September 10 is World Suicide Prevention Day. We have experts tell you what to do if you see disturbing messages on social media about someone wanting to take their life
(Trigger warning: If you are in distress or feeling suicidal, please avoid reading this article)
Whether you encounter a casual remark from a friend about the pointlessness of living or a message on social media on someone wanting to take theirs, it is always a good idea to take it seriously. It could be early warning signals or a last minute intervention to save someone’s life.
In fact, 80% of those with suicide ideation are ambivalent and if counselled appropriately, a majority do not take the extreme step, says Dr Lakshmi Vijayakumar, Chennai-based psychiatrist and founder-trustee of Sneha, a suicide prevention and crisis hotline.
From his 30 years of practice as a psychiatrist, Dr C Ramasubramanian, who established the MS Chellamuthu Trust and Research Foundation in Madurai, says that 90% of callers do not die by suicide when they are heard and feel cared for.
Preventing suicide is everybody’s business, not just the ‘job’ of close family and friends. “Each of us has a responsibility to allow others to see themselves as valuable and capable. It cannot be left in the hands of mental health professionals alone,” says Nandini Murali, a suicide loss survivor in Madurai, who runs Project Speak to help those who are contemplating the extreme step.
While trained gatekeepers and volunteers at helpline centres and counselling clinics have the tools for both immediate interventions and long-term therapy, people like you and me have the power to reach out to anyone who may put out messages that signal self-harm. Suicide is a serious public health issue caused by multiple factors that can be social, economic, environmental; it is not a disease. It is a symptom that can be addressed by offering hope and each of us can contribute responsibly.
Understand the urgency
Any message that signals death: “sleep forever”, “want to leave this space”, besides more obvious ones like “I do not want to live”, should all be prompts to reach out, for those of us reading them. But what if you do not know the person at all? Even if there is a mismatched emoji attached to telling messages, treat every word as an emergency.
Reach out immediately
Do not undermine the thought or attempt to make a diagnosis, so avoid writing back and asking the person if they are depressed, for instance. Instead, write back or find a contact number to speak directly. It is important to establish a physical or emotional contact without wasting time. Introduce yourself and express your concern, but in a calm voice. Offer to help in any which way you can, says Dr Ramasubramanian. If the person is willing to talk, it means they want to reach out, says Dr Sayantani Mukherjee, consultant psychiatrist with Columbia Asia Hospital, Pune. In most cases, people want to be heard, even in the midst of loneliness, helplessness, and hopelessness, she adds.
Guard against knee-jerk reactions and be gentle in your tone, kind in your words; not over-bearing. Talk to calm them down and to gauge the situation they are in. But do not slight or sound judgemental. For instance, if someone seems wealthy and well-educated, avoid telling them they are being unreasonable and ungrateful. Do not trivialise their problem by citing a worse example from your life.
Engage in a conversation
The objective should be to prevent them from carrying out the death wish. “Ask about friends, family, neighbours, place of residence and allow the person to talk as much and as long as they want. Do not shift the focus of conversation from them,” says Chennai-based psychiatrist and ex-director of SCARF, Dr Thara Srinivasan.
Create a safe supportive space
Tell the person you totally understand their feelings and believe it is a phase that shall pass. Assure them that there is help available and that you will stay on the phone with them for as long as they would like you to. The person may be rude, but adopt a non-confrontational approach. The point is to show concern, and if you do not know them it can be difficult for you to express love, but it is possible to offer words of comfort, says Dr Vijayakumar.
Understand the person is under psychological distress and an alternative-narrative makes them think and gives hope, says Dr Mukherjee. Help them to remember their hobbies that they could return to. Never advise, but resonate with the person’s feelings, she says. For example, if the person says that life is very difficult to live without money, ask if they want to talk about earlier struggles and how they faced it. It will give them the confidence to look at options.
Make a commitment
Ask if you can make a plan (like meeting them for coffee the next morning). If you find out they are good at something — like writing poetry for instance — ask if you can call the next day so they can read you some. Remind them of the protective factors that kept them happy earlier. If they talk about supportive parents, caring spouse or children, build on that gently to make them feel less agitated. This is also an activation of a person’s internal and external resources.
Connect and be in touch
Try to lead to a situation where the person is wiling to reaching out for professional help — first a helpline, then therapy. Approaching the police is the last resort and is helpful in case of an emergency with little time on hand. Remain in touch with the person as long as you can. An occasional phone call or a letter could help them, as it does any one of us.
(Sneha suicide prevention helpline: 044-24640060 (8 am to 10 pm); 044-24640050 (24/7; Brihanmumbai Municipal Corporation mental health helpline 022-24131212 (24×7); Vandrevala Foundation: 18602662345/ 18002333330 (24×7); I Call: 022-25521111 (8 a.m. to 10 p.m., Monday to Saturday); The Samaritans Mumbai: 8422984528/ 8422984529/ 8422984530 (3 p.m.- 9 p.m. all days); Kolkata: Lifeline Foundation — 033-24637401/32; Samikhani, Kolkata – 033-24663504, 7044087949)
What if it’s
If your friend shows disinterest in life, appears restless, complains of low appetite and sleep, focusses on fears, and dwells a great deal on problems and how they are not possible to resolve, how do you react? Dr Vijayakumar says it is natural between friends to brush it off, but it is better to ask some straight questions. “It is a myth that when you ask directly, you reinforce suicidal thoughts,” she says and adds, “It is better to show your empathy and concern instead.” If timely intervention comes by, the vulnerable feeling of unworthiness and a death wish can be conquered with help. Offer to go with them to a psychiatrist or an RCI-registered counsellor.