Suicide prevention

We all have a role to play in preventing suicide.          

If you are supporting someone within your professional role, the advice in this guidance should be applied alongside organisational and professional guidelines. Different staff groups will have different levels of responsibility in terms of understanding and responding to risk. If in doubt, always seek advice from a manager or safeguarding lead.          

If you are a volunteer, you may feel unsure about your role in supporting someone who is talking about suicide. It is important to talk this through with your volunteer co-ordinator or support worker from the organisation you are working with.           

Recognising the signs

It is not always easy to recognise the signs that someone might be having thoughts of suicide. However, evidence suggests someone may be feeling suicidal if they:          

• express feelings of hopelessness
• talk about wanting to ‘end it all’
• talk about their death or wanting to die
• talk about settling their affairs
• talk about being a burden to their loved ones
• talk about their self-harming

Self harm

People often self-harm to regain control of their situations, emotions or thoughts. Self-harm can involve cutting parts of the body, burning, scratching, picking skin or pulling hair. Some ways of self-harming are not always obvious: for example, older people may neglect their nutritional needs or wear ill-fitting slippers or shoes. It is often assumed that people who self-harm are suicidal, but for many people it is actually a way of coping or surviving. However, many people who take their own life do have a history of self-harm, so it is important to take this seriously as a risk factor for suicide.          

Questions to ask

If you recognise some of the signs above and feel concerned about the person you’re supporting, start a conversation about suicide to explore whether the person has a plan to harm themselves. It is a good idea to use direct questions to do this, so that there is no confusion and the person understands you are asking them about suicide and nothing else.          

It is completely understandable to feel anxious about asking someone about suicide. However, there is no evidence to suggest that bringing it up in conversation will encourage them to act on their thoughts.           

Use questions such as:          

• are you having suicidal thoughts?
• have you thought about how you would end your life?
• how are you coping with what’s been happening in your life?

Exploring causes and things that could help

Many people who have attempted or died by suicide have talked to someone about feeling suicidal or hopeless before acting on these thoughts. If someone talks about killing themselves, always take it seriously. Although it’s understandable to want to immediately jump in with solutions, allow the person to express their feelings first:          

• reassure them that they are not alone and that you can look for support together
• avoid making promises and be realistic about what you can and can’t do
• don’t worry too much about saying the ‘wrong’ thing; what’s most important is that you are listening and showing that you care

It is unlikely that you will be able to make their feelings go away, but you can help by encouraging them to see that there are some things worth living for. Talk to them about anything that might cause their suicidal feelings, and explore ideas of things that could help in these situations:           

• what have they been doing that helps?
• do they have a friend or family member they can talk to about how they feel?
• what are they doing that stops the suicidal feelings from getting worse?
• what doesn’t help?
• what do they feel would help right now?

Listening skills

Active listening uses skills that help to build trust and connection with the person you are supporting. It will also help you to give them your full attention and help create the space to talk about how they feel. To listen actively:           

• focus on the other person. Try not to talk about yourself and your own experiences
• have patience. Give the other person time to talk about how they feel. Try to make sure they don’t feel rushed
• ask open questions to explore the other person’s feelings. Open questions are questions that need more than a yes/ no answer, such as: “What happened next?” or “How did that make you feel?”
• say it back to check you’ve understood what is being said. Try to use the words they have used
• if you can, stay in touch with the person you’re supporting. Make a plan to check in with them the following week or in the next few days
• don’t be put off by a negative response. The other person might not feel ready to talk about how they are feeling, and this is okay

Language

Try to avoid using the phrase ‘committed suicide’ as this suggests suicide is a criminal offence. Likewise, avoid talking about people ‘threatening’ suicide as this assumes they are attention seeking. People who are suicidal genuinely feel as though they have no other option and often just need space to talk about how they feel.          

Adults

Safeguarding adults refers to the plans for protecting adults at risk from abuse or neglect. If the person you are concerned about is over the age of 18, has care and support needs (for example, they need extra help to live independently, through having support at home or with educational or social needs), and you feel they are being abused or are at risk of abuse from another person, you can seek help.          

Wherever possible, involve the person at risk in decisions about reporting a safeguarding concern. If this is not possible, you may need to act in their ‘best interests’ because they do not have the mental capacity to decide this for themselves. There are also occasions when you may need to report the concern without their permission, for example, it is in their vital interests, other people are also at risk, or the person is unable to consent because of coercion or duress.          

To report abuse or seek advice, call Adult Social Care on 0113 222 4401. For further information, see the Leeds Safeguarding Adults Board website.          

Children and young people

For an explanation of safeguarding principles and procedures when working with young people under 18, please see Mindmate's ‘Supporting young people who self-harm or feel suicidal: A guide for professionals in Leeds working with young people aged 25 and under’.          

Supporting someone who is suicidal can be difficult and may affect how you feel and cope. Remember to look after yourself and your own mental health too.          

It is important to talk through any difficult conversations you’ve been having and check in regularly with your volunteer co-ordinator/ supervisor as well as the other people you volunteer or work with. Talk to your organisation about getting additional support, especially if you feel this is getting too much for you and affecting your own mental health.          

MindWell has information on mental health support, including self-help guidance and resources.          

Help from the NHS

Suggest the person talk to their GP. GP practices are still open and offering appointments by phone or video call.          

If the person needs urgent care but their situation is not life threatening, they can ring NHS 111 (open 24 hours every day).          

If the person has seriously injured themselves or has already tried to end their life (for example they tell you they have recently taken an overdose), encourage them to call 999 and ask for an ambulance, or do this on their behalf.          

If the person you are supporting has a plan to attempt suicide or they tell you they have attempted suicide in the past, and they can’t or won’t call NHS 111 by themselves, tell your supervisor/ volunteer co-ordinator or clinical lead.           

Signposting to support

You can signpost to useful services that offer support:          

• NHS 111 - dial 111 or visit 111.nhs.uk and select the option for mental health support at any time
• Connect Helpline offers emotional support to people in Leeds every night 6pm-1am, 0808 800 1212 (free phone)
• Dial House is a place of sanctuary for people (16+) open 6pm–1am every Wednesday, Friday, Saturday and Sunday evenings. Visitors can access Dial House when they are in crisis, relax in a homely environment and have an hour of one-to-one support from the team of Crisis Support Workers. If you wish to visit, call 0808 800 1212 or text 07922 249 452
• Here for You (Touchstone): Out of hours support in a safe space – Here For You is open every day of the year for anybody aged 16 years or older, who is struggling to cope or experiencing thoughts around suicide or self-harm. We offer face-to-face confidential support which is free to access without the need for GP or hospital referral. To visit, call 07760 173 476 between 3:30pm and 9pm
• Samaritans provides space to talk, 116 123 (free phone, open 24 hours every day)
• Leeds Suicide Bereavement Service provides support to anyone bereaved or affected by suicide, 0113 305 5800
• The Mindwell website contains useful advice around accessing crisis services
• further support around issues which may have led someone to feel that they are struggling is listed on this resource (PDF)