As helpers we are like lifeguards. The majority of our work consists of prevention, but every once and a while we may find ourselves having to jump in and save someone from drowning. When it comes to talking to someone who expresses thoughts of suicide, many of us feel nervous about saying the wrong thing. In this life or death scenario, we can’t have full control over the outcome, but we can communicate with this individual in a way that will increase the likelihood of their survival.
As presented by LivingWorks in their ASIST training, the following three stages can guide flow of this crucial conversation to increase the chances of survival:
- Focus on the thoughts of suicide. Not everyone will be standing on a bridge. In most cases, the person in need will give subtle invitations for you to inquire further. The invitations may be the use of phrases such as, “I just can’t take the pain any longer,” or “I’m just going to put an end to all of this pain.” At this point, we need to accept the invitation, and confront the issue head on, asking, “are you thinking about suicide?” If the person agrees, they have invited us to explore further. We can then ask them if they have a plan, what their plan may be, and if they have had any past attempts.
- Elicit their story and find a turning-point. Once it is clear the conversation is about suicide, we need to explore their reasons for feeling this way, in addition to finding their own reasons for living. This stage may take some time and compose most of the interaction. Questions may include, “what are some things that brought you to this point?” and “tell me more about that.” Once you know their backstory, eliciting their own reasons to live is key to finding the turning-point. These reasons may include friends, family, pets, passions, or core values. When you hear them verbalize a reason, continue this topic of conversation through reflective listening.
- Develop a plan to keep them safe. The goal of this plan is to temporarily keep the person from enacting suicide until they receive professional assistance. Draw on the material you have elicited in the previous stage, collaborating with the individual to come up with a plan. A question you can ask may include, “who can we call right now?” This plan may consist of the person connecting with a loved one, handing over a bottle of pills they planned on taking, or even calling EMS if you feel the person is in imminent danger.
All in all, the goal is to engage the person in a conversation about their suicidal thoughts, plans, or attempts, gain an understanding of their story to elicit a reason for living, then collaborate on a plan to keep them safe.