Suicide: signs to watch out for and questions to ask

It doesn’t matter how old you are, what your background is or what you do for a living, suicide can and does affect all people.

In Australia, suicide has been described as a ‘significant health problem’, according to the Australian Institute of Health and Welfare (AIHW). The facts certainly back this up.

• In 2020, 3,139 people took their own life in Australia, around 12 per 100,000 population ⁱ
• In 2020, 2,384 suicide deaths were males, around 18.6 per 100,000 population ⁱ
• In 2020, 755 suicide deaths were females, around 5.8 per 100,000 population ⁱ
• Each year, over 65,000 Australians make a suicide attempt ⁱⁱ
• Suicide is the leading cause of death for Australians between 15 and 44 years of age ⁱⁱⁱ

The discussion around suicide, which was already important pre-COVID, is all the more so after what has been a tough couple of years for us all.

Now, in addition to pandemic fatigue, we’re watching interest rates climb to the highest levels in six years. Meanwhile, the effects of climate change and extreme weather events continue to batter the parts of the country, with flooding, droughts and bushfires becoming a constant threat.

It’s why, if you suspect someone you love or work with is having suicidal tendencies, knowing what questions to ask or what signs to watch out for are important.

To help, we’ve looked at some of the common reasons for feeling suicidal. Knowing some of the most common reasons can be a good first sign that you need to keep an eye out for somebody, or direct them to psychological therapy.

What causes suicidal thoughts?

The reasons behind suicidal feelings are varied. Everyone deals with things in different ways. What causes suicidal feelings in one person might not cause them in another.

Suicidal feelings can originate from outside events, such as losing your job, or they can be completely independent from them, such as a genetic mental health condition.

Beyond Blue has outlined some of the most common reasons for feeling suicidal. These risk factors – or vulnerability factors – can increase the chances of suicidal behaviour. Some of the factors are complex and can be intertwined:

• Access to harmful means, such as medication or weapons
• History of mental health conditions, such as anxiety, stress or PTSD
• History of substance abuse
• Legal problems
• Financial stress
• Ongoing exposure to bullying behaviour
• Physical illness or disability
• Previous suicide attempts
• Recent death or suicide of a family member or close friend
• Relationship problems

Warning signs of suicide: what to watch out for

The Suicide Call Back Service groups suicide warning signs into four categories: physical changes, behaviours, conversational signs and feelings. Before you can start organising psychological therapy, you need to be able to recognise the symptoms of suicidal ideation.

It’s important to remember that these signs aren’t mutually exclusive, nor are they only associated with suicidal tendencies. There can be multiple signs happening at the same time, or just one. It’s important we know what to look out for so we can ask the right questions at the right time.

Physical changes:

• Increase in minor illnesses
• Loss of interest in personal hygiene or appearance
• Loss of interest in sex
• Loss of physical energy
• Major changes to sleeping patterns, such as too much or too little sleep
• Sudden and extreme changes in eating habits, such as a loss or increase in appetite
• Weight gain or loss

Behaviours:

• Alcohol or drug misuse
• Emotional outbursts
• Fighting and/or breaking the law
• Preparing to enact a suicide plan e.g. stockpiling medication
• Prior suicidal behaviour
• Putting affairs in order
• Quitting activities that were previously important
• Self-harming
• Uncharacteristic risk-taking or recklessness
• Unexplained crying
• Withdrawal from family and friends
• Writing a suicide note or goodbye letters to people

Conversational signs:

• Alone: “I’m on my own, no-one cares about me.”
• Damaged: “I’ve been irreparably damaged”, “I’ll never be the same again.”
• Escape: “I can’t take this anymore.”
• Guilt: “It’s all my fault, I’m to blame.”
• Helpless: “Nothing I do makes a bit of difference”, “It’s beyond my control.”
• No future: “What’s the point? Things are never going to get any better.”
• Planning for suicide
• Talking about suicide or death
• Threatening to hurt or kill themselves
• Trapped: “I feel like there’s no way out of my situation.”

Feelings:

• Anger
• Despair
• Disconnection
• Guilt
• Hopelessness
• Isolation
• Loneliness
• Powerlessness
• Sadness
• Shame
• Worthlessness

What questions do you ask a suicidal person?

If you think someone may be having suicidal feelings, it’s important to ask the right questions and give them the chance to open up. Equally, it’s important to listen and not try to “solve” whatever may be affecting them and making them feel the way they do.

Mayo Clinic has put together some sensitive but direct questions that you can ask someone who you suspect is thinking of taking their own life.

It’s natural to feel nervous or tense when you’re asking questions on the topic of suicide, but Mayo Clinic says it won’t push someone in the wrong direction.

Instead, it can give them to opportunity to talk about how they’re feeling, and it may reduce the risk of acting on suicidal feelings. It is a vital first step towards getting support or treatment such as psychological therapy.

Some questions they recommend asking:

• 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?

How do you help someone who has suicidal thoughts?

It’s normal to feel pressure or worry if someone has told you they’re having suicidal thoughts. Try to stay calm and remember, this can be seen as a positive step, as the person having suicidal thoughts has given you the opportunity to help them.

Mental Health First Aid Australia has put together a few tips to keep in mind when someone tells you they’re thinking of taking their own life. These include:

• Be patient and calm while the suicidal person is talking about their feelings
• Listen to the suicidal person without expressing judgment, accepting what they are saying without agreeing or disagreeing with their behaviour or point of view
• Ask open-ended questions to find out more about the suicidal thoughts and feelings and the problems behind these
• Show you are listening by summarising what the suicidal person is saying
• Clarify important points with the person to make sure they are fully understood
• Express empathy for the suicidal person

When it comes to suggesting professional support, there’s a few ways to frame the conversation. Keep in mind, it’s important to empathise with their situation and reassure them that seeking professional help doesn’t make them “weak”.

You can try saying things like:

• “I hear you that you’re struggling, and I think it would really be helpful for you to talk to someone who can help you get through this.”
• “You know, therapy isn’t just for serious, ‘clinical’ problems. It can help any of us process any challenges we’re facing – and we all face serious stuff sometimes.”
• “I really think talking to someone can help you gain some perspective, and keep things from getting worse.”

What’s next?

If the person is willing to seek professional help, then it’s important to let them know you’re there to support them any way you can.

You can offer to help them find a mental health professional. You can even offer to call or email to set up an appointment for psychological therapy on their behalf.

On top of this, you can let the person know that you’re available to drive them to their appointment, or that you’ll accompany them on public transport.

If they don’t want to seek professional help right away and they’re not in immediate danger – that is they are not self-harming or about to – then be patient.

Let them know you’re there for them whenever they’re ready to seek help and tell them you’re glad they decided to open up.

Remember to stay positive about the help available and refer them to any relevant organisations, such as those listed below, should they need to speak to someone.

For urgent support and psychological therapy

If there’s an immediate risk of harm to yourself or others, please call 000.

If you need someone to talk with now, call:

• Lifeline: 13 11 14
• Beyond Blue: 1300 22 4636 or chat online at beyondblue.org.au
• Suicide Call Back Service: 1300 659 467

While these services aren’t able to offer long-term support like psychological therapy can, what they can do is provide immediate support.

Need to talk to someone?

If you want to organise psychological therapy for yourself or someone you know, the first step is to find a psychologist near you. With 85+ practitioners throughout the country as well as telehealth psychology options, Access Psych can make accessing a psychologist easier.

Alternatively, if you have any questions about Access Psych and what else we can do for you, visit our Frequently Asked Questions page.

When you’re ready, you can book an appointment online, speak to one of our friendly team on 1800 277 924 or email info@accesspsych.com.au.

The information provided in this document is general in nature and is intended to be used for information purposes only. While we have tried to ensure the accuracy of the information published, no guarantee can be given that the information is free from error or omission or that it is accurate, current or complete.

The information published is not, and should not be relied on as, health or treatment advice. The diagnosis and treatment of any mental illness requires the attention of a physician or other properly qualified mental health professional. If you are seeking diagnosis or treatment of any other mental illness, you should consult a physician or mental health professional.  You should not delay in seeking, or disregard, professional health advice because of something you have read in this document.

[i] https://www.aihw.gov.au/suicide-self-harm-monitoring/data/deaths-by-suicide-in-australia/suicide-deaths-over-time

[ii] https://www.blackdoginstitute.org.au/resources-support/suicide-self-harm/facts-about-suicide-in-australia/

[iii] https://www.aihw.gov.au/reports/life-expectancy-death/deaths-in-australia/contents/leading-causes-of-death