You matter. I matter. They matter. Some feel they do not matter. Some turn to drastic measures when they feel their life doesn’t matter. Sometimes this means suicide, the act of intentionally taking one’s own life. Many people may think of suicide at some time in their lives. Most decide to live because they realize the crisis is temporary and know death is permanent. Tragically, some having a crisis see their problem as inescapable and feel a loss of control. They may experience overwhelming pain, hopelessness, or mental health struggles. Reasons for suicide are complex and never due to a single cause. Suicide is a public health crisis affecting every community.

In my years of practicing as a therapist in hospital and outpatient treatment settings, I have met with many whom have contemplated suicide, have survived their own attempt, or are affected by someone else’s suicide. For those struggling with thoughts about ending their life we begin the important work of understanding their pain and finding hope and reasons to go on living. They start to realize they matter. It’s not easy work but it’s important work.  For those that have lost someone to suicide, they are never the same. They may learn to go through life without their loved one, but they can feel guilt and feel at fault, wondering “is there something I could have done?”  It is not their fault. They yearn for a re-do and in a sense the pain suffered by their loved one is now forever a part of them.

Suicide is a desperate solution to an unbearable mental state. According to suicidologist Thomas Joiner, who developed the Interpersonal Theory of Suicide, a person dies by suicide when they have both the desire to die and the capability to act on it. This desire stems from feeling profoundly alone, referred to as thwarted belongingness, and believing they are a burden to others, referred to as perceived burdensomeness. Both are often combined with hopelessness. To prevent suicide, we have to tackle thwarted belongingness, perceived burdensomeness, and hopelessness.

To combat thwarted belongingness, we need to connect with others in a genuine way.  When we show up and connect at a human level, we are reducing isolation and reminding others they are part of a community. To combat perceived burdensomeness, we can reach out and remind those struggling they are not a burden. Those suffering may have strong beliefs that they are a burden. Emphasize their value and that they are loved and needed. Who do they show up for? Who do they not want to hurt if they leave them behind? A child? A parent? A partner? A friend? A pet? Let them know YOU need them around.

We also need to prevent the perfect storm. This means that someone is having thoughts of wanting to end their life it’s important to make sure they do not have access to lethal means. Suicidal thoughts do not always lead to plans and actions. But if someone is in the planning stages, it’s important to restrict their means to carry it through. Suicide prevention experts recommend removing any possible access to firearms and locking up excess medications (including over the counter medication).  This would be important to do until the risk of acting on suicidal thoughts has been eliminated. We must take thoughts of suicide seriously and also remember that sometimes expression of suicide is the expression of the inner turmoil that is inexpressible.  Don’t be afraid to ask someone if they have thoughts of ending their life and if they have a plan. It is a myth that asking about it puts the idea in their mind. In actuality they may be relieved you asked and this may be one of the most powerful motivators to get them talking and connected with you.

There are many evidence-based talk therapies that can reduce or eliminate suicidal thoughts and help individuals build a life they see as worth living. While professionals can provide tools and teach coping skills, we must emphasize that suicide prevention is everyone’s job. Being a caring community means understanding and helping someone who is suicidal. Communities matter. Communities have resources that can help.  A suicidal person often cannot think past the moment and see hope.  Take a moment to care and connect. Encourage them to reach out to people they trust for help- a parent, a teacher, a coach,  a partner, a friend, a faith community, a support group, an employer’s employee assistance program, a doctor, a therapist, or call or text 988 to immediately connect with a trained mental health volunteer. Be their connection to living.

World renowned psychiatrist and Holocaust survivor Viktor Frankl wrote that “those who have a ‘why’ to live can bear with almost any ‘how;”. Being part of a caring community gives us the power to be someone’s why. You don’t have to be a mental health professional to make a connection. Intentional connections matter. Relationships matter.  Bring your humanity. Small connections matter- a smile, a greeting, a compliment, a conversation, an invitation, sharing a common interest, and simply allowing someone to be heard.  Humans thrive with connection. It makes us feel we are part of something greater, and ultimately less alone. Give the gift of stepping outside of yourself.  The community you offer might just be the “why” that makes someone stay. 

Warning Signs of Suicide

There is no “typical” suicide victim. Suicide can affect people in all stages of life and in all socioeconomic classes. Here are some common warning signs, when acted upon, can save lives. Look for the following:

• talking about dying by suicide
• having trouble eating or sleeping
• experiencing drastic changes in behavior
• withdrawing from friends and/or social activities or losing interest in hobbies, work, school, etc.
• preparing for death by making a will and final arrangements
• giving away prized possessions
• has attempted suicide in the past
• takes unnecessary risks
• has had recent severe losses
• is preoccupied with death or dying
• loses interest in their personal appearance
• Increases their use of alcohol or drugs

What Can We do if Someone is Threatening Suicide?

• Be direct. Talk openly and matter-of-factly about suicide. Show interest and support
• Be willing to listen. Allow them to express their feelings and accept those feelings.
• Offer non-judgmental support. Don’t debate whether suicide is right or wrong or feelings are good or bad. Don’t give lectures on the value of life.
• Don’t dare the person to do it.
• Don’t act shocked. This will cause the person to put distance between you.
• Don’t be sworn to secrecy. Seek support.
• Offer hope that alternatives are available but do not make promises you do not know will come true.
• Take action. Remove lethal means such as firearms or stockpiled pills. Do not return them or tell them where the weapons are placed.
• Call the National Crisis Lifeline by dialing or texting 988. Trained volunteers can give guidance on how to best support someone.
• If the person is going to act on thoughts of ending their life immediately, call 911. They may be angry with you temporarily, but they will be alive.

Christine Hilton is a licensed master’s level social worker in private practice and employed with Henry Ford Health’s Employee Assistance Program. You can visit her practice website at Hilton Wellness – Christine Hilton, LMSW | Psychotherapy and Wellness. She is passionate about bringing mental health awareness to the community, having presented at suicide prevention conferences and is an instructor of Mental Health First Aid.

To become trained in Mental Health First Aid, enroll in a local class by visiting Find Mental Health Training Courses and Instructors.

For more information on suicide awareness visit the American Foundation for Suicide Prevention Home | AFSP. If you or someone you know is in crisis and thinking of ending their life, reach out to the Crisis Lifeline by calling or texting 988. Hope and Help are available.