In the aftermath of two high-profile suicides and a Centers for Disease Control and Prevention report that showed suicide rates have risen 25 percent since 1999, the question is more urgent than ever: How do you talk about suicide with someone who is severely depressed?
The problem is particularly pronounced among young people, with suicide the second leading cause of death in 2015 for those between the ages of 10 and 24. A recent study published by the Journal of Pediatrics found that one in five California teens actively think about killing themselves, leading public health professionals to advocate treating suicide as a systemic problem rather than a personal one.
“Instead of changing individuals, we have the ability to take a public health approach and treat settings by bringing fixes and resources to groups,” says study co-author Ron Avi Astor, a professor at University of Southern California’s School of Social Work. He found that the percentage of students who thought about suicide ranged from the low single digits to upward of 70 percent, and depended largely on the school setting.
Until there’s a greater societal shift, however, what’s the best way to reach someone who’s thinking of suicide? We asked Astor for advice on identifying, and confronting, young people who may be harboring suicidal thoughts.
DON’T BE AFRAID TO SAY THE ‘S’ WORD
A big myth is that by talking about suicide with someone, you are planting the seed or promoting the action. That’s false.
“It’s important to know you can’t trigger suicidal thinking just by asking about it,” Allen Doederlein of the Depression and Bipolar Support Alliance, recently told The New York Times.
Astor agrees — especially when it comes to teenagers, who are remarkably open, he says. He notes that teens who have thought about suicide will likely be honest about it. Specifically, he says, “you want to know if they’ve thought about how to do it — if they haven’t given much thought about it versus thinking about … a time and a place.”
The more detailed they are, the more urgent it is to get them help.
“It’s very difficult to ask, but if the person has made attempts — even if they’re not strong attempts — all those factors bump it up.”
DON’T GUILT THEM INTO LIVING
When trying to convince someone not to take their life, a common go-to is to mention all the people they’d be leaving behind. “Just think of your family,” you might be tempted to say. But try to resist that urge.
“It’s important not to make someone’s suicidality about yourself or others. They’re the person who’s hurting, so the focus needs to be on their feelings, their thoughts, and finding them help,” wrote suicide survivor Sian Ferguson.
Guilting people by mentioning who would miss them only exacerbates the problem. Instead, experts recommend simply telling them how much you care about them and showing empathy by acknowledging the truth of their situation. Express to them that, yes, right now sucks, and what they’re feeling is real.
REACH OUT TO THEIR FRIENDS, TOO
In his research, Astor found that someone’s friends often have a better idea of what is going on with them than their parents or teachers do.
To that end, Astor suggests speaking with the friends of someone you think might be at risk. Oftentimes, he says, they are also harboring suicidal ideation in a type of groupthink and can help shed light on underlying issues.
HELP THEM GET HELP
If you know a teenager is, in fact, having suicidal thoughts, seek help immediately.
The Society for Prevention of Teen Suicide recommends first seeing a pediatrician, who can refer you to a mental health professional, and the American Academy of Pediatrics notes that “pediatricians are, and will continue to be, an important first source for parents who are worried about their child’s behavioral problems.”
When trying to get someone to agree to see a therapist or psychiatrist, don’t try and force them, say experts. But that doesn’t mean you shouldn’t be blunt and level with them.
“Try to make the optimistic assumption that if you could speak directly, though tactfully, and with care, then that might bring relief,” said Stephen Seligman, a clinical psychiatry professor at the University of California.
SHOW UP AND BE PRESENT
The best advice many experts give, though, is just to show up, ask questions and listen carefully to their response.
There is a lot to say about opening up the conversation and letting someone else — even angsty teens — know that things can get better with the right help.