HOW TO SAVE A LIFE: Ministering to a Suicidal Person

Facts about Suicide:
• Within the next 60 seconds, someone in North America will attempt suicide. In the United States alone, an estimated 200,000 people attempt suicide every year – that’s about 23 suicide attempts per hour. Every 20 minutes, someone succeeds.
• Four out of five people who commit suicide have talked about it or threatened it previously. It is not true that someone who talks about suicide will not try suicide. Often that is a clear call for help. All suicide threats must be taken seriously.
• Most suicidal people give many clues and warnings. Recognizing these cries for help can save a life.
• Most suicidal people are undecided about living or dying. They gamble, leaving it to others to save them. Almost no one commits suicide without letting others know how they feel.

Risk Factors and Warning Signs:
• Attempted suicide in the past.
• The most common characteristics of suicidal people are: 1) severe depression, 2) hopelessness, 3) feeling unwanted, unloved or forsaken/ abandoned (by others or God), and 4) loneliness/ isolation.
• Signs of depression: prolonged sadness, feelings of hopelessness, excessive guilt or deep apathy; loss of pleasure (including sexual pleasure); alterations in sleeping or eating patterns, such as excessive weight loss or overeating.
• Recent severe loss, such as death of a loved one, divorce, separation, or broken relationship; loss of a job, house, business, money, or social status; loss of health to serious or painful illness.
• Losing all hope in the future (“Things will never get better.”).
• Developing a specific plan for suicide. (This is the number one risk factor!)
• Talking or hinting about committing suicide. Suicidal feelings can be expressed directly (“I want to die”) or indirectly (“I would like to disappear or go to sleep forever,” “How do you think you’d get along without me?” or bringing up the topic of suicide or death).
• Drastic change in behavior, such as lack of concentration, poor school or work performance, cancellation of important appointments, and/or ignoring routine responsibilities that were previously being carried out.
• Social isolation (withdrawing from others and from social engagements).
• Risk-taking behaviors without regard for the consequences.
• Trouble eating or sleeping.
• Giving away prized possessions or pets.
• Preparing for death by abruptly settling affairs and/or making out a will.
• Extravagant, reckless spending.
• Preoccupation with death or dying.
• Loses interest in their personal appearance.
• The suicide rate is much higher for men than women at all ages. Men threatening suicide are more likely to follow through than women.
• Men over 65 account for America’s highest suicide rate. The rate escalates as they get older.
• Suicide rates rise with age for both sexes.
• The suicide rate is significantly higher for the divorced. The rate for single or widowed adults is also higher than for married adults. Older, single males are at highest risk.
• Alcoholics are at high risk. Sporadic drinkers are more vulnerable than chronic, heavy drinkers.
• Drugs or alcohol are involved in two out of three suicides. Use of these chemicals intensifies the already existing feelings of helplessness and hopelessness that the person is experiencing.

What to Do
• Be willing to listen. Allow expressions of feelings. Accept the feelings.
• Try to establish a rapport with the person.
 • Mention things you have felt, experienced, etc. that are in common with the person.
 • Be empathetic (show them that you are trying to understand their feelings and see their situation from their perspective).
• Be non-judgmental. Don’t mention or debate whether suicide is right or wrong.
• Be direct. Talk openly about suicide.
• Answer every question they ask with complete honesty.
• Don’t lecture on the value of life.
• Get involved. Be available. Show interest and support.
• Don’t dare them to do it.
• Don’t act shocked. This will put distance between you.
• Don’t be sworn to secrecy. Seek support.
• Offer hope that alternatives are available, but do not offer glib reassurances
like “It’s not so bad” or “This will blow over.”
• Take action.
• After developing rapport, get the person’s location and contact information, if possible.
• Try to obtain the phone numbers of other significant people who could help the person (relatives, neighbors, physicians, etc.) and contact them.
• Give them instructions to undo whatever part of the suicide plan they have already implemented.
• Ask them to commit to not harming themselves.
• Pray with them and
• bind and rebuke the spirit of suicide, (Matt. 18:18);
• cast down every lie, accusation anddepression, heaviness, hopelessness, lying and tormenting spirits
(Matt. 18:18);
• cast down every lie, accusation and argument of the
enemy that exalts itself against the knowledge of God
(2 Cor. 10:4,5);
• loose hope, peace, joy and deliverance upon them in
Jesus’ name (Matt.18:18); and
• give them words of encouragement and hope.
• Arrange for them to come to church for counseling or, if they live out of town, encourage them to go to a church, counselor or agency in their area.
 • After you have done all you can do, you may refer them to other resources:

Suicide Line
1 (800) 273-8255
National Suicide Prevention Lifeline

Further Study on How to Minister:

Step 1: Establish rapport, obtain information, maintain contact
Most suicidal people are undecided about living or dying. On the one hand, they want to kill themselves and are tired of going on with their life. On the other hand, they want to be rescued by someone. When such a person calls, it is important to immediately try to develop a positive rapport with him. This rapport could be the reason he decides to stay alive. It is also the only way he is going to open up and allow you to minister to him.

When the person calls, say something like: “You did the right thing by calling” or “I’m glad you made the decision to call.” This assures him that he made the right decision and that someone cares about him.

Talk calmly, confidently, with authority (without sounding authoritarian), and in a manner that he will not feel challenged. Caring, acceptance and genuine concern are very important.

As you talk, it is important to find some common ground upon which you and the caller can agree. A place to start is the fact that the caller has a problem and wants help, and you would like to help him.

Show interest in the caller and try to discern his feelings. A relationship of trust needs to be developed. This can be done by giving straightforward answers to questions. Answer all questions completely honestly, even if he asks you if you have ever helped a suicidal person and you have not. At the same time, re-assure him that you feel you have the resources and training to help him.

In establishing the relationship, identify yourself and try to get the person’s name, phone number and address. These questions should be spaced out in the conversation so the person is not unduly threatened by them. If there is a reluctance to give his name, do not pressure the caller. You could ask, “Could I know your first name so I have something to call you by? I would feel more comfortable with that.” If he will not give you an address, you could ask what part of town he lives in. If he gives you a general area, you could respond by saying, “oh, that is near…” This statement will perhaps stimulate him to give more information.

In the conversation, you should also attempt to obtain the phone numbers of other significant people who could help the person – relatives, neighbors, physicians, etc. You can give these numbers to a co-worker and have them contact someone while you are on the phone with the person so they can go over and help the person.

Suicidal people generally fall into three categories: 1) those who indicate that they are very depressed or hopeless but don’t say anything about being suicidal; 2) those who “beat around the bush” and mention death or make indirect comments about being gone, but will not directly tell you they are suicidal; and 3) those who tell you they are suicidal. In the first two cases, ask them point blank if they have had any thoughts of suicide. Get them to open up and talk about it because that is the only way you can help them deal with it and effectively minister to them.

Step 2: Identify and clarify the problem
Hear the person’s story with as few interruptions as possible. Encourage him to tell you: (1) what has led him to where he is now, (2) what is bothering him right now, and (3) what he has tried before to cope with his situation. Do not challenge what he is saying. Statements such as, “You should not feel that way” or “Things are not as bad as they seem” can make the person worse and are at least not helpful.

Focus on what the person is feeling and help him clarify his feelings. If he is having trouble expressing his feelings, help him label them. Try to reflect what you think he is thinking and feeling back to him; this will help him pinpoint the problem. You can do this with statements like, “So, you feel…”, “If I hear you correctly, you feel like…” or “What I hear you saying is…” These techniques will help him break up his overwhelming feeling of helplessness into specific problems, the solutions to which may be more easily seen. When he can see the problems, you can help him begin to construct a specific plan for solving them.

A person may call and just talk about being down or depressed without admitting that he is suicidal. Since depression is one of the most common symptoms of a suicidal person, always ask a few questions like the following to assess the suicide threat: “How much have you been depressed over the past few weeks?” “When do you get depressed?” “Have you ever had thoughts of suicide?” Questions like this can help the hesitant person put his feelings into words. The actual threat of suicide needs to be out in the open for you to help the person.

When a person has trouble talking about suicide, he is usually relieved to find that you are not afraid to talk about it openly. This can also relieve him of the trapped feeling. Suicide should be discussed in an open, non-moralistic manner. Suicide is not a moral issue for the suicidal person. Many are already struggling with guilt feelings, and if a discussion of suicide as an immoral act occurs, it can add to this burden and cause further discouragement.

If you are talking to an adolescent, talk to him about his beliefs about death. Many of them have never seen a dead person or been to a funeral. They do not understand the finality of death. They may be thinking only of the attention they will receive. Helping them gain a realistic perspective of death may deter them.

Step 3: Evaluate the suicide potential and lethality
1. Age and sex.
• Suicide rates rise with age.
• Men are more likely than women to follow through.
• Older single males are most vulnerable.
• Younger females are less likely to carry out their plan.
• Alcoholics are at higher risk.

2. History of suicidal behavior.
• The more recent the onset of suicidal behavior, the better the chance of preventing it.
• A person who has attempted suicide repeatedly needs professional help and is more likely to succeed in the suicide.

3. Evaluate the suicide plan.
• Ask, “How are you thinking of killing yourself?” and determine how specific and lethal the plan is. The more specific and lethal the plan, the more difficult the suicide is to prevent. Shooting and hanging are most lethal, followed by barbiturates and carbon monoxide poisoning.
• Determine how available the method is. If the gun or bottle of pills is at hand, the risk is greater. Ask what kind of pills they are and where they are. If he plans to use a gun, ask “Do you have a gun? Where is it? Do you have bullets for it?”

4. Stress.
• Ask questions to determine what stresses have led him to contemplate suicide. A recent loss of a loved one? Financial problems? Health problems?

5. Symptoms.
• Is there depression? Alcoholism? Agitation? Is the person psychotic?

6. Resources.
• What resources does the person have to help him? Are relatives or friends nearby? Are counseling services available to him in the community or at work? Does he have a place to stay? A lack of resources makes the risk higher.

7. Life-style.
• What is his lifestyle? If it is unstable, such as a history of changing or losing jobs, changing living locations, drinking, impulsive behavior and so on, the risk is higher.

8. Communication with others.
• Has the person cut himself off from friends and family? If so, he is at higher risk. If he is still in touch with others, you could use them to help.

9. Medical status.
• If there are no physical problems, the risk is less. If there is some illness or injury, talk about it and find out how serious it is. Is it really the case, or is it merely in the person’s mind? Has he seen a physician? Some who have a terminal disease may think of suicide as a way of eliminating the pain for themselves and the expense for their families.

Step 4: Formulate a plan to help the caller
It is important to find out what part of the plan he has put into action and get him to reverse it. If he has turned on the gas and sealed the windows, have him turn off the gas and unseal the windows. Do not let him promise to do it when he hangs up.

Give specific instructions and stay on the phone while he carries them out. Ask him to open the doors and windows. If he has a gun, have him unload it. If it is an automatic, have him take the clip out of the chamber, then take the bullets out of of the clip. Next, he should put the bullets in a drawer and put the gun in a place that is difficult for him to get to in a hurry. If the person has pills, you might ask him to flush them down the toilet.

If he does not want to reverse the plan, continue talking until your relationship is built to a point that he trusts you. If you have his phone number and/or location, give the information to a co-worker and have them call the police on a separate line.

Ask him to commit to you that he will not harm himself, and that he will call you if he is tempted to do so. Professionals have found this to be quite effective. The person may let other obligations go, but he will likely keep his promise to call you. Your word of encouragement on the phone may keep the person alive.

Be sure to convince him that there are various positive alternatives to suicide.
Before concluding the call, your last task is to get the person personally involved with someone. You may want to have him come to the church for counseling or go to an agency you know can help. For out-of-town callers, encourage them to go to a church, counselor or agency in their area.

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