How to start a conversation with a young person about self-harm or considering suicide

How to start a conversation with a young person about self-harm or considering suicide

Self-harming tends to be secretive and often associated with guilt and embarrassment. This can present challenges when trying to approach the subject of self-harm with a young person.

• It is important that the adult checks their own feeling and thoughts before asking any questions. If the feelings and thoughts are negative in anyway, they will be communicated to them non-verbally and this may hinder the helping process.
• It is important to young people to have someone to talk to who listens properly and does not judge.
• Resist the temptation to tell them not to do it again, or promise you that they won’t do it.
• Take a non-judgemental attitude towards the young person. Try to reassure the person that you understand that the self-harm is helping them to cope at the moment and you want to help.

When adults are concerned that a young person is self-harming, they often worry about saying the wrong thing and making the issue worse. The following approaches may help alleviate some of this concern:

• See the person, not the issue, talk in a genuine way.
• I’ve noticed that you seem bothered/ worried/preoccupied /troubled. Is there a problem?
• I’ve noticed you have been hurting yourself and I am concerned that you are troubled by something at present.
• We know that when young people are bothered/troubled by things, they cope in different ways and self-harm is one of those ways. Those who do this need confidential support from someone who understands issues in relation to self-harm. Unfortunately I don’t have the skills to help, but I would like to help you by asking (insert name of person e.g. counsellor) to see you. Would you agree to this?

Helpful language when talking about suicide

If someone is considering suicide, talking to someone who can listen and be supportive may be their first step towards getting help. They could talk to someone in their life. They could also talk to a professional such as a doctor or therapist, or a trained listener at a helpline.

If someone talks to you about self-harm or suicide it could help if you:

• Ask open questions
  Don’t ask questions with a ‘yes’ or ‘no’ answer, ask open questions such as ‘How are you feeling?’
• Give them time
  While you may feel anxious to hear their answers, it helps if you let them take the time they need.
• Listen to them
  Listening to how someone is feeling can be helpful in itself.  If they are finding it difficult, let them know that you are there when they are ready
• Take them seriously
  People who talk about suicide do sometimes act on their feelings — it’s a common myth that they don’t. It’s best to assume that they are telling the truth about feeling suicidal.
• Try not to judge or make assumptions
  When a person says that they have been considering suicide it may make you feel shocked, upset or frightened, but it’s important not judge how the person is feeling. Talking about this to you may well be a big step for them.  Try not to assume you know what may have caused the feelings or what may help them.
• Don’t avoid the topic
  There is a taboo about talking about suicide.  This can make it even harder for people experiencing these feelings to open up and feel understood. Direct questions about suicide like ‘Are you having suicidal thoughts?‘ or ‘Do you feel like you want to end your life?’ can help someone talk about how they are feeling.

When taking about an attempted suicide, more supportive language includes:

• Attempted suicide
• Attempted to take their life
• Engaged in suicidal behaviours
• Acted on thoughts of suicide

When discussing suicide, more supportive ways of discussing a person’s death includes:

• Ended their life
• Killed themselves
• Took their own life
• Died by suicide
• Suicided

Unhelpful Language when talking about suicide

Be mindful of your language when talking to a young person about suicide.  Some language can be unhelpful, may make them withdraw from talking to you about concerns and may make things worse.

Don’t ask someone “You are not thinking of doing something stupid/silly are you?”

This language is very judgemental and trivialises how a person is feeling and may make them feel worse.  When faced with this question, people will be less likely to talk to you about what they are going through for the fear of being viewed negatively and you may be viewed as someone it is not safe to talk to about suicide.

Saying someone is “intending to commit” or “has committed suicide”

Suicide has not been a crime since 1961 and using the word ‘commit’ perpetuates stigma or the sense that it is a ‘sin’. Stigma makes people feel less likely to talk about their thoughts of suicide if they feel judged.

Saying someone’s suicide was “successful”

When a young person takes their life, saying it was a successful suicide is not helpful. If someone dies by taking their life it cannot be considered success.

Saying someone was “Unsuccessful” or “failed suicide”

In the same way that you would not refer to someone taking their own life as a “successful suicide”, you should not refer to attempted suicide as “unsuccessful” or “failed”. Any attempt at suicide is serious and anyone who has attempted to take their own life should not feel further pressure by the negative view of ‘failure’, as this may reinforce feelings of failure in other areas of their life.

“It’s not that serious”

All suicide attempts must be taken seriously as there is a serious risk to life. Any attempt by someone to take their own life shows that they are in so much pain they no longer want to live.

“Attention seeking”

This phrase assumes that a person’s behaviour was not a true attempt at ending their life, and that they are being dramatic to gain attention from others. However, suicidal thoughts are serious. Anyone who attempts to take their own life needs attention, support, understanding and help.

“It was just a cry for help”

This dismissive phrase which belittles someone’s feelings and their need for understanding, help and support. If a person is considering suicide they are in pain and their life is in danger.  Saying it is a cry for help trivialises their feelings and shows that they are not being taken seriously, which can be dangerous.

Questions you could ask

• Are you having thoughts of suicide/killing yourself?
• What is happening for you?
• Is this affecting you?
• What help do you need?
• What would you like to happen next?
• Do not be afraid to talk about self-harm and suicide.
• Respond in a non-judgemental way if a child/young person discloses they are self-harming or thinking of suicide.
• Do not just focus on the self-harm or suicidal intent; consider the underlying issues.
• Be clear about your own organisational policies.
• Refer on for support or speak to a specialist for advice if you are unsure about the level of risk.
• Work with other professionals to ensure relevant information is shared when appropriate.
• Remember you can play a part in keeping children/young people safe.