Sunday, September 04, 2011

What to say to someone at risk of suicide

By now, many of you have seen a news item that public speaker and social media expert Trey Pennington committed suicide this morning.

I did not know Trey personally. He was one of my earliest Twitter followers (one of over 100,000 people he followed). If you look at his Twitter feed, even just before he passed away, you will see someone who was incredibly upbeat, articulate, and giving to others. And perhaps today, someone who reminds us that depression and hopelessness can strike anyone – even someone with enough friends to fill a small city.

Which brings up something I strongly feel everyone should know, just like we learn first aid or CPR. Most of us have the best of intentions when someone in our life is depressed – but in reality, we have no clue what to say. So we say things that don't help – or make the other person feel worse – or worst of all, we say nothing at all. (As one example, most of the things we think will motivate or cheer on a depressed person do not actually help.)

In 2005, when I was a crisisline counselor, I penned an anonymous piece for the Ithaca Journal about what we are trained to say to people in crisis. (Crisisline counselors, while actively serving, remain anonymous in the community.) I personally did not know these skills until I was taught them. If everyone learned them – especially how to really listen, without giving advice or "fixing" the other person – it would have a real impact.

People may not realize that crisis counseling is incredibly effective. Informal studies have shown that people who call crisislines are much more likely to stay alive afterwards. So if you are hurting, please, please call 800-273-TALK from anywhere in the USA, 24 hours a day. Be safe and be well.

* * *

As a volunteer for Suicide Prevention and Crisis Service, I am fortunate to work alongside a great team of staff and volunteers. Together, we help over 10,000 callers a year from all walks of life - and while the calls themselves are anonymous and confidential, some of the life lessons they teach us are worth passing along to all of us.

First of all, you might think that the main function of an agency called Suicide Prevention and Crisis Service is to prevent people from committing suicide. Wrong. That happens to be the most critical thing we do, and we are highly trained for it. But what usually happens day in, day out, 24 hours a day on the SPCS Crisisline is something that is even more important: we show respect, dignity and understanding to a great many people who often experience none of these things in the rest of their life.

You see, the typical Crisisline caller isn't about to commit suicide. The typical caller may be a teenager whose parents constantly scream at him about his clothes, his tattoos and his attitude - but is feeling lonely and scared. Or a severely mentally ill person who is keenly aware of the strange looks she gets from passers-by, and feels ignored and rejected by her family, friends and caregivers. Or a retired professional who feels alone and useless, as his once-busy days now drag on endlessly. Or someone who feels compelled to cross-dress, or cut themselves, and feels out of control.

They could be any of literally thousands of people in this community who are hurting in ways that make them feel alone and different from the rest of us - and desperately need to talk with someone.

Here are some of the things that crisis counselors do when these people call the SPCS Crisisline:

Really listen. When someone has a problem, human nature is to give advice - or criticism. Crisis counselors never do either. Instead, they listen - and continually acknowledge the feelings of the person they are listening to. This creates a zone of acceptance where people can truly open up and start to examine and solve problems.

Check for safety. Many of us are afraid to say anything when we are worried someone might hurt or kill themselves - sometimes, tragically, until it is too late. Crisis counselors check with every person, on every call, to make sure they are safe. Never be afraid to ask frankly if someone has been considering suicide.

Focus on the present moment. Crisis counselors cannot cure mental illness, take away losses, or fix someone's life. What they can do, perhaps better than anyone, is look for the one most important thing bothering someone right now. These "focusing questions" help shift the dialog toward making small, positive steps - the act of which is very important in crisis.

Explore alternatives. The next step in someone's life might involve a community resource, like counseling or shelter. Or it might just involve discussing feelings and alternatives with an empathetic and non-judgmental person. Crisis counselors help people explore their options, and make choices that are best for them.

Establish a safety plan. Above all, if someone has expressed a risk of committing suicide, work with this person to develop a plan for what they will do when they are overwhelmed - who they will call, what health care providers will be contacted, where they will go. Then ask this person to contract with you to execute this safety plan - and call you, or a crisisline - before they decide to act on feelings of suicide.

If we each started treating the people in our lives like this - whether it is our spouses, our children, our co-workers, or even the person sitting next to you at the bus stop - the difference would be truly life-changing, for them and for us. And in some cases, perhaps life-saving.

No comments: