According to the Mental Health Foundation, 4,400 people in the United Kingdom end their life by suicide each year (at the time of writing, August 2014). Between 2003-2013, 18,220 people experiencing mental health issues in the UK took their own lives. Simply put, one person deliberately ends their life every two hours.  Alarmingly, at least ten times more people attempt suicide.

If you’re a family member caring for someone who feels suicidal, these statistics will feel particularly upsetting, but there are steps you can take to support a loved one experiencing suicidal thoughts.

Understanding Suicidal Thoughts

The reasons for suicide are many. The public’s perception of why people take their own life is largely incorrect, anecdotal and adds to a family’s reluctance to seek help during times of crisis.  People usually commit suicide because their emotional pain has become too severe for them to manage. They are unable to think of a positive solution to overcome their difficulties. Over time, despair escalates to the point that ‘not being here’ makes perfect sense to them.  The antecedents to this assumption may be depression, bereavement, battles with addiction and so forth.  Each person’s circumstances may vary, but all share the common view – but erroneous assumption – that life has become unmanageable and will not improve.

It’s easy for bystanders to recognise that the suicidal person’s perceptions are skewed, but to the desperate individual, their plan is often viewed as a personal victory.  They have found a way out.  When an individual’s thoughts or psychological schemas have developed in this way, urgent mental health assistance is required.

While it is always the decision of the individual whether or not to kill themselves, mental health services MUST respond to calls for assistance from vulnerable individuals who find themselves in crisis. Timely intervention often reverses suicidal ideation.

It is important that if you are living with a partner, child or family member who is descending into suicidal thoughts that you are able to obtain help and quickly.

Preventing Suicide in a Mental Health Crisis – Advice for Family and Friends

These four steps can be taken when you’re supporting a loved one in crisis:

1. The first step is to visit your GP. Request an urgent appointment. Be assertive, be polite but be firm. Once with your doctor, it is important to request an urgent psychiatric referral. In reality an urgent referral is usually not a fast enough response for an imminently suicidal patient. Even where medication is prescribed, often symptoms get worse before they get better. Family members need to be vigilant and get additional help quickly if needed (see points 3 and 4).   An appointment for a STEPPS referral is never an appropriate stand-alone intervention for a client actively considering suicide.
2. If a referral cannot be secured quickly, consider a private consultation with a consultant psychiatrist or chartered psychologist. There are a number of private hospitals and clinics that are able to offer appointments quickly. Do check the credentials of clinicians especially to ascertain they are registered with the appropriate regulating bodies.
3. If symptoms worsen, go to your nearest A and E in the day or night. There will be an on-duty mental health crisis team.
4. If you are concerned about threatening of violent behaviour to self or others, call the police. It may result in the individual being sectioned, but this will also result in fast treatment that may save a life.

It is important that the family of a suicidal patient recognise that their loved one is unlikely to have the capacity to advocate fully for themselves. In our experience, it is often a very difficult process to be fully heard by mental health services and often even more difficult to obtain treatment when in crisis.  Attention to these steps will improve the chance of recovery.

Written by Dr Chrissie Tizzard, Chartered Consultant Psychologist, BSc, MSc, PsychD, C.Psychol, C.Sci, AFBPs.  Dr Tizzard works with adults, children and families and is an experienced expert witness in criminal and family law. www.ctpsy.co.uk