Suicide Prevention: The Role of Family and Friends

By Rudy Nydegger, PhD, ABPP

Suicide is one of the most tragic types of deaths, and what makes it more tragic is the fact that many of these tragedies probably could have been prevented. In some cases a suicide might seem rational (like someone dying of a terrible disease who wants to end their life), and perhaps it is, but if the suicide is the result of a treatable condition like depression, then perhaps that condition should be treated so that the patient can make a more “rational” decision about living or dying.

When a person feels that they have nothing to live for and they have no options, their feelings might be real but their assessment of the situation is not correct. There are always options, and if a person ends their life prematurely how could they ever know what they might be missing out on in the future? Further, when someone feels that others would be better off without them, they cannot truly understand the impact of suicide on those who are left behind—these friends and family of the victim will never completely get over it and will probably spend the rest of their life wondering what they could have done differently to have prevented the suicide.

It is terribly frightening to suspect or know that someone close to you is contemplating suicide and not know what to do or who to turn to. The first thing to remember is that unless you are a qualified mental health provider, you are not trained to evaluate suicidal risk or to determine what needs to be done to help keep the person safe and get them into treatment. The best thing a friend or family member can do is to continue to be who they really are—the suicidal person needs their friends and family to be there, but not to be their doctor. The next thing that a person should do to keep a potential suicide victim safe is to talk to someone who knows what to do—the family doctor, a psychologist, a psychiatrist, a clergy person, but find someone.

There are several general tips to keep in mind when dealing with a person you feel may be suicidal. First, if you are worried about someone—tell them. Let them know that you care and that you are concerned and would like to help them find someone who knows what to do to help them. Second, if it is a crisis situation do something—call their family, call their doctor, call a hospital, call the police; but do something and get help and/or advice. Third, offer help and support, but make it clear that you are not the expert and you can “be there for them” but you cannot fix their problems or treat them—that is for professionals to deal with.

In addition, there are some specific “DOs and DON’Ts” when dealing with people who may be suicidal:

When talking to a suicidal person DO:

Be yourself—do not try to be the doctor or psychologist, or the expert—be genuine and just be honest.
Listen—this is more important than what you actually say. If the person really feels that you are listening and understand what they are saying they are more likely to listen to you.
Be sympathetic, non-judgmental, patient, calm, and accepting. It will be difficult for them to talk to you and it is a big step forward if they do.
Offer hope—let the person know that there really is hope and that the awful feelings that they have will not last forever, but the sooner they get help the quicker the feelings will get better.
If the person is talking about how awful they feel do not hesitate to ask them if they feel suicidal—you will not put the idea in their head, but you will usually find that this is reassuring to someone that you are actually willing to talk about suicide.

When talking to a suicidal patient DO NOT:

Argue with them and try to invalidate their feelings; do not tell them how much they have to live for, or just to look on the bright side.
Act shocked, lecture on the value of life, and tell them how wrong suicide is.
Promise confidentiality—if they are a suicidal risk you need to tell someone, but do not lie to them and tell them you will keep their “secret” and then go out and tell someone. It is OK to say something like, “I know you do not want me to tell anyone what you are planning, but I would rather have you mad at me and alive than killing yourself.”
Offer to fix their problems, or give simplistic advice as to how to fix complex problems. This may make them defensive and more likely to try to prove just how hopeless their situation really is.
Blame yourself—their depression or emotional turmoil is not as simple as a reaction to something you may have done or said. You can apologize if you did something, but then quickly tell them that you are sorry but cannot change the past, but they can change the future and get the help to get by this crisis.

As awful and frightening as it is to have someone close to you who appears to be suicidal, it is also true that there are many things that can be done to help them. Being thoughtful and supportive, giving good advice, and suggesting options are things that can help. Getting people who are at risk in touch with professionals who are equipped and trained to deal with these types of situations is absolutely essential, and this is probably the best thing that anyone can do to help a person struggling with suicidal thoughts and impulses.

Rudy Nydegger, PhD, ABPP

Chief of the Division of Psychology at Ellis Hospital
Clinical and Consulting Psychologist in practice over 30 years
Former President of the New York Psychological Association, and current Chair of the Legal and Legislative Committee.