How to Talk About Suicide

Suicide is an emotional word. Feelings of confusion, fear, anger, and even disgust are common responses when the topic comes up in conversation, rare as that might be. As a clinical counsellor, I have felt all of these emotions when discussing suicide with clients and will continue to do so. But over years of working with people at some of the lowest points of their lives, I’ve learned not to let those emotions get in the way of compassion.

I ask you today to accept responsibility for how you react to hearing about suicide. I ask you to help foster a hopeful and meaningful conversation about suicide, as opposed to one full of stigma and discrimination. I do this believing wholeheartedly that to do so will change and potentially save lives in the face of arguably the most preventable major cause of death. Both those who experience such suffering, as well as those who are left behind in the wake of a suicide know the sting of stigma and discrimination all too well.

I work with and think about the issue of suicide almost every day. It has drained me and forced me to confront some of the most fundamental beliefs. There have been times when I have asked if I can continue to help people facing such terrible suffering.

Fortunately, that’s rare. I spend considerably more time being inspired by the strength and the courage of the clients I have the privilege to work with. Their stories of hardship are all too common, but the fact that they show up to sessions at all suggests resilience and a strength of character few are ever forced to employ.

The unfortunate and uncomfortable reality is that society shies away from the issue of suicide, when we should be embracing it. Even in the helping professions, it’s not difficult to find stories of therapists “firing” clients following suicide attempts. Our collective fear – of litigation, of loss, of the prospect of our ineffectiveness – dilutes our goal of helping others from a moral obligation to a convenient desire.

Instead of writing off people who are suicidal, we should be welcoming with open arms those who most need our help. A small but meaningful part of this includes being mindful of the language we use regarding suicide, just as we would with any other significant health issue.

Most people who are suicidal do want to live. The problem is that life has become unbearably painful, and when looking for an escape from suffering, suicide appears to be the only option. The solution is to see that alternatives exist and that life can be worth living, and this becomes a foundational component of treatment when a person who is suicidal seeks help.

Stigma thrives in silence. Not talking about suicide only serves to strengthen a discrimination of those experiencing suicidal thoughts and mental illness that is already too prevalent. But talking about suicide in a careless or judgmental way is worse. So how can we start to get it right?

I’ve go three ideas on where to start.

1. Stop saying “committed suicide.” Suicide attempts are not a death sentence, a permanent label, nor a crime. The word “committed” is judgmental and implies that a crime has occurred. “Died by suicide” is more factual, accurate, and respectful.
   
   I would also stay away from the commonly heard phrase “failed suicide attempt: (we want to avoid reinforcing the belief that a person is a failure if they survive their attempt).
2. Consider what is meant by how you use the word “suicidal.” As a label, it can be misleading and damaging, and not just because of the usual weight of stigma and discrimination that comes with it. “Suicidal” implies a trait that can become stuck to a person, much like a diagnosis.
   
   But this just isn’t the case with suicide. The proof is in the statistics: a 2002 literature review of 90 studies on suicide attempt survivors showed that 7/10 of those who attempt suicide will not attempt again, and 9/10 people who survive an attempt will not go on to die by suicide later.
3. Speaking of hope, please remember to talk about it, because hope above all other things cannot be taken away from a person, only given up or lost. Hope is powerful and it is contagious, and even the smallest spark of it might be enough for someone to decide that life is meaningful enough to live, even if just for one more day.
   
   As Viktor Frankl wrote, “he who has a why to live can bear almost any how.”

If you are in crisis, help is available. tell a friend, a health professional, or call 1-800-SUICIDE to speak to a crisis line volunteer. For more information on suicide warning signs and what to do about them, visit the Canadian Association of Suicide Prevention at suicideprevention.ca

Reference:

Owens D, Horrock J, and House A. Fatal and non-fatal repetition of self-harm: systematic review. British Journal of Psychiatry. 2002;181:193-199.