DEALING WITH SUICIDE THREATS

                   DEALING WITH SUICIDE THREATS
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     FEEL FREE TO DISCUSS SUICIDE.  Don't be afraid to ask, "Do
you sometimes feel so bad you think of suicide?"
     At one time or another, just about everyone has considered
suicide, however fleetingly.  There's no danger of your "giving
someone the idea."
     In fact, it can be a great relief if you bring the
question of suicide into the open.  Discuss it freely without
showing shock or disapproval.  Raising the question of suicide
shows that you're responding to the person's distress.
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     ASSUME THEY'RE AMBIVALENT.  Suicidal people have a deep
wish to both die and be saved:  "I want to kill myself, but I
don't want to be dead -- at least not forever."
     What most suicidal people want is not death, but some way
out of the terrible pain of feeling, "Life isn't worth living.
I'm not fit to live.  I'm all alone with this.  I don't belong.
Nobody cares."
     If you ease their pain even a little, their will to live
will overpower their desire to commit suicide.
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     ESTIMATE THE ACTUAL RISK.  If the person says, "Yes, I do
think about suicide," take it seriously.  Ask:
     o "Have you thought of how you'd do it?"
     o "Do you have the means?"  (If he says he's going to use
a gun, ask, "Do you have the gun with you?"  For pills:  "What
pills?  Do you have them?  Have you taken anything?")
     o "Have you decided when you'd do it?"
     o "Have you ever tried suicide before?"  ("When?  How?
What happened then?")
     o "Have either of your parents been attempted suicide?"
     If the person has a definite plan, if the means are easily
available, if the method is a lethal one, if the time is set,
if there's a history of suicide -- the risk of suicide is very
high.
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     KEEP THEM TALKING.  The best thing you can do is LISTEN.
Even people without special training can be very helpful in
encouraging suicidal people just to give vent to their
feelings.
     Allow the person to unburden without being interrupted,
judged, cricitized, rejected, or told what to do.  Often the
tension drops, the pain is relieved, and the suicidal feelings
pass.
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     TAKE THEM SERIOUSLY.  Acknowledge that they're feeling
bad.  Tell them, "It sounds like a difficult thing to be going
through."
     Avoid dismissing their feelings with remarks like "You're
okay" or attempts at humor.  Also refrain from blaming them.
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     FOCUS ON THE FUTURE.  You can buy time for them by calling
on their intense desire to go on living.  Some things to say:
     o "Suicide is a permanent solution to a temporary problem."
     o "Can you guarantee that it won't be better in five
weeks?"  "Five months?" 
     o "Time heals.  It seems like it won't pass, but it will."
     Get them to wait a while.  "Put a date on the calendar.
Then see how you feel."  Try telling them, "Promise me you
won't kill yourself until you've spoken to me again."
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     "YOU'LL NEVER KNOW."  A good point to make is, "If you
kill yourself, you'll never know how things would turn out."
     If the person says, "I'm too shy," you might say, "If you
kill yourself, you'll never know if you could overcome it." 
     If they have problems with a relationship, you can say,
"You'll never know if you'd meet someone."  Money problems?
"You can always make more money."
     Add this positive note:  "Now you know what to avoid.
You've learned something."
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     OFFER ALTERNATIVES.  Suicidal people's thoughts become so
constricted that they can't see the range of solutions open to
them.  They view their situation as black or white, all or
nothing.  Suicide seems like a good option because they don't
know what else to do.
     If they want to meet new people, you can suggest exercise
clubs, taking a class, going to the library, becoming active in
church, etc.  Talk about radical change they can make in their
lives:  Find a new talent.  Leave the country.  Get a different
job.
     Don't expect them to take your specific advice.  You're
mainly reminding them that there ARE alternatives.
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     EASE THEIR GUILT.  Suicidal people usually have deep
feelings of shame, hopelessness and isolation.
     Tell them, "A lot of people are like you.  You don't
think so?  You don't know what's going on behind people's
pleasant facade."
     If you've had a similar problem, share it.  Mention that
you thought it would never pass, and it did.
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     REMIND THEM OF RELATIONSHIPS.  Ask if they're willing to
give up their family and friends.
     "How would your family feel?  Don't you think your family
would want to know you're thinking about dying?"
     Mention that you personally would feel very bad.
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     LET THEM KNOW THEY'RE IN CHARGE.  Suicidal people feel out
of control of their lives.  They CAN control their living and
dying, which is one of the attractions of suicide.
     Keep telling them, "It's your choice.  I don't think it's
a good idea to kill yourself, but it's your choice."
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     URGE THEM TO CALL A SUICIDE HOTLINE.  All the person need
do is dial "0" and ask the operator for the nearest suicide
prevention service.  In an emergency, the operator will make the
connection directly.  Within a moment the person can be talking
with a trained volunteer.
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     YOU'VE DONE YOUR BEST.  As much as is reasonably possible,
follow the rule for dealing with most suicide threats:  Don't
leave suicidal people alone.  Stay with them until help arrives
or the crisis passes.
     However, in online threats, the person can simply break
contact.  If that happens, don't take it personally.  Try as
you might, it's not actually your decision whether people
commit suicide or not.
     Whatever the outcome, you can take satisfaction from having
done your best to save them.
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.REFERENCES
     Edwin S. Schneidman, M.D., School of Medicine, University
of California, San Francisco
     Suicide Prevention Services:
      The Samaritans of New York
      Grass Roots of Baltimore
      Family of Woodstock, N.Y.