An older member of my family is hinting at suicide.

August 13, 2006 7:06 PM

An older member of my family is hinting at suicide.

I don't believe there is an immediate risk today or tomorrow but it's been hinted at very clearly, more than once, that suicide has been considered. I don't want to pick the comments apart here, let's just say I believe this is a credible threat, given this family member's general depression and defeatist attitude toward life.

I discovered a book about assisted suicide techniques in the house, for example. When I asked her about it, she brushed it off as wanting to be prepared in the event of a wasting disease, etc. However the book was dog-eared and filled with handwritten notes. Very unsettling.

Here's my question: what do I do about it?

There are lots of things I can do to brighten her day and make her life more worth living, but I'm also thinking that this should be treated directly as a mental health concern as well. You can't prevent someone's suicide by just bringing them flowers and telling them jokes. It seems like some kind of treatment or intervention is called for. What are the options?

Compounding the problem is that this person is notoriously impossible to bring before any kind of health practicioner. Will only see a doctor when absolutely necessary, utterly refuses things like massage...

She is also notoriously clammed-up about her own personal issues and refuses to talk about family issues with me. I think it's incredibly unlikely that she would consider seeing a counselor.

Let me repeat that: it's incredibly unlikely that she would willingly consider seeing a counselor

She's middle-aged, fwiw.

So what can I do? How do you "get" someone into counselling? Are there resources I can consult or tactics I can use? Anybody been through this?

Private responses can be sent to [e-mail]

posted by anonymous to human relations (11 answers total)

You can "get" them into counselling by getting them committed against their will. Call a suicide hotline number and tell them the situation. They can direct you as to what to do. The other thing you might be able to do is to call their physician.

Someone that is a threat to themselves can be held against their will--usually three days while a thorough exam can be done.
posted by 6:1 at 7:33 PM on August 13, 2006

www.suicidehotlines.com
posted by 6:1 at 7:36 PM on August 13, 2006

It's unclear how frequently you see this person based off your message, but make an effort to spend more time with them. Do some activities together -- a dance class, book club, wine club, whatever -- that give her the opportunity to make more friends and stay active. If she's active, not lonely, and feels a strong connection with you, it might be easier to address the root of the problem without more drastic steps like forced counsellling.
posted by sixacross at 7:52 PM on August 13, 2006

Also be aware that anyone who is somewhat sane, but against therapy might take being committed as a hostile act on your part (which it is). If they aren't drowning in emotions, and can be sane for 3 days, and lie their way out of being committeed, you are going to look REALLY bad in their eyes. From there if they go downhill and do go through with it, it will be harder/almost impossible to recommit them.

I wouldn't even THINK about forcing them to do anything unless they are alot more serious, and will stay that way through an eval.

I would contact a local suicide hotline and explain your issue, and see what they say honestly. I dont think getting them to go out and do things with you is really going to help all that much. Get in touch with a professional
posted by SirStan at 8:38 PM on August 13, 2006

She's made credible threats of suicide; that alone should be taken seriously by making the call suggested above. A mental health professional can be dispatched to evaluate her, and if she's deemed an imminent danger to herself or others, there are things that can then be done to help -- with or without her cooperation.

In the meantime, be cautious about jumping to conclusions based on the current evidence. She's been taking notes on assisted suicide. This implies that she could be contemplating something different than what you have in mind. Maybe she's enlisted a friend to assist in her suicide. Or maybe she's planning to assist a friend with their own suicide. Or maybe this sudden interest in "preparing" for a wasting disease is because she's become worried that one is imminent. Or -- let's hope -- maybe she's just writing a story that has an assisted suicide plotline. The point is, if her intentions are different than what you envision, there's the real danger that your attempt to help could either backfire or leave an opening for the real plan to be carried out. Call for help, but do be clear with the counselor about what you know vs. what you've assumed. It'll be important information when they talk to her and try to evaluate her state of mind.
posted by nakedcodemonkey at 9:03 PM on August 13, 2006

"I believe this is a credible threat, given this family member's general depression and defeatist attitude toward life....Compounding the problem is that this person is notoriously impossible to bring before any kind of health practitioner. Will only see a doctor when absolutely necessary, utterly refuses things like massage... "

Lots of people prefer to be private and as self-reliant as possible. Not seeing a doctor except when it's necessary is pretty typical for the older generation, especially if they grew up poor or during the Depression (the economic one, not a psychological one).

So is skepticism about massage. Are you offering to massage her yourself? I wouldn't want a relative massaging me, and I might be reluctant to see a professional masseuse -- massage sounds great, but I don't enjoy getting naked and having strangers touch me. And if "things like massage" include "things like" acupuncture or Reiki or crystals or macrobiotic diets, maybe your older relative thinks you're a flake.

In any case, it doesn't sound like you have a close relationship with her, which would explain her brushing you off. And if you think she has a "defeatist attitude toward life", maybe she finds you judgmental.


"She is also notoriously clammed-up about her own personal issues and refuses to talk about family issues with me."

So, she doesn't want your massage or your advice. Just because she isn't comfortable confiding in you doesn't mean she doesn't confide in someone. And "notorious" makes it sound like there's an existing conflict between you and your relative. Maybe, sad to say, she just doesn't like you, or sees your solicitude as the work of a busy-body.

Regardless, she wants to live her own life (or end it). That's her right, not yours. Offer support, but if she doesn't want it, it's none of your business.
posted by orthogonality at 9:33 PM on August 13, 2006

An opinion from the other side:
"The thought of suicide is a great consolation; one can get through many a bad night with it."

From a semi-suicidal person, and yes I am in therapy, and no its more suicidal ideation than anything most of the time. Having recently gone thru a rather turbulant month between my depression plunging and the situation I was in and being diagnosed as borderline personality as well, I have probably come closer to "catching the bus" as they say than ever in my life (33). I am not one to do things wrong. I have been prepared for the last six months. I get things done the first time and my therapist knows it. She told me at one my first sessions that it was my choice. (strange answer huh) and that having those feelings were ok to have,(she validated my feelings which I personally struggle with) HOWEVER She made me promise before I self harm myself that I call her. And nodding my head wasnt good enough. I had to say it out loud to her that "Yes I promise I will not kill myself before I speak to her)

There was something about saying it outloud that stayed in my head. This is all still very fresh since it just been thru the last month. Even as recently as Saturday night I was perfecting my suicide note. She encourages me to get it out of my head even if it is in that form and not saying it outloud to her. What I am finding is that I still have alot of loose ends and cant seem to get the words in the right order that will give my family comfort that I am no longer in pain. I write and I cry. But then afterward I would be calmer.

My wounds are still fresh and I have miles to go, so dont think Im all fixed now. My depression is being more accurately controled now that the BPD has been dx'd. It wouldnt have mattered if anyone drug me kicking and screaming to a hospital or therapist, I would still be suicidal. I had to come to a point that I reached out for help. Talking to you and leaving the media around is her reaching. She needs someone to validate that she is depressed and that you arent judging her. She has every right to feel that way. If you can ask her to promise you that she wont self harm til she calls you. My therapist has had me look for one teeny tiny thing that makes choosing to live rather than choosing to die better. For me, I cant get over the pain I will add to my parents current struggles, (dad on strike, mom caring for her 93 yo alzheimers mother as she wastes away) and that children in families where one of the members suicides are more likely to commit suicide in the future. I have a neice and nephew and another on the way that would break my heart to know I passed my pain onto.

And last. You are not a therapist. It is her decision. All you can do is tell her that you love her, and you would miss her terribly, and that she matters to someone in this world (you). Have her breathe deep from her diaphram slowly.

If she goes to church there might be a counselor there that might help. Or ask her to go to therapy with you. To hold your hand. To help you work thru preparing for the loss of her. It might be a way to take the aprehension away from seeking prof help, if she is helping you and the focus is off her.

from my side... suicide is an open door, it is a way out, and that is a calming thing to know, that it is there if I need it.

"First principle: one must need strength, otherwise one will never have it."

"What does not kill me makes me stronger."

Nietchze also said"He who has a why can live .."

sorry for writing a book
posted by meeshell at 10:41 PM on August 13, 2006

it's been hinted at very clearly, more than once, that suicide has been considered

Then talking about it honestly is probably one of the best things you can do. I used to work at a suicide hotline, and we were trained to ask simple, direct questions about suicidal feelings, as in, "Sounds like you've been thinking about killing yourself." It's a way to begin a process of talking about the despair that you say is "very clearly" being hinted at -- a despair that friends and acquaintances may be quickly dismissing (out of their own uncomfortableness with suicidal thinking) with unhelpful statements like "Oh, it's not so bad" and other similar peppy nonsense.

Often, allowing the suicidal person to see that you're not freaked out beyond belief at the idea that they're thinking of killing themselves is just the thing to get them talking about what they're feeling, and perhaps put the idea aside for a while.

I believe this is a credible threat

One thing that might help gauge the level of the threat is asking if she's thought about *how* she'd commit suicide. It sounds horrible, I know, but finding out if there's any kind of specific plan or preferred method can go a long way towards determining how serious the person is about suicide. If they do have a plan, find out how far along it is: Do they have the pills on hand? Is the gun loaded? Have they thought about who'd find them? Etc. Again, just talking about it honestly and openly can go a long way towards helping the suicidal person through the current bad time, and maybe even get them to understand that professional help of some kind is warranted. Don't worry that you'd be putting ideas in their head; that's not how it works.

[Caveat: I'm not a professional counselor, but was a volunteer at a suicide/mental health hotline for five years during the mid-90s.]
posted by mediareport at 10:50 PM on August 13, 2006

Oh, also, at the end of an honest conversation about suicide, try getting her to agree to a simple contract that she'll call you, no matter what time it is, before actually doing anything to kill herself. If you've built up trust by honestly listening to her suicidal feelings, you can actually agree on something that has some value as a prevention tool. Just a simple, "Ok, will you agree to call me before doing anything to hurt yourself?" can be very helpful.
posted by mediareport at 10:55 PM on August 13, 2006

"Very unsettling. "Here's my question: what do I do about it?"

You need to talk to someone -- counsellor/Doctor -- about this situation. It may be best if you go with another family member, if you are in tune with them.

I suggest this because I have about 20 questions to ask about your middleaged female relative's life and I guess the first would be 'What do you really know about her life?' I could go on but the point is that this is a subject which needs to be discussed and I have no idea about the quality of your judgment of behaviour/cues you have witnessed let alone the extent to which you are involved in your relative's life.
posted by peacay at 12:59 AM on August 14, 2006

I dunno...You say she is tight-lipped, especially on personal matters. Seems to me, any intervention on your part may be seen as a severe invasion of her privacy and cause her to withdraw (or, at least, close up) even more. When a person gets as far as even contemplating suicide, they are in one of the most personal and private places within themselves...and it's an extremely fragile place. Can you imagine contemplating such a personal action and suddenly being discovered / outed / confronted?

Tread lightly and make sure you are making the right decisions.
posted by Thorzdad at 8:48 AM on August 14, 2006