How do I help my suicidal roommate?

September 11, 2007 7:00 PM

So, one of my housemates tried to kill himself this morning. He's in the hospital, and he's going to live. Now what?

Here's the story. I got home from work this evening to learn that one of my housemates (white, male, 39 -- call him "S") tried to kill himself in the wee hours of the morning. I slept through the whole thing. The third roommate ("D") heard him clawing at his bedroom door and called 911. Apparently, "S" had taken at least 30 Tylenol-3, at least 20 Paxil, some other drugs (opiates, I believe), as well as a copious amount of alcohol. He also had tried slashing his wrists with a utility knife that broke on him, and tried to hang himself from a light fixture (and got an electrical shock from the attempt). Basically, he tried a whole bunch of things and was incoherent by the time paramedics arrived. He is now drugged up in the psych ward in the hospital.

"D" found a suicide note, which I have not read and will not read. I have learned through talking with "S"'s sister that "S" has a history of depression and alcohol abuse of which I was not previously aware, even though I've been roommates with him for more than two years. "D" also did not know. "S"'s father was a depressive alcoholic who killed himself, which we also just learned. The whole family has problems with drink and depression. I understand this all too well on a personal level.

So. The sister has been told; she's the closest family member in town. The sister told his ex-girlfriend, who may have been the trigger; she broke up with him yesterday after several months in a foreign country. "S" is also recently unemployed, learned that his mother has cancer and his grandmother is dying, lost his car due to a catastrophic mechanical breakdown, and a couple of other things.

We're in British Columbia. "S" is likely to be in hospital for at least a few days, but medical expenses are not an issue. Neither "D" nor I can be around 24 hours a day when he gets out -- we are guys in our 30s with jobs. I am concerned that he may try again. Or burn down the house. Or worse.

Short term, he can't stay here alone. Long term, I'm not sure that he can stay here at all. However, he's a roommate and a friend, and I want him to survive and to thrive. So. What do I do now?

posted by solid-one-love to health & fitness (26 comments total)

Does he get along with the sister? I.e., will she be an active support for him? Does he have other friends in town who will be support?
posted by LobsterMitten at 7:07 PM on September 11, 2007

Talk to community outreach/support services at the hospital. Van has a lot of services like that--they should be able to help you deal with this, and help him get back on his feet.
posted by dirtynumbangelboy at 7:16 PM on September 11, 2007

I agree with the suggestion to talk with folks at the hospital. You're a roommate, not family.

Having him live with you after this event is not good for anyone involved, as cruel as it seems, he needs more support in his living arrangement, and you don't need someone this dangerous in your house..

talk to the social workers at the hospital, and be honest with them.
posted by HuronBob at 7:20 PM on September 11, 2007

I am concerned that he may try again. Or burn down the house. Or worse.

Is there information that you have not stated that leads to you believe that he will harm others? But yes, please contact services at the hospital or via phone.
posted by ALongDecember at 7:22 PM on September 11, 2007

Does he get along with the sister? I.e., will she be an active support for him?

Yes, and I'm not sure. I didn't even know her name before today.

Is there information that you have not stated that leads to you believe that he will harm others?

No; I'm concerned because neither "D" nor I saw this coming. Attempted suicide is a violent act, so there's no telling what the next violent act may be, if there is one.

We're now in contact with community support at the hospital. Thanks for that suggestion. Any further help is appreciated.
posted by solid-one-love at 7:44 PM on September 11, 2007

Under BC law (Mental Health Act) the hospital will have committed him as involuntary- for as long as they see fit and with whatever treatment they deem appropriate. A patient in BC can be released from hospital but still be be involuntary. This is known as Extended Leave (Sec 20 of the MHA). Before he is released, the hospital is bound to ensure the patient receives follow up care in the community. this usually consists of a psychiatrist and a clinician from the local Mental Health Centre.

It seems that he has received a great deal of stressors to induce this act. You have lived with him for 2 years and not known about it - suicide is violent but a solitary violent act. What he needs are support and tools to deal with the stressors

He probably will receive services from a concurrent therapist - a clinician at the Mental Health Centre that specializes in substance abuse and mental illness. Support him as best you can without enabling him

my 2 cents
posted by Country Dick Montana at 7:56 PM on September 11, 2007

I'm concerned that you slept through the whole thing. EMS and crazed roommates would be sure to wake most people. However to answer your question either S goes or you go. Living with the burdenof care of a suicidal family member is one thing, but a suicidal roommate...no one needs that kind of drama.
posted by Gungho at 8:01 PM on September 11, 2007

It's very probable he suffers from an undiagnosed mood disorder. Under treatment he could be a stellar roomie.

Make it a condition that he stays in treatment to stay with y'all. Then take him out for a burger and fries and talk sports or something.
posted by konolia at 8:02 PM on September 11, 2007 [1 favorite]

Most depressives are NOT violent towards others, so the burning down the house thing is unikely, if it makes you feel any better. D, sadly, is a danger to himself but not to you.

D will be in bad shape emotionally for quite a while. He will want someone to talk to, probably incessantly and repetitively, about how he feels, and hopefully his sister will be there for him. Others are right about the community resources; the hospital should be setting D up for some counseling, support group, etc.

If it's possible, D needs to visit his mother and his grandmother. His fear of losing them both is one of the factors which led to this attempt. Getting them to communicate to him that they want him to survive and go on after they die (sounds ridiculously obvious, but he is suffering and not thinking straight) will help him through the recovery period.

Your post is almost robotically matter-of-fact. I suspect you are actually feeling guilty for not knowing more about your friend's depression or suspecting he was capable of this and, honestly, creeped out, appalled and frustrated by what he has done, all of which are normal. Hopefully you and S have the kind of relationship that allows you to vent these feelings openly to each other, so you don't get into it with D.
posted by misha at 8:04 PM on September 11, 2007

I am so sorry, on preview I put in D where I meant S, please switch them.
posted by misha at 8:05 PM on September 11, 2007

Former suicide attemptees should never be left to their own devices after being discharged, no matter how stable they may seem. You can choose whether or not to rework your schedules in order to have him constantly under someone's eye, although it may turn out to be a huge hassle.

Surely there is some service out there where he can be kept under someone's watch, or live in a recuperating community of sorts.
posted by Xere at 8:10 PM on September 11, 2007

Try not to explode with disapproval when you see him. He may be looking for the slightest sign, or he may be too medicated to respond. Being honest about your concern (or even anger), for his safety and yours, is OK. Maybe you could use that to reinforce whatever "contract" he will have to make before he gets out. Or not. Check with his therapist/social worker to be sure he isn't too fragile. Here in Pennsylvania they wouldn't release him without verifying that he has reasonable support systems in place.

Find a local mental health advocacy group. In the US it would be NAMI; in BC it looks like HereToHelp might have some advice or pamphlets.

Good Luck.
posted by RussHy at 8:22 PM on September 11, 2007

It's important that you understand what you can and cannot do.

I have a feeling that your roommate will be hooked up with a social worker. If he wants to continue living with you, it's not unreasonable to ask him for emergency contact information.

Please do watch him, and if you have that relationship, be nice. But suicidal peolple need more than a few good friends. They need professional help. Mental illness is a medical issue.

Good luck.
posted by gesamtkunstwerk at 8:50 PM on September 11, 2007

Does BC/Canada include therapy as part of its medical program? Ask his social worker--perhaps you could stipulate he needs to see a therapist twice a week if he wants to continue living with you.

Good luck and my very best wishes to you during this unimaginably difficult time.
posted by fandango_matt at 8:58 PM on September 11, 2007

The question of whether to let him remain your roommate or not has been answered above and better than I might do so, but as far as being a worried friend is concerned, here's what I'd do.

First, treat him normally, but don't ignore the incident. Maybe the best way to breach it, if he seems genuinely better in the near future, is to bust his balls about it a little bit, in the way that friends do. While IANA Therapist, I'd bet that most of the risk of repeated attempts on one's own life come from feeling ostracized by those close to you, no matter how subtle. Respecting him enough to be honest with him might be the best course.

Second, keep him in the loop of any and all social things going on for a while. Seriously, maybe the best defense against suicide is the feeling that there's something, no matter how insignificant, to look forward to. Even if it's just a poker game with friends or whatever, having it on his mental calendar will likely make him hold out for another day.
posted by Navelgazer at 9:12 PM on September 11, 2007

the only thing I can say is thank god you're in canada. we're praying for you. You don't have to be the messiah, but be a witness.
posted by parmanparman at 10:00 PM on September 11, 2007

Having "been there" at one time, I can only say that someone, somewhere must help "S" find a PURPOSE IN LIFE. It always boils down to having a reason to wake up each day. Best of luck to "S".....
posted by Gerard Sorme at 10:23 PM on September 11, 2007

Don't forget to take care of yourself. It was mentioned upthread that your description sounded robotic. I'd be willing to bet you and D are in shock.

You'll definitely feel angry toward S for doing something "so stupid" and making your lives extremely complicated. You'll need to find someone to talk to about this, especially if S comes back to live with you.

You might also be afraid to be too harsh or too easy on S, "what if he does it again because of something I say/do?" "What if I miss the signs again?" For that, you may need to contact a Survivors of Suicide group (yes, even though he didn't succeed) for day to day help.

Good luck.
posted by lysdexic at 3:25 AM on September 12, 2007

Since no one has mentioned it, it bears considering that you cannot keep your roommate from killing himself, nor is it your responsibility to do so. No matter how much you care for him, if he wants to harm himself he will find a way. This is something you should keep in mind while making plans for the future.
posted by OmieWise at 5:50 AM on September 12, 2007 [1 favorite]

I think the original poster is worried that the house will burn down in another suicide attempt, such as trying to hang himself from the light fixture again. It's a legitimate concern (and that fixture should be checked for damage) and one of the reasons to be concerned about the roommate returning and being home unattended during the day. He could have killed all three of them, if not neighbors as well, if that light fixture had started a fire.

I would not be comfortable having him come back. People in that state are very rarely concerned about the safety and well-being, mental or physical, of others. That's not to say you can't help with the process of finding him somewhere safe and supportive to live, obviously, there's no need to chuck his stuff out on the lawn and change the locks, but I think that a roommate situation is not really going to work for him at this time.
posted by Lyn Never at 6:34 AM on September 12, 2007

Disagree with the suggestion to tweak your schedules - it is not your responsibility to make him better - only he can do that.

Yes be supportive to your friend but at the end of the day he has to learn ways of coping that don't involve killing himself - nothing you can do will help unless he helps himself.
posted by koahiatamadl at 7:01 AM on September 12, 2007

Thanks all. Just about everything is helpful (even the deleted answer that said, simply, "Move.")

To follow-up a bit:

-- D is an electrician, so he'll be able to check the fixture.
-- I have always been able to sleep through anything, so it's not surprising that sirens and shouting didn't wake me up.
-- Not robotic, just rational. It's how I roll.
-- I will hassle S. "Dumbshit. Season 2 of Dexter starts in a couple of weeks, and you'd have missed it."
-- D and I have talked, and S's continued presence in the house, long-term, will be contingent on whether or not we feel safe.
-- My comfort threshold is somewhat lower than D's, so I may look into moving even if D is comfortable.
-- Looks like S will have some family support. I'm hoping that he can stay with his sister (and his mom is staying with his sister for her own treatment) until he's out of the woods. That would be ideal, I think.
-- I accept that there are limits to my responsibility for his well-being.
-- We'll continue to be in touch with professionals; thanks for the pointers on who to talk with.

Thanks again. I pointed D at this thread, and he was pleasantly surprised by the useful, intelligent feedback. I told him: "It's AskMe. Best thing on the Web."
posted by solid-one-love at 8:36 AM on September 12, 2007

Most depressives are NOT violent towards others

Most depressives aren't violent towards themselves, either. Manic depressives, on the other hand, are much more inclined toward suicide and self-harm, and in hypomanic phase are capable of all kinds of violent acts that no one can predict.

All that said, if he tried to OD on Paxil, it's probably fair to assume it was prescribed to him. I've been on Paxil, and let me say on a personal level that that particular pill can be terrifying if he's prescribed the wrong dosage, or if he suddenly stops taking it, or if it's just not the right drug for him. It's quite possible that Paxil could be the problem, full stop. (Google up some Paxil+Suicide for some fun reads.)

Finally, some advice: Your roommate, despite his recent behaviour, is a big boy. He will probably understand why you might want to move out. Hell, he might even want you to, just to save on the embarrassment and awkwardness. Maybe, if you think it all over and still find yourself at an impasse, you could ask what he would prefer.
posted by Reggie Digest at 8:38 AM on September 12, 2007

the hospital is bound to ensure the patient receives follow up care in the community.

It's the other way around. The patient is bound to accept the treatment the mental health system thinks he needs, regardless of whether he wants it or not. Best analogy I can think of for community commital is, it's like being released from jail and put on probation. If he doesn't have a history of refusing treatment and spending lots of time in the hospital it's unlikely he'll be placed on Extended Leave imho

HereToHelp might have some advice or pamphlets.

Low on advice and heavy on the pamphlets ;)
posted by squeak at 11:17 AM on September 12, 2007

When he gets out of hospital, or if you visit him there, your friend's probably going to be extremely, excruciatingly apologetic. You're probably going to want to scream at him a lot. I've only ever dealt with the immediate aftermath of a similar incident (alcohol, probably some prescription medications, a very sharp knife) over the phone, where it was easy enough for one of us to hang up when everything got too close to screaming; I'm guessing it'll be harder face to face. But. Reassure as much as possible, stay as calm as possible. 'It's ok, I don't hate you, you're still my friend' goes a long way; if all you can manage is 'it'll be ok' and then get the hell out of the house for an hour or two, that's better than nothing.

You and D are probably going to need to be able to talk to someone else to let off some steam - talking to each other is good, but you may well just wind each other up. Good luck.

(Two years later, my friend has a more accurate diagnosis, is free of the medications -including Seroxat/Paxil- whose side effects caused/increased his suicidal impulse, and is generally doing much, much better. But there were a couple of months there at the start of it all that were very, very wobbly. Best wishes with finding the right support getting through them, I'm sorry I can't offer more help.)
posted by Lebannen at 11:22 AM on September 12, 2007

My friend (also in Canada) committed suicide last week. Male, aged 41, depressed, Paxil. He had contacted his psychiatrist previously. Nothing was done. He's gone now. These are very serious and real issues. Make sure real supports for him and you are in place, don't just assume that our health system will look out for his or your needs.
posted by kch at 8:59 PM on September 12, 2007