Stigma Excerpts

www.ZeroAttempts.org

14:53
9:14
Breaking the Silence
"I am not okay."

"You may feel reluctant to ask a teen if they've been thinking about hurting themselves.
You may think that asking about suicide could plant the idea. But that's not true.
Asking is alwys a good idea. Just starting the conversation helps in many ways."

Stigma Excerpts

Suicide is the 8th leading cause of death in Oregon, and the second leading cause of death for 10 to 24 year olds. Still, suicide remains a taboo topic, is highly stigmatized and is surrounded by myth and mystery.

Myth: Asking someone “Are you thinking about suicide?” or “Are you thinking about killing yourself?” will put that idea into someone's head.

What the experts say...

Studies show that asking at-risk individuals if they are suicidal does not increase suicides or suicidal thoughts. In fact, studies suggest the opposite: findings suggest acknowledging and talking about suicide "may in fact reduce rather than increase" suicidal ideation.
Source:
followupmatters.suicidepreventionlifeline.org/?_ga=2.80536272.652798766.1517774372-2041509344.1517774372#lifeline-centers

Does asking about suicide and related behaviours induce suicidal ideation? What is the evidence?

Abstract

There is a commonly held perception in psychology that enquiring about suicidality, either in research or clinical settings, can increase suicidal tendencies. While the potential vulnerability of participants involved in psychological research must be addressed, apprehensions about conducting studies of suicidality create a Catch-22 situation for researchers. Ethics committees require evidence that proposed studies will not cause distress or suicidal ideation, yet a lack of published research can mean allaying these fears is difficult. Concerns also exist in psychiatric settings where risk assessments are important for ensuring patient safety. But are these concerns based on evidence? We conducted a review of the published literature examining whether enquiring about suicide induces suicidal ideation in adults and adolescents, and general and at-risk populations. None found a statistically significant increase in suicidal ideation among participants asked about suicidal thoughts. Our findings suggest acknowledging and talking about suicide may in fact reduce, rather than increase suicidal ideation, and may lead to improvements in mental health in treatment-seeking populations. Recurring ethical concerns about asking about suicidality could be relaxed to encourage and improve research into suicidal ideation and related behaviours without negatively affecting the well-being of participants.

References

Comment in

Letter to the editor: Suicidal ideation and research ethics committees. [Psychol Med. 2015]
Letter to the editor: Suicidal ideation and research ethics committees: a reply. [Psychol Med. 2015]

Comment on

The ethics of doing nothing. Suicide-bereavement and research:ethical and methodological considerations.[Psychol Med. 2014]
Source: 
www.ncbi.nlm.nih.gov/pubmed/24998511

So, ask the question

Ask directly about suicide. Ask the question in such a way that is natural and flows over the course of the conversation. Ask the question in a way that gives you a "yes" or "no" answer. Don't wait to ask the question when the person is halfway out the door. Asking directly and using the word "suicide" establishes that you and the at-risk person are talking about the same thing, and lets them know you are not afraid to talk about it. Ask: "Are you thinking about killing yourself?" or "Are you thinking about ending your life?"

How NOT to Ask the Question "You're not thinking about killing yourself, are you?"

Do not ask the question as though you are looking for a "no" answer. Asking the question in this manner tells the person that although you assume they are suicidal, you want and will accept a denial.
Source:
www.ihs.gov/suicideprevention/howtotalk/

Start a conversation. Directly and gently ask the question, “Are you thinking about suicide?” or “Are you thinking about killing yourself?” This step can be particularly difficult for many people. Sometimes people worry if they ask if someone is feeling suicidal that they might “put the idea in their head”. Worry not. There is no research that supports this idea. Asking the question will not increase the risk of someone completing suicide. If anything the person will be grateful you expressed what they have been thinking about. Google "Know When to Get Help Suicide rarely happens without warning." Oregon Dept of Education

Do not be afraid to talk about suicide. Some cultures or families treat suicide as a taboo and avoid talking about it.[15]. You may also be afraid that if you talk to someone about suicide, you will prompt them to act on their suicidal thoughts. These factors or others may lead you to hesitate to speak openly about suicide. However, you should fight this instinct because the opposite is actually true; speaking openly about suicide often prompts someone in crisis to think about and reconsider their choices. Preventing Suicide: A Global Perspective by the World Health Organization (2014)
Source:
www.wikihow.com/Help-Someone-Who-Is-Thinking-About-Committing-Suicide

",,,the issue of suicide among young people, by inviting youth to take the lead. We recognize the need for student involvement and ideas in shaping the campaign against suicide. By engaging young adults and providing the facts, the NCPYS seeks to help those most at risk..."
Source:
www.suicidology.org/Portals/14/docs/NCPYS/UOKInfoPacket.pdf?ver=2014-08-29-142536-330

When we bravely have open and honest conversations about mental illness and suicide, we potentially make life-saving connections. Without those conversations, we only have loneliness, silence and unanswered questions. We might consider overcoming our reluctance to speak of suicide to break apart the taboo that encloses it. Until we start talking, healing cannot happen.
Source:
www.nami.org/Blogs/NAMI-Blog/November-2023/Suicide-A-Cry-for-Life

Suicide rarely happens without warning. Don’t be afraid to talk about suicide. You might save a life by talking about it. Never agree to keep suicidal thoughts or plans a secret; most important thing you can do is get help with the person. Google "Know When to Get Help Suicide rarely happens without warning." Oregon Dept of Education

Asking about suicidal thoughts or feelings won't push someone into doing something self-destructive. In fact, offering an opportunity to talk about feelings may reduce the risk of acting on suicidal feelings.
Source:
www.mayoclinic.org/diseases-conditions/suicide/in-depth/suicide/ART-20044707

Myth: Talking about suicide or asking someone if they have thoughts of suicide will encourage suicide attempts. Fact: Suicide is the second leading cause of death for young people age 15–24. Talking about suicide does not increase the risk of suicide. Rather, openly talking about fears is the first step in encouraging a suicidal person to live. That conversation can simply be asking the person if they intend to end their life. The danger is in not asking when you feel there is a risk. aix-xweb1p.state.or.us/es_xweb/DHSforms/Served/le8282.pdf (page 17)

If you suspect that your teen might be thinking about suicide, talk to him or her immediately. Don't be afraid to use the word "suicide." Talking about suicide won't plant ideas in your teen's head. Ask your teen to talk about his or her feelings and listen. Don't dismiss his or her problems. Instead, reassure your teen of your love. Remind your teen that he or she can work through whatever is going on — and that you're willing to help.
Source:
www.mayoclinic.org/healthy-lifestyle/tween-and-teen-health/in-depth/teen-suicide/art-20044308?pg=2

You may be concerned about your son or daughter, a student, or another youth. It is important to know "Are you thinking about killing yourself?" Talking about suicide does not cause suicide. If you have difficulty asking the youth about his or her thoughts, enlist another adult to help you. Or call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255) or text "SOS" to the National Crisis Text Line 741741.
Source:
www.suicidology.org/ncypys/someone-needs-help/child-youth-needs-help

Suicide Risk Assessment "Have you been having thoughts about killing yourself either now or in the past? Do you ever feel that life isn’t worth living? Have you ever wished you could just go to sleep and not wake up? Have you ever tried to hurt yourself, wishing you would die? Have you ever tried to kill yourself?
Source:
www.suicidology.org/Portals/14/docs/PreventionCourse/Presentations/Week%206%20Presos/Suicide_Risk_Assessment.pdf?ver=2016-06-27-151022-437

Don't shy away from the subject: Just talking about suicide isn't going to lead anybody to kill themselves. "We know that is just not the case," Karim said. "You will not put that idea into somebody’s head by talking about suicide." Said Oshel: "Just because you ask the question doesn't mean you’ve planted a seed in their head. It is far worse to ignore it than to openly address it."
Source: 
www.wral.com/10-things-parents-should-know-about-suicide-if-your-teen-s-watching-13-reasons-why-/16651028/

Some people (both teens and adults) are reluctant to ask teens if they have been thinking about suicide or hurting themselves. That's because they're afraid that, by asking, they may plant the idea of suicide. This is not true. It is always a good thing to ask.
Source:
kidshealth.org/en/teens/talking-about-suicide.html#

Suicide is difficult to talk about, there's no denying that. If you think someone close to you is having suicidal thoughts, you might feel reluctant to bring the subject of suicide up in case it gives them the idea to do it. This is not so. In fact, most people say talking directly about their experiences can be a huge relief, and helps them to discover other ways of getting through the pain they feel. Don't let this person carry their feelings around in silence - instead, give them a chance to release them.
Source:
www.counselling-directory.org.uk/help-someone-who-is-suicidal.html

Complex, interrelated factors contribute to suicide among AI/AN people. Risk factors include mental health disorders, substance abuse, intergenerational trauma, and community-wide issues. Be an active part of your loved ones’ support systems and check in with them often. If a they show any warning signs for suicide, be direct. Tell them it’s OK to talk about suicidal feelings. Practice active listening techniques and let them talk without judgment.
Source:
suicidepreventionlifeline.org/help-yourself/native-americans/

Don’t be afraid to ask whether the person is considering suicide and whether they have a particular plan in mind. These questions will not push the person toward suicide if they weren’t considering it.
Source:
www.psychologytoday.com/blog/all-in-the-family/201401/what-do-when-someone-is-suicidal

Many suicide attempts go unrecognized, but if you are aware of a previous attempt, pay attention to warning signs. If your friend is expressing some thoughts about suicide, it's okay to ask, "have you ever had these thoughts before?" and if so, "have you ever done anything about them?"
Source:
www.suicidology.org/ncpys/warning-signs-risk-factors

Having items close to you that you could use to harm yourself can create a dangerous situation. It’s important to remove items that you may use impulsively. What items do you have nearby that you could use to harm yourself? How can you safely remove them for the time being?
Source:
www.suicidology.org/Portals/14/docs/Resources/HandbookForRecoveryAfterAttemptSAMHSA.pdf?ver=2015-09-11-130215-527

"It is important to be straight forward," Foster said. "We say, 'Are you thinking about hurting yourself? Are you thinking about killing yourself?' ... Most of the time, asking them is going to be a relief for them. They don't have to say it. They didn't have to bring it up. You have opened the door for them to come to you because they know that you are paying attention and they know you care about them enough to ask."
Source:
www.wral.com/10-things-parents-should-know-about-suicide-if-your-teen-s-watching-13-reasons-why-/16651028/

"We know that those at risk for suicide do not necessarily want to die, but do want help in reducing the pain they are experiencing so that they can go on to lead productive, fulfilling lives. There is a lot of ambivalence surrounding the decision to take one’s own life, and by recognizing this, and discussing it, we can help the suicidal person start to recognize alternative options for managing their suffering. Often suicidal people are experiencing intolerable emotional pain, which they believe to be unrelenting. They often feel hopeless and trapped. By helping them to recognize and explore alternatives to dying, you are planting the seeds of hope that things can improve."
Source:
crisiscentre.bc.ca/frequently-asked-questions-about-suicide/

What’s the Harm in Asking About Suicidal Ideation?
Studies show that asking at-risk individuals if they are suicidal does not increase suicides or suicidal thoughts. In fact, studies suggest the opposite: findings suggest acknowledging and talking about suicide may in fact reduce rather than increase suicidal ideation.
Source:
onlinelibrary.wiley.com/doi/full/10.1111/j.1943-278X.2012.0095.x

R U OK?
It's ok to say, "I'm not ok.'

A conversation could change a life.

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