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.
If a friend of mine dies of committing suicide do I get blamed for it? Though i know you can’t do anything but will I be taken into custody and all of that because I’m so young I don’t want that to affect my future or my parents reputation. Please help.
Are you still in school? If you are, let your counselor or assistant principal know about the situation. Or, call the local law enforcement agency and let them know. Or call a local suicide prevention hotline.
My friend saved a friend from committing suicide … he has gone to see a counsellor … as he was feeling so helpless and confused … it has bothered him so much … how do I support him … in his feelings???
A woman who is like a mother to me, in her 80s, has had a variety of illnesses over the last few years. Her depression is deep. I understand her frustration at losing control over her body, and not living the life she used to. We were speaking weekly for 30 years. Throughout her illnesses, I continued calling, even though the woman I knew was gone – she had been lost to the depression long ago. Each call was such agony, as I knew I couldn’t cure her. She has now attempted suicide 4 times, that I know of, by pills over the last 18 months. They never let me know. I just leave a voicemail and never get a call back until after she’s out of rehab. Again. Why does her husband keep the pills available!?! When I speak with her she is so nonchalant about wanting to kill herself. It is torture for me, as I lost my mother to suicide when I was younger. I have told her how painful it is for me that she is suffering, that she speaks about wanting to kill herself. I listen, I encourage, I listen some more. However, now, I have to distance myself to protect myself. I don’t want to be cruel, but I’m the last one still listening to her (besides her husband). Everyone else has abandoned her due to her (lifelong, I admit) negative attitude: (all of the doctors are crazy/wrong/don’t care/bad/look at her funny); there is nothing ever positive for her to focus on – really, she doesn’t even have a TV show that she claims to watch that she likes; she’s helped so many people throughout her life, but now no one is helping her (um, what am I?). She hurts me so much with her casual talk of killing herself. Now that I’ve distanced myself (I’ve told her why), she has become desperate and cruel. Her voicemails are full of anger and demands. It’s agony. I write this here only because so much of suicide discussion is how to stop it (yes, let’s do that!) and giving the person who is considering it the hotline number, but this doesn’t address the reality when they lay it out for you, repeatedly, that they want to die. And, what am I supposed to do? There’s a lot going on here, I know. I know she is hurt, she is wounded. But, my energy is zapped. My home life is suffering. If I cut her off completely, I feel incredibly mean. It’s heartbreaking. Is there a support group for me, for this experience?
I feel you need to look after yourself as well by limiting your contact with your friend to certain amounts of time and tasks each week but to say you will not abandon her and want to make the best of those times, but must not allow this to have a major effect on your family. Yes this will make her feel burdensome but it is true and yes she may well attempt suicide again but there is only so much you can give
Gloria, I’m so sorry you are going through this. I have been in a similar situation for a long time. I eventually got to the point where I had to take care of myself and I’m glad you have recognised that you need to do this too. You are not mean. You are obviously a loving and giving person but now is the time to focus on your own wellbeing. You are in a caring role for this lady and there may be local support groups for carers that you could access. Whatever happens, know that you are doing the right thing by putting yourself first. You have a right to be happy and a duty to take care of your own life.
Wow. This comment and the two follow-up comments to it are so illuminating, though probably not in the way many expect. Just … wow. It seems clear to me that some problems we humans will never see eye-to-eye on. So who gets to make the big decision? (Rhetorical)
Is hard my daughter is been suicidal 2x I get upset family therapy is not helpful for me I feel worse when I leave her office. I don’t know how to help anymore I am scared I love my daughter. She is taking medication for depression looks better but we don’t really know she doesn’t talk because she knows we get scared.
I need help but can’t afford it . I had help in the past but when money ran out I he said I was better.
[This comment was edited, per the Comments Policy. – SF]
David,
It’s so hard to need help and not be able to afford it. Many cities have a mental health agency funded by the county, city, or state that provides help to people without the resources to pay for help. You can also use a hotline, text line, or other resource that I list at SpeakingOfSuicide.com/resources/#immediatehelp. I hope you get the help you seek, and soon!