TRIGGER WARNING: suicide
For mental health crisis services, here is some advice on what you should and should not do when someone comes to you for help.
- Do not assume that a suicidal person will not commit suicide/does not really want to because they would have done it rather than coming to you for help. You might be their last resort. If you cannot help, they might see that as a final confirmation that death is the only way out.
- Treat everyone as a unique individual. I understand that there are certain boxes you need to tick but we are complex and do not fit neatly into boxes. When you rattle off questions: what happened to cause these feelings? Have you been taking your medication? Can you keep yourself safe? makes you seem detached and puts people off opening up.
- Do not ask ‘can you keep yourself safe?’ A lot of people I’ve spoken to about this question find it annoying. People might say yes to avoid hospital admission or because they want to walk away and act on suicidal thoughts.
- Do not ask ‘what do you want us to do?” WE DO NOT KNOW. That is why we are here. It is almost impossible to think of what might help when the reason you’re talking is because it feels like nothing can.
- Listen carefully, express understanding.
- Take people seriously. Never dismiss someone as ‘attention seeking’ or think they will ‘get over it.’ Mental health is more complex than that and as a professional, you should know this.
Why have I written this? Well, I’ve had my fair share of bad experiences with crisis teams:
- There was the time that the person assessing me kept leaving the room to take phone calls. This is unprofessional and tells me that you’re not really listening.
- Being sent home with the full intention to commit suicide. I was fortunate that I had someone to go home to who stopped me but not everyone has that.
- Being told that suicide is an ‘unwise decision’ – not helpful.
- Being constantly asked what I wanted to be done. I kept repeating ‘I don’t know, I just want to die’ and they kept asking the same question. We went round and round until they decided to admit me to hospital… that was until they realised there were no beds available.
There are time constraints and expectations on crisis teams that make it a very pressured job. This needs to be addressed so the above can change so that when in crisis, people can seek help and not be put off by previous bad experiences. Sadly, I know a lot of people who refuse to use crisis services because of repeated bad experiences with them. Instead, they end up hurting themselves or others or ending up in A&E.
The job of a crisis team is to support those in crisis. Failure to do so can be fatal. If things do not change, these services will have a lot to answer for. This is not the fault of those working in these teams – they mostly do the best they can. It is the fault of those above who fail to understand what it is like to be in a mental health crisis. It is the fault of those who put money and numbers above the mental health and lives of the people they should be helping. There needs to be more time and more money and more understanding in crisis teams to ensure that lives are not lost.