How to Prevent Suicide

by: Michael G. Rayel, MD
A British weapon’s inspector was found dead in the woods after he slashed his wrist. For the past few weeks, he was entangled with a controversy about the war in Iraq.

On Monday, a Hyundai executive leaped to his death from the 12th floor. He was on trial for allegedly paying off North Korea $100 million to agree to a 2000 summit between North and South Korea.

In both urban and rural areas, many more suicide cases do not go unnoticed. Through local papers and the town’s rumor mills, suicide becomes a sad tale and a mystery.

Why would people kill themselves?

Recent studies have shown the correlation between suicide and serotonin deficiency in the brain. Moreover, the presence of significant stress has far-reaching consequences especially if such stressor, such as legal entanglements, results in profound hopelessness and depression. Frequently, when there is no immediate resolution to the problem, suicide becomes an attractive escape.

It then becomes obvious that suicide is not only a medical disorder but a psychosocial issue. It is more than just a manifestation of emotional distress. It is a complication of an unresolved state of affairs.

There is no question that suicide is devastating to everyone. I have seen loved ones grapple with the pain of the loss and shame associated with the manner of death. Pain and grief among relatives persist for months despite efforts to feel better though counseling and medication.

Can suicide then be prevented?
Suicide prevention is as much a science as it is an art. Although applying scientific psychotherapeutic techniques can be effective, the gentle art of dealing with the suicidal person makes all the difference.

Having stated these, if clues of suicidal behavior can be recognized early and sources of stress addressed immediately, then the risk of suicide can be reduced. The issue of early recognition and remedy therefore becomes crucial. The CARE approach can help loved ones cope.

What is the CARE Approach?
The CARE Approach is a practical four-step process that a person can use in dealing with a disorder such as suicidal behavior and depression. This approach emphasizes early recognition and intervention. The early process includes the following:

1) Check for signs of emotional illness
2) Anticipate complications
3) Remedy with early intervention and
4) Educate yourself about the illness.

Check for signs of emotional illness or distress
Suicide, like any medical disorder, does not happen instantly or “out of the blue.” Usually, it is preceded by emotional turmoil such as depression, agitation, significant anxiety, impulsivity, feelings of hopelessness and helplessness.

Look for outward sign that shows deviation from the person’s usual self. Observe any changes in functioning. Is the person less motivated to work? Does the person prefer to stay in bed and withdraw from friends and family members? Check also for any physiologic changes such as inability to sleep, eat, and concentrate.

Anticipate complications
Watch out for complications once you know that your loved one is in distress. Be aware of any changes such as suicidal and homicidal behavior and aggression. If not showing actual destructive behavior, ask for any thoughts of death or wanting to die or to kill.

Inquiring about the presence of suicidal or homicidal thought will not push your loved one to act destructively. In fact, your loved one might be encouraged to disclose more information and to express well-kept emotions.

Remedy with Early Intervention
Early intervention requires you to first accept or acknowledge that a problem exists and the urgent need to address it.

Being in denial can only make matters worse. Denial interferes in recognizing on-going problem.

Assist in addressing your loved ones pressing issues. Offer to provide some financial support or to contact appropriate government agencies. For someone in legal trouble, suggest obtaining the advice of a good lawyer.

Be available and supportive. Reassure your loved ones that you will be in their side no matter what. Let them talk about their worries and travails. Provide a listening ear. Avoid arguments and criticisms. Show empathy.

Be alert for signs of destructive behavior such as wrist slashing, overdosing, verbalizing death, agitated behavior, writing or changing a will, and giving away properties. If your loved one is in distress, clarify if one has entertained destructive thoughts.

Call for help. Because suicidal and homicidal behavior requires immediate help, further delay is a not an option. Call mental health hotline, mental health services, or emergency rooms to seek guidance and to ask for the next step. Do not hesitate to call law enforcement agencies or mental health crisis team if your loved one refuses to get help.

Educate Yourself
Knowing about the illness, the dos and don’ts, and how to best cope is a powerful way of dealing with suicide or other destructive behavior. Furthermore, education helps you get rid of misconception, self-blame, guilt, and shame.

In summary, suicide, like cancer, has only one goal — death. It has caused agony, sleepless nights, and oceans of tears for those who are left behind. However, despite its deadly intentions, suicide is also a cry for help. Fortunately, simple steps such as the CARE approach make suicide surmountable.

Choice Award 2002), has pioneered the CARE approach as a first aid for mental health. As an expert and an award-winning

author, Dr. Rayel has appeared on radio and prominent newspapers. As a first aid advocate, he has conducted Mental

Health First Aid workshops. To learn more about his work and books, visit http://www.drrayel.com/.