SUICIDE IDEATION EMERGENCY PROTOCOL

When you encounter a member with thoughts of suicide:

Contact - Immediately contact a staff member using the Report to Moderator link located in the bottom right corner of every post. A staff member will establish contact with the distressed member via PM, will give the member a text number (US: 741-741, Canada: 68-68-68) for text or voice help, and will post a notice to all other staff members to monitor the situation and help out.

Care - Keep the member engaged - talk openly, ask questions, and listen. Focus on what happened today - do not show panic or be obsessive in your follow-up. Enlist help from other members if you can. The basic message is that the distressed member is important, that depression can make difficult things seems much worse at times, and that it is important to take another day to reflect on things.

Call - Encourage the distressed member to make contact with a live person, either by text, local suicide helpline or a local emergency room. Modest steps are important - not calling out the cavalry. Telling a member to call 911 only makes sense if the member has injured themselves or has taken pills.

Encourage the member to reach out for "live" information. The text hotline is easy and non-threatening. Say things like "it's just for general information", "you can remain anonymous".

Most people will not call 911 as they are afraid that trying to get help may bring them more pain - being told they are foolish, weak; ending up with a police record; being billed $700-$1,000 for the emergency service; being involuntary committed; being shot by police. This is why we stress the help lines or going to an emergency room.

Staff Hotline Search

To find local support phone numbers enter nearest large city and state, or county and state

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Emergency trace

If you have suicidal thoughts:

Take it Seriously All thoughts of suicide ("suicidal ideation") should be taken seriously. Many of our members (72%) are depressed at one time or another. Suicidal ideation is not uncommon in clinical depression. The Journal of the American Medical Association has reported that 95% of all suicides occur at the peak of a depressive episode.

To evaluate your own situation, click the SafetyFirst Icon.

Act Early Often there is a progression over time from harmless ideations all the way to the act. The earlier we intercept this progression, the more likely harm can be averted.

Try the Text Message Hotline on Your Smartphone (741741) Local counselor can do everything from just answering simple questions, to suggesting places to go for 24 hour / low cost assistance, to connecting you with a live counselor by phone who can talk things through with you.

If you are helping someone with suicidal thoughts:

1.	Take it seriously. Myth: “The people who talk about it don't do it.” Studies have found that more than 75% of all completed suicides did things in the few weeks or months prior to their deaths to indicate to others that they were in deep despair. Anyone expressing suicidal feelings needs immediate attention. Myth: “Anyone who tries to kill himself has got to be crazy.” Perhaps 10% of all suicidal people are psychotic or have delusional beliefs about reality. Most suicidal people suffer from the recognized mental illness of depression; but many depressed people adequately manage their daily affairs. The absence of “craziness” does not mean the absence of suicide risk. “Those problems weren't enough to commit suicide over,” is often said by people who knew a completed suicide. You cannot assume that because you feel something is not worth being suicidal about, that the person you are with feels the same way. It is not how bad the problem is, but how badly it's hurting the person who has it.
2.	Remember: suicidal behavior is a cry for help. Myth: “If a someone is going to kill himself, nothing can stop him.” The fact that a person is still alive is sufficient proof that part of him wants to remain alive. The suicidal person is ambivalent - part of him wants to live and part of him wants not so much death as he wants the pain to end. It is the part that wants to live that tells another “I feel suicidal.” If a suicidal person turns to you it is likely that he believes that you are more caring, more informed about coping with misfortune, and more willing to protect his confidentiality. No matter how negative the manner and content of his talk, he is doing a positive thing and has a positive view of you.
3.	Be willing to give and get help sooner rather than later. Suicide prevention is not a last minute activity. All textbooks on depression say it should be reached as soon as possible. Unfortunately, suicidal people are afraid that trying to get help may bring them more pain: being told they are stupid, foolish, sinful, or manipulative; rejection; punishment; suspension from school or job; written records of their condition; or involuntary commitment. You need to do everything you can to reduce pain, rather than increase or prolong it. Constructively involving yourself on the side of life as early as possible will reduce the risk of suicide.
4.	Listen. Give the person every opportunity to unburden his troubles and ventilate his feelings. You don't need to say much and there are no magic words. If you are concerned, your voice and manner will show it. Give him relief from being alone with his pain; let him know you are glad he turned to you. Patience, sympathy, acceptance. Avoid arguments and advice giving.
5.	ASK: “Are you having thoughts of suicide?” Myth: “Talking about it may give someone the idea.” People already have the idea; suicide is constantly in the news media. If you ask a despairing person this question you are doing a good thing for them: you are showing him that you care about him, that you take him seriously, and that you are willing to let him share his pain with you. You are giving him further opportunity to discharge pent up and painful feelings. If the person is having thoughts of suicide, find out how far along his ideation has progressed.
6.	If the person is acutely suicidal, do not leave him alone. If the person is acutely suicidal, do not leave them alone - drive the person to the nearest emergency department or other service facility. They may be hesitant - that is normal. The local suicide hotlines can advise you of the best facility. If the situation is life threatening, or the person refuses to go for care, or you are unable to transport them, call 911. Please do not use emergency medical services to teach anyone a lesson. . If the means to commit suicide are present, try to get rid of them.
7.	Urge professional help. If someone is acting suicidal or talking of suicide, it is vitally important to get them into professional care at the first signs. Like many disorders, early detection and treatment yields better outcomes. Persistence and patience may be needed to seek, engage and continue with as many options as possible. In any referral situation, let the person know you care and want to maintain contact.
8.	From crisis to recovery. Most people have suicidal thoughts or feelings at some point in their lives; yet less than 2% of all deaths are suicides. Nearly all suicidal people suffer from conditions that will pass with time or with the assistance of a recovery program. There are hundreds of modest steps we can take to improve our response to the suicidal and to make it easier for them to seek help. Taking these modest steps can save many lives and reduce a great deal of human suffering.

Updated: 01/24/19