Assessing for Suicide Risk

Our brains can’t make sense of these back to back tragedies.

Here’s what I thought I knew:

Kate Spade:

Exterior = happy, colorful, accessible, inclusive, spirited, fun.

Anthony Bourdain:

Exterior = Lived life to the fullest, curious, man of the people, traveler, risk taker, zest for life

Here’s the cold reality of today: they have both chosen suicide as the way out of something unbearable.

What did the interior look like for each of these people? Most of us will never know.

I can’t begin to imagine the pressure either one of these public personalities must have felt. Sure, they had tons of money and fame, but at what cost?  What façade did you have to hold up every day, in order to be who all of us want you to be?  Was there room and support for them to fall apart, or reckon with their demons?

The next feeling many of us have around this sad news is:

If it can happen to them, it can happen to any of us.

It’s terrifying.  And it’s terrifying because it’s true.

I volunteered at CTL, a crisis text line service, where teens (and adults) in crisis can text with a counselor anonymously.  It’s an amazing resource, especially considering the texting is the only ways teens communicate in this day and age.

“Crisis” ranged from more manageable issues like pressure to get good grades and breakups to traumatic realities like cutting, eating disorders, bullying, abuse… and most of which were accompanied by heavy depression and anxiety.

As a counselor, I was trained to assess for suicide risk.  Sometimes, when the crisis is so big and so insurmountable, suicide can feel like the only way out.

We asked straight forward, direct questions to the texter:

“Are you thinking about killing yourself?”

“Do you have a plan of how you would do it?”

“Do you have a time frame when you’d likely do it?”

“Do you have access to a weapon?”

This is risk assessment.

Depending on how many yes’s we got, we escalated and called 911 and sent the cops to their location.  The priority at that point was saving their life.

I remember during my training, that volunteers (myself included) were afraid that bringing up the subject of suicide would actually make the person think about it. That it would give someone the suggestion.  As if it was something they hadn’t thought about before, and we put it into their heads.

I can tell you from experience (after I got over my initial fear of speaking so plainly)…

It’s not true.  Every time I asked these questions (straight forwardly) to someone in crisis, they answered either yes or no, in an equally direct fashion.

And if it was a “yes”, it was actually a relief to them that someone was willing to talk about it with them, to look at the taboo subject of suicide with them. To sit with them, without bringing judgment or flowery language to skirt the issue. They had their own fears and judgements about suicide and to have someone simply support them openly was freeing.  They felt seen.  And this was often just enough to keep them from going through with it.  To have another person see them and care whether they lived or died.  Even a stranger via text message can be enough to keep someone alive, if the empathy and connection is made.

So let’s be brave and TALK ABOUT IT.

NOT TALKING ABOUT IT is what’s gotten us to this dark place.

If you feel like your friend isn’t his or her usual self, ask them what’s going on. Be unabashed. Be unafraid to ask straight forward, direct questions.  Let them know that you are here, and that you love them.

 

Additional info on CTL resource:  https://www.crisistextline.org/

 

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