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.
I’m writing this on the first day of Suicide Prevention Week for 2015, a week in which I can expect to be inundated with “Know the signs” messages. Those are good messages, but I have lost a younger brother, an ex-fiancee and a childhood best friend to suicide, and none of these deaths happened because I or anyone else missed signs. Other people and I cared deeply about these precious individuals and their struggles. We offered what practical help we could, connected them with professional resources, sought emergency help when needed, and always made sure they knew that they were loved and not alone.
Along with the lists of signs to look for, I wish we had received more messages about our limits, about how to make peace–both pre and post-mortem–with the disturbing reality that someone who is not being swayed from a determination to exit this world will likely find a way to exit, regardless of the best efforts of others. I wish we had received guidance on how to both care for an individual in turmoil and protect ourselves from the manipulation and abusive behavior that can come with the very real pain and very real desire to die. I wish we had been taught the value of being a source of comfort to someone, even if that comfort does not prolong that someone’s life at all, or as much as we would like. I wish we were talking more about the conditions that set the stage for suicidal ideation–abuse, poverty, addiction; etc.–so that more could be done before people are in a state of desperation and even delusion, from which they cannot or will not extricate themselves. In the case of my friend, his family, other friends, and I wish that, when faced with an intractable illness from which there was no relief, he had been provided a way to die a more dignified death, and we had been provided with ways to support him in an entirely rational decision.
Berkeleyravine,
Beautifully and poignantly said. I completely agree. I think there is potential for harm in the “suicide is preventable” messages. Saying that suicide is always preventable implies that the people around the person did not do enough to prevent the death. In reality, although undoubtedly there are some cases where the suicide might have been preventable, there are many cases where people did everything they could to keep the person alive. And the person still died.
More recently, various mental health organizations have embraced a goal of zero suicides. This “zero suicide” movement has the same potential for harm, in my opinion. We must remain vigilant against suicide’s forces and do everything within our power to help the person resist those forces. But we must also recognize that sometimes suicide simply happens even with people’s best and proper efforts, and nobody is to blame but the forces of suicide themselves.
I am very sorry for your losses. You described very well the needs that you and other loss survivors have had, both before and after the deaths. I am grateful that you recognize the limitations that you operated under, without blaming yourself. May others extend that compassion to themselves, as well.
Thank you for sharing your articulate, well thought out and pain. I am saddened for your loss…nothing prepares you for that. Protect and look after you now. Good things and happy times, Blessings, to you from here
I am in need of guidance on a situation at hand this moment. May I humbly seek your wisdom?
For years I have opend my home to family and friends who were in need of shelter and food, some left here in peace, some left here not in peace. I have an extremely hard time saying no to those who reach out to me because of my kindess, loving spirit I have”. I am the oldest of 7 that is trying to help the 7th child. I didnt know that he was hooked on p.c.p and meth till recently in march. Of 2015 I drove for 2 hours from my home in attemp to “save” him when I got a call he (21) attempted suicide. When my brother was living in my home, I was able to get him mental help with medication, take him to councling, during the process, ive lost sleep and became stressed by giving all my time and energy over his paranoia at the same time going to school. One day he left my home to “supposedly” refill his medication, I get a call that he was having an episode, instead of refilling his meds, he purchased marijuana when he was not suppose to as that will make his paranoia worse creating major episodes. During the 2 months he was here, I made sure he did everything he was supposed to do, as well help him get back to his normal weight. The issue I am having now is he left my home 3 weeks ago to return for work, I gave him instructions on all that he needed to keep him on track as far as meditation on the scriptures, prayer, going to councling, and continued taking meds. Since he left, he attempted a 2nd suicide after getting high. And he calls again to come back. At this point, I really dont want him back here because my children of seen these episodes (twice) and have been exposed to these negative images, that I feel I bought upon myself in attemp to help him. He has not done anything to help himself since he left here and I am torn on not allowing him to return for fear of saying no that he will try to hurt himself. People that I help feel that my home is safe heaven. This is stressful and drains my energy as I will have to keep an eye on him 24 hours, the last attemp he dis not wake his girlfriend up, he attemped while she was sleeping and I fear this. I have a teenager and 2 small children. If I allow him to return, he has to quit his job, that will means missed car payments, I am already struggling myself, so how will I be able to care for my brother who refuse to take responsibility for his action? He lives with my mom who is currently taking care of my grandmother so that is stress on her. This feels like a burden, I feel if my brother followed what he was supposed to be doing, he will be okay but because he did not, I am stuck to care for him. I was suppose to move to a great oppertunity and ended up dropping it due to his paranoia over gangs (which he claim he does not gang anymore) I am seeking families who have dealt with this kinda of stuff. It ia a first for myself and my family. He ia extremely depressed. Please help!
I don’t think there is any good evidence that anyone can prevent suicide. The studies are clearly difficult to do, but admission is largely undertaken to protect the health professionals from litigation. A study comparing inpatient and day hospital care showed no differences in suicidal ideation and rates
Or here’s a thought. Stop pretending you care only when we reached the brink.
It’s plenty of back rubs and jolly goods when they blip about it and it’s often no one caring beforehand that builds to it.
Your entire list of suggestions is only focused on people who are claiming to be suicidal. There is no hint or speech ever pertaining to how to live with people whom are constantly depressed or may feel life is meaningless (hint: you probably shouldn’t bother). All the prevention focuses on: but … But… I will be sad! You will burden me! Blah blah blah.
So do humanity a favor and stop pretending to care.
I agree, the only reason people care at that point is so they can play hero.
I’m not here to fight but my hands are tied- I DO live with someone with depression, anger and social issues. It’s so hard and hurtful, he’s hurt me- crushed me so much to the point where I’m suicidal and can’t support him 24/7. I need sleep, I need to look after my child and go to work to pay HIS bills.
I try my best but I have a child who means the world to me and I just can’t be there 24/7, I get so little sleep that I’ve crashed a car twice, once trying to get him to hospital. I’m dying but I’m supporting him! If I didn’t care I wouldn’t have spent thousands of dollars and all my time on him. Please be careful with what you say to someone who is a carer and IS trying their beat but can barely support them, they need sleep, the abuse I get would make even you feel like nothing can be done. Don’t judges omens who is trying to help, they need to eat, they need sleep, they need to earn money so they CaN help, they need to be careful They don’t end up so depressed themselves they can’t love….they have to Live a life , study or work, function as a person needs to.
Depression and protection of self can seem selfish, suicidal threats can be selfish- hence I haven’t done it yet.
If someone says they can’t help, it’s probably the best they can do for someone- so that person learns to help themselves!
Take care and look after you
My mother killed herself 5 years ago today a few days before her 60th birthday. Her first attempt was 6 years before I was born when she was 16. She tried to kill herself so many times I always thought that was how her life would end. When she finally succeeded in killing herself I was still shocked and have found it hard to forgive her and myself. Your articles have been incredibly helpful to me – especially the questions you suggest the reader asks themselves. Thank you for publishing these articles. Georgia
Georgia,
How sad for you, your mother, and your family. Those feelings of forgiveness are elusive for many survivors of suicide loss, whether forgiveness of oneself, the person who died by suicide, or both.
I hope you will consider reading the posts “If Only”: Self-Blame After a Loved One’s Suicide and Do You Blame Yourself for Thinking of Suicide? Both posts cast the blame where it ultimately and truly lies – on the forces of suicide themselves, which might be mental illness, substance use, irrational thinking, trauma, impulsivity, or other factors that can fuel suicidal thoughts, desires, and actions.
Thank you for your feedback. It’s great to know that my site has been helpful to you in some way!