Knowing the signs of suicide

Here are signs you may observe from someone in suicidal distress:

• persistent low mood,
• sense of hopelessness,
• increased anxiety,
• decreased interest in activities that were previously enjoyable,
• sleep disturbance,
• social isolation,
• talking about being a burden or wanting to die,
• declining interest in personal appearance, and / or
• changing personal and or financial plans.

It is important to note that in many instances of suicidal distress there may not be any signs like those detailed above.

Intervening when someone you know is in suicidal distress

If you are thinking about offering support to a friend or colleague who you suspect is in suicidal distress, here are some steps to guide this conversation.

1. Pick a place and time to maximise privacy.
2. Start by expressing your concern and desire to help.
3. Ask them directly if they have thought about suicide. Here are some ways to phrase this question: 
   • • Are you having suicidal thoughts?
     • Are you thinking about killing yourself?
     • Are you thinking about ending your life?
4. Keep the conversation or dialogue going, even if they won’t talk to you.
5. Stay calm if they say yes.
6. Listen and validate their struggle. 
7. Tell them you want to connect them to any of these supports: 
   • • their GP
     • a dedicated counselling service (such as Pieta) specialising in suicide-related behaviour, or
     • any other mental health service. . 

You might help them make the call and / or accompany them to their first appointment. 

1. Don’t promise to keep what they tell you a secret.
2. Arrange a follow up call or meeting after this conversation.  
3. Remember to take care of yourself - some self-care tips include having a conversation with a supportive friend or colleague, taking a walk or a short break from your desk.

I need help

If you are experiencing distressing thoughts relating to suicide, it is important to seek support promptly.

Here are some important steps you can take to address suicidal distress: 

• Contact your GP to explore supports available.
• Seek out one-to-one therapeutic support from Pietato address suicidal distress and self-harm.
• You cannot be at work; compassionate leave from work may be available.
• Advise supportive friends and or family members that you are experiencing suicidal thoughts and ask that they check in on you regularly.  Be clear and direct when communicating your need for ongoing support.  You might even share our resources on helping someone who is feeling suicidal. 
• Later in your healing, in addition to ongoing therapeutic support, you may find the Wellness Recovery Action Plan (WRAP) programmeoffered by Suicide or Survive to be beneficial.

What prevents suicidal distress?  

According to the Centre for Disease Control and Prevention, some key factors can help to prevent suicidal distress:

• engaging in therapeutic support to enable personal growth;
• strengthening your emotional health and resiliency to allow you to thrive;
• support to develop coping and problem-solving skills;
• identifying reasons for living, such as family and friends;
• feeling connected to others; and/or
• reduced access to lethal means.

Resources

There are organisations and supports available for those in suicidal distress. Know that you are not alone. If you need support or want to help someone else, please see below.

Crisis phone lines if someone needs urgent help

• Contact your GP, or an “out of hours” GP
• Contact Samaritans 24/7 on Freephone 116 123 or email jo@samaritans.ie
• Contact Pieta House 24/7 on Freephone 1800 247 247 or text HELP to 51444 (standard message rates apply)
• Contact Text 50808 by texting HELLO to 50808, free of charge, anytime day or night

If you, or someone you know, is at immediate risk of harm, visit the emergency department of your local general hospital. You can also contact emergency services on 112 or 999 anytime, day or night.

Therapeutic Supports

• Samaritans: Offers emotional support 24 hours a day, 365 days a year, to anyone who is in distress, lonely, struggling to cope or feeling suicidal.
• Pieta: Free professional counselling service in your area via face to face, online or by phone. 
• Aware: National organisation providing free support, education and information services to those impacted by anxiety, depression, bipolar disorder and related mood conditions.

Organisations dedicated to suicide prevention efforts

• HSE Regional Officers for Suicide Prevention (ROSP): HSE Resource Officers for Suicide Prevention (ROSPs) work across a range of Community Health Services, Community Health Organisations (CHOs) and areas nationwide.
• National Office for Suicide Prevention: The HSE National Office for Suicide Prevention (NOSP) supports the implementation of Connecting for Life, Ireland's National Strategy to Reduce Suicide.
• Mental Health Ireland (MHI): MHI promote and enhance mental health, wellbeing and recovery for all individuals and communities.
• National Suicide Research Foundation (NSRF): The National Suicide Research Foundation (NSRF) is an independent, multi-disciplinary research unit that investigates suicide and self-harm in Ireland.
• Ohana: Ohana provides education to identify the signs that someone may be suicidal, to employ the correct language in asking the appropriate questions and to ultimately direct that person to the appropriate help. 
• Suicide or Survive: Suicide or Survive (SOS) is a nationwide Irish charity focussed on breaking down the stigma associated with mental health issues and ensuring that those affected have access to quality recovery services that are right for the individual.

Further Reading

Recognise the signs of suicidal distress

• Suicide: Know the signs and what to do (McLean Hospital, MA, USA)
• What to do when someone is at risk (American Foundation for Suicide Prevention)
• If someone tells you they're thinking of suicide - a conversation guide (American Foundation for Suicide Prevention)
• Responding to a person in suicidal distress - a guidance document (HSE)
• How to Ask Someone If They Are Thinking About Suicide in 10 Steps (Jed Foundation)
• Would you know what to do if someone told you they were thinking about suicide? (HSE)
• Concerned about suicide? (HSE)

Resources for employers

• Workplace wellness programmes (offered by Suicide or Survive)
• Responding to suicide - A resource for employers (Hospice Foundation)
• Best practice guidance for suicide prevention services (HSE)
• Language and Suicide (HSE)

Suicide prevention

• Suicide prevention (CDC)
• Wellness Recovery Action Program (WRAP)
• Resources for suicide prevention (HSE)

Supports for those bereaved by suicide

• You are not alone - support for people who have been bereaved by suicide (HSE)
• If you have been bereaved by suicide (HSE)
• Supporting someone bereaved by suicide (HSE)