Author and therapist EmiLeigh Whitehouse, LPC writes about suicide prevention and awareness
September is National Suicide Prevention Awareness Month. The topic of suicide is sensitive and taboo yet so many people struggle with it. Suicide is also 100% preventable. It is important to know that if you or a loved one are having thoughts of suicide, there is help available. In fact, if you dial 988 you will be connected to the national suicide prevention hotline where you can speak to a trained individual to help you through. While this topic can be difficult, bringing awareness to it can help connect people to resources. So, how do we know if someone is struggling?
Thoughts of suicide can be put into two different categories: passive suicidal ideation and active suicidal ideation. Passive suicidal ideation can be characterized as “thoughts about dying or a desire to die, without a specific plan for carrying out suicide” (American Association of Suicidology, 2023). This category of suicidal ideation signifies that the individual is emotionally struggling. Examples of passive suicidal thoughts can sound like: “I just want to die.” “I wish I could fall asleep and just not wake up” or simply thinking about death. It is important to recognize what passive suicidal ideation is because if left unaddressed can evolve into active suicidal ideation or may lead to the individual engaging in at-risk behaviours such as non-suicidal self-injury.
Active suicidal ideation can be characterized as “not only thoughts or desires about death, but also planning or intention to end one’s life” (American Association of Suicidology, 2023). The risk is elevated with these types of thoughts because it demonstrates that the person has moved beyond just thinking about death and has an active plan to carry it out. Individuals who are experiencing active suicidal ideation may not only express their desires to die but also actively prepare for their death such as giving away prized possessions, obtaining a means to follow through, or writing their will. These behaviors may indicate a life-threatening crisis that should be immediately addressed.
The mnemonic IS PATH WARM was developed to help identify the warning signs of an individual struggling with suicidal ideation (Juhnke et al., 2007). The mnemonic stands for:
Ideation - threatening to hurt/kill one’s self; looking for ways to die
Substance use - increased or excessive substance use (alcohol or drugs)
Purposelessness - no reason to live at all; no sense of purpose in life
Anxiety - increased worry, agitation; restlessness or unable to sleep
Trapped - feeling trapped like there is no way out; resistant to help
Hopelessness - feeling like there is no future
Withdrawal - isolating from family, friends, and society; excessive sleeping
Anger - increased rage, uncontrollable anger, and/or seeking revenge
Recklessness - acting recklessly, or engaging in risky activities seemingly without thinking
Mood changes - dramatic changes in mood that seem unexpected
While these characteristics on their own do not constitute the presence of suicidal ideation, if an individual is presenting with many of these concepts, especially burdensomeness, hopelessness, and helplessness, it may. Remember that talking about this won’t make a person suddenly become suicidal. Instead, these vulnerable conversations invite connection and community which help with prevention.
Preventing suicide doesn’t just stop at recognizing the signs. Suicide prevention is gender affirming care, land back, disability justice, reparation, thriving minimum wage, abolition, bodily autonomy, and universal healthcare.
NHI Suicide prevention week digital campaign - https://www.nimh.nih.gov/get-involved/digital-toolkit-for-suicide-prevention-month#:~:text=September%20is%20National%20Suicide%20Prevention,know%20how%20to%20get%20help.
References:
American Association of Suicidology (2023). Know the signs: How to tell if someone might be suicidal. https://suicidology.org/2023/06/01/know-the-signs-how-to-tell-if-someone-might-be-suicidal/
Juhnke, G. A., Granello, P.F., & Lebrón-Striker, M. (2007). IS PATH WARM? A suicide assessment mnemonic for counselors. Professional Counseling Digest Alexandria, VA: American Counseling Association.