Suicide
This is a basic overview of this important topic. Please consider a more in-depth training such as SAFER or ASSIST.
It’s very important to start with a reminder that talking about suicide won’t cause suicide. It can be very scary and uncomfortable to talk about suicide with someone we are worried about. However, talking about it is likely what they need, and it can provide tremendous relief for the person.
Confidentiality is always important. However, when someone is a danger to themselves or others, we must reach out for help from a supervisor or qualified clinician. Don’t ever promise to keep someone’s thoughts or plans of suicide a secret. Be clear with the person that you are required to seek help when someone tells you they have a plan for suicide. Know what your campus policy is for dealing with any situation around suicide, and follow them to the letter. If you have any confusion about this, please speak with your supervisor.
Since peer support staff are not trained clinicians, we must always take talk of suicide seriously. In some cases, someone might speak of suicide as a plea for help, and they might not be at risk. However, a peer is not trained to make that kind of assessment. It is essential that we reach out for clinical support anytime the topic of suicide comes up in peer support work.
Your campus should have a policy on what to do when someone share thoughts of suicide with you. Make sure you are familiar with it.
Language and Suicide
Words have great power; the way we speak about suicide matters greatly. It’s so important that as peer support workers, we are hopeful and respectful. Consider the language you often hear or use regarding suicide as you read the following chart.[1]
| Instead of saying this… | Say this… | Why? |
|---|---|---|
| Commit/committed suicide | Died by suicide, death by suicide, lost their life to suicide | The word “commit” comes from a time when suicide was considered a crime. It reinforces a stigma around suicide being an illegal and selfish act. |
| Completed suicide or successful suicide | Died by suicide, death by suicide, lost their life to suicide | Using either the words “successful” or “completed” is inappropriate, because suicide is tragic. Those two words are not congruent with suicide. It’s better to take a direct approach; suicide is fatal or it isn’t. |
| (person’s name) is suicidal | (name) is thinking of suicide/is or has experienced suicidal thoughts/ is facing suicide | As with all person-first language we never want to define someone by an illness or struggle. They are more than their suicidal thoughts. |
Suicidal Thoughts vs. Having a Plan
The clinical term for these thoughts is suicidal ideation. In this section, we’ll look at the difference between passive and active suicidal ideation.
Passive Suicidal Ideation
Suicidal thoughts can be ongoing for some people who are struggling with mental health issues. These thoughts are considered passive when someone thinks about dying or wanting to escape life, but has no plans for suicide. Many people who contemplate suicide are so overwhelmed with their life, and they feel like their situation is impossible to deal with. More than wanting to die, they want an escape from the unbearable feelings.
Active Suicidal Ideation
There is a continuum for active suicidal ideation. As well as having thoughts of suicide, the person has intent to do it, and a plan for how they will do it. People are at a great risk for suicide when they have intent and a plan.
The only way to know the difference between active and passive suicidal ideation is to ask the person. Like we mentioned earlier, it can feel scary to address this directly with someone, but that is exactly what we need to do when someone mentions wanting to die. Talking about suicide will not influence someone to take their own life. Ask them if they are thinking of ending their life. If they say yes, ask them if they have a plan.
If they have a plan, it’s important that you do not leave them alone. They are safe if someone is with them. Listen to them. Don’t try to fix anything. Seek professional help–contact your supervisor or a school counsellor. Don’t leave them until they are safely with someone else.
Warning Signs
The following are warning signs of suicide to keep in mind during your peer support work:
- Long-term unrelenting anxiety or depression
- Increased agitation
- Giving away belongings–especially possessions that are meaningful to the person
- Stockpiling medications
- Previous suicide attempts
- Talking about suicide
- Reckless behaviour
- Hopelessness
- Inappropriately saying goodbye
- Increased use of drugs or alcohol
- Withdrawing more than usual from others
- Increased emotional display, such as rage or sadness
- Verbal behaviour that is ambiguous or indirect (e.g. “I’m going away on a real long trip,” or “I don’t want to be a burden on others”).
- A sudden, unexpected state of calm
Be Present and Take Your Time
When someone tells us that they are contemplating suicide, it feels terrifying and overwhelming. As a peer supporter, it can be easy to slip into a panic mode, which makes it hard to be present with the person we’re supporting.
Both you and the person you are supporting will benefit from a relaxed response, rather than panicked reactions. There are practical tools we can use to help us respond in a way that is more supportive, hopeful and more relaxed.
Take note of what is happening in your physical environment. Is there anything you can do in the moment to limit noise and stimulus?
Notice your own emotional state. How are you feeling? It is very likely that you are feeling panicked. Take a moment to do something to calm your nervous system. Breathe a bit deeper and slower to help regulate your body and emotions. (Consider using some of the relaxation techniques we explore in this training).
If you are with the person, remember they are safe as long as you are with them. If you are on the phone with them, stay on the line, and contact your supervisor via text. Unless it is physically evident that their life is in danger, you don’t have to rush. This gives you some time just to be present and have a conversation.
Take time to listen to them share their experience and how they are feeling. Human connection and empathy are powerful. If you do have time constraints, remember the limits of your role and know when to support them in either continuing their conversation with another peer supporter on the team or connecting with a professional.
Know that you can call 911 if things escalate. Until or unless you are at that point, take your time and do what you can to support the person you are with.
- The information below was sourced from CAMH Foundation’s document “Words matter. Learning how to talk about suicide in a hopeful, respectful way has the power to save lives’ and “Language Matters: Committed Suicide vs. Completed Suicide vs. Died by Suicide” from the Speaking of Suicide website. ↵