Suicide is a deeply troubling issue, especially when it involves young people. In Australia, youth suicide is not just a statistic, it’s a reflection of the struggles that many Australians face. Suicide is a topic that is very close to my heart and I have had a lot of experience talking to people about suicide, I hope to impart a little knowledge and some strategies that you may find useful if you or someone you know is struggling with suicide and considering killing themselves.
How to talk about suicide with a loved one
Notice I said Killing themselves? It sounds so jarring and looking at it now while I am writing, it is a strange thing to write. However, it is essential to name what you are talking about. When you use open language, it indicates to the person you are talking to that you are a person who can talk to them about suicide. If you are not comfortable talking about suicide, name that as well, “I have a feeling that you may be thinking about killing yourself, I’m not sure I am the right person to talk about this but I would like to help you find someone to talk to, what do you think? Or “I’ve noticed some changes in your behaviour lately, you’ve been down and you’ve given some of your precious things away, sometimes people do this when they are thinking about suicide/taking their own life, I don’t think I am the best person to talk to about this but I could help you call lifeline if you’d like or can I help you find someone to talk to?
Some people think that if you say the word, suicide, this may push them over the edge, but evidence suggests the opposite. Whenever I have talked to people about suicide, naming it gets the conversation going, in many cases I notice a shift in body language. The shoulders can drop, the breathing may slow down, sometimes tears, sometimes anger, it is different every time. I am always buoyed by the fact that they are talking about suicide, it tells me that there is a part of them that wants to live.
Don’t be scared of silence in the conversation, sometimes you just need to sit with their pain and suffering, this can be draining and hard for you but if they are talking to you then this may be a sign that they have some ambivalence. Take your time, ask open questions when you can and reflect on their pain with empathy and no judgment.
Some statements/questions that may help;
I’ve noticed a change in you, you seem down
Taking your own life is the biggest decision you can make, if you’re not sure, would you consider leaving if for now and talking about it?
It sounds like you’re in a dark lonely place, it must be scary
If I’m not the right person to talk to about suicide, can I help you find that person?
Have you spoken to anyone else about this?
Have you told your parents or friends? Yes, that great, it must have been really hard/NO, I wonder if someone you loved was feeling how you are feeling, would you like the chance to talk to them?
How to recognise the signs of suicide in Australia's youth
Most of us lead very busy lives, juggling work, family, school drop-offs, sports, afterschool activities, parties etc and it can be difficult to recognise subtle changes in behaviour that may initiate a conversation about suicide. Here are a couple of signs to look for:
Giving away precious items
Changes in behaviour such as withdrawing from family and friends, not doing things that bring them joy like playing golf or hanging out with friends
Talking about things being hopeless, why bother, it’s all too hard, I feel trapped
Talking about death or openly discussing suicide
Unusual mood swings
If you notice any of these signs, it may be time to talk about suicide. Start the conversation with care, let them talk, listen, resist the urge to talk and to try and fix the problem, be present, encourage them to seek support and if you are comfortable, follow through with them. I use Lifeline as a resource and have made many calls with clients and supported them through the process, this introduces them to another support mechanism that they can use and it takes the mystery out of it. You can also contact Lifeline and they will do a 3rd party suicide intervention with you, essentially lifeline will give you some tools to have that conversation and this may help alleviate the anxiety and stress you may feel. I would also recommend seeking support for yourself at this time, the old saying “put your own oxygen mask before helping others”, I know that this is easy to say and hard to do.
How to assess the risk of suicide
As a Counsellor I am always assessing risk, especially with young people. I would recommend a 3rd party lifeline call or consider some training, ASIST is the best in my opinion https://melbourne.lifeline.org.au/training/workplace-and-community-training/
ASIST is run over 2 days and they will teach you the skills to do a suicide intervention and do a risk assessment, here are a couple of questions to asses risk from the ASIST model;
Have you thought of how you will kill yourself?
Have you picked a place to kill yourself?
Have you chosen a time to kill yourself?
Do you have the means to kill yourself?
Answer no to these, take a breath and sit with them, answer yes to them, and seek immediate support as in Lifeline or the Crisis Assessment Treatment Team (CATT) https://monashhealth.org/services/mental-health/acute-mental-health-services/
The CATT team with run through an assessment with you.
Resources
· Lifeline 13 11 14 https://www.lifeline.org.au/
· Headspace https://headspace.org.au/
· Beyond Blue https://www.beyondblue.org.au/
· Kids Helpline 1800 55 1800 https://kidshelpline.com.au/
· Suicide call back service 1300 659 467 https://www.suicidecallbackservice.org.au/
All of these services have an amazing amount of information on their websites and volunteers and employees who strive to support people. Like every service, sometimes you have an amazing experience, sometimes you don’t. If you are talking to someone and you are their approach is not resonating with you or the person you are supporting, hang up and try again, it is worth it. If you or someone you know is struggling with suicide ideation then ongoing support from a mental health professional is recommended and there are a few ways you can access this support.
Mental Health Plan
You need to see a GP to get a referral to a Psychologist, this usually has a gap fee that lasts for approximately 6 sessions that can then be reviewed. GP’s rarely refer to Counsellors as they are not able to give a Medicare rebate like a Psychologist or Social Worker can. Often a Counsellors cost is equivalent to the out of pocket cost with a Psychologist or Social Workers but waiting times can be an issue. You do not need to see a GP to access a Counsellor.
Find a therapist in Melbourne
Evidence suggests that the relationship built between the client and the therapist is the biggest predictor to positive change. Different people need different approaches and some prefer a Psychologist in an office whilst others prefer walking and talking with a Counsellor, invest in the relationship. Psychology Today lets you search your postcode and has profiles of therapists. https://www.psychologytoday.com/au?tr=Hdr_Brand
What to look for in a counsellor
Finding an accredited therapist is important. Counsellors, Psychologists and Social Workers should have an umbrella organisation that monitors their professional development and supervision hours, there is also ethical and practical codes of conduct. Here are a couple;
The Australian Counselling Association https://www.theaca.net.au can also search for Counsellors on this site.
Psychotherapy and Counselling Federation of Australia https://www.pacfa.org.au/
You can also search for Therapists on this site.
It’s their decision, not yours
At the end of the day, if someone decides to take their own life there is not a lot you can do other than be there, offer support and talk to them. It is not your fault, your responsibility, or your decision, this is a hard thing to come to grips with however I feel that it is true. I find that when I do a suicide intervention and I use an evidence-based model (ASIST), if I follow these steps, I know that I have done as much as I can do and then it is up to them. Talking to them about suicide and naming it will not make them kill themselves rather it will tell them that you are a person who they can talk to about suicide.
I have been a Counsellor for over 10 years and every time I talk to someone about suicide I feel drained, emotional and hopeful. I cannot imagine how hard it would be having this talk with my children, hopefully, I won’t have to however, if that time comes, I know what to do and you can as well. I find that debriefing with a supervisor helps me and for any parent out there, find a friend or family member you can debrief with or try Lifeline, they are a great resource for this however ongoing professional support may give you the best opportunity to work through it and gain some resources.
Look after yourself and lighten your load by sharing with a trusted person.
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