Welcome to another episode of our wellness podcast. I'm Mark DeFee and with me, is KC Schroder. We're both licensed therapists who focus on workplace mental health.

We're also pretty good friends so we're gonna have a little bit of fun. Maybe tell some stories but most importantly, we're gonna give you some great information to help you develop both personally and professionally. Does that sound good? All right! Let's dive in!

So, Mark, today we are going to be talking about suicide and I know that both you and I have clinical experience working with folks who are suicidal. So today I thought it would be wonderful if we could kind of share some signs and symptoms of what to look for if you think somebody might be suicidal. And then some ways that we can support either anybody who is suicidal at the moment or perhaps somebody who you think might be suicidal. I think you're in a unique position Mark, because you did a lot of crisis work. You actually have had several experiences where you would talk to somebody who literally had the means in their hands and was thinking about dying by suicide. So maybe if you could just kind of walk us through your experience and give us some insight about some signs and symptoms to look for if we think somebody is suicidal. I think that would be wonderful.

Yeah, and I haven't done this work for probably 10 years or so but for five plus years I did a lot of telephonic crisis intervention. And so, I would be the one helping someone determine if they needed to go to an emergency room or have a welfare check performed or if we needed to get them in with a counselor. And so sometimes, it was very obvious someone would start the call by saying they were thinking of harming themselves and they were looking for a reason not to. Other times, though it would be less clear the severity of what was going on. And so whenever I was speaking with someone I was paying attention to a few different things. I always started with kind of wanting to understand their history around suicide in terms of: Have there been any prior attempts that they've made? Is there a family history around it? Have they ever been diagnosed with depression or somebody else in their family diagnosed with depression? And then of course alcohol substance use, feelings of hopelessness but also, how are they sleeping? How are they eating? And this isn't historically. It's in the last few days to get an understanding of kind of their current mindset but there was no one cause like I heard this and I had to act on it. It was really just kind of a combination of the risk factors and trying to determine: Is someone an imminent risk or do they have what is called passive suicidal ideation? So, if a bus hits me tomorrow it wouldn't be the worst thing. It is kind of that mindset. They're not actively trying but they're also "okay" if something were to happen to them and the worst place I think people would get into is that tunnel vision not being able to see any other options. I always felt good that they were calling because it means that they were looking for someone to help them find a different solution because they couldn't think of any. And this is the only thing that they had left and often it was just helping them see that there were other options outside of just choosing to take their own life that really got them to open up and talk through different ways that I could possibly support them right then. And it's interesting KC, that you and I become such close friends because I would be sending them basically to someone like yourself in the emergency department, emergency room saying they need a welfare check and possibly a 72-hour hold and that's when you would kind of take it from there. So, let me kick it back to you to hear a little bit about your experience and you know what you do to work with someone who's suicidal.

Yeah, it's a coincidence that we would basically be doing these handoffs. So you would talk to somebody on the front end I would help them with their next step. So, I worked in emergency departments for years and would do like you said some work with folks who came in, who were actively suicidal or in some cases passively suicidal and were experiencing -how you described it was perfect- that tunnel vision of where they couldn't find the hope to keep on living by themselves that they needed help to even get to that next level of hope. Like you I did this type of work a lot of years ago and a lot has changed. I think in the world especially in the US when we talk about suicide. One of the most kind of obvious changes is that there are far more children and adolescents who have that passive suicidality that you're referring to and who are actually dying by suicide now. And I think that's something that we really have to point out if we talk about suicide at all.

Suicide is now the second leading cause of death for people the ages 10 to 24. And it does take a little bit of a different approach when you're talking about helping somebody who's suicidal if that somebody is a child. But first and foremost no matter who you are working or who you are talking to who needs help. You need to arm yourself and really get support for yourself before you approach that person. Maybe that means doing some research. Maybe that's I'm talking to a therapist on your own. Maybe that's talking to a loved one or somebody that you have in common to get that support. But you need support before you approach a person who you think might be contemplating suicide. A really important piece of getting that support is understanding the next steps. If you approach somebody who you think is suicidal you need to have options. So, once you get those options, once you get that support and you approach that person you do it in a loving way. You're not doing it in a judgmental way, you're not trying to solve all their problems. All you're doing is saying: "Hey, I love you I'm concerned about you. What's going on? How can I help?" Kind of a deal. And if that someone is a child I think it's really important to make sure you're approaching them in a child-friendly way. A lot of times children might not know what you mean by suicide or what you mean by depression or what you mean by a lot of different kind of adult words. So, make sure that you arm yourself with child friendly phrases and child friendly words so that they understand your concerns. After that, I think it's really important to make sure that you remove all the dangerous items in that person's possession. Be very cognizant about their surroundings and what kind of means they might have in their surroundings. And then of course get into that professional help as soon as possible. Maybe that's a pediatrician for a child, maybe that is calling into a crisis line, maybe that's going to the emergency department. But again if you do step one which is getting that support before you approach that person you'll have an idea of your next best steps.

That's a great point and one thing I didn't mention that I feel like I did a lot of and that's putting safety plans in place for people.

Helping them understand if they did begin feeling these increased thoughts of harming themselves. What are they going to do? And you're right, it evolved a lot of removing the means to take their own life. But also who are you going to call? Have you prepped them? Do they know what's part of the safety plan? It takes a lot of coordination.

Yeah, which again going back to getting that support before you approach that person you can get help with creating a safety plan, you can get help with connecting the next steps. So, I think that's a really excellent point.

Yeah.

So, I think we could talk about suicide for two more hours, Mark. There's so much we could cover. If you do think you have suicidal thoughts for yourself or you know somebody who might be feeling suicidal, please reach out and get that support we've been talking about. An excellent resource is the National Suicide Prevention lifeline at 1-800-273-8255. Thank you and be well.