HEALTH

How To Start The Conversation About Suicide

Showing genuine compassion is the key.

04/05/2017 11:38 AM AEST | Updated 04/05/2017 11:40 AM AEST

Talking about suicide can be confronting and complicated.

In Australia, suicide rates have reached a crisis point; more people are taking their lives now than they have for at least 10 years. In 2015, 3,027 Australians died by suicide Australia.

That's more than eight people every single day.

It's now also the leading cause of death for Australians between the ages of 15 and 44, with men being three times more likely than women to take their lives.

With no particular part of our society being left untouched, the language used when talking about suicide has become more important than ever in order to stimulate healthy, respectful conversations.

And if you're not quite sure how those conversations should be held, here is everything you need to know to get things started.

How Important Is Language When Talking About Suicide?

Head of research and evaluation at BeyondBlue, Dr Stephen Carbone told HuffPost Australia that, while language does play an important part in dealing with suicide, it's also about the attitudes we display when having a conversation with someone who may be suicidal.

"I think the essence of the conversation is partly in language but it's also partly in an attitude that you project and that is of being basically non-judgmental," he said.

"The thing that people want is someone that they can talk to who they're not going to feel ashamed or embarrassed or in any way judged by what they have to say.

"The language needs to be accepting and non-threatening and non-judgmental to be able to let the person to open up and express what they're going through."

How Can You Start The Conversation?

According to the Executive Director of the Lifeline Research Foundation, Alan Woodward, the conversation needs to start by showing "genuine compassion and engagement" with someone who may be suicidal in order to understand their struggle.

"It's more than just the words. It's also about showing genuine compassion and engagement with the person," he said.

"It is so important for us to take time with any friends or family members or work colleagues that are going through a tough time, to listen to what they're saying and really trying to understand what they experiencing.

"It may be then, through taking that deep listening on, that the depth of the despair may be revealed."

Woodward believes that, while it is important to pick an appropriate time and place to have a conversation about suicide, it should be primarily focused on showing a person who may be suicidal that they are cared for and that someone wants to listen.

"Essentially, it's about picking the time and the moment but, more importantly, being responsive to what the person shows. Look at the body language, listen to what a person is saying and ask open questions -- 'Are you OK?' is not a bad start," he said.

"One of the things to point out here, is that a person in deep despair and [who is] starting to consider to end their life is experiencing incredible psychological pain and their desire is not so much as to die but as to end the pain.

"The conversation needs to be around understanding what is causing that pain in someone's life and making the offer of help and support towards addressing the issues so that the pain can go away. In that sense, it's about having a helping conversation that meaningfully is trying to understand what a person is experiencing and to provide help and support.

"It's fundamentally about the exercise of compassion and simply showing the person who is in deep despair that someone else cares for them, which is one of the most effective things that can be done."

When Is The Appropriate Time To Talk?

Carbone says it's important that the conversation is not something that is had in passing, but rather at a point where a person can take the time to empathise with someone who may be suicidal -- even if it takes more than once.

"It's really about asking them out for a coffee or making a time where you can just sit down somewhere private and confidential where you can start having that conversation and once you get the ball rolling, the conversation often flows," he said.

"I think it's about not being put off just because someone might be hesitant to talk. Not everyone wants to tell everyone their business straight away but providing that opportunity to know that you're there if they want to talk to someone. It's really about being empathetic."

According to the Director and Chief Scientist at the Black Dog Institute, Helen Christensen, the conversation can't come "out of the blue" but needs to be spurred on from a genuine concern for a person's welfare.

"There has to be a reason that you would initiate the conversation, maybe because of something that the person says to you or the behaviour that has worried you," she said.

"I think you should be actively seeking out people if you think they are feeling this way and just spending time with them. It's always good to have a private conversation as opposed to a public one.

"It's about having a conversation with somebody, having a good conversation and seeing if they're OK."

Is There Anything You Shouldn't Say?

Research conducted in 2013 showed that, when it comes to discussing suicide, it's best to avoid words such as "commit" in order to lessen the stigma around someone taking their own life.

In Australia, there are also reporting guidelines set out for the media by mental health organisation Mindframe in order to "inform of appropriate reporting of suicide and mental illness, minimise harm and copycat behaviour and reduce the stigma and discrimination experienced by people with mental illness".

Woodward told HuffPost Australia that discussing issues around suicide respectfully comes down to not being judgmental of a person's feelings or experiences, avoiding suggesting how someone should be coping with suicidal thought,s or reacting negatively about a person's struggles.

"There are some things that we know will be a barrier to engagement and real help for a person. Being judgmental about their life circumstances or their feelings will certainly be a barrier," he said.

"Telling a person what they should do in response to the difficulties they're facing may also be a barrier and indicating negative views about suicide or struggle such as 'come on you can get over it' will also be a barrier.

"There's probably a range, but certainly not using language as 'are you going to commit suicide' which reinforces suicide being a crime. Certainly not making judgments about a person through language such as 'it's your fault' or negative comments about feeling suicidal in being selfish or self-obsessed."

According to Carbone, the less dismissive a person can be when listening to someone who may be suicidal will often lead to an easier path to recovery for that individual.

"I think it's about not being dismissive, such as saying 'why would you want to do that?'. Those things are very unhelpful," he said.

"Saying things like, 'you think your life is bad, what about my situation?' or trying to guilt them into not taking their life by trying to make them feel like they're doing something wrong to other people [are] unhelpful approaches because they reinforce the negative self-view that people have."

Is It OK To Ask A Person Directly If They Are Suicidal?

While it might seem like a taboo method of approaching a conversation about suicide, Woodward says "there is nothing wrong and there is nothing dangerous" about asking someone directly if they are having suicidal thoughts.

Rather than influencing a person to consider suicide as an option, he believes being direct with someone may offer them the opportunity to understand their feelings and discuss them.

"It's important to clarify that there is nothing wrong and there is nothing dangerous about saying directly to a person after listening to them, 'are you thinking of taking your own life? Are you thinking of suicide?'" he said.

"That will not plant a seed in that person's mind and, most likely if they are feeling suicidal, it may provide an opportunity for them to acknowledge that feeling with you and therefore have a further conversation."

Carbone says "there is enough research to suggest" asking direct questions about suicide is effective, particularly if it seems someone is nearing a crisis point.

"If you get to the point where you're concerned about a person that may be suicidal, it is reasonable and important and helpful to ask them direct questions [such as] 'I'm a bit worried, have you been thinking about taking your own life?'," he said.

"You won't be putting ideas in their heads, it's helpful to ask them direct questions so they can open up because they most likely have been bottling up their emotions.

"That helps to establish how severe or acute the risk is. The closer a person is to thinking about taking their life, the more immediate and forceful the intervention you're going to require."

He also believes that anyone who asks direct questions about suicide also need to be prepared with extra information about professional help that they can offer to someone who may be suicidal, should the need arise.

"Those probing questions allow the person to do most of the talking. It's about opening the conversation to open the flood gates and then being a good listener and giving direction to other sources of information and help," he said.

"You need to be a little forearmed with some information, such as a list with a couple of numbers and information so that, should you need to take the next steps, you can be clear about what you're going to tell them.

"Ultimately, when a person is significantly suicidal, they really do need professional help and it's important to guide them towards the people who deal with this more routinely and can help the person through their feelings and experiences."

According to Christensen, it's important that people don't feel scared of approaching the topic of suicide for fear of the effect it may have on someone who may be suicidal -- so long as you're prepared to connect them with trained mental health professionals.

"I don't think we should give people the idea that it's dangerous to talk back to a person because we're too scared of the effect it may have on them or that it'll make things worse," she said.

"You may not want to have the conversation yourself but you may be talking to someone and understand that they're feeling pretty down and so you might suggest that you could take them to see [someone].

"Getting from having the conversation to people who can help is a really important thing... You can help them find someone who can help them in a professional capacity and then just hang in with them rather than being afraid to help them."

Talking About Suicide

  • Language matters. Avoid being judgmental or negative and instead focus on showing genuine concern for someone;
  • Take time to listen to people, understand their circumstances, reflect on what they're saying, show that you can offer your support;
  • Be patient with someone who may be suicidal. The conversation shouldn't be in passing;
  • Avoid using negative words such as "commit" in order to limit the stigma around suicide, suggesting ways for people to deal with suicidal thoughts or being dismissive of someone's feelings;
  • It is OK to ask someone directly if they're having suicidal thoughts. It could offer them the opportunity to express their feelings and start a conversation;
  • Always be prepared to direct a person in need towards professional help.

Lifeline is exploring Australia's suicide emergency with business and community leaders. The #StopSuicideSummit was held on May 1 in partnership with HuffPost Australia and Twitter.

If you need help in a crisis, call Lifeline on 13 11 14. For further information about depression contact beyondblue on 1300224636 or talk to your GP, local health professional or someone you trust.

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