Suicide: When prevention is better than cure
By Soh Yoke Wah
As a person who never had a suicidal thought, it was hard for me to fully comprehend what hardships or sorrows a person goes through for him or her to come to a state where the wish to die is so much greater than the wish to live. Perhaps you are like me, but this does not mean we cannot do anything to help.
According to Benjamin Franklin, “An ounce of prevention is worth a pound of cure.” For those of us who are around people who are struggling, we can move from being helpless bystanders to doing our part in reaching out to help those who are struggling with suicidal thoughts to prevent an otherwise tragic outcome.
Why do people take their life?
Understanding why people take their life is a good starting point to reaching out to them. Research shows that suicide involves the interplay of various psychological, social, biological, cultural and environmental factors. These risk factors vary with age, gender, and ethnic group.
Some of the key risk factors that may contribute to suicidal ideation and attempts are:
- Psychological issues e.g. acute depression, post traumatic stress disorder (PTSD), bipolar disorder
- Chronic illness e.g. AIDS, cancer
- Grief and losses of significant loved ones and relationships
- Failed or failing relationships with loved ones
- Financial issues or resulting devastating changes in lifestyle
- Events that bring forth great shame and disgrace
- Severe social rejection and isolation
- Sexual, emotional or physical abuse
- Substance abuse e.g. drugs or alcohol
- A family history of suicide
- Prior suicide attempts
It is important to note that not everyone who has the above risk factors is suicidal. As humans, we are all wired to strive for survival and thus many people choose to fight in times of stress and threats. However, there are others who would seek to escape life through suicides especially when they could no longer love life or find any meaning in it. Sometimes, they may not wish to die but yet they see no way out of their problems except through suicide. There are yet others who attempt suicide as an unconscious cry for help, a means for revenge, or as merely a way to manipulate those who are emotionally close to them.
What can I do to help?
There is a suicide prevention strategy developed by Wesley LifeForce in 1996 called See Ask Listen Tell (S.A.L.T). This intervention could be a good and simple guide for us who seek to play a role in preventing suicide:
NOTICE the warning signs
When the suicidal individuals are ambivalent about suicide i.e. one part of them wants to die but the other part wants to live, they often give warning signs to let others know that they are in trouble. Tt is important for us to recognize these warning signs and to take them seriously as we are better off over-reacting than under-reacting in this case. Once we notice any warning signs, we can be proactive in reaching out to them, offering them immediate
help they need and ensuring their safety before it is too late. If you notice somebody with the following signs, they may be at risk of suicide:
- Sense of hopelessness;
- Talking about suicide;
- Isolating themselves;
- Perceived burdensomeness i.e. when a person starts to think that others are better off without him or her;
- Displays extreme mood swings;
- Exhibits drastic changes in behaviour
According to many research studies, social isolation can increase the risk of suicide while strong connectedness can be protective against it. As such, if you are aware that someone may be at risk of suicide, you can help by reaching out and connecting with them. Offering them your friendship, help and support may convince them that they are not alone in their suffering and pain, and thus could be life-saving. Here’s what you can do:
1. ASK about suicide intent
When you are concerned that someone may be at risk of suicide, ask them directly about their suicidal thoughts and feelings. This is not an easy thing to do as most think that if you ask these individuals directly whether or not they are thinking of killing themselves, you are actually planting the suicidal ideas in their head. To the contrary, asking this question often offers these individuals opportunities to be open with their suicidal thoughts and the reasons for them.
2. LISTEN to the person
In order to help the suicidal persons, you have to understand what pain or hopelessness that has brought them to a stage where they want to end their life. Start by letting them share about their experiences and struggles while listening attentively. Often, the simple act of sitting together and expressing in words their overwhelming feelings may calm them down and may bring them hope about their situation. Once they feel safe in telling you about their struggles and pains and feel that you understand their situation and care, they may be more willing to discuss and explore with you more constructive solutions other than ending their life.
It is important to not rush into talking the person out of suicide or to convince them how wonderful life could be. Worse, avoid getting into arguments with them about the reasons why they shouldn’t take their own life. If you do so, you may just help confirm their feeling that no one actually understands the depth of their pain and distress. Keep in mind that what may seem hopeless to them may not seem hopeless to you at all. As such, learn to see their situation through their perspectives, as they are experience and feeling it. This can be a big help in reducing their feelings of isolation.
3. TELL or TAKE the person to appropriate help
Apart from listening and exploring alternate options with the suicidal individuals, it is equally important to develop an action plan that will keep them out of immediate harm and get them the help they need. If you think that someone is in immediate danger of suicide, inform his/her immediate family or take them directly to the emergency room at any hospital. Otherwise, follow up with them to make sure they are okay and to let them know you care about them staying alive. Also, connecting them to local therapist who could help them further.
About the author
A former accountant cum montessori teacher, Yoke Wah, or fondly known as “Yoki” is one of our bilingual therapists at KIN & KiDS who can speak English, Malay, Mandarin, Cantonese and Hokkien. She is also a Licensed and Registered Counsellor. Read more about her here.