Saturday, October 27, 2012

Who is at Risk for Suicide? Here are some things to look for

On Thursday evening we talked about becoming gate keepers, people who are trained to look for suicidal warning signs and risk factors that might be able to clue them into a persons mental state and be a sign that they are thinking about committing suicide.  Keep in mind that there are a lot of factors that can be present and certain individuals are at higher risk then others.  In this blog entry I want to focus on some risk factors that you may notice when talking to someone that might be an indicator that they are considering or contemplating suicide.  Remember, you cannot tell by looking at a person what their mental state is, so you need to be aware of what they say to you and how they act around you. These could be major clues as to whether or not they are thinking about committing suicide.  It is always better to be safe than sorry.

Potentially everyone of us is at risk for suicide or suicidal thoughts.  But here are some facts that you should know, these will help you when you are talking to others to feel out what they are trying to say and if they might in fact be a risk for suicide.  How you bring out the information you need is up too you and how you handle the conversation.  But this is what you should be aware of people with previous suicide attempts are more likely to actually go through with it than a person who hasn't.  People suffering from mental disorders, or returning veterans that could be suffering from post traumatic stress disorder.  Just keep in mind that not only veterans can have post traumatic stress disorders, so can individuals who have been involved in or through any type of traumatic experience.  Such as rape, car accident, fire, flood, natural disaster, loss of a loved one, etc.  Any type of trauma can trigger the disorder.  It is important that you listen to the person as they are talking to you and be receptive to what they are trying to tell you.  Remember that most people that are contemplating suicide or talking about it don't really want to die, they feel utterly hopeless and trapped and only want their pain to end. So find out all you can about them and the surrounding situation, this will help you assess the risks.  You also need to remember to keep your feelings about suicide out of the conversation, this isn't about you, it is about them and their needs.  They may have different cultural or religious beliefs that may in fact support suicide and that is something you need to be aware of.  Find out if they are ill, illness can bring with it a host of problems and expenses that can overwhelm and individual and leave them feeling vulnerable and trapped with no way out.  Or it could be legal problems, again when a person feels trapped and hopeless, without an escape route depression and suicide can creep in.

It can also become very easy for individuals who think that they are alone and having to face daily stress, such as losing their job, or being bullied at school or even going through physical or mental abuse. Stress can definitely lead to depression, and as I have said before depression and sense of hopelessness are very important factors in suicide.  But, you should also be aware that a person whose family has a history of suicide is definitely at risk and if their family structure changes because of divorce, separation, loss of a loved one, loss of possessions or job, a child, miscarriage and other factors need to be looked at as well.  The more information you can find out about the person and their situation, the better able you are to assess the potential for suicide, offer assistance, and get them the appropriate level of help.  Remember they came to you to talk about their plans and troubles, they didn't go to a therapist, counselor or other mental health professional.  Maybe they can't afford to seek out professional help, or they view you as a friend or because you go to church with them a family member.  Whatever their reasoning it is up too you.  The more you get them talking and digging into the problem, gives you more information, and may even lessen their anxiety level.  Just by you being a compassionate, sincere listener you may just have saved their life. Because once it is all out in the open, they won't feel so weighed down by their problems, and just by talking about it might bring them a different focus or perspective that allows them to think more clearly about the situation or crisis that they are going through.

Life can be overwhelming for anyone, and bills are piling up in this economy, and money just isn't going as far today as it did yesterday.  It is easy to become weighed down and burdened by stuff like this, and add on loss of work and other factors and you have a ripe situation for suicide.  All you have to do is be a patient listening ear, a friendly face and voice to help them see that someone does care and that they aren't in this alone.  Too often people think that they are in it by themselves that they have no one to turn to for help or guidance, and just by you being there can make all the difference in the world.  You may never know how your words of kindness and sympathy may impact another persons life, nor do you know where that casual conversation you have might take you.

The last risk factor that I want to talk to you about is lethal means, you need to find out if they have access to weapons, guns, knives, pills, or any other type of means that might provide them with a lethal way to injure themselves.  If you identify that risk in your conversation I urge you to find away to keep them away from it, never let them be alone, and get them help and assistance at the earliest possible opportunity. You are not a trained counselor, and it isn't your responsibility to put yourself or anyone else in harms way, including the person you are talking too. Getting them help as appropriate is essential in keeping them from going through this situation and crisis over and over again.

So here is what I want you to take away from this entry. Pay attention to others when they talk to you, really hear and comprehend what they are saying to you, listen and be aware that they maybe reaching out to you and crying for your help, be compassionate and sincere when they are talking to you, find out as much information as you can about the crisis that they are feeling and going through. Get as much back fill information as you can gather, about family, friends, and any illness, legal problems, trauma that they might have experience. Stay with them and refer them or get them the help that they need.

Let me review what is written above:  Who is at risk for suicide?

People with:
- previous suicide attempts
- mental illness including Post traumatic stress disorder
- co-occurring mental health and alcohol/substance abuse
- cultural and religious beliefs that may support suicide
- physical illness
- resistance to accessing mental health treatment
- easy access to lethal means, especially guns
- legal problems, incarceration etc.
- stressful life event or loss: job loss, abuse sexual/mental, bullying
- family factors :
            - family history of suicide and violence, emotional issues, low level of communication and coping skill
            - change in family structure such as:
                - divorce
                - separation
                - loss of an important person
                - loss of capacity
                - death of a loved one or friend

After going over this I see that I left out loss of capacity when I was talking above, and this can be an older person who thinks that they are no longer useful, they have to depend on others to help them accomplish simple tasks that they were so used to taking care of on their own before.  They feel like that have become a burden on everyone around them and may feel that their frailty and weakness is too much to bear.  Or it could be because of physical illness like I discussed earlier, but wanted to draw a little more attention to this, because of how close it hits to me and my situation.

I too at times go through the feeling of diminished capacity because of the surgeries I have had and the scaring, the bags and everything else that I have been through.  I have to admit that I have some amazing friends that have accepted me inspite of these limitations and modifications to my body.  But the fear still remains that one day I will find myself alone with no one that can love me because of the damage that has been done to my body.  If you would like more information about this check out my blog on "Inner Demon Finally Revealed...Is there still hope?"  I am sure you will find out how deep my fears go, and you can read my blog entry on "True Friendship" and how my friend Jason Blake saved my life by just sitting there and listening to my fears and helping me see that I am someone that can still be loved and that I have something to offer the world.

Trust me when I tell you that all you have to do is listen, extend a hand in friendship, be sincere, and compassionate and loving to others and you can change their life.

As always my hopes and dreams are with you,

Uncle B