"When you reach out, you are not alone."
This is meant as a preventive fact sheet to prevent suicide in this population.
The American Indian most inclined toward a completed suicide
has the following social characteristics:
- He is often a male between 15 and 24 years of age.
- He is single.
- He is under the influence of alcohol just before his suicide attempt.
- He has lived with a number of ineffective or inappropriate parental substitutes
because of familial disruption.
- He has spent time in boarding schools and has been moved from one to another.
- He has been raised by caretakers who have come into conflict with the law.
- He has often been jailed at an early age.
- He has experienced an emotional loss, such as divorce, desertion, or death
in the family.
- He has experienced a past loss through violence of someone to whom he
Ten Preventive Steps:
The first thing a patient in a mental crisis needs is
someone who will listen and really what he is saying. Every effort should
be made to really understand the feelings behind the words.
- Evaluate the seriousness of the suicidal patient's feelings.
All suicidal talk should be taken seriously. If the patient has made
definite plans, the problem is apt to be more acute than when his
thinking is less definite.
- Evaluate the intensity or severity of the emotional disturbance.
It is possible that the patient may be extremely upset but not suicidal. If a
person has been depressed and then becomes agitated and moves about restlessly,
it is cause for alarm.
- Take every complaint and feeling the patient expresses seriously.
Do not dismiss or undervalue what the person is saying. In some instances the
person may express his difficulty in a low-key manner.
- Do not be afraid to ask directly if the person has entertained
thoughts of suicide.
Suicide may be suggested but not specifically mentioned in the crisis
period. Experience shows that harm is rarely done by inquiring directly
into the person's thoughts. In fact, the individual welcomes it and is
glad the counselor enables him to open up and bring it out.
- Do not be misled by the suicidal person's comments that he
is alright and is past the crisis.
Often the suicidal person will feel initial relief after talking of
suicide, but many times on second thought he will try to cover it up.
The same thinking will come back later, however. Follow up is crucial
to insure a good treatment program.
- Be affirmative but supportive.
Strong, stable guideposts are extremely necessary in the life of a
distressed individual. Provide him with strength by giving him the
impression that you know what you are doing and that you intend to
do everything possible to prevent him from taking his life.
- Evaluate the resources available
The person may have both inner psychological resources, such
as various mechanisms for rationalization and intellectualization
which can be strengthened and supported, and outer resources such as
ministers, tribal elders, relatives and others whom one can call in.
If these are absent, the problem is more serious. Careful observation
and support are necessary.
- Act specifically.
Do something tangible; that is, give the patient something definite
to hang onto, such as arranging for him to see someone else. Nothing
is more frustrating to the patient than to leave the counselor's office and feel as though he received nothing from the interview.
- Don't be afraid to ask for assistance and consultation
Call upon whomever is needed, depending upon the severity of the case.
Don't try to handle everything alone. Convey an attitude of firmness
and composure to the suicidal person so he will feel that something
realistic and appropriate is being done to help him.
(Source: American Indian and Alaskan Native Mental Health Research)
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