Indicators of Risk

Sometimes it can be difficult to work out if a friend, boyfriend, girlfriend or a family member is just having a rough time or whether their behaviour means that something more serious is going on.

Approximately 80 per cent of young people who complete suicide communicated suicidal thoughts and feelings and their intent to kill themselves to someone prior to the suicidal act. One of the difficulties is that we may not be fully aware of what the signs mean or that they are very subtle and so we do not recognise them easily. What we can recognise, however, are changes in behaviour and some of the common crises that may trigger suicidal behaviour. Knowledge of the warning signs and risk factors may help parents, friends and families to intervene and take action.

It is important to remember that few people are intent on dying; it is more that they want the pain they are experiencing, or have experienced, to stop.

Indicators

Listed are some of the changes or behaviour that may indicate there is some sort of personal crisis for the person. Several indicators often occur together.

Sudden changes in their usual pattern of relating to others

• Withdrawing from family/friends;
• Not wanting to be left alone;
• Not wanting to be touched;
• Loss of interest in usual social activities;
• Developing violent, argumentative or disruptive behaviour;
• Problems with relationships, for example, exhibiting disruptive and unsuitable behaviour.

Significant personal changes

• Skipping classes and opting out of school activities generally;
• Marked decline in school performance and levels achieved;
• Apathy about dress, appearance and personal hygiene.

Changes that suggest depression or other mental health problems

• Loss of interest in previously pleasurable activities;
• Marked weight increase or decrease due to changes in eating habits;
• Lack of concentration;
• Changes in sleeping patterns (too much or too little);
• Delusions or hallucinations;
• Lack of energy or motivation.

Disinterest in the future or expressions of having no future

• Talk of being worthless, useless or hopeless;
• Sudden happiness after a lengthy period of depression;
• Unusually disruptive or rebellious behaviour;
• Death or suicide themes dominating written, artistic or creative work;
• Noticeable increase in compulsive behaviour;
• Unrealistic expectations held of self.

Impulsive and/or risk-taking behaviour

• Running away from home, truanting from school and an increase in sick days from work;
• Careless, accident-prone behaviour and taking personal risks,
• such as not looking after oneself when sick or playing 'chicken' on the road;
• Increased or heavy use of alcohol or other drugs.

Making final arrangements

• Making a will;
• Giving away valued possessions;
• Organising own funeral;
• Saying goodbye.

Self-harm and suicide attempts

• Self-mutilation, such as cigarette burns and cutting oneself;
• Having made previous suicide attempt(s) is one of the most important and reliable indicators of risk.

Verbal expressions - direct or indirect

• 'I wish I were dead';
• 'You won't have to bother with me any more';
• 'I think dead people must be happier than when they were alive';
• 'I'd like to go to sleep and never wake up'.

Thoughts and feelings often experienced

• Sense of hopelessness and/or helplessness, of having no control over one's life, persistently thinking things will never get better and that no-one can help;
• Feeling overwhelmed by the expectations of oneself;
• Loneliness, fear, feelings of abandonment and not being heard;
• Consistently high levels of anxiety and/or anger;
• Difficulty expressing emotions, for example difficulty expressing or accepting affection or having outbursts of uncontrolled anger;
• Preoccupied with thoughts of death or dying;
• Feelings of worthlessness, being a burden or feeling as though they have let parents or others down;
• Feelings of guilt and failure.

Often the person is trying desperately to make sense of their situation or to change it in some way. They often feel isolated and unheard. By showing your concern and caring enough to become involved, you can help the person express their thoughts and feelings. You can make a difference. Help them to achieve their needs in other ways and to seek help. Do not keep the secret or assume that things 'will be okay'.