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Suicide Awareness

What Is Suicide?

Suicide is intentionally ending one’s own life. It is not self-harm or an accident. It is a permanent solution to a problem in the person’s life. This problem is temporary. It will not last forever. Suicide is irreversible. The individual may feel like they have run out of options and suicide is the only option left, but this is not the case.

Myths About Suicide

There is a lot of misinformation and stigma surrounding suicide. Think of how we speak about suicide. When someone dies by suicide, we usually say someone has committed suicide. The word committed is laced with judgement. Committed is typically said when someone “commits” a crime. This has a negative connotation which creates the feeling the person is a bad person which is simply untrue. Alternatively, some people will say “completed suicide.” Completed sounds positive. Someone completes a project, assignment, school, etc. This comes with the intrinsic judgement and positive feelings. Suicide is neither good nor bad. It is tragic. The phrase “died by suicide” is used to remove judgement.

Suicide has carried a stigma for centuries. To deter people from dying by suicide, many cultures have punished those who are suicidal or who have died by suicide. These punishments have ranged from improper burials, being declared a sinner, property seizure, and more (Eghigian, 2018). This fear-mongering approach has not deterred people from having suicidal thoughts or dying by suicide. It simply created a world where it can be difficult to have open conversations and to ask for help.

FACT – Unfortunately, this is untrue. Approximately 700 000 people worldwide die by suicide each year, which is one person every 40 seconds. 

There are approximately 4 000 people who die by suicide each year in Canada. For everyone one suicide, there are roughly 20 people who attempt.

FACT – Most people who are suicidal have a mental illness.

More than 90% of people who are suicidal have a mental illness. Depression accounts for at least 50% of people who are suicidal.

That does not mean everyone who has a mental illness is suicidal. There are many people with a mental illness who are well and have learned how to manage their disorder. Mental illnesses simply put them at a higher risk to be suicidal especially if the mental illness is untreated. There are many factors which contribute to suicide.

FACT – Talking about suicide with empathy and compassion is important and can empower people to seek help.

There is a long history of shaming or ignoring people who are suicidal. The misguided belief is not talking about it so people will not think about it. They will not become suicidal. That is untrue and harmful. If you mention suicide to someone who may be at risk, it can validate their experience and empower them to get help. Talking about suicide is very important in helping people. It lets them know they are not alone and there are people who care and are willing to listen.

When you are talking about suicide, it is important to practice empathy and compassion. Sometimes, when we are uncomfortable, we make jokes or laugh about a challenging topic, but it is important to act with empathy.

FACT – There are several groups which are at a higher risk of suicide.

Youth who are 2SLGBTQ+ are at a higher risk of suicide as compared to their peers who are not 2SLGBTQ+. There are many factors which can contribute to increased suicidality. This could be due to the increased prevalence of bullying. People of the 2SLGBTQ+ community face increased discrimination. There are also societal, family, and religious pressures. In addition to outside pressures, there could also be pressures within themselves, too.

Indigenous Canadians are at a higher risk of suicide than non-Indigenous Canadians. First Nations people are 3 times higher risk for suicide than non-Indigenous; Metis Canadians are 2 times higher for suicide than non-Indigenous Canadians; Inuit Canadians are 9 times higher risk for suicide than non-Indigenous Canadians.

Men die by suicide 3 times more often than women, but women attempt suicide 3 times more often. There are a couple of reasons why this is true. The first reason is men use more lethal means (methods) than women, such as using a gun or jumping off a building. There is no time to call for help and have a change in mindset. Whereas women use less deadly methods. The other reason is society’s perception of masculinity. While ideals are shifting and evolving, there is a general sense of what it means to be a “man.” “Real men” do not show emotions other than anger; they do not ask for help, they take care of things, they get things done, they cannot be friends with women without sexual intentions, etc. These ideals are harmful to all genders. These expectations make it very difficult for men to ask for help. It is a stifling set of expectations which are completely unrealistic. Remember, emotions are not gendered. They are for everyone. If you need to cry, cry. If you need help, ask for help. There is help out there and there are people who will listen.

FACT – Sometimes people talk or joke about suicide as a way of coping with their thoughts of suicide or to see if anyone is listening.

There is no one size fits all for mental health concerns. Some people do not say much. Their actions speak for them. Others talk about suicide or joke about suicide. This could be their way of asking for help. Joking about suicide might be easier than asking for help.

Consider the following story:

“My friend would joke about suicide all the time. We never thought he would do it because he talked about it all the time. Until he killed himself.”

FACT – Suicide is not illegal in Canada.

Suicide was decriminalized in 1972 in Canada. Euthanasia (medically assisted suicide) was decriminalized in 2015.

FACT – Suicide is about ending the pain.

A common misconception is people who are suicidal want to die. Suicide is not about death. It is about ending the pain whether physical, emotion, or mental pain. The person feels like they have no other option.

Some people think people who are suicidal are selfish. That is not the case. As mentioned above, most of the people who are suicidal have a mental illness. Their brain cannot think clearly to see other options. Their brain, the part responsible for perceiving reality, is telling them their loved ones/the world would be better off without them, their death is worth more than their life, and living is selfish.  They cannot see any other option to end the pain. Part of struggling with a mental illness can make it difficult to concentrate and think clearly. Here is a question to consider: if a person who is suicidal or dies by suicide could see the devastation their death would cost and the ability to think long term, do you think they would still kill themself?

FACT – There is hope and help.

There are people to help. One of the cornerstones to suicidality is feelings of hopelessness. While the person may feel overwhelming hopelessness, there is hope. There is help. There are resources that can help them feel better. If you need resources in your area, call 211 and they will be able to assist you.

Causes of Suicidal Thoughts

When someone is suicidal, people often ask why. Why would someone template ending their life? The answer is not as simple as the three-letter word why. It is complex and multifaceted. There is no one answer. It is usually a combination of many stressors and circumstances.  Every person’s experience is different.

Dr. Thomas Joiner, world renowned suicidologist, notes there are 3 cornerstones of suicide. They are feeling burdensome, feelings of lack of belonging, and the ability to enact lethal harm. The burdensomeness relates to a person’s connection with others or society. They feel like they are too much of a burden for others while they are living. The lack of belonging is feeling disconnected or not accepted by others. Humans need to feel connected to one another, and when people do not feel that connection, it increases their risk of suicide. The ability to enact lethal harm relates to the person being able to kill themself. This is something the person must acquire. People are not wired to want to harm themselves. These three components coupled with feelings of hopelessness place a person at high risk for suicide. 

 

For people who have a loved one who is suicidal, they might only know one part of what is going on in the person’s life. They might not know all the details of every stressor, trauma, or experience. They might not know the magnitude of what is going on because they have not been told everything.  There are many things that put a person at a higher risk for suicide, such as abuse, mental illness, death of a loved one, substance disorders, bullying, intergenerational trauma, and prior suicide attempt. If you notice someone struggling with any of these, connect with them and get them help if they need it.

What Are the Warning Signs?

The warning signs can also be considered invitations to the conversation. They are a change in a person.

To remember the warning signs, think of the acronym PASES.

P- Physical Appearance

A- Actions

S- Self-Talk

E- Emotions

S- Situations

 

**This is not a complete list. These are examples**

Physical appearance refers to a change in how the person looks.

This could include:

  • Change in hygiene (showering more or less)
  • Wearing the same clothes
  • Looking tired or worn down
  • Slouching
  • Avoiding eye contact
  • Red puffy eyes from crying
  • Change in style of clothes or hair

Actions are the things they are doing.

Their behaviour has shifted in some way. They are not acting like themself. There is something different.

This could include:

  • Recklessness
  • Withdrawing
  • Loss of interest in things they used to enjoy
  • Isolating or cancelling plans
  • Increased substance use/abuse
  • Fixation on death (drawing, talking about, writing about death)
  • Giving away possessions
  • Promiscuity
  • Saying heartfelt goodbyes instead of the usual “See ya!”
  • Brilliant and sparkling mood after threatening suicide (this could mean they have made the decision to kill themself, so they feel relief)
  • Shifting mood
  • Poor concentration
  • Avoiding or skipping work or school

Self-talk is how the person is speaking about their situation or themselves.

If someone is not doing well, oftentimes you will hear it in how they speak. They may start speaking poorly of themselves.

They may say something like:

  • “You’ll be sorry when I am gone.”
  • “You won’t have to worry about me after the weekend.”
  • “It will all be better soon.”

Emotions can feel overwhelming and all-encompassing when you are not doing well.

The person may display or say that they are feeling:

  • Sad
  • Overwhelmed
  • Lonely
  • Disappointed
  • Guilty
  • Angry
  • Burdensome
  • Disconnected

 

The person can feel like they are filled with uncomfortable emotions.

Situations are the things going on in a person’s life.

These stressors begin to build and build until it feels like there is no escape.

Situations which can indicate someone might not be doing well or needs support could be:

  • Relationship break-up (romantic or friendship)
  • Abuse
  • Failing at something
  • Job loss
  • Death of a loved one
  • Previous suicide attempt (especially if they have not received help after the attempt)
  • Moving
  • Mental health concerns
  • Financial issues

These signs may not necessarily mean the person is suicidal. They are signs that a person needs help and support. Warning signs can be tricky, too. Someone may do something out of character one time which can be easy to dismiss or forget about, but if you feel like something is going on with your friend or someone you love, check in and make sure they are doing alright. If they need additional support, help connect them with a trusted adult who can get them help.

What to Do if You Are Suicidal?

Thinking about death and mortality is natural but thinking about ending your life is different. Thinking about killing yourself is scary and overwhelming. It can feel like there is no help or hope, but there is help. There is hope.

So, what do you do if you are thinking about killing yourself?

  1. Acknowledge that you are not doing well. It is not an easy thing to admit. Just remember, we cannot be tiptop all the time. It is okay not to be okay. It is about seeking help.
  2. Talk to someone.

    Seek help with someone you trust whether a loved one, doctor, or a mental health professional. You deserve to feel better. It is important to take care of yourself and feel better. Telling someone you are thinking about killing yourself can be very difficult, but it is important. There is the misconception of the “strong silent type,” but reaching out takes great strength. You deserve help, and you deserve to feel better.

    When you are reaching out for help, tell a person you trust. If the first person you tell does not listen to you, tell someone else. Remember, if someone does not listen to you, that does not reflect your value. Their reaction reflects their prejudices, mental state, or ideals. For some people, saying the words out loud can be very difficult. It makes it feel more real. If you are having a hard time saying the words out loud, write it down and give the note or letter to the person you trust. This way you will still be able to communicate to the person how you are doing without having to say it out loud.

    Once you have talked to someone you trust, seek professional help, like your school counsellor/social worker, spiritual leader, elder, family wellness worker, counsellor, doctor, or Kids Help Phone 1-800-668-6868. The person you tell may be able to help you by connecting with help too. You deserve help! That is exactly why those services exist.

  3. Practice self-care. Self-care is taking time to care for yourself and your health and wellness. Make healthy choices to support your mental health. Take some time for yourself to feel better, to unwind, and to take care of yourself.

In addition to seeking professional help, there are many things you can do to help support your mental health. Check under the tips for wellness or the wellness sessions for ideas about how to take care of yourself.

Help Lines:

Canada Suicide Prevention Service

Toll-Free 1-833-456-4566

Text 45645

First Nations and Inuit Hope for Wellness Help Line

Toll-Free 1-855-242-3310

Online chat Hope for Wellness Chat 

 

What Do You Do About a Suicide Disclosure?

When a loved one tells you they are struggling, it can be terrifying, and it can be hard to know what to do/say. It is easy to become caught up in emotions. Many people fear saying the wrong thing. We often want to try to fix our loved one’s problems or counsel them, but that is not your job. Your main job is to connect your loved one to help.

The following are some guidelines as to what to do when your loved one tells you they are struggling and how to handle those difficult conversations. This is not to counsel the person. This is to get the person connected with a helping professional. Please remember the conversation will not be linear like on the page. These are guidelines of some things to consider. 

The person is telling you something scary and personal to them. This is terrifying for both of you. Take that moment to gather yourself and take a deep breath. Remember this is about them and their experience. When we care about someone and they tell us about their struggles, we sometimes react with what seems like anger. This is often an outward display of fear which comes across as anger. This can make it difficult for the person to open up to you.

Take a moment to recognize your own biases or judgements about mental health issues. You are entitled to your opinion, but remember this conversation is about your loved one. It is about their emotions, experiences, and perception. It is all valid and real for them. If you are going to have the conversation, place your judgements or preconceived notions aside to allow for understanding and compassion.

Validate, Encourage, Empower, Refer. (This is not counselling the person. It is connecting them with help.)

Give the person the time and consideration you would like if you were struggling. Be the person you would like in the situation. Give them your full attention. They deserve it. Listening will also help you know what the person is trying to tell you. While you are listening, be understanding and compassionate. Give them the space to talk.

Facing mental health concerns can be very challenging and scary, but your loved one needs help. Without help, the problems can escalate.

Talking to a loved one who is struggling is challenging. Talk to someone about it to help cope with the stress of the situation. Practice self-care. Do something you enjoy. For self-care ideas, visit the self-care section here.

Sometimes, people are not ready to talk to you. That is okay. It is their choice. Simply let them know you are there to talk if they need someone and give them resources.

Remember VEER.

Validate, Encourage, Empower, Refer. (This is not counselling the person. It is connecting them with help.)

 

Validate – Validating is so important. It is letting the person know what they are feeling is okay. It is acknowledging their emotions as understandable.

For example:

  • Yeah, that would be frustrating.
  • I am sorry that happened to you.
  • It is understandable you feel that way. I would feel that way, too.
  • I believe you.
  • From what you are saying, I am hearing you are…because of… Is that correct?

 

Encourage – This is letting the person know they did a good thing by telling you. Talking about mental health struggles can be very challenging. Let them know they are doing the right thing by telling you.

For example:

  • Thank you for telling me. That must have been challenging.
  • You did the right thing by telling me.
  • I am here for you.

 

Empower – Struggling with mental health issues can be overwhelming, so it is important to let the person know there is help and they can feel better.

For example:

  • I know things seem really overwhelming, but there are resources and people to help.
  • Let’s find some things which can help you feel better.
  • You deserve to feel happy! We will find a way to get there.

 

Refer – Connect the person with help. They deserve to feel happy and healthy again. There are resources to help them. Your loved one needs to get help. This is not something you can deal with without professional help. Help the person think of someone they trust/who they would like to talk to about their challenges. Everyone connects with a different type of help. Give your loved one options, like a doctor, individual counselling, group counselling, or an elder. You can also offer them some helplines they can call when they are struggling, too. 

For example:

  • Here are some phone numbers you can call when you feel like you need someone to talk to.
  • Let’s look up some resources and see what you like best.
  • There are many options of people you can talk to. We could talk to the doctor, find a counsellor, or elder. What would you feel most comfortable with?

How Do You Ask Someone About Suicide?

If you notice someone displaying any of the warning signs listed above or have a feeling something is going on, have a conversation with the person if you feel comfortable talking to them. (If you do not feel comfortable, that is okay. You just need to tell someone who will have the conversation with them and connect them with help). Oftentimes, when someone is suicidal, they are looking for a connection. They are looking for someone to take notice. 

The following are some guidelines of what to do if you suspect someone is suicidal or not doing well. This is not to counsel the person. This is to get the person connected with a counsellor, doctor, or another professional. Please remember the conversation will not be linear like on the page. These are guidelines of some things to consider. 

Before You Have the Conversation

  • Make sure you have time for it
  • You are in a place the person will feel comfortable talking to you
  • Approach the situation with compassion
  • Make sure you are willing to listen
  • Remember you can initiate the conversation and let them know you are there, but it may take some time before they talk to you.

 

DO NOT keep it a secret.

You must tell someone, so the person gets help. You must connect the person with a healthcare professional. 

The conversation will not be as linear on the page as that is not how conversations work. When you are talking to someone you love, it can be hard to think straight and know what to say. If you are struggling to know what to say, remember VEER: Validate, Encourage, Empower, and Refer. Click here for more information.

  1. Take notice. If you feel like something is going on with someone, there likely is something. Trust that gut instinct.
  2. Talk to them. Open the conversation in a nonjudgemental and compassionate way. While you may fundamentally disagree with suicide, think it is wrong, or not understand it, it is very real for that person. Begin the conversation by stating a change you have noticed. Use “I” statements so it does not feel like you are accusing them.
    • Example: “Hey, I have noticed you have been falling asleep in class lately. How are you doing?” or “I heard you putting yourself down in class. What’s been going on?”
  3. Listen. Listen to hear and understand. If you do not understand something they are saying, paraphrase and ask them to clarify. Listening means putting down your phone and giving them your attention. Let the person talk. Do not feel the need to fill the silence. Allow them the space they need. Sometimes, we want to interject our opinion, but this is about the person, not your opinions. While you listen, approach the situation with nonjudgement and compassion.
  4. Ask the question. If you feel like the person is thinking about suicide, ask them. It is important to ask! Ask the question directly so there is no misinterpretation. This could include: “Are you thinking about suicide?”; “Are you having thoughts of suicide?”; “Are you thinking about killing yourself?” or “Are you thinking about ending your life?” (If you feel like you are not able to ask, tell someone who will ask the person like a healthcare or mental health professional).
    • Try to avoid leading questions, like “You aren’t suicidal, right?” This can make the person feel like they have to say no.
    • Asking “Are you going to hurt yourself?” is not the same as asking about suicide. The person might not think of suicide when you ask this.

    If the person says yes, the next step is a risk assessment. If they say no, it is important to connect them with help if they need it.

  5. Risk Assessment. If the person says they are thinking about suicide and you feel comfortable, the next step is a risk assessment. While the person is talking, listen for the answers to these questions; or ask the person the following questions. (If you feel like you cannot ask these questions, connect the person with a healthcare or mental health professional).
      • Frequency. How frequent are the thoughts? The more frequent the thoughts place a person at a higher risk.
      • Plan. Do they have a plan? If they have a plan, they are at a higher risk.
      • Means. Do they have the means to carry out the plan? If they have the materials (means) to carry out the plan and cannot keep themselves safe, you must call emergency services immediately.
  6. Connect the person with help. If their level of risk is high and they cannot keep themselves safe, connect them with emergency services. If they are not a danger to themselves, they still need help. Connect the person with a counsellor, agency, or person they can talk to about what is going on in their life. There are a couple of places you can find help to support the person. You can take the person to their family doctor, a counsellor, local mental health agencies, call 211 for local resources, or call the Canadian Suicide Prevention Services at 1-833-456-4566. 

Follow-up Support

Parents

  • Listen without judgement. – This can be tricky, but it is important. Oftentimes, when we are scared, we react with anger or irritability. Yes, this is scary, but your child needs your support right now.
  • Talk to a professional yourself.  – This can be very helpful. A counsellor can help you work through any emotions you may have and give you tools to help your child/youth.
  • Try to stay connected with your child/youth – Let them know you are there to talk. Yes, teenagers are trying to assert their independence, but maintaining a connection with them can help them combat the challenges they face.
  • Check-in with your child/youth. – Talking about mental health and suicide can be challenging and scary, but after the initial conversation with your child about their mental state, it does not immediately change. Checking in with them will let them know you care and help you know how they are doing.
  • Work to decrease the stigma around mental health by talking openly. – There are many preconceived notions about mental health. Educate yourself so you can better understand what your child is going through.
  • Model positive coping skills. –  Children/youth learn a lot by observing. Show them what positive coping skills are through your actions. If you need help with this, seek help.
  • Facilitate/encourage your child’s connection to mental health resources and positive relationships. – Help them book appointments if they need help. Drive them to their appointments if they need a ride to ensure they go. Maintain open communication with your child’s counsellor.
  • Do not shrug off your child’s mental health/status as moody youth/teenager behaviour. – Yes, teenagers and youths can be moody. Anyone can. If you notice a shift with your child, check in with them and see what is going on. 
  • Have fun! – This will help facilitate a connection with your child and help them to cope with stress positively.

Things to Avoid

  • Making jokes about suicide or mental health
  • Judging the person
    • This could be something as simple as asking “Why” can be viewed as judgement. While it may seem like an innocent question, it is laced with judgement. Think of a time when someone has asked “Why did you do that?” It automatically makes us defensive. It feels like they are judging us. The same is with suicide. The person needs compassion and understanding to help them think of other ways to cope with what they are going through. When someone is struggling, they often feel down on themself. Therefore, empathy and compassion are so important. There is also the chance the person does not know the exact reason why they are suicidal due to the cumulative nature of suicide.
  • Leave them alone if they are a danger to themself.
    • If a person is at a high risk of killing themself, do not leave them alone. Make sure they are connected with help and are safe.
  • Making assumptions about a person’s mental health without talking to them.
  • Threatening or blaming the person
  • Ignoring the person’s mental health problems
  • Counsel your loved one
    • Your loved one needs to be connected with professional help who is not connected to through family or friends
  • Making the person’s mental health issues about you
    • If you are struggling because of someone’s mental health, seek help for yourself. When you are helping the person, it is about them and getting them help.
  • Comparing people’s mental health journeys
    • In our society, there is sometimes a compulsion to compare. We compare everything from social media to lifestyle to clothing. Mental health should not be compared. Do not get stuck in the “anything you can do I can do better” trap. Every person’s story or experience is valid.

Tips for Wellness

If you or someone you know is struggling, please reach out for help. Remember it is okay not to be okay. It is important to reach out for help when you need it. If the person cannot keep themselves safe, do not leave them alone.

Tips to encourage wellness:

  • Talk to someone
  • Connect with resources, helplines, counselor, doctor, etc.
  • Practice positive coping skills
    • going for a walk
    • hobbies
    • listening to music
    • practicing mindfulness or gratitude
    • journaling
    • drawing
    • connecting with nature
    • playing with a pet
    • reading
    • playing a game
    • watching a movie

 

In addition to seeking professional help, these activities can help support mental wellness. Check the wellness sessions for ideas.

Please reach out to The Outreach Centre (home of Suicide Information and Education Services) or CMHA for more information/assistance.

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