Vitamodo School · Bundle 2: Suicide Recognition & Prevention · Brochure 2 of 10 · Version 1.0
Andris Saulitis, MD
If you are yourself currently considering suicide, this brochure is not the right place to start. Please reach out to a crisis line or emergency service now.
Latvia: 116123
European Union: 112
United States: 988 (Suicide & Crisis Lifeline)
United Kingdom: 116 123 (Samaritans)
For other countries: findahelpline.com
For those who: are about to have, or have decided to have, a direct conversation with someone they fear is at risk, and want to know how to hold that conversation well.
Not for those who: are themselves at risk — see the crisis lines above and reach out before reading further.
What this is — the clinical reality
This brochure is about a single specific event: a conversation in which you ask someone whether they are thinking about suicide. The conversation may last twenty minutes or two hours. The person may answer yes, no, or somewhere in between. The conversation will not, on its own, solve the underlying crisis. What it will do, more reliably than any other intervention available to you, is interrupt the constriction the person has been inside of. The interruption is what allows everything else.
Most helpers approach this conversation badly — not because they are uncaring, but because they are anxious. The anxiety produces three predictable failures: the question is asked too indirectly to produce a real answer, the question is asked too aggressively and triggers defensiveness, or the question is asked successfully but the helper does not know what to do after the answer arrives.
Three things you need to know about the conversation itself.
The first is that the opening matters more than the words you use. The opening is about presence, not phrasing. The person can read, within seconds, whether you are calm, whether you have time, whether you can hear what comes next. They are deciding, in those first moments, whether to let you in. If you arrive rushed, or distracted, or already speaking before you have sat down, they will say what they have been trained by life to say: "I'm fine."
The second is that the direct question must come, and it must be specific. Indirect questions — "how are you really?" or "is everything okay?" — rarely produce a real answer. The mind in constriction is already keeping the topic away from speech. A general question lets it stay there. The specific question — "Are you thinking about ending your life?" — does not let it stay there. The question may be uncomfortable to ask. It is what works.