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CHAPTER 11 ■ Suicide Prevention
suggestions for interacting with people who are suicidal: ■■ Acknowledge and accept their feelings and be an active listener. ■■ Try to give them hope and remind them that what they are feeling is temporary. ■■ Stay with them. Do not leave them alone. Go to where they are, if necessary. ■■ Show love and encouragement. Hold them, hug them, touch them. Allow them to cry and express anger. ■■ Help the person seek professional help. ■■ Remove any items from the home with which the person may harm themselves. ■■ If there are children present, try to remove them from the home. Perhaps friends or relatives can assist by taking the children to their home. This type of situation can be extremely traumatic for children. ■■ DO NOT judge suicidal people, show anger toward them, provoke guilt in them, discount their feelings, or tell them to “snap out of it.” This is a very real and serious situation to sui- cidal individuals. They are in real pain. They feel the situation is hopeless and that there is no other way to resolve it aside from taking their own life. Intervention With Families and Friends of Suicide Victims Suicide of a family member can induce a whole gamut of feelings in the survivors. It has long been recognized that the bereavement process for families in which a member has taken their own life is compli- cated and requires an understanding by health-care providers of some unique burdens of this type of loss. Macnab (1993) identified the following symptoms that may be evident in family and friends after the suicide of a loved one: ■■ A sense of guilt and responsibility ■■ Anger, resentment, and rage that can never find its “object” ■■ A heightened sense of emotionality, helplessness, failure, and despair ■■ A recurring self-searching: “If only I had done something,” “If only I had not done something,” “If only . . .” ■■ A sense of confusion and search for an expla- nation: “Why did this happen?” “What does it mean?” “What could have stopped it?” “What will people think?”
■■ Do not keep secrets. If a suicidal person says, “Promise you won’t tell anyone,” do not make that promise. Suicidal individuals are ambivalent about dying, and suicidal behavior is a cry for help. It is that ambivalence that leads the person to con- fide to you the suicidal thoughts. Get help for the person and for you. The national hotline 1-800- SUICIDE is available 24 hours a day. ■■ Be a good listener. If people express suicidal thoughts or feel depressed, hopeless, or worthless, be supportive. Let them know you are there for them and are willing to help them seek profes- sional help. ■■ Many people find it awkward to put into words how another person’s life is important for their own well-being, but it is important to stress that the per- son’s life is important to you and to others. Empha- size in specific terms the ways in which the person’s suicide would be devastating to you and to others. ■■ Express concern for individuals who express thoughts about suicide. Individuals may make veiled comments or comments that sound as if they are joking, or people may be withdrawn and reluctant to discuss what they are thinking. In each case ask questions, acknowledge the pain and feel- ings of hopelessness, and encourage individuals to talk to someone else if they do not feel comfort- able talking with you. ■■ Familiarize yourself with suicide intervention resources, such as mental health centers and sui- cide hotlines. ■■ Ensure that access to firearms or other means of self-harm is restricted. ■■ Communicate caring and commitment to pro- vide support. Fleener (n.d.) offers the following BOX 11–4 SAFE-T: Suicide Assessment Five‑Step Evaluation and Triage 1. Identify risk factors. Note those that can be modified to reduce risk. 2. Identify protective factors. Note those that can be enhanced. 3. Conduct suicide inquiry. Evaluate suicidal thoughts, plans, behavior, and intent. 4. Determine risk level and intervention. Choose appropriate intervention to address and reduce level of risk. 5. Document. Record assessment of risk, rationale, inter- vention, and follow-up.
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