Editor's note: This is part of an ongoing series about how communities are addressing rising teen suicide rates. Read more about the response of an affluent urban high school and a tight-knit, rural community.
Talking about suicide is hard.
It’s uncomfortable to acknowledge a loved one may be fighting suicidal thoughts. And research suggests discussing suicide in a way that normalizes or sensationalizes it may encourage those at risk to adopt suicidal behaviors.
But total silence can be even more dangerous, experts say. If we don’t talk about suicide, we can’t help people who are contemplating it.
Many avoid bringing up the topic because they fear doing so will introduce suicide as a potential option to someone who might not have been considering it in the first place.
Craig Bryan, a suicidologist at the University of Utah, calls this “one of the oldest myths that must be debunked on every level.”
Research on suicide screening in schools indicates that asking about suicide actually benefits teenagers who are at risk.
A 2005 study of more than 2,000 high school students showed that asking students whether or not they had considered suicide had no negative effects. In the study, researchers split the students into two groups and gave each group a different survey. One survey included questions about suicidal thoughts and the other did not. They found that students, including those who had previously attempted suicide, were no more likely to report suicidal thoughts days or months after being exposed to questions about suicide in the survey. Furthermore, researchers observed that students at risk for suicide who were asked about the topic actually experienced improvements in their depression.
Another common concern that discourages people from discussing suicide is fear of not knowing what to say to someone considering it.
Chet Ludlow, suicide prevention specialist at the Central Utah Counseling Center, said many parents fear they won’t react correctly if their children say yes, they have suicidal thoughts. So parents don’t ask the question.
But Andrea Hood, suicide prevention coordinator at the Utah Department of Health, insists that there are safe and appropriate ways to have these crucial conversations with children or friends who may be at risk for suicide.
First, it is important to directly ask individuals if they are considering killing themselves. Hood said this gives people permission to be honest and shows you are prepared for them to say yes.
She suggested reassuring people they are not alone in experiencing suicidal thoughts.
“One way to do that would be to say, ‘Sometimes when people are experiencing depression, one thing that comes along with that is thoughts of suicide. Have you had thoughts of suicide?’”
This type of dialogue conveys an absence of judgment, which can make them more willing to talk.
What should you do when someone says yes?
Hood recommends calling the national suicide prevention lifeline: 1-800-273-TALK (8255). That way, the burden to assess whether an individual should go immediately to the ER or wait to see a therapist or doctor doesn’t fall on you alone.
If you are in an emergency situation where a person is about to attempt suicide or is not physically with you (for instance, you read an online post), call 911. In all other cases, calling the national lifeline is the best way to get expert advice on what to do next.
Even in conversations with people who are not suicidal, it’s important not to discuss suicide in any way that presents it as a feasible option to those at risk because it may encourage the imitation of suicidal behavior — a phenomenon called suicide contagion.
ReportingOnSuicide.org, a website developed by leading experts on suicide prevention, offers guidelines to help media outlets avoid contagion in reporting on suicide, but they can also inform any conversation about the topic.
These experts warn against discussing a suicide method or location in detail, portraying suicide as a normal response to adversity or glamorizing a suicide death. These practices can make suicide seem more accessible and attractive to someone considering it.
They also encourage avoiding some common phrases that unintentionally convey negative messages.
For instance, saying someone “committed” suicide implies the act is an immoral crime, which can make individuals feel guilty for having suicidal thoughts and more reluctant to seek help.
And referring to a suicide attempt as “successful,” “unsuccessful” or “failed” portrays suicide in a positive light, suggesting it is something one can “succeed” at.
Instead, choose neutral words: a person “attempted suicide,” “died by suicide,” “completed suicide” or “killed him/herself.”
Above all, experts recommend focusing on positive narratives of recovery and resiliency by telling stories of individuals who overcame periods of suicidality. Suicide is not inevitable.
Hood said that when we follow these guidelines, we can be confident of doing more good than harm.
“It’s important to realize that silence isn’t helping the problem,” she said. “We have to be willing to take action and share our personal stories. That is what accomplishes the changes we are seeking.”
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