Supporting Your Loved One After A Suicide Attempt

The month of May is Mental Health Awareness Month, a time to reflect on mental unwellness, mental wellness, and lowering the stigma associated with living with a mental health-related disorder. In addition, this is often a time where we see an increase in awareness for suicide prevention, including access to resources and learning the warning signs of someone considering ending their life. What we don’t see enough of, however, is what to do if someone has attempted but did not die by suicide.

Suicide is a difficult topic to discuss with someone, but knowing how to support someone who may be considering it versus someone who has already attempted, can result in everyone feeling helpless. That’s because the former feels potentially hopeful, like we can change someone’s mind with the right words. The latter feels petrifying because we don’t want to say the wrong thing, thinking it will incite another attempt. It’s always challenging to find the right words when discussing suicide. Still, when we feel devasted, overwhelmed, upset, or even confused by someone’s attempt, we start to believe our actions will worsen the situation.

Common Reactions

There are some common reactions after we find out our loved one has attempted to die by suicide:

• Anger: towards ourselves and our loved ones.

• Shame: embarrassed by the event, so we start to keep it a secret.

• Guilt: for not seeing the signs or knowing how to prevent the attempt.

• Fear: that our loved one will try again.

• Confusion: not understanding why they want to end their life.

• Avoidance: often pretending the event didn’t happen.

• Minimization: believing that the behavior was attention seeking or the attempt not that grievous.

• Ignoring: passing the burden of safety onto someone else or the loved one themselves, essentially believing it is not our problem.

In my practice, I have many parents and guardians reaching out to me about their youth who have attempted suicide. Often, it’s after the youth has been released from hospitalization. They are angry, confused, and turn the situation inward, blaming themselves. They focus on their perceived inaction or inability to prevent the attempt. These same feelings and conversations are repeated by clients seeking me out after their partner, family member, roommate, or friend attempted. These are common reactions towards a relationship-altering event.

If possible, attempt also to give yourself and your loved one grace. Though you may not know the exact words to say to provide the support your loved one needs after an attempt, shying away from the topic increases shame. It also puts the onus on you, centering you in the experience and not the individual needing the support and healing. Grace gives you both the ability to breathe, take a step back, and find trust and understanding with one another again.

For anyone who wants to support their loved one after a suicide attempt, here are some steps that can be taken.

Create A Safe Environment

For months after the attempt, be aware of safety. We may be on the alert a few days or weeks after the event, but we will often resort back to our regular patterns and behaviors. If we believe the individual is “doing good,” it’s easy to create opportunities for their pain to be unseen, and therefore warning signs for another attempt to go ignored. Again, the goal is to limit the chance of self-harm.

• Safety Through Prevention:

  • Have emergency numbers easily accessible. Put it in the individual’s cell phone, on the fridge, in their room, in the family car/their car, and the bathroom. Make sure they are in your cell phone, as well. This creates more opportunities to seek help sooner.

  • Ensure medication safety by locking up or hiding medication that can be used for self-harm. Individuals taking new medicines after the attempt will need to be supervised, as it takes about 4-6 weeks for the medication to start working correctly. Be mindful of the side effects of the medications. Do regular check-ins for mood (or have them download a mood app to do check-ins with). Additionally, be mindful of medication doses, especially if this was a method for the previous attempt.

  • Remove, lock up, or hide sharp objects. This includes knives, razors for shaving, pencil sharpeners, and scissors. Removing these objects should not be punitive. For example, if someone likes to shave their legs, it means “checking out” the razor. Another example may be an individual who is a cook. They will need access to knives to make meals. For safety, it may mean meal-making is not an alone activity. That way, the individual can still engage in a strength-based activity while maintaining awareness around security. Remember, we do not want to lower someone’s quality of life because they attempted to end it. Instead, we want to show our concern for their well-being and hopefully improve their quality of life.

  • Remove or lock up firearms. Ownership of handguns is directly linked to higher suicide risk. But, many families purchase them for protection, and some may need them as part of their employment. When safety is involved, it means making the firearm less accessible. This includes having ammo located in another location and obtaining new locks or changing lock codes to gun safes.

  • Remove, lock up, or hide alcohol. Alcohol can be misused or abused when someone is hurting. It’s an easy way to minimize pain and numb ourselves. Consequently, it is also an easy way to lower our inhibitions and increase thoughts of suicide. Monitoring consumption and making alcohol less accessible will be a good preventative measure from impulsivity being a factor of self-harm.

• Safety Through Resourcing:

  • Provide professional resources for support, including support groups, access to mental health services (including therapy/counseling and psychiatrists), increased medical check-ups, and access to holistic medicine (including acupuncture or Reiki). Remember that you are not taking on the role of counselor. Enlisting the help of professionals will help take the burden off of you to “say the right thing” and instead focus on supporting your loved ones the way they need to be supported.

  • Provide community resources for support, including access to Tribal leaders, access to clergy members, access to engagement groups (like local community centers), meetings with a financial advisor, or access to training courses (stress management courses, assertive communication courses, or wellness courses). Providing enrichment and opportunities for growth will support your loved one in problem-solving if a triggering event (such as getting fired or having a baby) aided in thoughts of self-harm.

  • Create support around exploring and developing plans and solutions that assist your loved one in addressing and resolving emotional pain. For a loved one to let go of the idea of suicide as a solution, they will need assistance with making necessary changes in their life. These changes can be small, such as addressing overwhelming tasks like cleaning out a closet, developing an easy-to-understand meal plan, or pulling weeds in a garden. These small actionable steps are tangible images of change, environmental control, and what support looks like.

• Safety Through Communication:

  • Create an environment where they feel accepted, safe, and understood for their actions. This doesn’t mean that you agree they should end their life. It means that you will not judge them and that your goal is to seek understanding. Understanding can lead to the prevention of future attempts. Be aware that asking someone directly about suicide does not trigger suicidal ideation or action. Instead, communicating about the event will be the most constructive way to start a dialogue.

  • Remind the individual that you are open and available to support them. Seize any moment where you can remind them that you are there for them. Here are some examples, though everyone is different, so adapt them to the needs of your situation with your loved one.

    • “I won’t pretend to know how you feel, but know I’m here to learn when you want to share.”

    • “I’m here to help whenever you need support.”

    • “I’m usually up early/late if you ever want to call and talk.”

    • “How would you like me to be there for you?”

  • Provide them with opportunities and moments of empathy and support without judgment. Ask open-ended questions to open the lines of communication. Be comfortable with silence or confusion.

Creating a Support Network

As mentioned before, there is a stigma surrounding suicide. Feelings of disgrace and shame invite us to avoid the topic of our loved one’s attempt around others. We fear they will be judged, and we fear we will be criticized, especially if we are a caregiver. We often create beliefs that others’ knowing will only make the situation worse.

Though it is up to you and your loved one to choose who to talk to about the situation and how it is revealed to them, it’s crucial to increase access to support during this healing time. The more people the loved one can access if they have thoughts of self-harm, the quicker a response could lead to prevention.

To minimize others creating situations of judgment, the dialogue must begin with expectations. Inform anyone who will be in the know about using open-ended questions, avoiding judgemental statements, and the focus on safety. It may even require meditation by a counselor or other professional to ensure all parties understand their expectations.

Below are some support networks that can be developed and ways to build them. It’s worth noting that cultural differences may shift some of the duties, attitudes, and beliefs identified below. Remember to look at the examples, instead, not as an exhaustive list, but as a guide or tool to develop more support networks, in whatever fashion that may look like for you and your loved one.

• Familial Support:

  • Family can be some of the most considerable support at this time, but it can also be one of the most harmful. Therefore prepping family members by highlighting actions they can take to create support will aid in removing movements of shame.

    • Create shifts or time slots of opportunity that the loved one can reach out to different family members when in need.

    • Discuss ways family members can help lower the burden of stressful tasks and duties, such as cooking, cleaning, and scheduling appointments for the loved one’s children.

    • Identify family members who can stop by and be present with the loved one, even if it’s to watch a movie, to create more opportunities for connection and communication.

• Peer Support:

  • Just like family, friends can be a vital part of the support system. Just like family, friends need actionable steps. They can take on the same steps as a family member, but additional support they can provide that is unique may include:

    • They can increase the opportunity for joyful outings. This could include picnics in the park, pampering at a salon, or going to a dog beach. Friendship can help us access the parts of our brain that need connection and understanding from someone that isn’t relative. We often believe relatives must care for us, whereas friends are choosing to.

    • Friends can become a “translator” or voice that helps the loved one share their experience, thoughts, and emotions with others around them. Close friends often have a shared language with us, and they may have a better understanding of the loved one’s thought process and emotional states. This helps us better understand and find ways to maintain prevention and increase the quality of life.

• Vocational/School Support:

  • If our loved one attends work or school, using these institutions as a resource to support them can be a hidden gem in their healing. Providing these institutions with safety plans and warning signs specific to our loved one may increase prevention opportunities. Additionally, highlighting the importance for these institutions to maintain safety through confidentiality and limiting gossip (and actions that can be taken to support your loved one if gossip occurs).

    • School

      • Allowing the loved one access to a school counselor, who can regularly check in on them, provide them guidance, and give them opportunities for a safe space to share their journey.

      • Accessing the program for Students with Disabilities, to receive accommodations, such as an extension on assignments, private space for test-taking, or other accommodations. This will lessen the mental and emotional toll school can place on an individual.

    • Vocational

      • If attending a work environment, ensuring HR has provided them with resources through the Employee Assistance Program (EAP), the loved one can obtain counseling and access to additional resources (such as a therapy, financial advisor, child care, or wellness coach).

      • Discussing with HR any accommodations that can be given to help lessen mental and emotional toll. This may mean access to ergonomic furniture, an increase in using breaks (especially in states with mandatory break laws), and guidance/support on projects to help lessen isolation.

Looking Long Term

When someone has concluded that suicide is an option to end suffering, it can be difficult to go away as a potential option. However, if the individual cannot increase their ability to seek resources, assistance, and support, suicide may regularly be a viable option in the back of their mind. Therefore, it’s important to think not just in the immediacy but also for the long term when supporting someone who has attempted suicide.

• Regularly remind your loved ones of the importance of caring for themselves. Give them opportunities to engage in self-care routines. Let them know that their wellness is a priority, as much as any other task or duty.

• Remind them of problem-solving skills or any other tools and techniques they received in counseling. These may include reminding them of grounding techniques, access to support lines, or engaging with their hope box.

• Encourage them to regularly take their medication, even if they feel better and thoughts have subsided or disappeared. For some, their bodies cannot make the chemicals necessary to feel joy and peace. Often, people forget that they’re feeling joy again because the medication is working to create the chemicals. This can result in not taking the medication, which could cause a relapse in suicidal ideation and other symptoms. Depending on the dose, this could also be damaging to the body, as the body is no longer receiving access to the creation of these necessary chemicals. Encourage your loved one to discuss discontinuing medication with their provider before doing so.

What Not To Do

During this time, you must be aware of your feelings and reactions. Over-reaction can block communication which will make it easier for your loved one to withdraw. If your goal is safety for them and yourself, then shutting down lines of communication will not achieve this goal.

• Avoiding talking about the attempt will increase shame for your loved one. Pretending nothing happened or that the attempt did not affect us will create more confusion, as it suggests that we do not care. Do not avoid using the word suicide, either, as this increases stigma around the experience.

• Panic can lead to overreacting, responding in shaming ways, and increase confusion. Though alarm and fear are expected, panic will tell our loved one that we cannot handle hearing about their pain, and therefore they need to hide it from us. If possible, remain calm. Calm doesn’t mean we can’t feel; it just means that we attempt to stay in the present moment.

• Judgment statements or questions will increase shame for your loved one. Examples include:

  • “Why did you do this?”

  • “Your life is so great. You have no reason to end it.”

  • “Think of the people who love you. Do you have any idea how you hurt us or how much loss you would hurt us?”

  • “So many people have it worse than you.”

  • “Why don’t you learn to appreciate your life?”

• Treat supporting your loved one or yourself as a punishment or being punitive. Often we use tactics such as ignoring or criticizing to show our disgust with the attempt. We may take items away that are important to the loved one, like computers or game systems. Essentially, we treat the suicide attempt as a “naughty behavior” and not an event to treat with empathy, concern, and compassion.

• Simplifying our response with quick fixes will not be helpful. We often believe medication alone or the proper diet will “fix” the problem and remove thoughts of self-harm from our loved one. When we oversimplify the experience, it gives the subtle suggestion that if they can’t “get over” these thoughts, they are flawed or damaged, leading to thinking ending their lives is an appropriate solution for pain.

• Allowing guilt to be the response motivator. So often, especially for caregivers whose children have attempted suicide, we overcompensate by buying gifts, taking them to theme parks, or doing “fun.” This often comes not from repairing a relationship and strengthening trust but from a fault without our skills and abilities that somehow led to the attempt. Though creating opportunities for enjoyment and enrichment can help increase resourcing for our loved one, authentic connection, communication, and support are needed to heal from the attempt.

Support for You

It is both emotionally and physically draining to support someone who attempted suicide. It’s impossible to watch them 24/7, and it can be challenging for our minds to turn off imagining the worst if we aren’t the “right” kind of vigilant. Therefore, similar to creating support networks for your loved one, you will need to create support networks for yourself. Seek counseling, identify trusted individuals to confide in, or join a support group of individuals who have also experienced the aftermath of someone attempting suicide.

Ensure you are engaging in your self-care routine. This may mean regular walks; this could be curating a playlist that keeps you motivated or scribbling sketches for 5 minutes a day. Whatever your routine is, make sure it’s also a priority. This not only models for your loved one the importance of caring for ourselves, but it also keeps you healthy to continue to be a support for your loved one.

Ensuring your own wellness and safety is even more critical if you were the individual who interrupted or found your loved one during or after their attempt. Experiencing this unique trauma will bring about a variety of thoughts and feelings that you’ll need to heal from yourself, before you can be a support for your loved one.

Remember, suicide attempts can affect our families and us long after the loved one has stabilized. Recovering from such a trauma can take a toll on everyone. When possible, find moments of grace because healing is hard work.

If you or someone you love are having thoughts of self-harm, reach out to the National Suicide Prevention Lifeline at 1-800-2373-8255.

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