All in the Family

Mental Illness and Caregiving Across the Generations

What to Do When Someone Is Suicidal

One family’s loss is a lesson for us all.

What do you do if your young adult daughter tells you she’s thinking about killing herself?

This was the issue facing 19-year-old Madison Holleran’s parents James and Stacy in December. “We knew she needed help. She knew she needed help,” her father told the New York Post.

The University of Pennsylvania freshman’s parents did what they thought was right. They talked with Madison. They encouraged Madison to make an appointment with a therapist who could prescribe anti-depressant medication. They suggested she take time off from school. Even as her father was driving Madison back to Penn on January 11, he told her he’d support her decision to transfer schools if she wanted. He offered to drive her to Chapel Hill so she could look at the University of North Carolina.

I probably would have done the same thing.

But Madison said she’d made plans with a friend in Philadelphia that she needed to keep. Even once Madison was back at school, her father stayed in contact with her, texting often.

On January 17, the beautiful track star from New Jersey plunged from the roof of a parking garage, killing herself.

Suicide has no demographic boundaries, affecting people regardless of their gender, race, socioeconomic status, culture, or religion. According to the American Foundation for Suicide Prevention1, approximately one million people attempt suicide each year. In 2010, the most recent year for which data exist, 38,364 Americans took their own lives; that’s one suicide every 13.7 minutes. Suicide is the 10th leading cause of death among all Americans and the third leading cause of death among people Madison’s age (15-24 years)2. Unlike many other leading causes of death, the number of people who commit suicide grows each year.  

Risk factors for suicide exist. 90% of people who die by suicide have a potentially treatable mental disorder at the time of their death—a disorder often unrecognized and untreated. Other risk factors include a previous suicide attempt, family history of attempted or completed suicide, history of trauma or abuse, and chronic pain or serious medical condition. Stressors such as losing someone close, financial loss, trouble with the law, and bullying can make people susceptible to suicide.

Like Madison, people who die by suicide usually show some indication of immediate risk before their deaths. Madison told her parents she was thinking about killing herself. Other warning signs of suicide include feeling hopeless, trapped, desperate, humiliated, and losing interest in things. Madison had lost confidence in academics and in her track abilities. Some people develop insomnia, isolate themselves from family and friends, and become irritable.

“Was there anything else Madison’s parents could have done to help her?” I asked my friend. She understands suicide. She’s a mental health practitioner who, years ago in the throes of desperation, swallowed too many pills. Luckily, she survived.

“Absolutely,” she said. “If a person is threatening, talking about, or making plans to commit suicide, it’s a crisis requiring immediate attention. Madison needed hospitalization; a safe environment, until she no longer had suicidal thoughts. Her depression needed to be aggressively treated and that can’t be done on an outpatient basis.”

“What if there’s no hospital bed available? Look at the disaster that ensued when Virginia Senator Deeds tried to get his suicidal son hospitalized.”

“Then you put the kid on suicide watch for 24 hours and don’t let her out of your sight.  Depression has gotten too serious by the time someone starts talking about suicide.”

What my friend said made sense. It’s also consistent with what the American Federation for Suicide Prevention recommends. According to its website, 50-75% of people who attempt suicide tell someone about their intention. If someone shows the warning signs, they must be taken seriously.

But most parents are like James, Stacy, and me. They don’t know what to do when someone talks about suicide3. Moreover, a large study of suicide intervention skills of community and health professionals found that new volunteers at a suicide crisis line, pharmacists, and psychology students also didn’t know how to respond to people talking about suicide and that general practitioners, hospital nurses, and police had levels of knowledge that were barely acceptable4. Only community mental health center staff and experienced volunteers at suicide crisis lines knew the appropriate responses.

Now you can know too. If someone you know shows the warning signs of suicide:

  • Tell the person you’re concerned about him/her.
  • 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.
  • Ask if the person is seeing a doctor or taking medication. If so, encourage them to contact the treating physician immediately. Offer to go to the appointment with the person. If not, help them find a mental health professional and make an appointment or take them to a walk-in clinic at a psychiatric hospital or a hospital emergency room.
  • Don’t argue someone out of suicide. Let the person know that you care, that they are not alone, and that they can get help. Don’t say things like “You have so much to live for” or “If you kill yourself, it will hurt your family.”
  • Call 911 or the National Suicide Prevention Lifeline at 1-800-273-TALK (8255).
  • Do not leave the person alone.

At Madison’s funeral, her father urged the congregation to learn from his loss. The lesson for us is that we can take action to prevent a suicide.

No parent should have to live with the legacy of a child’s suicide. Share this blog with a friend. Maybe you’ll save someone’s life.

 

  1. https://www.afsp.org/understanding-suicide
  2. http://www.cdc.gov/violenceprevention/suicide/
  3. S. Maine, R. Shute, & G. Martin (2001). Educating parents about youth suicide: Knowledge, response to suicidal statements, attitudes, and intention to help. Suicide and Life-Threatening Behavior 31 (3), 320-332.
  4. G. Scheerder, A. Reynders, K. Andriessen, & C. Van Audenhove (2010). Suicide intervention skills and related factors in community and health professionals. Suicide and Life-Threatening Behavior 40 (2), 115-124.

Rachel Pruchno, Ph.D. is Endowed Chair and Professor of Medicine at Rowan University School of Osteopathic Medicine. Her memoir Surrounded by Madnessis available at online bookstores.

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