The singular most important thing to remember when a caller or resident expresses suicidal thoughts is TAKE IT SERIOULSY! If you receive a suicide telephone call, these are some important guidelines to follow:
Be clear and direct, but not threatening in your speech. Remain calm.
Ask the caller if she is suicidal.
Ask if the caller has a plan and what that plan is.
Ask if the caller has done anything and what they have done, ie: pills, razor, etc..
Try to get a phone number, address, or name - anything that might help to identify the caller. Do not however, frighten the caller into hanging up. You need to keep the caller on the line if you are to have the opportunity to intervene.
If medical help is required, inform the caller that you wish to send an ambulance. The caller may refuse; however, you will need to use your judgement regarding whether or not to hang up and call your team leader so an ambulance can be sent even against the caller's wishes.
If the caller is in no immediate physical danger, speak with them about what suicide means. do not be afraid to use words such as death or die.
Ask the caller if they wish to die or want to end their pain. This statement will give the caller the opening to begin speaking about their pain. Use you empathic listening skills: Suggestion: Help the person to remember some painful event in their experience that they survived. How did they survive? What inner resources did they use? Emphasize that strength.
Contract with the person no to do anything to harm themselves, for instance, until the morning when they can then call their counsellor, doctor or the crisis line back. Do not attempt to make a long term contract. Most caller will find it enought to handle to just think a few hours ahead.
Make appropriate counselling referrals if the caller in not already in counselling.
Remember that if the caller does choose to die, it is not your responsibility. Do all that you can, but the bottom line is that the caller must ultimately make their own choices. Emotional Blackmail is often involved - ie: "Give me a reason to live."
AFTER HAVING A SUICIDE CALL
For the volunteer - for posible guilt feelings and stress that hits after the call, always debrief the call immediately. Remember that you can call your team leader or staff back-up again during your shift for further support. You can also call staff or drop in during the office hours to discuss the impact of the call.
LOOKING AFTER YOURSELF
This is the most valuable skill you can develop for this work. If you can take care of yourself, identify and meet your own needs, you will be better equipped to support another, and you will be able to offer helpful, practical suggestions from your own experience.
The most important acitivity you can undertake to look after yourself is to find respectful, confidential ways to talk about the feelings and emotions you will invariably expereince in this work. Having trusted friends, family members or colleagues is critical. Look to your colleagues in training for sources of support as they will look to you. This should seem like sound advice - it is the same thing you would recommend to a person who has survived violence.
SUICIDE DESPITE INTERVENTION
There is always a limit to what we can do.
Don't blame yourself. Are you looking for magic solutions? Do you want control? Sometimes there is nothing you can do, or could have done.
Get your own support.
The final decision belongs to her. We give women options, including the option to die (a way out). We intervene and try to help her look at all of the options and to shift. But the final decision to shift or not, is not ours.
