1. Recognizing signs of Suicidality
Crisis intervention
Recognizing signs of Suicidality
© 2014 Cambria Lowe All rights reserved. No part of this document may be reproduced in any form or by any means without the prior written permission of the author

2. Suicide
How To Recognize the Signs
What To Say
What To Do

3. Signs of Suicide Hopelessness Recent loss
Financial: job loss, financial loss,
Personal: death of loved one, pet, home
Medical diagnosis
Rejection: relationship, employment

4. Signs Anxiety Sudden mood changes Depression Withdrawal Anger
Feeling hopeless, desperate trapped
No sense of purpose
Reckless behavior
Changes in sleep
Increased drug/alcohol use
Talking about wanting to die/suicide
Giving away possessions
Putting affairs in order

5. Be Prepared Have resources ready to offer your patient
Before starting a conversation
Have resources ready to offer your patient
Have crisis hotline numbers ready
Check with the mobile crisis unit if you want support before the conversation

6. What to Say
Give some context for your question so that the question doesn’t seem “out of the blue”:
“I notice you’ve talked about feeling hopeless a lot lately. What’s going on?

7. What to Say
You can follow this with a direct question about suicidality:
“Sometimes when people say things like that they are thinking about suicide. Are you thinking about suicide?”
“Are you thinking about ending your life?”
Asking a direct question about suicide insures that both of you know what you are talking about—it is unambiguous.

8. What to Say
“I can’t imagine how tough this is for you. I understand when you say you’re not sure if you want to live or die. But have you always wanted to die? Maybe there’s a chance you won’t feel this way forever. I can help.”
Listen and validate that they are considering both options and underscore that living is a real option for them

9. What To Say
“I am deeply concerned about you and want you to know that help is available to get you through this rough time”
Let the person know you are concerned and also available to help. Feeling your care and support can go a long way in helping them choose life.

10. Assess Ask the person if they have the means to kill themself.
If they have answered yes, ask them how they planned to kill themself.
Sometimes people just feel so low they can’t imagine going on with life but they don’t actually have a plan
The more realistic the plan, the more concerned you should be.
If they have a:
A gun
Pills
The name of a bridge/place to jump from
Rope
Your concern level should be very high and you should not let the person leave the clinic/your office

11. What To do Stay calm and grounded within yourself
You should do what you can to keep your client at the clinic/office until help arrives.
You can also call the mobile crisis if your city has one
To get some support for thinking about a patient
If you feel the person is open to talking with someone from that agency while they are at the clinic/office.
If you call 911 from a cell phone you will reach a dispatcher who isn’t necessarily near you
Keep local emergency numbers on your cell or landline

12. What To Do
If you assess that your patient is having a rough time but not actively suicidal
Have referrals ready for:
Counselors/therapists
Low fee Community Clinics
Hotlines

13. Questions

14. Resources