Learning to ask ‘the’ suicide question

Talking about suicide is hard.

Talking about suicide with a person you think may be considering it is even harder.

“‘Are you considering suicide?’ Doesn’t really just roll off the tongue, does it?” James Gallanos, a prevention coordinator for the state, asked 60 or so people packed inside the Juneau-Douglas High School library Thursday night.

It may be awkward, but directly asking that question saves lives, said Gallanos, who gave a free training session on a suicide prevention technique called Question, Persuade, Refer. QPR’s motto is “Ask a question, save a life.”

The three Rotary Clubs in Juneau teamed up to host the training session for the public, part of a Rotary move to promote suicide awareness and prevention across the state.

“The Anchorage Downtown Rotary actually applied for and received a Rotary district grant from Rotary International to promote suicide prevention statewide, so our current district governor is from that club,” Karen Morgan, president of the downtown Rotary club, explained. “So he came and really promoted it.”

Juneau responded. Students — lured by the promise of credit in health class, and extra credit if they brought a friend — parents, teachers, Rotarians and many in the mental health field crammed into the library to learn how to be a better gatekeeper for their friends and family.

“I was surprised to see so many people here,” said Charity MacKinnon, a Rotarian who helped organize the event. “I guess for me, it just kind of reinforced that it is an issue, people understand it’s an issue, and we’re all doing our best to do something about it.”

In his two-hour presentation, Gallanos explained one of the basic principles behind QPR: Most people considering suicide send out warning signs beforehand. If friends and family are attuned to those signs, they can help by asking the person their intentions, trying to persuade them out of it and referring them to professional help.

“One myth is that confronting someone makes them angry when the fact is it really opens up a dialogue and lowers the risk of an impulsive act,” Gallanos said.

Some people give direct verbal cues as a warning sign, such as “I wish I were dead,” or “I’m going to end it all,” or “If X happens/doesn’t happen, I’m going to kill myself.” Others are more indirect. “Who cares if I’m dead anyway?”, “I’m tired of life, I just want out,” “My family would be better off without me,” are common refrains.

There are also behavior cues (a relapse in drug use, sudden interest or disinterest in religion, and sudden behavior change) and situational clues (fired from job, unwanted move, diagnosis of serious illness, loss of relationship, death of a loved one, especially by suicide).

If you recognize some of these signs and have a feeling that something isn’t right — or even if you’re in doubt — ask the question, Gallanos said. He asked audience members to practice it on the person sitting next to them.

“I care about you. Are you thinking about suicide?” each person said, role-playing.

If the person is reluctant, be persistent, Gallanos advised. Talk to the person alone in a private setting.

If you can’t ask the question directly, lead up to it. You can ask, for instance, if the person has been feeling unhappy lately. You can ask just about anything to get them to talk freely about their intentions, except, Gallanos advises, asking something like, “You’re not suicidal, are you? That’s crazy,” or something with similar negative connotations.

All in all, “how you ask the question is less important than that you ask it,” he said.

After all, what’s the harm in asking?

“The worst that can happen is that you show you care, and that’s not a bad thing,” he said.

After asking the question, Gallanos says to give the person your full attention, don’t rush to judgment, offer hope in any form, express concern (“I want you to live,” “We’ll get through it”) and ask them if they will let you help them. Then, refer them to someone or an organization that can help, which may be difficult since most people believe they cannot be helped. (See crisis information below.) Most people don’t want to die, Gallanos reminded the group. They’re just in such severe emotional pain that they’re looking for a way out. At least try to get a commitment from them that they will get help when you’re trying to refer them.

Learning exactly what to say to someone was really helpful, said JDHS senior Chantel Eckland.

“They usually say, like, ‘Oh, confront them,’ and you’re like, ‘Well, that’s really awkward.’ I think it’s great that he gave us some examples,” she said.

Rotarian and father of two Jim Scholl said he was already familiar with the warning signs and well versed on intervention before the event, but the training gave him “a better handle on it.”

“Since I have two teenagers, I’m always on the lookout,” he said.

Another Juneau parent addressed the students and begged them to be on the look out for warning signs. He said he didn’t see his own son’s until it was too late.

Don’t be afraid to ask the hard questions,” he said. “Show your support.”

Juneau Suicide Prevention Coalition member Kevin Ritchie said he hopes the training will continue.

“The biggest thing is getting through those stigmas of talking about suicide,” he said. “People can feel really uncomfortable, and you have to make them comfortable.”

■ ■ ■

Are you in crisis? If you need immediate help, call 911 or go to the E.R. immediately. If you need someone to talk to, call the Alaska Careline 24/7 hotline at 1-877-266-HELP (4357). You can also text ‘4help’ to 839863. The text line is available Tuesday through Saturday, from 3 p.m. to 11 p.m.

For more information from Alaska Careline Crisis Intervention, visit www.carelinealaska.com.

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