First aid for Depression: On suicide, and how to help a suicidal person.

1. Ask about suicide

2. Listen non- judgeementally

3. Give reassurance and information

4. Encourage the person to get appropriate help

5. encourage self-help strategies

STEP 1: Ask about suicide

Suicide accounts for less than 1 percent of all deaths but nearly two thirds of them are linked to depression. Approximately 320 Welsh people of all ages and from all walks of life die by suicide each year. They leave behind friends, families and whole communities who can be deeply affected by the loss of their loved ones. A person can feel so overwhelmed and helpless that the future appears hopeless.They may think suicide is the only solution. Depression is a major risk factor for suicide, although not everyone who attempts suicide is depressed. If you think someone may be having suicide thoughts, work through the steps below:

How to assess the risk of attempted suicide

1. Engage the person in serious conversation about in the way they are feeling:

For example, you may ask if they are ‘ experiencing a crisis or if something distressing has occurred in their lives. Are they feeling hopeless or helpless?. Have they withdrawn from their usual activities? Have they started risk-talking behavior? Let them describe how and why they are feeling this way. Be aware of any cultural and social contex that may have an impact on why the person is feeling this way now. Particular look for signs that the person has experienced or is experiencing loss that they feel significantly lessens the value of their life.

2. Identify if the person is at risk. Ask them ‘ are you having thoughts of suicide ?’

Contrary to common belief, this type of question does not encourage people to pursue suicidal behaviour. Rather, it signals that you care, that you realise they may be considering suicide and that you are ready to talk with them about it, The opportunity to discuss the feelings and emotions surrounding thoughts of suicide is often a graet relief to people. If the person says they having thoughts of suicide,give them time to say why they want to die. This can help them here their own reason out loud for the first time, and give room for ambivalence to emerge and be recognised.

3. Explore and asses how high the risk is. Try to gather information about how prepared they are to attempt suicide:

• Have they they thought about how they would do it?
• Have they collected the things they need to commit suicide?
• Have they planned when they would do it?
• Are there times when the pain feels unbearable?

4. Find out about their supports. If people feel totally alone and without any resources then they are greater risk of attempting suicide:

ASK THEM:

• What resources do they have to support themselves?
• Who do they think they could turned to for help?
• Have they made arrangements for when their are dead? e.g (canceling g deliveries, sending pets away)

5. Try to find out about theirprior behaviour. People are at greater risk of completing a suicide if they have attempted suicide in the past or have displayed risk-taking behaviour. Try to find out:

• Have they attempted suicide before?
• Are they receiving or have they received mental health care?
• Try find out if they have a Mental Health Crisis Card. Advanced  statements or crisis plans. ( Some people carry them in case of an event of a emergency) They could give you important information about who they would like you to contact, and may identifying what to or not to do.

Any communication of distress should be taken seriously:

If you believe a person is at risk in harming their self , call an emergency service, and do not leave them until other sources arrives.

1. How to help a suicidal person:

• Ensure your own personal safety:
• Do not get involved physically if the person is distressed and threatening:
• Call for assistance:
• Observe from a safe position, until help arrives:

2. Ensure the person is not left alone:

• Stay with them if you think there is a big risk:
• Ask them if they would like you to contact anyone:

3. Seek immediate help:

• Refer to anyone trained in ASIST:
• Phone their GP and ask for an emergency home visit:
• Call 999
• Call NHS Direct 24hr help line ( numbers on other pages)
• Pass on any further information that you have gathered about the level of the persons risk:

4. If the person is consuming alcohol or drugs, try to discourage them from taking any more.

5. Try to ensure that the person does not have ready access to some means to take their life without putting your own safety in danger.

6. Encourage the person to talk:

• Listen without judgement:
• Be polite and respectful:
• Do not deny the persons feelings:
•  Do not try and give advice:

Don,t keep planned suicide a secret, even if they have asked you to, friendship can be mended later:

Next page to follow is, what to do if you believe someone has taken a overdose.