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Suicide is the second leading cause of death among college students. A person who is feeling suicidal is typically intensely ambivalent about killing himself or herself, and usually responds to help.
Suicidal states are definitely time-limited and most who commit suicide are neither crazy nor psychotic. High risk indicators include: feelings of hopelessness and futility; a severe loss or threat of loss; a detailed suicide plan; history of prior attempts; history of alcohol or other drug abuse; and feelings of alienation and isolation from others.
Suicidal students usually want to communicate their feelings and any opportunity to do so should be encouraged.
Helpful Responses
- Taking the person seriously; 80% of suicides give warning of their intent.
- Acknowledging that a threat of suicide (or attempt) is a plea for help.
- Asking the individual directly whether they are considering harming themselves. For example, “You seem so upset and discouraged that I’m wondering if you are thinking of suicide?”
- Being available to listen, to talk, to be concerned; but refer to Counseling & Wellness Services (509-359-2366) or Frontier Behavioral Health (509-838-4651).
- Consulting with the above resources as necessary.
- Contacting the Dean of Students’ Office (509-359-7924) to initiate appropriate university responses.
- If the situation is believed imminent, call 9-1-1 or the Regional Behavioral Health Crisis Line (988).
Less Helpful Responses
- Minimizing the situation or depth of feeling (e.g., “Oh, it will be much better tomorrow”).
- Being afraid to ask the person if they are so depressed or sad that they want to hurt themselves.
- Overcommitting yourself and, therefore, being unable to deliver on what you promise.
- Ignoring your limitations (i.e., not consulting with available resources).
If you observe any of these warning signs that indicate suicidal risk, especially in combination, communicate with a mental health professional as soon as possible:
- Expression of desire to kill self or wishing to be dead.
- Presence of a plan to harm self.
- Means are available to carry out plan to harm self.
- Suicide plan is specific as to time, place; notes already written.
- High stress due to grief, illness, loss of new job, academic difficulty, etc.
- Symptoms of depression are present, such as loss of appetite, sleep, severe hopelessness or agitation, feelings of exhaustion, guilt/shame, loss of interest in school, work or sexual activities, change or deterioration in hygiene.
- Intoxication or drug abuse, including alcohol.
- Previous suicide attempt by the individual, a friend or family member.
- Isolation, loneliness, or lack of support.
- Withdrawal or agitation.
- Preparation to leave, giving away possessions, packing belongings.
- Secretive behavior.
- Major mood changes (e.g., elation of person who has been depressed).
- Indirect comments implying death is an option (e.g., person implies they may not be around in the future).
This student may have trouble distinguishing fantasy from reality. To some extent, this person will appear confused or illogical. As you talk to this student, you may notice that his/her speech jumps from one topic to another with little or no logical connection between the topics. The individual may also pay a great deal of attention to some unimportant detail that is being discussed or may be generally scattered and incoherent. The student may coin new words and expect others to understand their meaning or may put words together because they rhyme, not because they make grammatical sense.
Such individuals may make inappropriate emotional responses. For example, they may overreact to their feelings, or be very “flat” emotionally. Many times the person knows that their emotions are inappropriate, but just feels overwhelmed and cannot control them.
Persons in poor contact with reality may experience themselves as especially powerful or important, or may believe that people are attempting to harm or control them in some way. They may also believe that certain actions have special meaning for them (e.g., when people in a small group begin to laugh, they are laughing at the student). Such students may experience hallucinations, usually auditory, although hallucinations can be experienced through any sensory modality. Generally, these individuals are not dangerous, but are scared, frightened and overwhelmed.
Helpful Responses
- Respond to them with warmth and kindness, but with firmness.
- If you are comfortable in doing so, remove extra stimulation from the environment and see them in a quiet atmosphere.
- Acknowledge their concerns and state that you can see they need help (e.g., “It seems very hard for you to integrate all these things that are happening and I am concerned about you; I’d like to help”).
- Acknowledge their feelings or fears without supporting the misperceptions (e.g., “I understand how you think they are trying to hurt you, and I know how real it seems to you, but I don’t hear the voices”).
- Reveal your difficulty in understanding them, as appropriate (“I’m sorry, but I don’t understand. Could you repeat that or say it in a different way?”).
- Focus on the ‘here and now.’
- Switch topics and divert the focus from the irrational to the rational or real.
- Speak to their healthy side, which they have. It is okay to joke, laugh, or smile when appropriate.
Less Helpful Responses
- Arguing, disputing their illusions, or trying to convince them of the irrationality of their thinking. This typically just makes them defend their position (false perceptions) more ardently.
- Playing along (e.g., “Oh yeah, I hear the voices”).
- Encouraging further revelations of delusional thinking. It would be more helpful to switch topics and divert focus from delusions to reality.
- Demanding, commanding, or ordering them to do something to change themselves.
- Expecting customary emotional responses.
If you have a concern about a student, there is a referral form that faculty, staff, family, and friends can complete.
It will be followed up by a member of the Student Care Team (part of Student Accommodations and Support Services.)
Here is the link to the form: iCare
Their office contact information: 509-359-7924
