Engaging with and creating a collaborative relationship with a young person with suicidality is essential in order to collaboratively work with the young person to be safe. For a young person to discuss their suicidality, they need to trust the person they are confiding to and feel comfortable to talk openly and honestly. The foundation module Engaging is a good guide to build a collaborative relationship.
In discussing suicidality, health professionals need to be empathic and non-judgmental in their approach. A young person will likely be discouraged from discussing their suicidality if they feel judged or dismissed. Express to him/her you are concerned and care for them, and that you take what they are saying seriously. For example, “I’ve noticed lately you seem very down. How are you coping with what's been happening in your life?”
Creating an environment where the young person feels comfortable to discuss his/her suicidality is also essential. It is advantageous to hold the conversation in a private area, where the chances of being interrupted or overheard are minimised. This will help him/her feel most at ease. Also allow sufficient time to have the conversation. It takes time to discuss a person’s suicidality and experiences contributing to how he/she feels. Suicide is a serious topic, and it is not a conversation that should be rushed.
2. Actively listen
Active listening involves giving him/her undivided attention, and patiently allowing them to express their feelings and experiences. The module Active Listening provides a good guide in developing active listening skills.
Active listening allows the identification of possible suicidality in young people. For example, a young person may use language that reflects feelings of hopelessness through statements such as “I can’t take it anymore” or “Everyone will be better off without me”. By hearing concerning statements, the meaning behind the statements and the presence of suicidality can then be explored.
For young people with suicidality, active listening enables a clear picture of their psychological well-being and their experiences that have contributed to how they are feeling. It allows the exploration of what factors led them to feel suicidal and what has helped them keep going. Understanding the precipitating events contributing to their suicidality, the risk factors and the protective factors for the young person allows an individual response to helping them manage their suicidality and recover.
3. Ask about suicide in a direct and calm manner
It is important to talk openly about suicide. This shows the young person you are willing to hear about his/her suicidality and are not afraid to talk about suicide. Asking about suicide should be done in an empathetic manner. For example:
- Sometimes when people feel depressed they have thoughts that life is not worth living. Do you sometimes have thoughts like this?
- Have you ever felt that life is not worth living?
- Do you sometimes feel so bad that you think of suicide?
- It sounds likely things are really difficult, and I’m concerned about you. Are you thinking about killing yourself?
- Have things been so bad lately that you have thoughts that you would rather not be here?
- Do you think about dying, or wish you were dead?
If they respond “yes”, it is important to further explore their suicidality (link to understanding and assessing suicidality section).
4. Provide reassurance
Reassure them that there is help and while it may seem overwhelming and hopeless at the moment, they will not always feel like this.