Stacy Marr

*Trigger warning: this post discusses ways to support those who may be in crisis and survivors of loved ones who have died by suicide.

The call you never wanted to receive, the drop in your stomach while you’re reeling upon hearing the news, and the realization your life will never be the
same—most of us have been touched by or know a friend of a friend who has died by suicide.

September is Suicide Prevention Month, and as the month draws to a close, I want to discuss the topic of how we can facilitate more meaningful conversations and alleviate the stigma surrounding it. 

Like many of you, I’ve been touched by someone who has died by suicide. Yet we still have trouble discussing this issue that is plaguing our nation and our world.

Where do we start?

How can we have open, honest conversations around a subject that has been stigmatized for decades? How can we speak to someone who has suicidal ideation (wishing, thinking about, or planning to act upon thoughts of suicide) or lost a loved one who died by suicide? 

 Let’s start by looking at just how prevalent this problem is. Then we’ll explore when to be concerned and end with some specific techniques for having caring conversations.

Statistics

In August of this year, the World Health Organization shared some statistics on suicide.

• More than 700,000 people die by suicide each year. 
• Suicide is the 4^th leading cause of death among 15-to-29-year-olds.
• For every suicide, many more people have attempted it.

In the United States, there are similar statistics.

• In 2022, nearly 49,500 people died by suicide.
• In 2021, suicide was the 11^th leading cause of death in the United States.
• 2022 was the largest number of deaths by suicide ever recorded.

When to Be Concerned

These statistics are alarming, but even more troubling is the fact that our society still fears talking about this subject, which leads to suffering in silence and perpetuates the stigma surrounding suicide. 

If you are worried about someone, trust your intuition and open a conversation.

Here are some warning signs and causes that could indicate a person has suicidal ideation. 

• Bereavement, including losing someone to suicide.
• Isolation, or wanting to isolate from people and their daily routine.
• Feelings of depression, hopelessness, anger, or anxiety.
• Continuous, overwhelming pain that seems to have no end.
• Sleep issues—either too much or too little. 
• Joking or talking about death.
• Losing interest in hobbies or things that once brought the person joy.
• An increase in alcohol, drug use, or rash behavior.
• Suffering from other traumas. 

There are many reasons why someone may be having suicidal ideation, including a mental health condition, feelings of loneliness, postnatal depression, serious illnesses, and financial or food insecurities. 

Suicide rarely has to do with death and is more about pain. In many instances, the individual is experiencing excruciating pain that they want to stop, but don’t know where to turn or how they can alleviate it.

Your intervention can save a life, so be brave. Here are some techniques for having that all-important conversation.

Helpful Ways to Speak with Someone Who Is in Crisis

We often feel that we don’t know what to say to people who are suffering, and we may be concerned about infringing on their privacy.

But as humans, we have an innate emotional need for belonging which, in turn, can create more support for the individual. 

When you ask someone how they are doing with the intention of helping, it provides a sense of belonging for the individual, leading them to feel accepted and comforted. By offering support and genuine concern, it can create a space where the individual feels safe to share.

Here are a few ways to have an open dialogue with someone you’re concerned about.

Ask questions. “Are you all right?”  “I’m a little worried about you.” These are just a couple of ways to start a conversation that helps the other person open up.

Ask if they have had or are having thoughts of suicide. “Are you having any thoughts of harming yourself or about suicide?”

• Directly asking about suicide ideation can be difficult, but if you believe this is a real concern, ask. It’s important to note that by doing so, you’re not putting thoughts into someone’s head or encouraging suicide.

• Your friend or loved one will most likely feel relieved that someone has reached out, feeling seen and valued in the process.   

Find a place that is quiet where you can talk without interruption. This creates more privacy and safety for the individual to open up. 

Listen actively. Active listening is being present, showing interest, and asking open-ended questions such as, “Can you share more about that?” while noticing body language and other non-verbal clues.

• When we engage in active listening, it ensures deeper understanding, which leads to greater connection.
• The bottom line is to listen more than you speak and not try to fix anything for the person. Just let them talk.

It’s okay to be clumsy. It’s okay if the conversation is awkward or clumsy; what’s most important is your intention and care.

• By letting them know you are there for them, you are being supportive during a difficult time in their life while creating comfort and safety for the individual.

Offer to help them find professional support. When someone is experiencing suicidal ideation, they may feel at a loss as to where to find help.

• Saying something like, “I care about you and love you. Let’s find help together” can help the individual strengthen their desire to take action toward their health and well-being while also diminishing the fear around the stigma of seeking help. 

Acknowledge their bravery. It takes real courage to open up and talk about a subject surrounded by stigma.

• Acknowledging your friend or loved one’s courage to share how they are feeling brings relief and also offers reassurance that you’re not judging them for what they are experiencing. 

How to Support Someone Who Has Lost a Loved One to Suicide

When my loved one died by suicide, there were times I felt incredibly alone. I was very young at the time, and I didn’t know where to reach out or how.

The stigma surrounding mental health caused such fear that I didn’t seek professional help until several years later.

Thankfully, we’re learning how to talk more about these important topics because when we do, and as the statistics show, talking about suicide can save a life. 

Here are a few ways to help someone who is a suicide survivor. Some of the items that I mentioned above also apply here.

Language is important. Language can ostracize survivors and propagate the stigma surrounding suicide.

• In an article from the Centre for Suicide Prevention, Robert Olson says, “To ‘commit’ suicide has criminal overtones, which refer to a past time when it was illegal to kill oneself. Committing suicide was akin to committing murder or rape; linguistically, therefore, they are still linked. The original notoriety of the word may have dulled over time, but the underlying residue remains.”

Now, more people use the phrase “died by suicide” versus “committed” to help destigmatize the subject and have a more neutral tone.

• Canada’s Centre of Addiction and Mental Health put out a language guide with neutral phrasing when discussing suicide. Take a look at it; I find it helpful.

Research. Doing research on the subject can create insights into what a friend or loved one is experiencing while also accessing tools that could benefit you and your friend.

• The American Foundation for Suicide Prevention is a great resource and provides many offerings on their website, including a list of books that you can find here.

Active listening and reassurance. As I mentioned above, being an active listener in compassionate conversations helps the recipient feel more connected and engaged.

• Because of the stigma, people who have lost someone to suicide often suffer from guilt and shame.
  
• Being present and reassuring can generate hope for the individual while also encouraging them that it is safe to share.

Offer to help them find professional support. When you’re overwhelmed, it’s hard to reach out. Offering to help breaks the isolation. 

• Professional help could be from a psychologist or bereavement groups for both adults and children. This act of care helps the person who is grieving know that they can count on you and have your support. 

Having thoughtful conversations about suicide is never easy.

But when we do, it generates more understanding and greater awareness while helping those who are in crisis feel less stigmatized and more supported as they process their grief and engage in healing.

By destigmatizing suicide with the right language and tools, we can connect with others on a more profound level.

Those who may have (or had) suicidal ideation, or survivors of someone who has died by suicide, can feel seen and heard, knowing they no longer need to suffer in silence.

Above all, in facilitating thoughtful and compassionate conversations, understanding the power of our words, and creating a safe place while offering support, we help those in need while also potentially saving a life.