What to do if you think a loved one might be suicidal

Image: Robin Williams’ suicide last year left the world in shock and mourning (via Getty)

News reports and personal stories of suicide leave many of us wondering what we can do to support the people in our own lives who may be at risk.

It’s easy to feel helpless, but even starting a conversation with someone you’re concerned about can be enough to help them seek the support they need.

The Glow spoke to Dr Michael Player, a psychologist and research officer at the Black Dog Institute, to find out what your action plan should be when you think a loved one might be at risk. Dr Player has recently been heading up research into suicide and poor mental health in men.

How do I know if someone might having suicidal thoughts?

As suicide is often precipitated by a mental illness, a person exhibiting depression, anxiety or substance abuse may be at risk of suicidality. “Initially, you want to be looking at people’s moods, particularly friends and family members who you observe on an ongoing day to day basis,” Dr Player says.

Some signs and symptoms are overt – a person might talk about wanting to die, research methods, or say things like, ‘There’s not much for me to be here for’. Others are sub-symptomatic; for instance, social isolation and withdrawing from contact with loved ones by turning off their phone and not responding to messages. A suicidal person might sleep too much or too little, or talk about feeling like a burden to others.

Giving away belongings, saying goodbye and making contact with people they haven’t seen in a while is a particularly clear signal. “That usually coincides with them suddenly feeling happier or calmer after they’ve been down – that’s often a pattern where someone has made the decision to [end their life], and it relaxes them because that decision has been made,” Dr Player says.

It’s also important to realise that warning signs tend to vary significantly between men and women. While women may exhibit more emotional symptoms of mental illness, like crying, men tend to present more externalised behaviours. This includes “recklessness with their body, drinking, drugs; men might drive their car fast and recklessly, get in fights, and have a general drop in their standards of behaviour,” Dr Player says.

What should I do?

The first step is to talk to your friend or loved one about your concerns as soon as you’ve observed warning signs.

“You have to approach them in a way that’s not too anxiety-provoking,” Dr Player says. “Mention that you’ve noticed their mood has changed, that they haven’t been themselves lately, and just open up the space for them to talk.” Do this in a one-on-one, quiet environment, and simply listen, withhold judgement, and be supportive. Every person is different, and they might not be at the stage where they want to talk – but it’s important to open up that dialogue early.

“When someone is acutely suicidal, they do want someone to bring it up – there’s still a bit of stigma about bringing it up themselves,” Dr Player says. This feeling is particularly resonant among men. “There seems to be a perception that if you can’t handle or deal with your own mental issues you’re less of a person, less of a man. They prefer to isolate rather than deal with the perception from others that they’re not coping.” Sadly, Dr Player adds, around 80% of deaths caused by suicide in Australia each year are men.

Dr Player says the best outcome from a conversation with someone you’re worried about is getting them to agree to speak to a mental health professional. You can begin by encouraging them to visit a GP, who can then prepare a mental health plan or refer them to a psychologist.

Should I tell anyone else?

If you’re really worried about someone, and you can’t be with them all the time, it’s important to get other close friends and family involved in keeping an eye on them. However, keep in mind that your loved one might not want that information to be spread too far.

“It depends on their level of suicidality – mental health and suicide are still quite stigmatised, and it’s still a sensitive area, especially in men – they don’t want the net cast too wide. It’s better to talk to the person one on one and just find out where they’re at,” Dr Player says.

When should I take it further?

“If you’re approaching that person but they’re ignoring or still not relating to you, and they are suicidal, you do have to get some professional help in,” Dr Player says. The acute mental health care team in your local area can offer crisis support and recommendations, and you can access urgent mental health care in the emergency department of your nearest hospital.

If you think someone is at imminent risk of attempting suicide, or they have threatened to do so, you need to call Triple 0.

Where else can I find support?

There are a number of organisations in Australia which offer crisis support services for suicide prevention, information and resources, both for people who are suicidal and their concerned loved ones. These include:

Lifeline: call 13 11 14, visit www.lifeline.org.au

beyondblue: call 1300 224 636, visit www.beyondblue.org.au

Suicide Prevention Australia: visit www.suicidepreventionaust.org

The Black Dog Institute: visit www.blackdoginstitute.org.au

For more information about supporting people with mood disorders, Dr Player recommends the Black Dog Institute’s resources – including this fact sheet and self-test for depression.