Reflections on Suicide Prevention Month
Written by Alexandra DeHoff, LCSW-S, Licensed Therapist
As it is Suicide Prevention Month, I thought it necessary to take a moment to reflect on this difficult, but real issue. Recognizing triggers and warning signs is important, but I wanted instead to elaborate on what to do when someone has already disclosed their suicidal thoughts. I often hear client's worries that having these thoughts automatically means that I will recommend psychiatric hospitalization, that they would be stripped away from their families, locked away in solitary confinement.
Don't worry - it does not!
When someone shares this information, it's not necessarily helpful to try and understand "why" at that time. If someone is in crisis, they likely can't articulate "why" and, worse, persisting about this, could increase their distress. Triggers, stressors, and warning signs of returning suicidal ideation is, however, very helpful to discuss when they are no longer actively suicidal. A therapist will likely be an important part of this process.
After someone discloses suicidal thoughts, I like to lead by acknowledging the strength it took to share this vulnerable information. Next, with compassion, ask if this person has a plan to attempt suicide. If so, assess if they actually have means to carry out this plan. Next, it's relevant if they have intent. Suicidal thoughts + a plan doesn't necessily mean this person has intent to act. If they do, though, this is time to take extreme caution, including hospitalization. A safety plan will also include securing or discarding prescription or over-the-counter medication, car keys, and firearms. If you know a person's mental health history, a history of suicide attempt increases one's risk of another attempt.
If a person has "passive" suicidal thougths (feels like dying but does not actually want to) or has suicidal thoughts but does not want to die (egodystonic), the safety plan should include both coping and distract skills (also helpful to identify with a therapist) and a support person to contact if thoughts change. Sometimes this passive suicidal ideation is actually a coping mechanism for a significant stressor and this person likely needs some validation, alternatives for coping, some professional support, and perhaps medication management.
Suicidal thoughts can be chronic and require professional support. But it's important to note, in my experience, people recover from depression and manage all depression symptoms, including suicidal thoughts.
If you or someone you know is actively suicidal, please seek treatment at an emergency room. You could also contact 911 or the suicide and crisis hotline, 988. In Travis County, the psychiatric emergency services number is 512-472-HELP. After acute care, if you need help finding a therapist, please reach out for support. Colors of Austin Counseling can help!
Prior to joining Colors of Austin Counseling, Alexandra spent 7 years of her career with Acension Seton Shoal Creek Psychiatric Hospital in Austin, TX. Daily, she discussed suicidal thoughts, safety planned with individuals and families, and planned for a safe discharge. This setting taught Alexandra about people's resilience and willingness, despite crises, trauma, and pain. With adults in outpatient therapy, she had the experience addressing issues of belonging, depression, relationships and challenging life transitions. Today, Alexandra supports her clients by working alongside them to help navigate the balance between acceptance and change; challenging the ideas or behaviors that no longer serve her clients, and holding space in a safe and authentic environment.