Just about every list of “suicide myths” mentions this one: “If a person is serious about killing themselves then there is nothing you can do.” But is it always a myth?
In important ways, yes, it is a myth. There are many things that loved ones of a suicidal individual can do to help – things like asking directly about suicidal thoughts, fully listening to the person, providing nonjudgmental emotional support, removing firearms and other lethal means from the home, giving a list of resources for help and support, and helping them to get professional help.
At the same time, especially when suicidal thoughts and behaviors persist for many months or years, loved ones may come to a point where they have to recognize their limitations. In some important ways, their hands are tied.
Recognizing My Own Limitations with a Suicidal Person
I came to the realization many years ago that I could not fully protect a close friend from suicide. She went through an extremely suicidal time for over a year. One night, she came to my house at midnight with her wrist bleeding. She had attempted suicide. She refused to let me call an ambulance, and it even took much persuading before she would let me take her to the ER. They gave her stitches and discharged her to my house (she refused hospitalization and did not meet criteria for involuntary commitment). The doctors advised me to remove all sharp implements and pills from her reach.
My friend stayed with me a couple days. When she went back home, I was left with this feeling of abject helplessness, this recognition that she might kill herself, and also this sudden acceptance that ultimately I could not control if she died by suicide.
Even when she was at my house, even with all my sharp implements and pills hidden in the locked trunk of my car, I could not have prevented her suicide. I had to use the bathroom sometimes. I had to sleep. She could have walked out the door at any time and found other sharp implements, pills or means to die by suicide.
Recognizing Your Limitations with a Suicidal Person
No matter how desperately you may wish otherwise, there is only so much you can do to stop another person from dying by suicide. You cannot monitor a family member or friend every second of the day. You cannot remove all means for suicide entirely from their world. Although you can talk with them about their suicidal thoughts, you cannot read their mind if they choose not to share them.
Even professionals are not fully able to prevent suicides. One study found that almost 1 in 5 people who died by suicide had seen a mental health professional within 30 days of their death. That means that in the United States, with almost 43,000 people dying by suicide in 2014, more than 8,000 of them had recently seen a mental health professional. A study in Finland found that almost 10% of suicides occurred within 24 hours, at most, of an appointment with a health professional.
Even inside locked psychiatric hospital units, even when patients are under constant supervision, some patients die by suicide. That is staggering. It is also illuminating. If mental health professionals and psychiatric hospitals cannot prevent all suicides, then how can friends and family be expected to do so?
Coping with Your Limitations when Someone You Know is Suicidal
When I realized my inherent limitations with my friend, I came up with a saying (I’m sure I’m not the first):
Do everything you can, but know you can’t do everything.
It is hard, terribly hard, to sit with the fundamental helplessness you may feel about your loved one who is in danger of suicide. At these times, it can be helpful to really recognize that many, maybe most people, who die by suicide have depression, post-traumatic stress or another mental illness, a genuine and sometimes severe illness, just like cancer or heart disease. Although the illness is treatable in most cases, and although most suicidal people go on to live many years without ever dying by suicide, the illness occasionally proves to be fatal.
Michael J. Gitlin, M.D., is a psychiatrist who lost a patient to suicide shortly after finishing his psychiatric residency. He wrote about his experience in a poignant journal article. As somebody who specialized in treating people with severe depression, he articulated the high probability of suicide among some of his patients. He came to accept that his work was like that of a doctor working with cancer patients: Not everyone could be saved.
What You Can Do to Help a Suicidal Person
I am not saying that loved ones and therapists should not do what they can to prevent a person’s suicide. Of course they should! There are many things you can do to help someone who’s in danger of ending their life:
First, listen. Really listen. Don’t immediately give advice, try to talk the person out of suicide, or try to make the person feel better. Instead, try to understand. Be curious, not judgmental. (For more info, see my post: How Would You Listen to a Person on the Roof?)
Talk directly about suicide. Ask questions about suicidal thoughts. (I talk about this more in my posts Uncovering Suicidal Thoughts and Let’s Really Talk about Suicide.)
After you’ve truly listened, heard, and tried to understand the person, help the person to problem-solve, identify other options besides suicide, etc. Also help them create a safety plan.
If you’re unsure what to say or do, call 988 to reach the Suicide & Crisis Lifeline. A counselor there can give you advice. (You can also find other free places to get help by phone, text, or chat on this site’s Resources page.)
I’ve also written a book about what you can – and can’t – do to help someone with suicidal thoughts, and how to take care of yourself, too, during such an ordeal.
Limitations and Hope when Helping a Suicidal Person
Many lives have been saved by the actions of concerned others who did their best to help. In fact, my own friend, the one whose possible suicide I’d come to feel hopeless about, recovered.
Not everyone is so fortunate. And when a life is lost to suicide, that does not necessarily mean that anyone failed, that anyone made a grave mistake, or that anyone is to blame.
You do everything you can, with the understanding that “everything you can” cannot be everything.
EDITED: Feb. 5, 2015; Aug. 12, 2021, Sept. 2, 2022
*Copyright 2013 Stacey Freedenthal, PhD, LCSW, All rights Reserved. Written For: Speaking of Suicide. Photos purchased from Fotolia.
Early, consistent intervention, based on evidence based mental illness research, education, training, and consistent contact with our loved one -whether our loved one responds to our contact, engagement in the spirit we expect/hope/want from them or not. Genuine advocacy includes not indulging maladaptive coping with the beyond difficult challenges, that ‘always’ run tandem to the mental illness of a loved one, via denial or resentments about the intense commitment we ‘must’ make toward mental health advocacy, and suicide preventative when what we have witnessed -with our own eyes/ears- tells us “this behavior is not just melancholy over a bad day”. It’s NEVER healthy or helpful to respond with ‘attack’ -verbally/physically – when the mentally ill patient/ loved one behaves badly, accuses their caregiver/family member/clinician of things that are disparaging/untrue. An advocate’s job is to remain measured and demonstrate ‘genuine’ empathy when engaging someone struggling with depression and/or in mental health crisis.
It’s not about guilt we don’t want to feel and need to avoid. It’s not about us anymore than if our mentally ill loved one had a potentially fatal, chronic heart disease with no cure. It’s about ‘knowing’ we tap into, and apply EVERY resource available and EVERY best practices tool with the target of increasing our mentally ill loved one’s sense of hope and self efficacy in our cross hairs to the very best of our ability. If we do that then ‘guilt’ has no place in our journey. It’s a waste of energy. The patients are the priority.
If you’re the loved one/advocate of a person challenged by mental illness, find yourself a support group.
Avoid those support groups where group members, thus collective group energy, spirals into a pity party with moderator standing idly by allowing it to continue. Cathartic venting is only healthy to a point. Then, it just becomes self absorbed, pointless self pity.
Look for encouraging, goal-oriented, problem-solving, relationship strengthening training kind of mantra from your support group. Ask moderator what their clinical training includes. If no actual clinical training, try it out. If the spirit in the room goes ‘war stories, whiney, negative hopeless runamuck with no attempt by moderator to respectfully redirect the catatrophic thinking montague toward positive problem solving, then get the heck out there. Find another support resource.
I think I agree with most of what you say but Im also mindful that you are asking a lot of the people who support those with devastating mental health issues. People who are at their wits end may not want to hear that an emotion they’re feeling has no place in their journey. Or that their cathartic venting is pointless.
Early, evidence based intervention is a pipe dream for many who are constantly battling a broken system. My loved one was misdiagnosed and spent years bouncing around the system receiving sub-therapeutic interventions and I am very experienced in the administration of of public services. I can’t imagine what it must be like for people who have no experience of it.
Guilt happens. It’s an unhelpful byproduct of the relational aspects of care but it does happen. You say it’s a waste of energy. What energy? After supporting a chronically suicidal person for many years compassion fatigue, vicarious trauma and holding down a job to support the family had taken every bit of energy I had. And sometimes when my loved one said incredibly hurtful things I reacted with anger. Out of exhaustion and hopelessness.
I could no more find and contribute to a support group than I could wave a magic wand and cure BPD.
So my message is that as a carer or advocate for an ill person don’t think in terms of absolutes. Don’t say to yourself you must do this. You must never do that. You can’t feel this way. This or that is a waste of time.
Do your best. Get all the help you can. Feel what you feel and let it pass through you. Take care of your own health and well-being.
I just wanted to thank you for your comment.
I was in a similair situation. Both me & my partner had severe depression, but I ended up pushing down a lot of my feelings to support my partner, because he was mentally more vulnerable than I was.
We’ve supported each other for 7 years. I’ve focused solely on him and work for the past 5 years, to allow us to begin our future together.
Always focusing on “that day”, when we can finally marry, move in together and I can finally feel relief at the side of my partner.
This year was supposed to finally bring “that day”.
Finally bring that relief. Start our new chapter together.
But in the beginning of this year, my partner could no longer go on…
From talking about, where we wanted to live, what we wanted to do together, suddenly a week later I’ve had to hear about his end over the phone from his family… see his body at the funeral… and now am left with 1000 questions, intense guilt & no explanation…
There never will be that moment of “relief” for us.
There never will be an “us” again.
Your comment was the first one, that seemed to be close to my experience. In that you have supported your partner for several years as well & know how draining those years were.
So hearing from you…
“So my message is that as a carer or advocate for an ill person don’t think in terms of absolutes. Don’t say to yourself you must do this. You must never do that. You can’t feel this way. This or that is a waste of time.
Do your best. Get all the help you can. Feel what you feel and let it pass through you. Take care of your own health and well-being.”
… it touched my heart more than anyone else’s words.
I felt understood.
It won’t remove the pain, but still I wanted to thank you, for helping me feel some hope, that maybe someday this guilt will quieten down (at least a little) and I might be able to accept those words of yours as truths, rather than believing that I’m solely to blame, as I sadly do now.
Thank you.
I read this tonight because my husband attempted suicide 2 nights ago. I took the gun out of his hands before he pulled the trigger. He cried like a baby then drove away in the night drunk. I called the cops and they found him and took him to the hospital and he was Baker acted. Now I’m left with 2 babies and many decisions to make. I’m not sure how to cope, what to do, if I want to have him around the kids. I feel like I don’t know him anymore, like I don’t know what he’s capable of or if it’s safe for us to ever be a family again without fear.
Dear JW, I hope you have discussed this with many people to make your decision. Yes the children’s lives and yours are very important, but it is very difficult as a separation will increase your husbands feelings of failure. Maybe suggest a temporary safe separation if you can work one out? See what happens with hospital care , but that may make him feel more of a failure as well. It sounds very difficult
If we all had empathy and were kind to one another and showed genuine love no one would commit Suicide. But in this world it is the reality right now until it’s made right by someone who is stronger than all of us. God
I’m not religious, but I agree with you about empathy. But that takes way too much time and effort. It’s much easier to tell someone to go get help (so long as it’s away from us) or to offer some hollow platitude that takes a few seconds to say.