How many of us have said these statements either in our heads or out loud to a trusted loved one? Were we thinking about suicide when we said it? Maybe. Maybe not.
“I can’t take this anymore!”
“I give up!”
“I just want to quit!”
So how can you know? Isn’t it better to “be safe than sorry”?
Many of us remember the day last June when we lost a dear friend to suicide. She did post a statement similar to the ones above just hours before her death. Concerned people jumped on board to encourage her not to give up. In the end, our “help” did not matter. We are still grieving her loss.
I can tell you countless stories of similar posts where quick action stopped a tragedy. I can also tell you that posting encouraging words were not the actions that saved a life. What it took were people who knew how to get the right kind of help to the person in suicidal crisis.
For every genuine cry for help there are dozens of people who use these statements to express their frustration at a health care system that provides meager help for their suffering. Many times these statements are nothing more than the exasperated words of a patient who does not know what to do next — not a suicidal threat.
That doesn’t mean we don’t take these type of posts seriously.
The important thing to remember is to stay calm. If we over-react to every frustrated patient who is sick and tired of stupid doctors then we risk alienating the very people we are trying to help. It is also important to know your own limits. If you are not qualified to assess the severity of an apparent suicidal threat, then don’t even try. That doesn’t mean you can’t help.
Here is what you can do:
Don’t assume that every expression of frustration is a suicidal threat. It is probably still a cry for help, so write back asking for clarification. Find out what it is that has the poster ready to “throw in the towel”. In my experience, I have been “ready to give up” many times, but my expression was no a suicidal threat. My “giving up” usually meant I was tired of doctors not helping me and I wanted to fire them but I didn’t have any other alternatives. Validate their frustration by acknowledging their right to be pissed off. Sometimes we all go on “we hate doctors” rants. The point is to have a conversation with the poster rather than flame them with “don’t give up” replies. Frankly, when I have been at this point, what I needed was understanding and validation, not to be surrounded by people who were unnecessarily panicked on my behalf. It is certainly okay to ask the person what it means to “give up” or directly ask if they intended the make a suicidal threat. This will not make them more likely to complete suicide!
So what if someone posts and actual suicidal threat, using more specific statements, like “Goodbye world, I’m moving on.” or worse yet, “I’m going to kill myself”? That’s reason for concern and there are steps you can take. Someone who is expressing suicidal threat needs the support of trained mental health professionals. In a crisis, the best way to get this help is through emergency services. It can be a daunting challenge to figure out how to get this help when you might not even know the person’s real name. When all you have is a user ID and an avatar how in the world will you get paramedics to the person in time?
If I know the person outside of social networks (i.e. He or she is a real live friend) then I will try to reach them directly. If I can’t then I will call emergency services in their hometown and request a “welfare check” to make sure my friend is okay. If I don’t have a relationship with the poster, I will still reply to the post with something like this:
I’m so sorry you are feeling this way and care about your safety. Please know that there is help available. Take a minute to visit http://www.suicidepreventionlifeline.org or call 1-800-273-8255 and talk to someone then post back and let me know how you are doing.
Then I will follow the reporting procedures for that particular social networking site. Each one has a policy for reporting, so it’s important to have those links available in case of such an emergency. I have listed as many as I can find below for handy reference. Take some time to visit each one and bookmark the link so you are prepared if anything happens in the future.
Not all sites have specific reporting procedures for a suicidal threat. Facebook and Twitter do. The rest have generic reporting forms you can use. Even if you don’t know the person’s real name or where they live, by reporting what you do know, then the company who sponsors the site can locate the user and report the threat to local emergency services.
Knowledge is power, ladies and gentlemen. Knowing what to do in an emergency is half the battle.
National Suicide Prevention Hotline
Suicide Prevention Resource Center – Guide to suicide threats on social networking sites
Letting Go – Nice blog with good resources
Another psychologist’s point of view
A beautiful description of this issue from an amazing friend, Alejandra Cavanillas.
This post is dedicated to the thousands of migraineurs who care enough to respond when one of our own is at the end of his or her rope.
Disclaimer: A suicidal threat is a medical emergency that should be addressed by trained health care professionals. Please do not try to “talk someone down” from such a threat without the proper training or in an inappropriate location (i.e. online). Simply refer them to the appropriate help listed above or call 911.