options are available, call 911 and ask for an officer with mental health training.  You might also call the National Suicide Prevention Lifeline at 1-800-273-TALK, or click here to be redirected to their website. In addition to support, this source can also recommend on-line and in person support groups.

Finally, it is also imperative that she seek professional help.  If she is not in treatment, you can become actively involved in seeking it out.  You can be useful to her in finding a knowledgeable mental health professional or a reputable treatment facility.  If needed, I encourage you to physically accompany her to treatment.  I might also note that friends and family members of persons who have committed suicide are also at risk for psychological difficulties.  It is often important for those close to the situation also seek out counseling to deal with the emotions that are stirred by the situation. The DBSA website:  www.dbsalliance.org includes a referral list of professionals who have been recommended by their patients.  This is an excellent place to start.

~Dr. Manuel S. Silverman, PhD