Questions to Ask If Someone You Know Expresses Suicidal Ideation

 It is possible many of us may come in contact with a friend or family member seized by their worst day, and they may express to us their suicidal ideations (thoughts). The following are questions we can use to engage, assess, and determine a course of action.
1. DO YOU HAVE A PLAN?
Assuming a loved one has already expressed to us a suicidal ideation, the above is a logical follow-up question, the answer to which denotes differences between contemplation and intent. A person who verbalizes a plan is further along in the suicide process. We do not always consider suicide a process, but it is. Depending on said plan, subsequent questions posed could be, How do you intend to do it?Do you have the medications/poison in the house? These questions are part of a dialogue necessary to keep a person engaged and connected, and to compile crucial information to pass along to emergency services should a call be made. (Suicide help lines in Kenya; Samaritan Kenya 0707633692)

2. WHERE DO YOU SEE YOURSELF IN 5 YEARS?

The purpose of this question is to establish hope for the future. Every person who completes an intentional suicide does so because he/she has lost hope for the future. When a patient to whom I have asked the above question tells me he has no future, or all she sees is black, I am alerted to profound hopelessness, and you will be too. Other patients have expressed hope to attain desirable jobs, college degrees, or love. Those answers tell me a person sees a potential end to his depression. An expressed suicidal ideation is never to be taken lightly, but there clues as to who is more likely to make an attempt, or even complete one.

3. HAS ANYONE IN YOUR FAMILY COMPLETED A SUICIDE?

The answer to this question establishes a potential genetic predisposition to suicide, and if such a link exists, there is a greater chance your loved one is at high risk for attempted or completed suicide. If your family member expresses suicidal ideation, you might know the answer to the question, but if it is your friend, you will want to gain as much information as possible in the event you are on site during a mobile crisis community outreach, or accompany your friend to an emergency room. This is information a psychiatrist and psychiatric screener will find valuable when determining treatment disposition. It is important to ask these questions in the flow of a natural dialogue, and not to sound as though an interview is being conducted.

4. WOULD YOU STILL WANT TO DIE IF YOUR CIRCUMSTANCES CHANGED?

I used this question often when assessing prisoners whose arrests and sentences caused acute suicidality. The answer helps determine presence of endogenous (biochemical) or exogenous (circumstantial) depression. If a loved one tells you she would want to live if she found a new job, wealth, or love, the possibility for recovery increases, and it is possible she would benefit from therapy to develop coping skills or initiate life change. However, if a person tells you life is pointless even under optimal conditions; hospitalization may be the more appropriate course of action. 

5. DO YOU WANT TO GO TO THE HOSPITAL?

This question determines your course of action. If your loved one expresses suicidality, and agrees to visit an emergency room, you might want to accompany her for support, and be of assistance by providing all information gathered in your collateral role. However, if you are convinced self-harm is imminent, and your loved one refuses to go to the hospital, Suicide help lines in Kenya; Samaritan Kenya 0707633692 is your only option. If you can keep the person attended while the call is made, the process is easier. If the person leaves your company, alert 999 of potential danger, and provide your loved one’s address, and all the information you accrued. There is no room for guilt in this situation. Let professionals decide course of treatment as you rest on the knowledge you acted in good faith. If you call 999, you lose nothing. If you do not, you may lose a loved one.

Those are among the questions that are most effective in determining severity of intent, and remember no expression of suicidality is to be underestimated. Remember, you may be in the presence of a person during her worst day. Although it may feel helpful to use phrases such as I’ve been there or Things could be worse, they are not as helpful as a simple acknowledgement and validation of your person’s pain. Someone contemplating suicide does not believe things could be worse, nor does he care about your lowest point. The important thing is to remain connected, gather information, and have the phone number where you can get psychiatric/counselling help. Doing so may place you in a position of saving someone’s life.
Article courtesy of Vincent Fitzgerald, Huffington post, with a few edits to localise the content