Suicide Support

Statistics on suicide, suicide awareness classes, and other shocking words regarding suicide do not communicate loud enough the pandemic of suicide. Suicide has long been held in our culture as a taboo, or even something which is contagious. However, it is unfortunately normal to be personally touched or know of someone who has completed suicide. For many, the option of suicide continues to be a permanent solution for a temporary problem.

There is no absolute predisposition to suicide, and therefore, no one is completely predisposed to complete suicide. If however, someone has many of the factors indicating suicide as an option, the predisposition is obviously higher. However, not everyone who completes suicide gives forewarning. Unfortunately, countless cases recall a healthy individual who encounters an acute incident which begins the desperate measure of suicide. For anyone whose loved one has completed suicide, it is a difficult road.

Survivors

Those who have lost loved ones to suicide know well the shame typically felt regarding the loss. Coping with the loss is multiplied enormously by this added cultural pressure. Further, as previously mentioned, there are those who act as though suicide is contagious, and being with the survivors could somehow cause injury. Similarly, many people do not know how to relate to the survivors and thus, avoid contact altogether. Sadly, these reactions are exactly opposite of what those close to the victim need during the difficult time. Simply being with them, not offering advice, guilt, or a platitude, but a cup of coffee will assist tremendously through the grieving process. Like other losses, listen to the survivors recall stories of the loved one. Remember, the grief process does not have a "completed by" date, it will likely last a long time.

Hope

Daily coping with a suicide, even through the cultural problems is, however, possible. While moving into seclusion may temporarily feel good, it is critical to keep open the various venues of relationships and community, recognizing some may not know how to respond to the loss. Practically, these relationships should fulfill some of the needs associated with the loss.

It is also normal to feel anger toward the loved one. Being a survivor often exhibits feelings which communicate help offered would have been of no use. This is not limited to completed suicides, but to attempted suicides as well. Thus, coping with feelings of anger combined with constant reminders of the loss remains difficult but possible. Although difficult, relinquishing the very real right to be angry and giving undeserved forgiveness affords great release of responsibility.

Spiritually, the relinquishing process allows God to take responsibility of the situation. Spiritual health relies on recognizing God's sovereign place, and although it may seem dangerous, being angry at God is not only normal, it is shown over and over in the Bible. Throughout the Psalms, the writers pen angry why questions at God, yet God never denies peace. Further, divine presence never leaves due to feelings of anger. God simply draws more close even in the middle of difficulty (Deuteronomy 31:6,8; Joshua 1:5; Hebrews 13:5). It may feel like God has disappeared, but realize normal people have faced absolute crisis situations without feeling God, and rather, trusted God's sovereignty through simple faith.

Often, people speculate whether a true Christian believer can complete suicide. In short, yes. This possibility exists due to the fact that Christianity is relationship based. If, for instance, a loved one made one mistake, would you banish them from your sight forever? I hope not. How much more so with God, who paid a great price to establish relationship with us. People have impaired judgment at times, and depression can affect even the strongest of Christians. Although suicide is wrong, God's grace through Jesus Christ is sufficient (2 Corinthians 12).

Awareness

While the indicators of possible suicide are not predictors, awareness of certain behavioral changes may allow people to recognize when suicide should be addressed. Thus, when people recognize certain changes, specific and direct questions can be asked to expose hidden suicidal feelings. A common misconception assumes asking people if they have thought about suicide will somehow give them the idea and thus, pushes them into a downward spiral. However, if indicators are present, they are more likely already thinking about suicide, and if not, people often feel care when such a topic is seriously addressed. Further, when suicidal feelings are exposed, the individual is more likely to agree to postponing any suicidal plans long enough for help to be reached. It is far more dangerous to avoid the topic when multiple indicators are present.

Some of the indicators include depression, use or abuse of alcohol, changes in diet or weight, seclusion, and although seemingly backward, a sudden positive change in demeanor. The sudden change may be due to resolving the tough decision to use suicide as a solution. Once the burden of the situation is lifted by this resolve, a positive demeanor may result. Other indicators show suicide as a viable option to the individual and include being influenced by someone who has modeled suicide. These models range from family or friends who have completed suicide, to acquaintances or heroes. Finally, past suicidal attempts indicate very strongly the decision to use suicide as a permanent solution to a temporary problem. Due to the nature of the decision, once suicide becomes an option, the individual resorts back to accepting suicide more easily. The first time the decision is made toward suicide is far more difficult than any later decision for the same. People of all backgrounds, ages, and gender have the potential to feel hopeless, helpless, and worthless. These feelings can result in suicidal thoughts and feelings. However, with direct intervention, suicide can be reduced.

Intervention

Although this brief overview does not replace a training course on suicide intervention, it will give some help when dealing with those who display indicators of suicide. The key to intervention recognizes the use of a question which includes the word suicide. The question can be proposed in any fashion as long as the key feature is included. For example, the question, "Cindy, I've noticed some of your habits lately have seemed to change. Many of these changes indicate something bad might be going on. Are you thinking about harming yourself, are you thinking about suicide?" While it may be uncomfortable, direct questioning is necessary to establish what is truly at stake, a life. Seriously addressing the topic with this key ingredient leaves no room to interpret the question incorrectly.

After exposing the individual's intentions or thoughts, the intervener must determine the risk level. The risk level directly relates to how close the individual is to completing suicide. If, the assessment determines thoughts of suicide but the individual does not have a plan or a timeframe, the risk is much lower than an individual who has a plan, a timeframe, and the method available. Assessing the risk allows for the intervener to determine how much immediate help is required. When the risk is high, the person must NEVER be left alone. In one case I am familiar with, the duty NCO was doing what he thought to be right, but unfortunately left a high risk person alone for only a few minutes just before tragedy struck. Regardless of the risk level, all individuals who reveal thoughts or intentions of suicide must be treated seriously.

The Contract

One of the best ways to support the individual after assessing the risk is to ask them to make a contract in which they will postpone any suicidal action until a definite time (ie: 24 hours). It must be an agreed upon time where a commitment is made to staying alive. During the time of the contract, the intervener must locate further help and remove any equipment which was identified in the plan (ie: pills, guns, car keys). Help can be from multiple venues depending upon the situation. If escorting a high risk person, calling emergency services for assistance may be most appropriate. Another certain help is local hospitals or emergency rooms. Further, chaplains always have on call personnel willing to assist in immediate situations. Other, less immediate help may be available through a health care provider's recommendation as most health insurance plans offer some type of confidential treatment plan. Whichever method is appropriate, treat each incident seriously and without reservation, for it is much better to go too far than not far enough.

After Intervention

After intervention, resolve to get help to address the initial problems. Stopping the forward progress toward a completed suicide does not equal health. Health comes through discovering and implementing resources to deal with the initial situation which lead up to potentially completed suicide. However, closely monitor the individual's progress through specific questions and observation. The individual likely has more strength to cope with life but may also have enough energy to complete suicide with little to no warning. Thus, it is important to ask specific questions and keep potentially dangerous items away.

Anniversaries

Regarding suicide, anniversary dates remain a vital link to the individual. Whether the individual completed suicide, attempted suicide, or made a commitment to staying alive, anniversary dates remind of what transpired and give value to the event by recognizing something changed that day. These dates are celebrations of life, and reminders that we are all fragile humans, walking the Earth by God's grace. For all affected by suicide, emotions flood when memories of a sad day on which life was seen as less valuable have changed into a more promising future with each passing milestone.

Key Points:

• Suicide is a permanent solution to a temporary problem.
• Intervention must include using the word suicide.
• Contracts need to be agreed upon by both parties.
• Survivors can not neglect the support of a community.
• Celebrate life by recognizing anniversaries.

• Denial, Isolation, and shock.
• Anger
• Bargaining
• Depression
• Acceptance