The Following Questions Can Help You Assess the Immediate Risk for Suicide:
- Do you have a suicide plan? (PLAN)
- Do you have what you need to carry out your plan (pills, gun, etc.)? (MEANS)
- Do you know when you would do it? (TIME SET)
- Do you intend to commit suicide? (INTENT)
Level of Suicide Risk
Low — Some suicidal thoughts. No suicide plan. Says he or she won't commit suicide.
Moderate — Suicidal thoughts. Vague plan that isn’t very lethal. Says he or she won't commit suicide.
High — Suicidal thoughts. Specific plan that is highly lethal. Says he or she won't commit suicide.
Severe — Suicidal thoughts. Specific plan that is highly lethal. Says he or she will commit suicide.
In an Acute/Imminent Crisis – call 911
How to Respond to a Potential Suicidal Service Member
If You Think Someone Is Considering Suicide:
- Trust your instincts that the person may be in trouble.
- Do not swear to secrecy.
- Do not counsel the person yourself, get professional help, even if the person resists.
- Encourage the person to continue talking and let them know that you want to help them.
- Be yourself. The right words are not as important, if you are concerned, your voice and manner will show it.
- Listen. Let the person unload despair, ventilate anger. If given an opportunity to do this, he/she may feel better by the end of the call. No matter how negative the call seems, the fact that they called is a positive sign, a cry for help.
- Be sympathetic, non-judgmental, patient, calm, accepting. The caller has done the right thing by getting in touch with another person.
- If the caller is saying, "I'm so depressed, I can’t go on", ask…
- WHO are you? Who is with you?
- WHAT is your intent?
- WHEN are you planning?
- WHERE are you?
- WHY – get them talking
- HOW are you planning to do it?
- Ask for his/her address and phone number.
- Are you having thoughts of suicide or hurting yourself?
(You are not putting ideas in his head; you are doing a good thing for him. You are showing him/her that you are concerned, that you take him/her seriously, that it is OK for him/her to share their pain with you.)
- If the answer is yes, you can begin asking a series of further questions: Be conversational, ask open ended questions to try to get them to keep talking.
- Avoid arguments, problem solving, advice giving, quick referrals, belittling and making the caller feel that has to justify his suicidal feelings. It is not how bad the problem is, but how badly it's hurting the person who has it.
- Is there someone with you right now?”
- if YES: If so, could I please talk with them? (At this point, speak to the person with the SM and express your concerns. Encourage that person to accompany the SM to a hospital emergency room.
- if NO: Is there someone I can contact who could come and be with you right now? If distance permits, “Could I come to you now?”
- Have you thought about how you would do it (PLAN)?
- What is your Plan?
- Have you thought about when you would do it (TIME SET)?
- Are you thinking of hurting yourself today?
- Have you tried hurting yourself in the past?
- Have you got what you need (MEANS)?
- Do you have pills/weapons in the house?
- How much have you been drinking lately? What are you drinking?
- When was the last time you had anything (alcoholic) to drink? Do you have alcohol at home?
- Do you take any medications, drugs or pills? If so, what kind and how much?
- Are there other drugs that you have been using to help you cope? Ie, cocaine, marijuana, meth, etc.
- If the person is ingesting drugs, get the details (what, how much, alcohol, other medications, last meal, general health) and call Poison Control at (800) 222-1222.
- Have a battle buddy call while you continue to talk to the person, or you can get the callers permission and do it yourself on another phone while the caller listens to your side of the conversation.
- If Poison Control recommends immediate medical assistance, ask if the caller has a nearby relative, friend, or neighbor who can assist with transportation or the ambulance.
- In some cases the person will initially refuse needed medical assistance. Remember that the call is a cry for help and stay with him/her in a sympathetic and non-judgmental way.
- Do you have weapons at home? If so, is there someone who can remove them?
- If they do have weapons, call the local police and explain the situation, they can remove them. (Should this go up through the COC to the TAG or is this good?)
- If you can, SAFELY, remove or secure from the vicinity any firearms, drugs or sharp objects that could be used to complete a suicide.
- Simply talking about their problems for a length of time may give suicidal people relief from loneliness and pent up feelings, awareness that another person cares, and a feeling of being understood. They also get tired -- their body chemistry changes. These things may take the edge off their agitated state and help them get through a bad night.
- Ask the individual for their address. Have a battle buddy, contact the police department using another phone line, and ask them to conduct a Wellness Check.
- If the individual will not give you the address, have a battle buddy contact the Readiness NCO, or call the service member’s cell phone company to track a location, or if imminent danger, call the police and ask to have the line traced.
Contact your chain of command who will
submit a Serious Incident Report (SIR).
- Do not go it alone. Get help during the call and debrief afterwards.
NEVER LEAVE A SUICIDAL PERSON ALONE!