Talking Them Down: A guide to communicating with a suicidal person
On an April day in 2017, Milwaukee Fire Chief John Litchford was driving home when he came across a “red flag” situation. A woman, most likely in her 20s, was sitting on a dangerous part of the bridge.
“I recognized someone on top of the Hoan Bridge, outside of their vehicle, sitting on the rail,” Litchford said. “With 21 years of experience I know that no one breaks down at the top of the bridge, and you don’t get out (of your car).”
Litchford knew the situation was a suicide attempt and exited his vehicle to help.
“I was able to get over to the side and engage my warning lights and get up there and start talking to the individual,” Litchford said.
Suicide attempts are extremely common in the U.S. According to the CDC, there are 3,269 suicide attempts made every day in America, and 27,484 suicide considerations made in the same time span.
Knowing how to respond to someone making an attempt to end their life is critical. Here are methods and advice from several different kinds of individuals.
Point of View: Fire Chief
Some officials are trained more than others to help talk people down from attempting suicide. According to Litchford, FBI negotiators are more knowledgeable about talking people out of the idea, but all of the first responders have complex training in de-escalation.
“We want all our members to be trained to acknowledge it and recognize a situation, and just be able to make things get better,” Litchford said.
Oftentimes in situations of suicide attempts, first responders don’t get the chance to try to de-escalate the situation by talking.
“A lot of the time when we get to these runs, it’s already after the attempt has been made, and we’re recovering from what they’ve already done,” Litchford said.
In the event that someone has not yet made the attempt, it is critical to know how to talk to him or her. According to Litchford, effectively communicating is the way to help somebody who is considering suicide. This means not only asking what’s wrong, but listening.
“The longer they’re talking, they’re not jumping,” Litchford said. “You’re not there to talk, you’re there to listen. You can start building your questions. It’s always initially, ‘What’s going on? What’s wrong?’ It’s key to just then listen, because their first answer is always going to be ‘Nothing. Leave me alone.’ You still have to engage.”
While talking someone to safety, it is important to consider your words and topic of conversation. A person may be reluctant to talk, but finding something that you have in common makes it easier to continue communicating.
“You want to find that common thread to have rapport with them,” Litchford said. “Now we have something to talk about. It was children for us. We were able to talk about what she was going through. I found out essentially what was truly bothering her.”
It is also crucial to make sure that the conversation is a positive one, and not a conversation that gives someone more reason to feel the need to end their life.
“You gotta keep away from the negative, and always give focus to light,” Litchford said.
Shortly after he made the call, an FBI negotiator arrived to help. Litchford recalled passing on the information, and that the negotiator was able to continue the conversation with ease.
“It was just a very fluid switch,” Litchford said.
There are several factors to keep in mind when talking down a person who wants to end their life. There are ones centered around the conversation, but there are more pieces that make an enormous difference. One of the most important rules that Litchford follows is the fact that you don’t grab a person when trying to help them. Grabbing may cause the person to react badly, and could be the reason that they end up falling over the edge.
“When we talk to individuals, do not grab them,” Litchford said. “We had people suited up for rescue, but mainly it was for if the individual was to slip, or if one of the other individuals, say the negotiator himself, would have slipped or fallen.”
Point of View: University Counselor
Dr. Tom Troast is a counselor and director of the counseling center at Mount Mary University. Between working at Mount Mary and his own practice, he has had a lot of experience talking to students as well as other people who want to end their lives.
In both jobs, Troast has learned the patterns of suicidal ideation, and what to keep in mind when talking with a suicidal patient.
“The suicide attempt, many times, is episodic,” Troast said. “It has a beginning and an end. (It’s our job to) carry that student through that moment so that the suicidal ideation can be decreased.”
Troast explained that building trust with a patient is important in the beginning stage, and that doing so will better allow them to open up about their pain.
“(Obtaining trust) requires listening and understanding,” Troast said.
Once the patient is able to talk a little bit, an assessment is made. Troast described it as figuring out how much in danger the person might be due to their feelings. This assessment is done in cases of a possible suicide attempt no matter the degree of the situation.
“We have a problem that we can’t walk away from,” Troast said.
The assessment involves things such as listening to the patient talk, finding out the severity, and making them feel supported. Sometimes it involves sending a patient to see somebody else for treatment.
“It’s a lot of caring,” Troast said. “It’s a lot of telling the student that we’re doing this out of caring, that they’re not in trouble.”
According to Troast, talking through the concept of suicide can help to get past the idea. There are alternative ways to make someone’s life situation better. Suicide has lasting effects on others.
“What are they leaving behind?” Troast said. “An intervention can be really important to let an individual know they are not alone.”
As for advice, Troast urges people not to keep quiet if their friend is struggling with suicidal thoughts. He said it’s okay to risk a friendship by involving a third party if it means that the friend can get treatment and not end their life.
“That person may say ‘I’ll never talk to you again if you tell somebody about this,’” Troast said. “This is more important: ‘I think that this person is going to hurt themselves. I’m not going to walk away and not tell anyone because I don’t want them to be mad at me.’”
Doing nothing may seem like the more favorable option, but it is the most dangerous. Troast highlighted the importance of getting somebody trained in suicidal ideation involved.
“You have to bring them the resources, especially if the threat includes a means and a plan,” Troast said. “You can’t walk away from that.”
Point of View: Chairperson of Suicide Prevention Organization
Barbara Moser is the chairperson for the organization Prevent Suicide Greater Milwaukee. Part of her role is to train people in QPR (prevention training) which stands for question, persuade, and refer. According to Moser, there is a specific process to helping someone who is considering suicide.
“QPR is intended to offer hope through positive action,” Moser said.
Knowing how to respond to somebody’s suicidal feelings can be life saving. The first step, question, is to confirm that a person does in fact have suicidal feelings. Clues can be found in the way someone acts or what they say, but if it’s not clear, it’s important to ask, or to find someone else to ask.
“If you can’t ask the question, you want to find somebody who can,” Moser said.
Once the person’s feelings are confirmed, the next step is to persuade them to stay alive. This happens through conversation. In doing this, you can try to find the things to say to convince them to push through.
“Why haven’t you considered suicide before?” Moser said. “Maybe they have a little brother. If you’re gone, his life will never be the same.”
Whether or not this works, it is important to make sure that the person does not feel alone. Offering to support them through treatment and be there for conversation can help someone to feel a little better.
“This is a commitment when you say that to somebody,” Moser said. “You have to follow through.”
The last step is refer, as in refer the person to someone else for treatment. Your support is helpful, but according to Moser, a suicidal person still needs professional help. If the person is hesitant, there are things you can say to try to make it easier.
“Say, ‘I know it can be hard going to a therapy appointment, can I go with you?’” Moser said.
Acting fast and being there for someone can make all the difference.
“The thing to know is that a suicidal crisis is short, a few hours or a day or two, and if you can stay with them for that short time, the crisis will go down,” Moser said.
Point of View: Survivor
People who consider or attempt suicide and survive are, in multiple cases, glad that they didn’t die. In 2013, Travis Pipes was going through a very hard point in his life and felt like suicide was inevitable.
“I was introduced to the thought of taking my own life as just an occurrence, a passing thought, but it became this riveting sort of beacon in the back of my head,” Pipes said.
Pipes felt that ending his life would be the easiest option, and that it might be better that way.
“I wasn’t taking care of myself, so I met myself at that point where I go, ‘Is it worth it to be here anymore?’” Pipes said. “I thought life would just be easier at that point. I literally thought …that killing myself was the easy way out and no one was going to notice anyway.”
Although the thought was overpowering, there was a part of him even in that moment that wanted help. Although it was 4 a.m., he picked up the phone and called Kevin Hines, another survivor who became an advocate for suicide prevention.
“Kevin answers the phone, and he connected with me,” Pipes said. “It sounded like he cared. He sounded sincere. He volunteered some resources that were available to me that he’d already looked up in terms of me getting treatment.”
That connection was the turning point. Pipes, who had been planning his death by suicide, finally felt like hope was possible.
“The connection I had to him immediately changed the trajectory of my life,” Pipes said. “I felt like, I’m glad I made this phone call, because if Kevin wouldn’t have answered, I would be dead.”
Pipes believes that having a connection with someone considering suicide is a way to help them get past the feeling.
“Just the availability of being there for somebody is 80 percent of the battle for me,” Pipes said.
Having support from multiple places can help a person push through their emotions. This means not having the support from only friends, but from the community as well.
“Support from resources that are willing to understand what I’m struggling with and support from the hospital and from a care perspective is really critical,” Pipes said.
Part of the battle for Pipes and for others is the stigma around suicide. People don’t want to talk about it, and someone asking for help getting over the thought is looked down upon. Pipes voiced the need to end the stigma.
“Make me feel like it’s okay for me to get that help,” Pipes said. “And not feel like there’s stigma. And there’s stigma.”
Pipes wants to let people know that when someone is feeling depressed, that there are people who do notice and do care.
“I didn’t feel like I belonged,” Pipes said. “I didn’t feel like I mattered. The reality is I did matter. People did care.”
Being a part of someone’s support system is a critical part in helping them live through their feelings.
“Letting people know it’s okay to talk is part of this process,” Pipes said. “It’s the idea that you’re not alone.”