WHAT YOU NEED TO KNOW:

What do I need to know about suicide prevention? A person may see suicide as the only way to escape emotional or physical pain and suffering. You can help provide emotional support for him and get the help he needs. Learn to recognize warning signs that the person may be considering suicide. Find resources to help prevent him from attempting to take his life.

What should I do if I think the person is considering suicide? Call 911 if you feel the person is at immediate risk of suicide, or if he talks about an active suicide plan. Assume that he intends to carry out his plan. Resources are available to help you and the person. The following are some things you can do:

• Call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255).
  
  
• Call the Suicide Hotline at 1-800-SUICIDE (1-800-784-2433).
  
  
• Contact the person's therapist. His healthcare provider can give you a list of therapists if he does not have one.
  
  
• Keep medicines, weapons, and alcohol out of the person's reach. Do not leave the person alone. Stay with him if he says he wants to commit suicide or you think he may try it. Make sure you do not put yourself at risk if he has a weapon.
  
  
• Do not be afraid to ask if he is thinking of ending his life. Ask if he has a plan for hurting or killing himself.

What warning signs should I watch for?

• Talking about his plan for committing suicide, or suddenly deciding to make a will
  
  
• Cutting himself, burning his skin with cigarettes, or driving recklessly
  
  
• Drug or alcohol use, or not taking your prescribed medicine or taking too much
  
  
• Sudden anger, or lashing out at others
  
  
• Not wanting to spend time with others or doing things he usually enjoys
  
  
• Trouble at work, or not showing up for work
  
  
• A change in the way the person eats, sleeps, or dresses
  
  
• Weight gain or loss, less energy than usual, or trouble sleeping or spend a lot of time sleeping
  
  
• Giving away or throwing away his belongings

What increases the risk for suicide?

• Depression
  
  
• Alcohol or drug use
  
  
• Death of an important person, or the anniversary of that person's death
  
  
• A past suicide attempt, or someone close to him attempted or committed suicide
  
  
• Mental illness, such as schizophrenia, bipolar disorder, or posttraumatic stress disorder (PTSD)
  
  
• Chronic pain, or a serious illness, such as heart disease, cancer, or AIDS
  
  
• Being physically dependent on others
  
  
• Mental, physical, or sexual abuse
  
  
• A history of violence or aggression toward others, or feeling guilty for hurting someone else
  
  
• Stress from divorce or a breakup, or loss of a friendship, or loneliness
  
  
• Struggling with being gay, lesbian, or bisexual
  
  
• Stress from the loss of a job, or a stressful job

How will healthcare providers help the person?

• Healthcare providers will ask questions about the person's suicide thoughts and plans. They will ask how often he thinks about suicide and if he has tried it before. They will ask if he hurt himself, such as with cutting or reckless driving. They may ask if he has access to weapons or drugs.
  
  
• A healthcare provider will help the person create a safety plan. The plan includes a list of people or groups to contact if the person has suicidal thoughts again. The list may include friends, family members, a spiritual leader, and others he trusts. The person may be asked to make a verbal agreement or sign a contract that he will not try to harm himself.

What medicines may the person need? Medicine can help the person feel well enough to continue with all of the treatment he needs.

• Antidepressants help reduce and control symptoms of depression. The person will need to take this medicine as directed. A sudden stop can be harmful, so he must not stop taking the medicine unless directed. It may take 4 to 6 weeks for the medicine to help him feel better.
  
  
• Mood stabilizers help prevent mood swings.
  
  
• Antipsychotics help decrease symptoms of severe agitation and anger.

What kinds of therapy may the person need? A therapist can help the person talk through his thoughts and feelings. This can help the person identify problems that are making him think about ending his life. The therapist can help find solutions or make changes that will help the person feel more positive about life.

• Life review therapy focuses on both the successes and failures of the person's life. He can express his feelings and find peace with anything he feels is not resolved.
  
  
• Cognitive bibliotherapy uses written materials or computer programs to help the person change thoughts that make him feel depressed.
  
  
• Problem solving therapy helps the person find the best way to solve problems. It may also help reduce his desire to commit suicide when he is faced with hard times.

What can I do to help the person?

• Encourage him to seek help for drug or alcohol abuse. Drugs and alcohol can increase suicidal thoughts and make the person more likely to act on them.
  
  
• Exercise with him. Exercise can lift his mood, give him more energy, and make it easier for him to sleep at night.
  
  
• Help him create a sleep routine. Sleep is important for emotional health. The person should try to go to bed and wake up at the same time every day. Let his healthcare provider know if he is having difficulty sleeping.
  
  
• Do activities with him that he enjoys. Simple things the person enjoys can help lift his spirits. He may want to keep a journal of his thoughts and feelings, including things he values.
  
  
• Call, visit, or send postcards to him often. Check on him after the loss of a pet, longtime friend, or child. Holidays, birthdays, and anniversaries can be difficult for a person after a loss. The loss of a spouse can be especially painful and lonely.
  
  
• Schedule a visit with his religious or spiritual leader. This person may be able to offer additional support and resources to the person.
  
  
• Help him find resources for financial support. Call a financial advisor for help with the person's financial problems if appropriate.

Where can I find support and more information?

• National Suicide Prevention Lifeline
  NA
  New York , NY10004
  Phone: 1- 800 - 273-TALK (8255)
  Web Address: http://www.suicidepreventionlifeline.org
  

• Suicide Awareness Voices of Education
  8120 Penn Ave. S., Ste. 470
  Bloomington , Minnesota55431
  Phone: 1- 952 - 946-7998
  Web Address: http://www.save.org
  

Call 911 if:

• The person has done something on purpose to hurt himself or tries to commit suicide.
  
  

When should I seek immediate care?

• The person tells you he made a plan to commit suicide.
  
  
• The person acts out in anger, is reckless, or is abusing alcohol or drugs.
  
  
• The person has serious thoughts of suicide, even with treatment.

When should I contact the person's healthcare provider or therapist?

• You begin to see warning signs that the person may be considering suicide.
  
  
• The person has intense feelings of sadness, anger, revenge, or despair, or he cannot make decisions easily.
  
  
• The person tells you he has more thoughts of suicide when he is alone.
  
  
• The person withdraws from others.
  
  
• The person stops eating, or begins to smoke or drink heavily.
  
  
• The person feels he is a burden because of a disability or disease.
  
  
• The person has trouble dealing with stress, such as a breakup or a job loss.
  
  
• You have questions or concerns about the person's condition or care.

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.