Talking about suicide

by Raven Ballard, PLPC, MOLAP clinician and well-being coordinator

Suicide is a heavy topic, and I have yet to meet an individual who enjoys talking about it. Regardless, it’s imperative that we have these discussions.

Suicidal ideation, otherwise known as suicidal ideas or thoughts, is a broad term used to describe contemplations, preoccupations, and desires regarding death and suicide, and it’s important to note that there is no universal definition for what exactly defines a suicidal ideation. Usually, suicidal ideations occur during depression or a similar mental health ailment such as anxiety, though its prevalence is highest in those dealing with a major depressive episode. According to the Diagnostic Statistical Manual-5-TR, a common symptom of depression is recurrent thoughts of death, suicidal ideation with or without a plan, and past or present suicide attempts, which is a common phenomenon for individuals suffering from depression. 

A study from the Hazelden Betty Ford Foundation discovered that on a self-reporting survey, where 12,825 lawyers were assessed, 11.5% of those lawyers reported having had suicidal thoughts at some point in their career.

Having suicidal thoughts can be scary, and I often find clients hesitant to share with me that they’re experiencing these types of thoughts, likely out of fear for my reaction. Thus, it’s important to know the types of suicidal ideations, and what to do not only if you’re experiencing these, but also what to do if someone confides in you that they’re having these types of thoughts. We’re going to break it down into two categories: passive suicidal ideation and active suicidal ideation.

Passive suicidal ideation is what I come across most often in my daily work. This is when an individual has thoughts about death, ending their own life, or not wanting to exist anymore -- BUT the individual has no plan and does not intend to follow-through with these thoughts. Usually, these thoughts occur when we’re not happy with our lives. We want to escape, so our mind may fantasize about death as an escape, but we don’t really want to die, we just don’t want to feel stuck anymore. When this happens, it’s important for me as a clinician to find out what’s making one’s life bad enough that death feels like a potential escape and help the client to turn that around.

In contrast, active suicidal ideation is when a client not only has thoughts about death and ending their own life, but they also have a plan and an intention to follow-through with their plan. Active suicidal ideation is no joke, and if you’re experiencing this, or someone confides in you that they’re experiencing this, take these situations seriously and reach out for help. It’s important to note that it’s not your responsibility to decide if a loved one is experiencing active vs. passive suicidal ideation. If they’re experiencing any thoughts about suicide, encourage them to seek a professional who is trained in determining active vs. passive ideation.

Here’s a quick guide for what to do when a loved one does confide in you that they’re experiencing suicidal thoughts:

• Encourage them to reach out for counseling. Counselors are trained experts in this area.
• Assess protective factors, such as what would keep them from acting on these thoughts. Do they have children that depend on them? A loving group of friends who would miss them? Or even a cat or dog at home who need their human best friend?
• Give them the number for the national crisis hotline: 988. This will connect them with a trained individual who knows what to do in a crisis.
• If you’re scared your loved one can’t keep themselves safe, call 911. Remember, it’s better to error on the side of caution than to lose a loved one due to not taking them seriously.

Lastly, if these are thoughts that you yourself are having, please reach out to someone. MOLAP is here and happy to help, or if you’d rather not utilize MOLAP, we have a growing list of great practitioners and clinicians all around that state whom we highly recommend. Suicidal thoughts are not something you have to face alone, and you’d be surprised just how freeing it is to share these thoughts with a professional who knows how to help.  

If you would like to discuss any concerning thoughts you’ve been having, the Missouri Lawyers’ Assistance Program is here to help! Please consult the Missouri Lawyers’ Assistance Program at 1-800-688-7859 for free, confidential counseling. 

References:

American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders: 5^th edition, text revision.

Harmer B., Lee S., Duong T.V.H., Saadabadi A. (2023). Suicidal Ideation. PubMed. Retrieved from: https://pubmed.ncbi.nlm.nih.gov/33351435/

Krill, P. R., Johnson, R., & Albert, L. (2016). The prevalence of substance use and other mental health concerns among American attorneys. Journal of Addiction Medicine. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4736291/