Suicide Prevention Quick Guide

This quick guide provides a framework to help you recognise the signs, assess risk, and take appropriate action. Remember your intervention can make a significant difference.

Key Principles

• Talking helps: You won’t make things worse by discussing suicide. People often want to escape their pain, not die.
• Don’t handle it alone: Always seek support from your peers or supervisors when dealing with suicide risk.

Assessing the Risk

1. Intention:
   • How often are they thinking about suicide? Is it a passing thought or a serious intention?
2. Time Frame:
   • When do they plan to act on their thoughts? Is it immediate or in the distant future?
3. Means:
   • Do they have access to a method (e.g., stockpiling medication, obtaining a noose)? Access to means increases the risk.
4. Plan:
   • Do they have a specific plan? Knowing how and when they intend to act is a significant risk factor.

Warning Signs

• Black and white thinking
• High levels of self-criticism
• Hopelessness and helplessness
• Risky behaviours and lack of concern for safety
• Rigid thoughts and lack of empathy

Risk Factors

• Men aged 25-44
• History of suicide attempts
• Chronic medical conditions, particularly those involving pain
• Drug and alcohol dependencies
• Members of the LGBTQ+ community
• Serious mental illnesses (e.g., bipolar disorder, schizophrenia)
• Bereavement by suicide or a history of nonsuicidal self-injury

Action Steps

Stage 1 - Safety:

• Ensure Immediate Safety: If there’s an immediate risk, stay with the person and remove any means of harm if possible.
• Get Help: Don’t handle the situation alone—contact a supervisor or emergency services.

Stage 2 - Talking:

• Listen: Give them space to talk about their feelings without judgment.
• Ask Questions: Assess the risk by gently asking about their intentions, time frame, means, and plan.
• Look for Solutions: Encourage them to think of alternative solutions or ways to reduce their pain.

Stage 3 - Helping:

• Address Underlying Issues: Support them in identifying and addressing the root causes of their distress.
• Refer for Professional Help: Guide them to appropriate professional services.
• Safety Planning: Work with them to create a plan that includes steps they can take to stay safe.
• Empowerment: Focus on small, achievable steps that can restore their sense of control.

Strategies for Support

• Identify Strengths: Ask how they’ve managed to survive this far—highlight their resilience.
• Find Reasons to Live: Encourage them to think of people or things they care about.
• Reframe the Future: Help them envision positive aspects of the future.
• Distraction: Use light conversation or topics like sports to distract them momentarily from their distress.
• Quick Wins: Suggest small actions that can give them a sense of empowerment.
• Break Isolation: Invite them to social activities to reduce feelings of loneliness.

Managing Threats and Manipulation

For individuals exhibiting traits of Borderline Personality Disorder (BPD) or using threats as a form of communication:

• Communicate Concern, Not Responsibility: Express care without taking on their responsibility.
• Set Boundaries: Keep your emotional and physical boundaries clear.
• Avoid Reinforcement: Don’t reward the behaviour with hospitalisation or constant attention unless absolutely necessary.

Useful Contacts

• Samaritans: 24/7 confidential emotional support (08457 909090).
• Saneline: Crisis care and support for mental health issues (0845 767 8000, 6 pm – 11 pm daily).
• Crisis Team: Out-of-hours assessment for high-risk patients (01914415738).
• Mind: Mental health charity offering counselling and advice (local bases).
• NHS 111: Non-emergency medical advice (dial 111).
• Talking Changes: Self-referral for psychological therapies (https://www.talkingchanges.org.uk/).