On our courses, we are being asked more and more about how to have conversations with people who talk about having suicidal thoughts. As the Christmas season and January approaches, I thought it might be helpful to capture some thoughts about how you could navigate such conversations. To help me write this I do draw from the expertise of The Samaritans.
Before looking at communication skills that can help you have these sensitive conversations there are a couple of things you need to consider.
Communicating with someone who expresses suicidal thoughts requires sensitivity, empathy, and a non-judgmental approach. Here are some key steps to effectively support individuals in distress:
Initiate a conversation by expressing your concern and willingness to listen. You want people to feel able to talk to you and to feel safe in your presence. They need to feel valued and important. You might want to ask some open questions to try to get them to start talking to you. If you are with a patient who explains that they have been having suicidal thoughts, you might want to ask them to explain how they have been feeling, how are they feeling now, and listen to their responses. Summarise what you hear them say, to let them know that they have been heard. It is important to help them share their feelings without fear of being judged.
Provide a safe space for them to express their emotions. Listen attentively, acknowledging their feelings without offering immediate solutions or personal opinions. To listen attentively, pay attention to their verbal and non-verbal cues, summarise what you hear them say, check you have understood correctly, you could reflect back one or two words and then sit silently to allow them time to think and to express themselves. Acknowledge and show empathy, for example, ‘This looks and sounds difficult for you right now’.
The Samaritans advise that if you suspect someone is considering suicide to address this upfront. Ask them directly if they are considering suicide. If you are open about this, it doesn’t mean that you are planting a thought in their minds, it shows you are willing to support them and listen to them.
Refrain from using phrases that may minimise their feelings, such as “Things could be worse” or “You have so much to live for.” Such statements can make them feel misunderstood and isolated.
Gently suggest seeking help from professionals like therapists or counselors. How much support you are able to offer is really up to you, but you might want to offer to speak to them again and/or help them find professional help and support.
I had a young friend who used to have suicidal thoughts on a Sunday evening. Whilst he was feeling low, I would phone him on a Sunday evening to talk to him. Sometimes we spoke about his feelings, sometimes we chatted about his work. I tended to follow his lead. This went on for a few weeks, until he worked through these thoughts and sought professional support. We talked about different organisations and how they might be able to help and considered the pros and cons of them – I was really guided by him.
Respect their privacy by keeping the conversation confidential, unless there is an immediate risk to their safety. Building trust is crucial for ongoing support.
I guess this depends on your role and what you are able to do, but you might want to consider how you can check in with them moving forwards. Knowing that someone is there for them and cares for them can be a great source of support. If you can’t offer this support, utilising other organisations and personnel may be able to step in.
