Education, The Heart of It

Nurses Can Make It Okay to Talk About Suicide

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nurses can make it okay to talk about suicide

September is Suicide Prevention Awareness Month #notalone

If you or someone you know is in an emergency, call The National Suicide Prevention Lifeline at 800-273-TALK (8255) or call 911 immediately.

Nurses make a difference every day. #nursessavelives

September gives us a unique opportunity to save lives by combating a cause of death that is 100% preventable: suicide.

The tragedy of loss that family and friends must navigate through after a loved one dies by suicide is tremendous. It is paved with stigma and feelings of shame, shrouded with confusion and helplessness.

These feelings prevent them from speaking openly about suicide.

Nurses are in unique positions to reach those affected by suicide. We can raise awareness by sharing stories and resources. We can connect people who are struggling with suicidal ideation to treatment services. Nurses can start the conversations that lead to suicide prevention.

We have the power to make it okay to talk about suicide. Here’s what you need to know:

1. Understand the Prevalence

Individual Impact
  • More women attempt suicide than men, but men are 4x more likely to die by suicide
  • Of all persons who die by suicide, 75% are male
  • For persons ages 10-34, suicide is the 2nd leading cause of death
  • For persons ages 35-54, suicide is the 4th leading cause of death
  • Of people who die by suicide, 46% had a diagnosis of a mental health condition
  • Of people who die by suicide, 90% experienced symptoms
Community Impact
  • In 2018, suicide was: 
    • the second leading cause of death for African Americans, ages 10-14, third cause of death for ages 15-24, and fourth cause of death for ages 25-34 (1)
    • the second leading cause of death for American Indian and Alaska Natives, ages of 15-34 (1)
    • the leading cause of death for Asian Americans and Pacifica Islanders, ages 10-24 (1)
    • the second leading cause of death for Hispanic people, ages 15-34 (1)
  • LGBTQ+ youth are 4x more likely to attempt suicide than their straight counterparts
  • Transgender persons are 12x more likely to attempt suicide than the general population
  • The rate of deaths by suicide for American Indians and Alaska Natives is 20% higher than for non-Hispanic white adults
  • The percentage of young adults who have experienced suicidal thoughts in the past year = 10%

2. Be Resource Ready

Informational Resources (4)

Crisis Resources (4)

  • If you or someone you know is in an emergency, call 911 immediately.
  • If you are in crisis or are experiencing difficult or suicidal thoughts, call the National Suicide Hotline at 1-800-273 TALK (8255)
  • If you’re uncomfortable talking on the phone, you can also text NAMI to 741-741 to be connected to a free, trained crisis counselor on the Crisis Text Line.

Resources courtesy of National Alliance for Mental Health

3. Start the Conversation

It’s okay to ask directly about suicide. Use a natural tone and flow while conversing and present it as a “yes” or “no” question. By being direct and using the word “suicide” or “killing yourself”, you ensure that you are both talking about the same thing. It also shows the person at risk that you’re not afraid to talk about suicide.

“Are you thinking about hurting yourself or ending your life?”

“Are you having thoughts about killing yourself?”

Additional questions: (3)

  • How are you coping with what’s been happening in your life?
  • Do you ever feel like just giving up?
  • Are you thinking about dying?
  • Are you thinking about hurting yourself?
  • Are you thinking about suicide?
  • Have you ever thought about suicide before, or tried to harm yourself before?
  • Have you thought about how or when you’d do it?
  • Do you have access to weapons or things that can be used as weapons to harm yourself?

4. Validate Their Experience

  • Don’t panic. Listen and allow emotional expression.
  • Talk openly while maintaining a calm demeanor.
  • Don’t be judgmental or critical.
  • Recognize that thoughts and feelings of suicide are serious.
  • Offer and reassure that help is available.
  • Do not promise to keep secrets.
  • Never leave the person alone.
  • Never negotiate with a person who has a gun, leave and call 911.
  • If at any time you feel the person, you, or others may be in danger, call 911.
  • Be willing to go to the ED or phone 911 with them when they’re ready.

5. Know the Signs of Acute Risk

When you recognize any of these signs, it’s time to ask directly about suicide.

  • Talking about suicide or death (this is not a just cry for help and should never be ignored)
  • Seeking a means, either lethal or non-lethal methods of harm
  • Agitation or anxiety
  • Substance abuse
  • Insomnia
  • Purposelessness
  • Hopelessness
  • Anger and recklessness
  • Social withdrawal
  • Mood changes

6. Know the Warning Signs of Increased Risk

  • Previous attempts. Either one or multiple. Multiple prior attempts drastically increase risk.
  • Triggering events. Be alert for emotions or words surrounding humiliation, shame, or despair as these are known to elevate risk. Other triggers may be real or anticipated and include the loss of relationship, health status, or financial status.
  • Presence of or accessibility to firearms. Increases acute risk. Speak up in order to act and reduce access.

7. Realize That Teens Are Among The Highest Risk

The risk for suicide and attempted suicide increase significantly in adolescents. The pressures to fit in socially, perform academically, and act responsibly are stressful and worrisome for many teens. Additionally, they often lack the maturity and perspective to deal with intense situations and emotions.

When talking to parents about their teenagers, help them understand the seriousness of suicidal ideation. The risks are real and not simply an attempt to seek attention. Here’s what parents should NOT say to teens:

  • That’s crazy.
  • Don’t be such a drama queen.
  • You’re making too much of this.
  • That boy is not worth killing yourself over.
  • It’s not going to solve anything.
  • You are NOT going to kill yourself.

If you catch parents throwing around these types of phrases, it’s okay to turn the conversation to inquiry. Your response could be crucial to saving a life.

Make it okay to talk about suicide. All it takes is a question, some empathy, and some solid resources. In every age group, suicide is preventable.

Ask questions. Share resources. Save a life.

Cheers!

Julie don't forget your power
Resources
  1. CDC. National Center for Injury Prevention and Control. Web-based Injury Statistics Query and Reporting System (WISQARS). [Accessed 09/22/2020].
  2. SPRC.org. Patient education tool and resources. Is Your Patient Suicidal? Poster. [Accessed 9/22/2020].
  3. Mayo Clinic. Suicide: what to do when someone is suicidal. [Accessed 9/22/2020].
  4. National Alliance for Mental Health. Suicide prevention awareness. [Accessed 9/22/2020].

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