One week from today, or less by the time this is published, I'll be participating in the Out of Darkness Overnight Walk. It'll be the second year I'm walking it, and this year I'm heading to Boston to do so. Literally, we walk overnight, or as long overnight as it takes us to complete the 16-18 miles (the exact course is a surprise), starting at sundown-ish. The walk supports the American Foundation for Suicide Prevention, or AFSP.
When I tell people I'm doing this walk, their response generally falls into one of three categories. 1.) They address the walk itself but not the cause. Something like "wow 16 miles that's a lot". 2.) They directly address the cause, thanking me for doing the walk, ask about donating, etc. FYI, you people in category 2, you rock! 3.) They awkwardly think of a reason to leave the conversation.
The last of these three is way more common that it should be. It's not that people are insensitive. It's that they don't know what to say. The topic of suicide makes people squirm. So, for that matter, does the topic of mental health in general. Because if someone is doing a cancer or heart disease walk, people have no problem asking if they know someone affected. Or maybe they have been themselves and share a story. If they're walking for suicide prevention, nobody feels OK saying "oh, have you been suicidal? Do you know someone who killed themselves?". This just doesn't happen. At least not outside of the mental health community. In fairness, it is difficult to find a tactful, sensitive way to address this. Still, to me it means all the more reason to address it. Particularly, I wanted to share some rather vital information on what to do if you think, or know, someone you care about may be suicidal. I'd like to note, as always: this is my position as someone with a mental health condition, not a mental health professional.
1. DO NOT threaten them in any way. This may sound obvious, but it's not, apparently. Example: do not react by threatening to call the hospital, or the police for that matter. Do you know what this does? This moves them closer to suicide. You've just told them that they're options are death, the "mental hospital" (possibly with little or no control over their release), or the police station/possibly jail if the police decide the person is "dangerous". Sadly, the latter happens all too often, because the media has made those with mental health conditions an easy, yet inaccurate, scapegoat. If someone is suicidal and given the three options above, death may well look like the best one.
2. Take them seriously. This might seem contradictory to the above. Certainly, if you're taking them seriously, you'd get them help, correct? Correct. But they do not view you giving them up to someone who will hall them off to some sort of system or another, with results beyond their control, as help. Instead, talk to them. Ask them what you can do, what they need? Do not ostracize them. Trust me, if they're planning to take their own life, or even thinking about it, they're feeling ostracized enough. Make them feel loved, valued, needed. Show them they can trust you, and that there's a reason to live. And if you earn that trust, do not disappoint them - not now, not later.
3. Do not throw religion at them. Telling someone they'll burn in hell if they take their life will not help. If they're truly religious, they'll feel like either it's hell on earth, or hell in death, so what's the difference. If they're not religious, quite honestly they could care less where you think they'll end up, and this will just look like you not supporting them.
4. Likewise, don't use the refusal of a proper burial or something similar against them (Catholicism traditionally says that those who take their life should not have a Christian burial. Other religions may as well, I just am not as familiar with the teachings). This feels to them like not only have you given up on them in life, but you're giving up on them in death.
5. Don't mock or goad them. This is a no-brainer, right? Sadly not. Suicide is not weak. It is not selfish. It is NOT THEM TRYING TO GET ATTENTION OR PITY. Yet those who are suicidal or have ever thought about it are constantly accused of all three of these. To the person thinking of suicide, they are desperately searching for a way to finally escape the pain of life. Your doing any of the above will only prove to them why they need to escape.
6. Just because someone has said previously that they're thinking of suicide, and has not attempted (to your knowledge), does not mean they won't in the future. Thinking so could be a critical mistake on your part.
7. Do not use the word "successful" to refer to a suicide. There is nothing successful about someone losing their life.
8. Do not refer to an attempt that does not result in the end of a life as a "failed attempt." This person already feels like a failure in life. Now they'll feel like a failure in attempting to end it. They'll feel like they "can't even kill themselves correctly". It'll only serve to further their feeling of worthlessness. Next time, they may well ensure they do not "fail."
9. Do not give them an ultimatum. You'll be giving them a choice between a life they don't want and a death they do. Guess which one they'll chose?
10. Do not believe that someone who suddenly seems "recovered" is actually OK. Growing up, I had an old neighbor who had outlived his wife, both kids, and most of his grandkids by many years. One day, he fell off the porch and intentionally didn't call for help. He laid there for two days, not making a sound, hoping to die, because this life held nothing for him any longer (he was found, finally, but passed a few days later). When someone's finally made the decision that they want to die, they see the end of the pain, and they may feel at peace. They may appear suddenly, almost miraculously, improved, because to them, the struggle is almost over. Watch them carefully. *Note: Those with cycling disorders, especially rapid cycling, may in fact swing from one extreme to the other quickly as part of their condition. This makes it additionally tricky to know if they're feeling "better" (i.e. have gone from depressed to (hypo)mania), or have taken a sudden down turn and are suicidal. Watch them extra carefully.
11. Some people who are suicidal show absolutely no "signs". They may never be diagnosed with a mental health condition. Even if they are, they may never talk about suicide. They may, in fact, put on a particularly happy facade in order not to alert anyone. Or they may not want to "burden" or worry anyone so they keep it to themselves. This doesn't mean they are in any less danger.
12. Suicide does not discriminate. There is no age, ethnicity, gender, social status, level of "success" that buffers against suicide. Do not assume that someone is immune because of any of these factors.
13. If someone asks to talk about how they're feeling/their condition/their suicidal thoughts, by all means, please, for the love of everything, talk with them! And even if they don't ask, if you notice something may be wrong, reach out. I watched a documentary about a gentleman who said that he got on a bus, headed towards a bridge, prepared to jump and end his life. He said he'd decided that if one person showed concern, he'd feel like his life mattered, and he would not jump. He rode several buses, and walked miles of city streets, clearly crying and distressed. Not one person stopped him or asked if he was OK. Someone even stopped him and asked him to take a picture of them on the bridge as he was preparing to jump. They took no notice of his condition and walked happily away, their picture taken. He jumped. He lived. This happened not once, but twice. The only reason he's alive today is because he happened not to die either time he jumped, and took it as a sign that his life should go on. But had just one person, even a complete stranger, stopped him, asked if he was OK, listened to him, offered to help, he wouldn't have felt he had to jump at all.
I know this isn't a cheery topic. For that reason it's an incredibly imperative one to discuss. For all who have supported and donated to my walk, I thank you, from the bottom of my heart. You truly have made a difference. On Saturday, I'll be walking for all of those who no longer can. With your support, I know I will not be doing it alone.