Ten Most Common Errors During A Suicide Intervention Based on research of 215 medical students, master level counselors, addiction counselors, and crisis line staff by Robert A. Neimeyer Angela M. Pfeiffer Based on research of 215 medical students, master level counselors, addiction counselors, and crisis line staff by Robert A. Neimeyer Angela M. Pfeiffer

#1: Superficial Reassurance “You’re so young and have so much to live for! How can you think of killing yourself?” “Come on now. Things can’t be that bad.” Make sure responses don’t come across as trivial or superficial. Rather than being reassuring a teen may feel even more isolated and misunderstood.

#2: Avoidance of Strong Feelings When faced with intense depression, grief, or fear don’t retreat into professionalism, advice giving, or passivity.When faced with intense depression, grief, or fear don’t retreat into professionalism, advice giving, or passivity. Do not move into an analytical discussion of why they feel that way.Do not move into an analytical discussion of why they feel that way. Do use empathy skills by putting expressed feelings into words.Do use empathy skills by putting expressed feelings into words. “With all the hurt you’ve been experiencing it must be impossible to hold those tears in.”

#3: Professionalism “You can tell me. I’ve been trained to be objective.” Intended to put a person at ease this can come across as disinterest or hierarchical. Be empathetic.

#4: Inadequate Assessment of Suicidal Intent “You say you’re suicidal, but what’s really bothering you?” “You say you’re suicidal, but what’s really bothering you?” Most common among physicians and master level counselors. Time pressures, personal theories, or discomfort with intense feelings. Find out what they have been thinking, for how long, specific plans, and previous attempts.

#5: Failure to Identify the Precipitating Event “It sounds like everything collapsed when your brother died three years ago, but what has happened recently to make you feel even worse? That dying is the only way out?” Ask about any recent key incidents or events. This can help move interventions toward necessary action steps.

#6: Passivity “Go on. I’m here to listen.” “Call back some other time when you can talk more easily.” “Call back some other time when you can talk more easily.” 25% of counselors and helpers took a passive clinical stance. Early stages of suicide interventions need to be active, engaging, empathetic, with the helper structuring the interaction.

#7: Insufficient Directness “If you keep feeling suicidal remember you can call back.” At a minimum, a verbal “no suicide contract” should be obtained. “Ok we have an appointment set up for you, you have my phone # for tonight, and I’ll stop by the school to see how it’s going tomorrow.”

#8: Advice Giving “Just ignore the person bothering you.” “Try not to worry about it.” “Remember, focus on the positive.” Concrete action ideas are helpful, but after trust has been established. An action plan should come from their tentative ideas, rather than from the authoritative advice of the helper.

#9: Stereotypic Response “She’s a borderline, attention getting female.” Focus on the individuality of each person. During a crisis an attempt to use shortcuts can lead toward stereotypic assumptions.

#10: Defensiveness “How could you ever help me, have you ever tried to kill yourself?” Anger or rejection is common during intense crisis. Don’t engage in power plays, quick witted sarcasm, or put downs. Maintain a caring stance.