SOS Suicide Prevention

Mrs Tan briefed us on the types of services provided by SOS at the outset of workshop:

- Email befriending (targeting the young people mainly)
- Face to face counselling sessions
- Hospital and police referrals
- Emergency squads (2 volunteers on standby)
- Local outreach to suicide survivors/bereaved (LOSS)
- Healing bridge
- Community education (suicide prevention)

Trained counsellors man the 24 hr hot line – 1800 2214444 and types of crises intervened include accidental (sudden and unexpected ) or situational (retrenchment) crises, developmental or maturational crises (unwanted pregnancy, loss of health), disasters (mass destruction). When a person’s coping mechanism is overpowered by disequilibrium, it is not a pathological state; it may occur to anyone at any stage in a life span. (Golan 1978) It is possible to overcome the crisis if the problems are clearly defined and the significant persons re involved in the resolution.

The six stages of a crisis:

1. Hazardous build-up (stress/pressure/tension evaluated from Client’s point of view.)
2. Precipitating event (coping mechanism stretched as a result of direct/indirect events; experience loss of some sorts.)
3. Disorganization (can’t think properly; turn to secondary resources – eg social worker)
4. Breaking Point (pinnacle/unbearable. Reach out to anyone/anything even to an active suicide attempt.)
5. Re-organization (exhausted emotions, rediscovery of strength and options.)
6. Restoration (renewed confidence in self. able to make choice and take action.)

While handling a crisis situation:

1. Remain calm and attend to the feelings by putting judgement aside. Reflect client’s feelings (say ‘I sense you feel…’ ‘I hear you say….’)

2. Explore the problem NOW, not the root cause. Examine triggers/meaning/impact.

3. Periodically paraphrase/recap to the client to ensure common understanding of key terms.
4. Define the focus - WHAT is causing the client great pain? Allow focused area to change.

5. Explore available resources - What has Client tried so far? What would the client wish to do about the situation? What is client afraid to do? Who would he like to talk to if he could?

6. Establish open line of communication for client to re-contact if client’s choice of action plan fails.

On the continuum of suicidal behaviour, the following take place:

1. Client harbours and exhibits risk-taking thoughts and behaviours respectively.
2. Suicidal ideation – (at thinking level) either fleeting or intense
3. Suicide threat (e.g. sitting on the window ledge)
4. Suicide attempt (any form) – High intent to die but survive attempt
5. Suicide (death is the outcome) - High intent to die.

6. Low intent to die and end in death – classified as accidental suicide if no foul play (misadventure, accident)
7. Low intent to die and survive – para-suicide

Facts:

- Suicidal people don’t want to die.
- A suicidal crisis is generally of short duration.

Myths:

- People who talk about suicide won’t do it.
- Suicide occurs without warning.
- Asking someone if he is feeling suicidal will put the idea into his head.
- Suicidal people do not seek medical help.
- Terminally ill people often die by suicide.

A suicidal person is more likely to be thinking about ending their pain, rather than ending their lives.

Acknowledge and reflect their strong feelings of suicide AMBIVALANCE.