Back in my early days as a Beijinger, I taught a class full of wide-eyed youngsters. One of the boys in that class was a lively blond-haired boy whom I shall never forget. He was endearing and full of wit, with a cut-glass British accent that reminded me of home. As I was completing my first year of expat life he was completing his last. Months after our first encounter, he and his family relocated back to the UK and I never heard of him again. About half a decade later I learned that that boy had taken his own life; he was fourteen years old.
Suicide is a bleak topic and one that is often spoken of in hushed tones. However, as with most taboo subjects, open discourse is empowering and can have life-changing ramifications. In recent years, there has been a heightened appreciation of the importance of a holistic approach to self-care. This trend has been reflected in the expat community, as awareness has grown that global relocation is amongst life’s most stressful events. Many employers have adopted comprehensive strategies to safeguard their employees’ mental wellbeing. But is this enough? How can we look out for the welfare of others? Might there be a way for us to prevent somebody we know doing the unthinkable? Just how can we offer assistance to a person we think might be suicidal?
Know the warning signs and take them seriously
According to mental health website HelpGuide, the best way to prevent suicide is to recognize the warning signs and know how to respond if you spot them. Warning signs may include an unusual focus on dying, suicide, or self-harm. This preoccupation might be alluded to, or directly expressed by talking or writing about these topics. Another warning sign is a person planning or looking for a way to kill themselves. This might be revealed by online searches, stockpiling medication, or acquiring potentially lethal items.
Another warning sign is hopelessness. Studies have found that hopelessness is a strong predictor of suicide. Feelings of hopelessness may be conveyed by referring to life or the current situation as “unbearable.” A person may also speak of having nothing worth living for. Talking about being a burden to others, using drugs or alcohol more often, withdrawing from friends or family, and neglecting personal care and appearance are all potential warning signs. It is essential to bear in mind that this list is not exhaustive, and that a suicidal person may not necessarily display all of these signs.
Any suicidal talk or display of these warning signs should be taken seriously. Research has found that more than 75% of people who die by suicide did things in the weeks and months prior to their deaths to indicate to others the depths of their despair. A person expressing suicidal feelings needs immediate help.
Speak to the individual about your concerns
If you suspect that somebody you know may be suicidal it is advised that you share your concerns with them. According to the National Suicide Prevention Lifeline and a host of other experts, asking the question “Are you thinking about suicide?” in this direct way does not increase suicidal ideas. On the contrary, this question can give the person concerned an opportunity to share their thoughts and feelings and really be heard. Asking this question directly can also be the best way of identifying if somebody is at risk.
After asking this question it is essential to let the person know that you care and that you are willing to listen to what they have to say. If they do decide to open up to you, be calm and listen even if you find their outpouring extremely negative and uncomfortable. The fact that they are willing to talk openly is a positive thing. Avoid offering quick-fix solutions, or trivializing their experiences and making them feel as if they need to justify their feelings of despair. Offer them hope that help is available, and that these suicidal feelings can pass. Don’t promise confidentiality. A life is at stake and you may need to speak to a mental health professional in order to get the suicidal person some help.
Respond quickly in a crisis
If somebody tells you that he or she is thinking about death or suicide, it is important to evaluate the immediate danger the person is in. Have they already done anything to try to kill themselves? Do they know how they would kill themselves? Do they have a specific plan? Have they decided when they will enact this plan? Do they have access to their planned method? Those at the highest risk of suicide in the near future have a specific suicide plan, the means to carry out the plan, a time set for doing it, and an intention to do it. If a suicide attempt seems imminent, call a crisis center or take the person to an emergency room. Remove potentially lethal objects from the vicinity and do not, under any circumstances, leave a suicidal person alone.
According to the Harvard T.H. Chan School of Public Health, “means reduction (reducing a suicidal person’s access to highly lethal means) is an important part of a comprehensive approach to suicide prevention.” A number of studies have demonstrated that when lethal means are made less available or less deadly, suicide rates by that method decline.
Help them connect
Do everything you can to get a suicidal person professional help. This will often necessitate being proactive. Do the necessary research, make the phone calls, escort them to appointments if needed. Rather than waiting for them to call you “if they need anything,” be the one to call or visit them.
It is also extremely helpful to encourage someone with thoughts of suicide to develop a safety plan that clearly documents what they should do in times of crisis. The plan should set out steps which he or she promises to follow during a suicidal crisis. It can also include ways for them to identify if they start to experience severe thoughts of suicide. An important feature of a safety plan is a list of individuals to contact in an emergency. Identifying people that are trusted enough to call in times of crises can be lifesaving in and of itself. The process can also help develop the very important feeling of connectedness.
Many experts agree that combating a person’s isolation and increasing their connectedness to others can help to prevent suicide. Thomas Joiner, a psychologist and leading expert on suicide, states that a sense of low belongingness (also known as social alienation) is one of two psychological states which when held simultaneously over a long period of time can result in a desire for death. Joiner defines a low sense of belongingness as the experience that one is alienated from others, and not an important part of a family, a circle of friends, or some other valued group.
Expats are particularly susceptible to feelings of isolation and social alienation. Most expatriates move thousands of miles away from family and friends when they leave for another country. Some expats find that the stress of relocation, adjusting to new jobs and educational institutions, and the challenges of navigating a new culture accentuate their feelings of alienation and lack of connectedness.
Follow up
After connecting a person experiencing suicidal thoughts with the support that they need, it is extremely important to follow up with them. Leave a message, send a text, or give them a call. Following up can help the development of a feeling of connectedness. It also provides an opportunity to ask what else you can do to help.
It is important not to commit to anything you are not willing or able to accomplish. If you are not in a position to be physically present with someone with thoughts of suicide, talk to them about what and who they think will be the most suitable sources of help.
Helping a person who might be suicidal ought not to be regarded as a task that is suited only for mental health specialists. Research has proven time and time again that there are things that every one of us can do to reach out to and support an individual struggling in this area. Small things so often can make big differences. For those of us who know people who are currently in the throes of this battle, or who have known individuals that died by suicide, it goes without saying that it is not your fault. Nobody has ultimate control over the actions of another. We don’t get to determine who lives and who dies. What we can do is educate ourselves and others so that we are all better equipped to be of assistance to a person who might be contemplating suicide.
Suicide Prevention Resources
Lifeline Shanghai
This helpline serves the English-speaking community with free, confidential, and anonymous emotional support via telephone 10am to 10pm, 365 days a year. Trained volunteers listen, help to provide another perspective, and connect callers with other support services. (021 6279 8990)
My3
This is a safety planning and crisis intervention app enables users to add the contact information for three people who can help them when they are experiencing thoughts of suicide. The app also allows users to construct a customized safety plan.
This post appeared in the beijingkids October 2018 Mental Health issue.
Photos: Adobe Creative Cloud, Kat Jayne via Pexels
