Suicide Prevention Starts With Listening, Communication, Say Experts
By Paul Gingras

Careful listening and open communication can help people identify friends who may be at risk for suicide, said Michael Powers, a suicide prevention expert who gave a seminar for the public at St. Ignace Middle School Tuesday evening, November 20. Pointing out that most suicides are planned in advance, he encouraged people to use direct language when talking with someone who may be thinking of suicide, to find out as much as they can about that person's circumstances, and to reassure them that such thoughts are not unusual, then seek professional help.

Mr. Powers was invited to speak by two local prevention groups, A Sense of Life and the Lucas Izzard Foundation for Teens (LIFT), and the program was scheduled before the holidays because this is a particularly difficult time of year for many people, Mr. Powers said.

More than 30 attended, including several young people.

Mr. Powers taught how to identify circumstances that can lead to self-destructive thinking and behavior. His careful advice focused on discovering how often an atrisk person thinks about suicide and the importance of discovering whether he or she has a viable plan. By perceiving the warning signs and learning how to engage someone at risk, the average person can make referrals to mental health professionals in time to save a life, he explained.

"Suicide touches all ages, ethnic groups, genders, occupations, geographic areas, and socioeconomic status," Mr. Powers said.

Most people who consider suicide do not want to die, but faced with seemingly insurmountable pain, they identify suicide as a method to solve a problem, or set of problems, to which they see no other solution, he said.

"The act of suicide is preceded by thoughtful agonizing over the intricate details of killing themselves," he said, and it is during this struggle that friends or family members can discover their plight and open up dialogue that may save their lives.

Deep depression is one of the most common and serious psychological triggers for suicide. Identifying and helping a deeply depressed person can save his life, Mr. Powers said. The signs of depression tend to manifest in many areas of a person's life. Seriously depressed people may suddenly stop activities they enjoy, such as cherished hobbies. They may engage in extreme behaviors, like oversleeping, under-sleeping, overeating, or eating too little.

Depressed people may also lose motivation, a problem often noted by employers, and may neglect their personal appearance. Seriously depressed people may subconsciously manifest psychological trauma as bodily discomfort, and frequently complain of physical pain. Others form a preoccupation with death.

"If you see these signs of depression, be concerned and start to ask questions," Mr. Powers advised.

People in life-threatening despair often make direct or indirect statements that reveal suicidal thinking. The most blunt, Mr. Powers said, are statements like, "I am going to kill myself," "I am going to commit suicide," "I wish I were dead," "You would be better off without me," "I might as well be dead," or "If [something specific] does not happen, I will end it."

Less direct statements send the same message, such as, "I cannot go on any longer," "I am taking the plunge," "Nobody needs me anymore," "I am tired of life," "You won't be seeing me any more," "Life has lost meaning for me," "We all have to say good-bye sometime," "You would be better off without me," or "I cannot take the pain."

Nonverbal signals can reveal that someone is considering suicide, such as a person who suddenly buys a weapon, or when someone gives away prized possessions, makes a will, speaks of taking a long trip, or engages in unusual such as a non-gambler who abruptly takes a sizable chance at a casino, Mr. Powers said. Sudden changes in personal beliefs can also be signals, such as when someone who has never expressed a belief in God suddenly does so, or when a long-time believer abruptly renounces his faith.

If someone may be conveying suicidal signals, Mr. Powers offered guidance for asking the essential question: "Have you been thinking about killing yourself?"

It is critical to ask this question, he said, and when doing so, to pour as much empathy and compassion into your voice as possible. Ask the question in a straightforward manner, absent of stuttering, hesitation, or nervous body language.

Mr. Powers encouraged his audience to use the words "killing yourself" in favor of phrases like "hurt yourself," "injure yourself," or "end your life."

The process of thinking about suicide is called "ideation," and it is common. Nearly everyone thinks about suicide at some time in their lives, Mr. Powers said. The frequency and intensity of those thoughts can determine whether a given person chooses to act.

When talking to someone who may be at risk, it is important to find out how often that person thinks about taking his own life, and if he has a plan. The more frequently he thinks about suicide, the more planning he has done, and the more viable that plan is, the more concerned you should be, Mr. Powers said.

For example, many people in despair make plans that are unlikely to succeed, such as planning to take a fairly low dose of aspirin at an unspecified time. Others carefully plan, and choose lethal methods. A very dangerous plan, Mr. Powers said, involves access to a gun, coupled with a timeline specifying when the at-risk person will be alone.

Discuss with the person what has brought him to despair, he advised. Listen carefully, and when learning about the problems that led to the crisis, explain that feeling suicidal in the face of such difficult issues would not be unusual at all. Normalizing the situation can help dramatically, he emphasized.

Mr. Powers emphasized the importance of enabling a distraught person to talk about his problems. Rephrase the thoughts expressed, create a genuine, compassionate dialogue, and explain that feeling suicidal is a temporary state.

Permitting a person to talk suicidal

about thoughts will not increase the chance that he will carry out a suicidal act, Mr. Powers reassured his listeners.

In a conversation with a person who may be suicidal, Mr. Powers advised certain things to do, and not to do.

Remaining calm is critical. Accept his feelings, and focus on the most pressing problem. When someone admits to suicidal thoughts, stay close and do not leave his side, Mr. Powers said.

When responding to someone who admits to feeling suicidal, do not appear shocked or offer empty promises like saying, "You will be fine tomorrow," he advised. Do not try to cheer up a suicidal person, debate the morality of suicide, assume things will improve, keep the situation a secret, or remain the only person helping. Stay close and contact someone with the expertise to help further, such as a mental health professional.

Such referrals are important. Only 8.5% of people who commit suicide seek the help of mental health professionals on their own, he pointed out.

Helping someone who admits to suicidal thoughts may involve setting aside your own beliefs and discomfort, Mr. Powers stressed. Do not entertain the impression that a suicidal person is being manipulative, and ignore thoughts such as "people who are suicidal are weak, immoral, crazy, illogical, cowardly, or committing a sin," he said.

"My point here is very clear," he explained: "If practicing professionals have to be on guard for these issues, you need to be careful, as well."

Mistreating someone considering suicide is dangerous. Doing so could cause him to hide his thoughts, or even trigger a suicidal act.

Many changes in life can trigger suicidal thoughts. Some are compelled toward suicidal thinking by the loss of a loved one or by the stress of dealing with a serious health problem in themselves or a family member, from divorce or separation from a spouse, after losing employment, legal problems, sexual abuse or assault, losing a cherished possession, or even a pet. Even retirement can alter a person's life enough to cause suicidal thoughts, Mr. Powers said.

Isolation is particularly dangerous. Those lacking personal support systems, such as spouses, partners, or close friends, are at higher risk for suicide.

"The more supporters they have, the better off they are. The fewer supporters they have, the higher is my level of concern for their safety," he said.

People with friends or family members who have committed suicide are also at higher risk, as are those who are not thinking rationally owing to prolonged lack of sleep, extreme stress or anxiety, or abuse of alcohol or drugs. In fact, alcohol or drug use is a factor in approximately 70% of suicide cases.

Biological factors can also promote suicidal thought, and Mr. Powers touched upon the complications of schizophrenia, bipolar disorder, and other forms of mental illness.

When trying to help a suicidal person, stay close and promptly seek professional guidance. Try to help the person develop a shortterm plan to improve his life. Remember this clearly, Mr. Powers said: "It is my job to sow the seeds of hope."

Suicide Prevention Hotline

Call (800) 839-9443 to reach a local Toll Free Crisis Hotline in Mackinac, Chippewa, or Schoolcraft counties.

Call (888) 728-4929 in Alger, Luce, Delta, or Marquette counties. Hiawatha Behavioral Health can be reached at (800) 839-9443.

Statistics on Suicide

In his address to the public Tuesday, November 20, suicide expert Michael Powers offered statistics and presented the following facts:

• Suicide is the 11th leading cause of death in America.

• It is the third leading cause of death among America's young people.

• The elderly are the demographic group most likely to commit suicide.

• Approximately 30,000 Americans each year end their own lives.

• One million people worldwide end their own lives each year.

• There are 790,000 suicide attempts in the U.S. annually.

• Five million living Americans have attempted suicide.

• Afirearm is used in 54% of all suicides

• Individuals who die from suicide represent only a fraction of those who have suicidal thinking or attempts. In 2003, there were 348,000 non-fatal emergency room visits by adults who had harmed themselves. Some research suggests that there may be as many as eight to 25 attempted suicides for each death.

• Every 17 minutes, an American takes his own life.

• The U.S. Surgeon General in 1999 declared suicide a serious public health problem, issued a call to action, and encouraged development of a national strategy for suicide prevention.

• Approximately 50% to 58% of those who commit suicide see their primary physician within 30 days of ending their lives.