Suicide. It is a topic that broaches ethical and moral boundaries of human nature. It’s an awkward topic that not many want to talk about. Suicide tests the parameters of what many cultures find taboo to talk about: death and talking about death. Nevertheless, it’s a topic that we should not avoid. We need to have these difficult conversations with our fellow human acquaintances, friends, and family members. But the question you might be wondering is, how? How do I even start a conversation about suicide? Given the stigma and taboo around the topic, that is a fair concern.
In this article, I will help give some context to why people may have suicidal thoughts, what it might be like for them, and how to start and have a conversation about suicide.
Why might people have suicidal thoughts?
Contrary to popular thought, mental illness is not the cause of most suicidal ideation. Instead, suicidal thoughts often arise from a complex interaction with our biological, social, psychological, historical, cultural, and economic environments. What’s more, these are not simply someone having these thoughts randomly, but these thoughts often arise due to ongoing difficulties that can leave someone feeling like a burden, without hope and purpose in life. Some of these difficulties include:
- Struggling with feelings of hopelessness, purposelessness, burdensomeness, inadequateness, failure, rejection, and loneliness
- Experiencing domestic, physical, sexual, or emotional abuse
- Mental illness, mental health problems, or trauma
- Being subjected to bullying and discrimination
- Struggling with social conditions such as economic problems, debt, housing, homelessness, poverty, and job loss
- Going through bereavement and loss of someone close or the end of a romantic relationship
- Struggling with addiction and substance abuse
This is not an exhaustive list of difficulties that someone may experience. Often suicidal thoughts arise from experiencing situations that leave someone feeling hopeless and like a burden.
What might it be like for someone having suicidal thoughts?
Not everyone has suicidal thoughts, but for those that do, it’s a dark time. To have a conversation about suicide, it’s useful to understand what it might be like for someone experiencing suicidal feelings.
Firstly, there are some misconceptions about suicide that have been historically driven. Traditionally, people experiencing suicidal thoughts and even mental health issues were seen as irrational, crazy, mad, and thought to have faulty thinking. In some cases, these traditional ways of viewing people in this way still prevail and heavily influence the stigma attached to the topic and the idea of seeking support for those in this dark place. Ultimately, approaching any conversation with these traditional thoughts in mind about the person will likely inhibit positive outcomes for the conversation. Why? Because by suggesting a person is crazy, mad, irrational, or has faulty thinking, it invalidates their experience, their humanity, and dignity as a human being. The result is it shuts down further exploration or openness in a conversation.
Through my research and life, I’ve talked to a range of people online and in person about suicidal thoughts and intentions. To be clear, suicidal ideation is quite common — about 1 in 8 people report having serious thoughts of taking their own life at some point. I have had friends and acquaintances confide in me about their experiences with suicidal thoughts and intentions. I’ve lost friends to suicide and friends of friends to suicide. And personally, I have also questioned the meaning and purpose of life through my journey in church and life experiences. This questioning led to some dark places of seeking to know whether life is worth living and what is the purpose of life. The position I hold now is one where I believe that there are many possible explanations for life’s worth and many different routes to finding meaning, purpose and hope. Based on my research and my own experiences, I have developed a broad understanding of what it may be like for people to experience suicidal thoughts. It’s brutal, real, and dark.
- A voice that attacks you in the weakest moments. Sometimes sits quietly in the background, waiting to pounce at you. Other times it’s shouting down at you. The voice attacks you with everything that has gone wrong, every mistake, every flaw, every invalidation in your life. And leaves you feeling hopeless.
- It feels lonely and cold in the darkness, as though nothing will ever get better. At times you feel numb, dead inside. Feel alone and drowning in the darkness that suggests that no one wants you and that there is nothing worth living for in life. It gets darker and darker, and it feels like this will carry on forever. You just want to escape the darkness or situation you are in and feel you are left with no other choice.
- Nothing seems escapable. Situations and events feel inescapable. You feel alone, worthless, and a burden to those around you. You feel that everybody hates you. That to them, you are worthless and a burden. You feel insignificant and feel it would be better if you never existed to reduce the burden on people.
- You feel that the mistakes you’ve made, the people you’ve lost, and your lack of abilities make you useless and unwanted. Leaving you to question whether life is worth it anymore, whether anything matters and whether anyone would miss you if you were gone.
- It’s like an unending war going inside the mind. You’re tired of surviving and fighting the internal and external battles. It feels that no matter what good things people say to you, there’s no hope.
- The emotions and darkness fill up, getting heavier and more painful until everything loses meaning. Life loses colour and meaning. Nothing seems purposeful or meaningful, and an existential dread settles.
These insights can show what it can be like for someone having suicidal thoughts. It feels lonely, dark, painful, and inescapable. The flame on the candle has truly gone out. Any other candlelight ceases to be seen in the darkness.
How to start a conversation around suicide
So, the question you may be wondering is, how do I have a conversation around suicide? For many, this might seem daunting, and that’s true if we only leave it up to a few individuals to lead the change. That’s why I argue in my master’s thesis that we need to go upstream and incorporate a whole society approach to suicide prevention. In another article, I further argue that suicide prevention starts with the community. Part of starting suicide prevention at the community level requires preparing yourself first through learning to listen, be curious, and be non-judgmental (read our guide on advanced listening skills). Building belonging and connection in community groups. And further interacting and showing compassion to those on the outskirts of society. But what about the conversation part?
The key to a conversation about suicide is to ask open-ended questions. Open-ended questions cannot be answered with a simple yes or no. These questions allow the person to explore their thoughts openly and help you understand what is going on for them. An open-ended question can be as simple as “I’m concerned about you. Can you tell me a bit about what’s going on for you? I’m here to listen.” To explore what a conversation might look like, let’s look at a conversation between Mark and his friend Joe.
Take an example of a dialogue between Mark and his friend Joe. Mark mentions in a conversation with Joe that he doesn’t want to live anymore. Joe lets him know he cares about Mark and isn’t alone. He starts by being calm, doesn’t panic, and listens intently to what Mark is expressing to him. He knows that someone who is thinking about suicide needs to feel understood. After Mark finishes expressing that he doesn’t want to live anymore, Joe asks:
“Thank you for opening up to me about this, Mark. It saddens me to hear you are hurting like this. I can’t imagine the pain you are going through right now, but I would like to try to understand. If you feel comfortable, can you talk me through what has been happening for you?”
Mark starts to discuss his thoughts and some of the events that have been happening in his life. Mark discusses that he feels lost, alone, and a burden to all those around him and that life is not worth living anymore.
Joe listens carefully and doesn’t interrupt. He nods and remains non-judgmental by not criticising, blaming, or shutting him down. To show Mark that he understands, he repeats what he heard in his own words to show he is listening and to clarify his understanding.
At times, for Joe to fully understand, Mark doesn’t go into full detail about his stories. To deepen his understanding, Joe asks:
“If you feel comfortable, can you tell me more about that time you were talking about?”
Joe continues to listen carefully and doesn’t interrupt as Mark speaks. When Mark finishes talking about what has been going on for him, Joe acknowledges the pain that Mark is experiencing and says:
“That sounds awful. I can see why this is painful for you.”
Joe wants to know a bit more about Mark’s proposed actions and understand if there’s an immediate risk.
“Mark, I’m wondering whether you have made any plans of when and how you may act on your thoughts.”
Gaining an understanding of this information will allow Joe to decide on what to do next. Suppose Mark is about to act soon and has a plan in place. In that case, Joe will need to work with Mark about engaging with professional support, such as talking with his GP, Counsellor, Psychologist, a suicide hotline, or an emergency department. If Mark doesn’t intend to act right now, then Joe can focus on continuing the conversation. In either case, Joe needs to be with Mark and be there for him.
In this conversation, Mark indicates that he has not made any plans yet and is not an immediate danger to himself. So, to continue the conversation, Joe asks about Mark’s reasons for living and dying. Joe focuses on the reasons for living in more detail. As the conversation continues, Joe asks:
“Mark, I’m wondering what might need to change in your life for you to keep going.”
Joe asks Mark this question to help him start thinking about other possible solutions for his life. Mark discusses other possible solutions and ideas, so Joe continues to help Mark explore them in more depth as he did previously when Mark was talking about his situation. As the conversation comes to a close, Joe says:
“Mark, I’m thankful you have been open to me about this. I hope that you will keep talking to me about your suicidal thoughts. I want you to know that you are not alone, that I care about you, and that further help exists. I would like to help you explore some professional help that you might be comfortable with, such as seeing a counsellor, doctor or joining a support group. What do you think might be helpful, and what can I do to help you?”
This dialogue explores a suggested conversation about what to say if someone opens up to you about wanting to take their own life. The conversation focuses on listening and gaining a deeper understanding of the situation through being curious, non-judgmental, and exploring the person’s story. An important thing to remember is that you don’t necessarily need to solve or find an answer for them. What’s important is to listen, be there for them, and help them work towards finding support and any actions they identify.
Okay, but what if no one talks to me about suicide? How might I know if someone is having suicidal thoughts?
There are many suicide warning signs you can look out for
- They tell you they want to end their life
- Making plans to end their life
- Sending goodbye messages or creating goodbye letters
- Sleeping a lot or hardly sleeping at all
- Lose interest in life or in things they previously enjoyed (e.g. a hobby, club, sport)
- They start giving away possession, paying back debts, or tying up loose ends
- Stop taking their medication
- They become more isolated or withdrawn from their friends and family
- They are hurting themselves
- Have changes in mood such as becoming depressed, angry, or enraged
- Start mentioning that they feel worthless, like a burden, or that nothing has a purpose anymore
- You notice that they have no hope for the future or say that they feel there is no way out of a difficult situation
- Say lots of negative things about themselves
- Talk about suicide or become obsessed with death
- Don’t seem to be coping with any problems or are using drugs and alcohol to cope with difficult feelings or thoughts.
These warning signs can indicate that someone may be thinking about suicide or thinking about taking their life. If you notice changes that are out of place for a friend or family member, it doesn’t hurt to start a conversation with them and let them know you are concerned about them. To start the conversation:
- Ensure there is privacy and that you won’t be easily disturbed
- Choose a good timing so that you have a good amount of time to have the conversation
- Ask them where the right place for them is to talk about it.
Are there any dos and don’ts when talking about suicide?
How we approach the conversation and have the conversation matters. Some key inhibitors for the conversation might be:
- Changing the subject or shutting down the conversation
- Trying to solve or give them advice
- Downplaying how they are feeling or comparing their situation to other people’s situations and explaining that others have it worse
- Telling them that they are silly and that they should just snap out of it
To have a helpful conversation, it’s important that you:
- Let them know they are not alone
- Be non-judgmental
- Don’t blame them or criticise them
- Listen to them
- Listen more than you speak and let them do the speaking
- Reassure them that you are here for them and can help them find the support that they need
Overall, if you are unsure what to do or feel you are clamping up in the conversation, you can just start with listening to their story and look at helping them call a suicide hotline. The best thing you can do is just to be present with them, offer emotional support, and help them find the support they need at that moment.
About the Author – Shaun Foley
Shaun has a Masters of Applied Psychology in Community Psychology from the University of Waikato, New Zealand. His research thesis advocates for broader perspectives to be initiated on the topic of suicide. His thesis was titled: Moving beyond psychocentric perspectives of suicide: Towards an ecological and social justice understanding. You can read his thesis here.
Support Services
If you feel you need immediate support and you are in Australia, these services are here to help you.
ADULTS
- Lifeline 13 11 14 lifeline.org.au
- Suicide Call Back Service 1300 659 467 suicidecallbackservice.org.au
- Beyond Blue 1300 224 636 beyondblue.org.au/forums
- MensLine Australia 1300 789 978 mensline.org.au
ADULTS
- Kids Helpline 1800 551 800 kidshelpline.com.au
- headspace 1800 650 890 headspace.org.au
- ReachOut ReachOut.com
LGBTQI+
- 1800 184 527 qlife.org.au
ABORIGINAL AND TORRES STRAIT ISLANDER
- healthinfonet.ecu.edu.au