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Suicide Prevention

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C.A.R.E. Helping Someone Who is Suicidal

C - Show that you Care

  • Work to remain calm. It's normal to feel anxious when talking about suicide. However, remember that you are responsible for your assistance not the outcome. You can connect the individual with resources, but are aren't required to solve their problem.
  • Be a good listener. Don't worry about saying the right thing. Stop talking and listen. Maintain eye contact, don't interrupt, and summarize what you heard. "Let me see if I understand..." 
  • Be non-judgmental. There is no need to debate or lecture the individual about the morality of suicide. This may cause them to shut down and stop talking. The primary goal is to have them openly share their thoughts and feelings with us.
  • State directly that we care about the person. Talk about our feelings and our concerns. We might say to the person, "I'm concerned about you...about how you feel" or "You mean a lot to me and I want to help" or "I'm on your side...we'll get through this together." The person may not appear to appreciate or even hear what we say in the moment, but these statements may have an important and lasting impact in ways that are not immediately noticeable.

A - Ask Calmly and Directly About Suicide

Asking about suicide will not give them any ideas that they haven't already considered. It actually decreases the risk by providing an opportunity to talk about their distress.

  • "Has it gotten so bad that you thought about suicide/killing yourself?" It is important that we ask calmly and directly about suicide. Our frankness will communicate to the person that we care and that it is safe to talk about this "taboo" subject with us.
    • "Have you thought about how you would do it?"
    • "Do you have access to what you would need to carry out your plan?"
    • "Have you ever tried to hurt or kill yourself in the past?"
    • "Are you able to see things getting better in the future?"

The risk of suicide increases if the person (1) has a specific plan and the means to carry it out, (2) has made past suicide attempts, and (3) feels helpless and hopeless about the future.

R - Refer the Person to the Counseling or Emergency Services

If the person confirms that suicide is a concern, the goal is to connect them with a mental health professional. For many students, it is appropriate to refer them to the Counseling Center for a crisis appointment. However, if the individual is in imminent risk of suicide, the Emergency Room at Sentara RMH is the best option.

"Let's talk to someone who can help you feel better. Let's get in touch with the folks at the Counseling Center right now" or "Would you be willing to go to the ER?"

  • Your role is not to take on the person's problems or to provide counseling. Connect them with a mental health specialists. 
    • Call the CC at 540-568-6552 between 8 am and 5 pm, Monday through Friday, or come to the 3rd floor of SSC. The CC offer emergency services throughout the work day. 
    • After 5 pm, over weekends, or when there is imminent danger, call the JMU Office of Public Safety at 540-568-6911. The dispatcher will gather information about the situation and, if necessary, contact the CC on-call clinician.
  • Public Safety is your first call when there is imminent risk of harm, including if the student is intoxicated, violent, or unconscious.
  • Do not leave the person alone. If you want to provide comfort and support, you can accompany the student in crisis to the CC. It is also important to remove firearms, drugs, sharp objects, and anything else that could be used in an impulsive suicide attempt. However, if there is a possibility of being harmed by the person, leave the area and call Public Safety at 540-568-6911.
  • Let the individual know that CC services are free and confidential. Students are often concerned about the cost of receiving crisis services and who will know about their situation.  If the student is at a significantly high risk to attempt suicide, the CC clinician may need to break confidentiality to ensure the safety of the student. 
  • Remind the individual that the decision to seek help is a courageous, mature choice. Because of the stigma associated with mental health issues, people can believe that going to counseling is a sign of weakness. Frame the decision to seek counseling as a mature choice which suggests that the person is ready to address their problems.
  • Follow up with the person after the appointment. The counseling process can be difficult. Check in with the student after their appointment and offer support.
  • Do not fall into the "confidentiality trap". If you believe a student is at risk of attempting/completing suicide, never agree to keep that information secret. They may claim, "You're making this worse than it already is," but, for their safety, you need to share that information with the CC, Public Safety, Residence Life, or another responsible professional. Remind the student, "You're expressing these serious desires to end your life, but you're asking me to ignore it. That really puts me in a challenging situation. If you were in my situation, what would you do?" Do not keep a secret that may cost a life.
  • If the person refuses to seek help, contact Public Safety, CC, or Residence Life. We may have to take a more assertive, even authoritarian, approach. We might say something like, "When a person tells me things like you have today, I feel obligated as someone who cares about you to do all that I can to stop you from hurting yourself." 

E - Encourage Hope for the Future

The final step is to encourage them to develop some positive expectations for their future. People considering suicide tend to share a common mindset that is characterized by overly negative views of the world, themselves, and their future. For example, "I will never feel better, life will always be awful, I will always be in pain. I can't do anything to improve my situation. I am helpless and hopeless. I can't change my past, but I can't live with it either. I am so tired. I have to get some relief, some rest, an escape. I do not deserve to live. I contribute nothing. I am unlovable. I have no control over anything -- except this. I want to be missed by someone. I want someone to know how much I hurt."

These thoughts are often accepted without challenge or debate, so the individual sees them as true and unchangeable. The goal is to challenge those thoughts and instill some reality-based hope that the future will be brighter.

  • Don't debate the person about the right to die. Don't argue with a student or try to convince them that suicide is wrong, immoral, or illegal. Since suicidal people frequently feel like their lives are out of control, they will often vigorously defend their perceived right to remain in control of whether or not they will continue living. If the students they can retain that power, they will often be more open to considering other alternatives.
  • Don't make statements that blame the student or dismiss the pain he or she feels. Don't try to "snap" them out of it by saying things like, "You're just feeling sorry for yourself" or "Other people have a lot more to worry about than you do." These kinds of statements are likely to cause the person to shut down and withdraw.
  • Work to frame suicide as a permanent solution to a temporary problem. Remind the person that crises and problems are almost always temporary. Problems are solved, feelings change, and unexpected positive events do occur.
  • Offer alternative solutions. The intense emotional pain they're feeling frequently blinds suicidal students to alternative solutions to their problems. Alternatives include going to counseling, taking medication to reduce the acute distress the person is experiencing, and engaging in spiritual/religious practices.
  • Explore and reinforce the person's reasons for living. Reasons for living can help sustain a person in pain. Family ties, love of art or nature, spirituality, pets, and dreams for the future are just a few of the many aspects of life that provide meaning and gratification but which can be obscured by the pain the person is experiencing.