Spring, with its longer days, blooming flowers and rising temperatures might seem like a time of peak happiness, but some studies indicate that suicides are more common in the spring and summer months than in December. Researchers don’t know why they’re higher in these seasons, but they say that friends and loved ones should not be lulled into thinking a brighter season necessarily means a brighter mood for someone who is struggling with mental health issues. Intervention is important no matter the month.
Getting involved – by reaching out, asking questions, offering assistance – can help people contemplating suicide find another way out, says Alan Berman, executive director of the American Association of Suicidology. But first their suicidal intentions must be recognized.
About 80 percent of people who die by suicide indicate their intention through behavior or words, but it can take a careful observer to spot the warning signs, says Berman, a clinical psychologist.
“People do such subtle things,” says Dese’Rae Stage, a Brooklyn-based suicide awareness advocate and creator of Live Through This, a collection of survivor stories, including her own. “They start saying things like ‘I don’t know if I’ll see you again’ or they give stuff away, or start tying up loose ends.” Sometimes these behaviors are recognized as red flags only in retrospect.
Other signs of acute suicide risk – threatening to hurt or kill oneself, looking for or obtaining lethal means such as firearms or pills and writing or talking out of the blue about death, dying or suicide – are more obvious.
A group of suicide experts convened in 2003 by Berman’s Washington-based organization developed a list of warning signs and a mnemonic – “IS PATH WARM?” (Ideation, Substance abuse, Purposelessness, Anxiety, Trapped, Hopelessness, Withdrawal, Anger, Recklessness, Mood changes) – to help the public and clinical professionals identify people at acute risk of suicidal behavior.
If someone you know exhibits any of these signs, ask him or her what’s going on, says David Litts, a suicide expert at the Education Development Center, a Washington-based nonprofit that supports a wide array of programs, including ones on mental health.
“You might say, ‘Joe, I’ve noticed that lately you’ve seemed agitated or hopeless, and sometimes when people act this way it’s a sign that they want to die. I’m wondering if you’re having these kinds of thoughts,’” Litts says.
It’s important to listen without judgment, says Julie Goldstein Grumet of EDC’s Center for the Study and Prevention of Injury, Violence and Suicide.
Don’t dismiss what the person is feeling or make judgments about those emotions. Your objective should be to get the person help, not convince him or her that his or her reasons for contemplating suicide are wrong, she says.
A good place to go for help at any time is the National Suicide Prevention Lifeline, a network of 160 crisis centers in 49 states and the District of Columbia. Your call – to 800-273-8255 (800-273-TALK) – will be routed to the center closest to you, and the conversation will be confidential, Litts says. The Lifeline can help you find resources for both emergency and ongoing support.
Finding the right help requires identifying the source of the person’s pain, whether it’s a mental illness such as depression or a physical one such as chronic pain or loss of physical function, Litts says.
If the person is in imminent danger, take him or her to an emergency room, but that shouldn’t be the end of your assistance. Make sure that the person gets follow-up help and a long-term plan, Goldstein Grumet says.
If the person’s situation isn’t urgent, look for a local mental health center or advocacy group, or go to the National Alliance on Mental Illness Web site, which can point you to resources available through its local affiliates.
Before leaving the person alone, take steps to make the immediate environment safe. “You want to keep that person separated from lethal means,” Litts says. “If they’re a gun owner, work with them to get the guns out of the home.” Remove medications or alcohol that might be used in fatal doses.
Help the person create a safety plan. The EDC’s Suicide Prevention Resource Center offers a template on its Web site. A good safety plan identifies an individual’s best coping strategies and the people to contact should suicidal thoughts occur.
This approach has worked for Stage. “I have people who know that this is part of my mental landscape, and I’ve asked them: Is it OK if I call you if this happens?” After her divorce in 2012, she relied on this support network to get her through. Sometimes she just needed someone to come sit with her. “Listening is absolutely the most important thing you can do,” she says.