How to Have an Effective Suicide Conversation

“How to Have an Effective Suicide Conversation” by Alexandra Eisner

In everyday life we assess risk levels of situations to ensure our safety. Assessments can look like checking for accidents on the freeway, looking both ways before crossing the street, and checking the weather before going outside. Most times we may not even realize that we’re doing safety assessments, but it is this situational type of thinking that you need to tap into while having the suicide conversation. 

In this blog I will provide questions to ask the person you’re planning to have the conversation about suicide with. These questions stem from what’s called a Suicide Risk Assessment (SRA). Most will be “yes” or “no” questions, and with every “yes”, the risk that they may kill themselves increases. Please keep the previous blog post in mind, titled “Preparing to Ask Someone About Suicide.” As it’s important to prepare your own mindset, energy and a safe space, before sitting down with the individual. 

Once with the individual, the first SRA question is “are you having thoughts of suicide?” It is imperative that you do not use the phrase “committing  suicide.” The word “commit” tends to link with “committing crimes”, and suicide is not a crime. We do not want to have the person shut down at the first question because they feel like they’re accused of being a criminal. 

The second question should be, “Have you done anything to harm yourself today?” If they’ve done something such as cut deep and are still bleeding, or have taken a handful of pills, we want to stop the conversation here and take them to the hospital. If the answer is no, or they’ve done something but it’s not life-threatening, then continue the talk.

Next we want to ask, “Do you have a plan?” Which may lead to, “What is your plan?” “Do you have access to the means for your plan?” “What is the timeline in completing the plan?” If they have the means, ask them if you could help remove the means from their sight or hold-onto the means for them; as long as it is safe for you do to so. If their means is a gun and they legally own it, you can call the local police department and ask if they could hold onto it for them.

Whether they have a plan or timeline in-mind, next is asking the scale question. Let them know you’re asking a scale question from 1 – 5. Number 1 means that they’re having thoughts of suicide but the thoughts come and go, they’re not going to act on them, and a 5 means they’re going to kill themselves today. If they answer 3 – 4 this shows higher risk but not imminent. If you’ve gotten to this point and they’ve mainly answered “yes” along with a 5, then they most likely should be taken to the hospital now. 

If the risk is not imminent, it’s time to hear their story. Questions to assist in opening the story up include, “How long have you been having these thoughts?” “Have you told anyone about this before?” “Have you every attempted suicide?” “Is there something that’s been triggering these thoughts?” “What can I do to support you?” Allow them to open up without the return of judgment and typically you will find the person will deescalate. 

Keep an eye out for next weeks blog on safety planning and resources. A safety plan is a personalized plan for the suicidal person that will assist in keeping them safe. It includes coping ideas, people to call in a crisis and more. 

To learn more about Alexandra, LiveLong Movement, suicide prevention hotlines and resources, go to: www.LiveLongMovement.org

Or visit the Facebook & Instagram @LiveLong_Movement

For crisis support, please call Lifeline: 1-800-273-8255

To hear Alex’s interview on The LIFE CHANGES Show go to:  https://lifechangesnetwork.com/suicide-prevention-talking-to-save-lives-with-guest-alexandra-eisner-and-musical-guests-the-waters-on-show-582/