Learning to Ask Difficult Questions About a Loved One's Safety
By: Laura Miller, LMSW
The unfolding of the current coronavirus pandemic has resulted in profound mental health consequences. Individuals are facing unprecedented levels of uncertainty, managing anxiety and depression, coping with sleep disturbances, all while continuing to face incredibly difficult situations. Given the ongoing and significant number of stressors, there is concern among researchers that rates of suicide may increase throughout the pandemic. Furthermore, research trends suggest that significant predictors of suicide such as depression, suicide ideation and self-harm behaviors have already increased since the pandemic’s start.
With concern, must come preventative action; it’s incredibly important to remain alert to risk factors that may increase the likelihood someone considers suicide. Equally important is knowing how to approach conversations around this topic.
First, one of the greatest myths of suicide is that you shouldn’t talk about it with
someone else because by doing so you may somehow “implant” the idea of harming
oneself into someone else’s head. Although often accepted as true in mainstream culture, this has been debunked several times in research settings. In fact, there is actually evidence to support the opposite; talking about suicide may reduce, rather than increase suicide ideation and actually lead to mental health improvements. It’s important for people to know that they can discuss these topics, and that it’s okay to both ask for and offer help.
Even with the understanding that talking about suicide isn’t going to encourage someone to think about doing it, it’s still not grounds to talk about the subject cavalierly. Below are some tips and ideas on how you may start a conversation.
“Did you hear that since the start of the coronavirus pandemic more people have been experiencing depression and suicide ideation? It was really difficult for me to learn that so many people are struggling at the same time. This has been a very difficult time period. What do you think about it?” (By using this prompt, you are modeling appropriate sharing of your reactions to the topic while also promoting open disclosure of someone else’s reactions.)
“How do you feel when talking about coronavirus’s impact on mental health? Do you ever talk about this in school or with friends? Have any of your peers shared that they are having a difficult time with you?” (Sometimes, people are often more comfortable talking about other people’s reactions and might prefer to start the conversation discussing someone else’s feelings or reactions prior to speaking about themselves.)
Many people are feeling anxious, overwhelmed and have experienced significant mood changes throughout the pandemic. Have these ever been challenges for you? (This prompt allows you to broaden the conversation from suicide to its underlying risk factors).
“I want you to know that I am always here for you if you want to talk. I may not know exactly how to make the problem go away, but I can always listen and work to understand how you’re feeling. Is there anything that I can do to make myself more available to you?” (With this conversation starter, you are conveying that you are present and will be receptive to someone’s needs).
“Sometimes, when people are experiencing significant stressors and hopelessness about the future they may experience thoughts of suicide. Have you ever had thoughts like this? I’d love to talk about it with you so that I can provide you with any support that you may need.” (Using this prompt, you are asking directly to show that you are not afraid of this topic and that you’re available to talk).
If the individual you’re talking to expresses some thoughts about suicide, it’s important to gently find out more information. You can generally ask when they started having these thoughts and what stressors they are currently experiencing. Next, it’s important to ask the person whether they have made any plans or thought about how they might attempt suicide. Next, you can ask if the person has any intention of acting on their plans and how often they think about completing their plan. It is important not to over-react or under-react, and instead be an understanding an empathetic listener.
Additionally, take some time to assess if the person your speaking to has experienced any risk factors or warning signs. For example, have they experienced a recent job or financial loss, death of a loved one, or have a history of engaging in impulsive behavior?
Have you noticed a recent shift in mood, a change in sleep pattern, or do they appear to be more withdrawn? (For more information on assessing risk factors during COVID-19, click here.) Make your goal to gather as much information as possible so that you can make an informed decision about what to do next.
If the person you are speaking with is currently experiencing risk factors and warning signs and also expresses thoughts of suicide, citing that they think about it often, and have also thought about a method or made a plan, these are significant concerns. If you are worried, call a mental health professional and or recommend that someone seek emergency services. You can also provide resources such as the National Suicide Prevention Hotline. Talking to individuals about suicide and assessing risk can be an incredibly stressful. If you have any concerns, contact a mental health professional immediately.