What should you do if you suspect one of your clients is thinking about harming themselves?
As an ER doctor, I rehearsed emergency scenarios. When a life-or-death situation presented, I knew the drill. I had done my thinking in advance. I was prepared to act.
Suicide is, by definition, is an emergency. How you respond is a matter of life or death.
3 Questions to Ask Yourself
Suicide is a challenging subject, often shrouded in darkness. It is important to shine a light on your own experiences, memories, and feelings. So before approaching a client, ask yourself a few pointed questions, and answer them honestly.
What Are My Beliefs on Suicide?
Let’s be clear: from a biblical worldview, suicide is wrong. The Ten Commandments forbid murder. God never wants one of his beloved children to kill themselves. Before you approach a client who may be suicidal, you need to be certain of this truth yourself.
What Do I Feel When I Think about a Person I Know Who Committed Suicide?
Recall the first suicide you knew of personally. How close were you to the person? What events and conversations led up to the suicide? Do you feel any responsibility? Guilt? Regrets? Do you believe that you could have done something more to intercede? Before approaching a client who might be suicidal, it’s a good idea to write down your experiences with suicide and process them with others.
As a Christian Coach, Is It My Business to Get Involved in Someone Else’s Life-and-Death Decisions?
Biblically, we learn the answer to this question by looking at the Bible’s first murder: Cain killing his younger brother, Abel. When God asked Cain where his brother Abel was, Cain infamously quipped, “Am I my brother’s keeper?” The lesson of the story is that we are indeed our brothers’ and sisters’ keepers. We have a responsibility for the welfare of others. As coaches, we can always find excuses for not getting involved. From a biblical worldview, however, it’s not okay to wait until it’s too late.
5 Questions to Ask a Client
If you think a client might be suicidal and you’ve taken your own pulse, what do you do next?
Where Do You See Yourself a Year (or Five Years) from Now?
Your client’s response to this open-ended question will reveal volumes. If they cannot articulate dreams for the future or their responses sound bleak or hopeless, ask follow up questions to determine if they are in immediate danger.
I’ve Noticed You Sound Discouraged Lately—Can You Share What’s Going On?
In my experience, if you sincerely care about a client, they’ll open up. Throughout my time in clinical medicine, I was never sued or named in a suit for malpractice. Partly, I was lucky. But another reason was that I kept in mind that even though the patients I was caring for didn’t necessarily understand the science behind what I was doing, everybody has a PhD in detecting attitude. They know whether you care.
If the person begins to cry, let them. Resist the temptation to hush them or tell them that everything is going to be okay. If they are thinking about suicide, things are not okay. Be prepared to listen quietly. You want to learn how they are really doing.
Have You Thought About Hurting Yourself?
When it comes to communicating and asking very hard things, I’ve found it helpful to have a script memorized that I don’t vary from. Having a script doesn’t mean you care any less; it means you care enough to be prepared.
My scripted question for suicide is “Have you thought about hurting yourself?” At some level, every person knows that committing suicide is wrong. I think that most want to be asked whether they are thinking about it. They want to share the burden. Most want to be stopped.
Do You Have a Plan?
If someone says they have considered suicide, ask if they have a plan. If they have a plan and the means to carry it through, you must act immediately. This is the time to call 911 and say that you are sitting with someone who is suicidal and has a plan. If it’s appropriate, and you are certain that you and they will be safe, you can take them to the emergency department yourself.
Never agree to keep a client’s suicide plans secret. Suicide is still viewed by society as murder, and you would never keep secret a client’s plan to murder someone. Getting your client help is the beginning of their road back to life and recovery.
This is an uncomfortable subject, but when asking about a plan, you need to also ask about the means of committing suicide. You would be surprised how many people—even trained professionals—forget this step. Ask your client how they plan to kill themselves, and then take steps to have the means (firearms, pills, etc.) removed.
If You Do Become Suicidal, Do You Know What to Do?
If your client has no suicidal thoughts or plans but they sound depressed, ask if they know what to do if they become suicidal. This is similar to the situation of evaluating someone in the ER for chest pain. If I determined that their chest pain wasn’t a heart attack or another serious malady, I would nonetheless give them a list of warning signs and instructions for when to return.
None of us is perfect. We all make mistakes. Situations change. Leave the door open for your client to get back to you or someone else if they do become suicidal. Make sure that they have a number to call and that it is written down—whether it is as simple as writing down 911 or the National Suicide Prevention Lifeline, 1-800-273-TALK (8255). You can also text the Lifeline number to them so they have it in their phone.
To request a free downloadable Hope Always Suicide Prevention Toolkit, email firstname.lastname@example.org.
Adapted from Hope Always: How to Be a Force for Life in a Culture of Suicide by Matthew Sleeth, MD. Copyright ©2021. Used by permission of Tyndale House Publishers, a division of Tyndale House Ministries. All rights reserved.
Matthew Sleeth, MD, a former emergency room physician and chief of the hospital medical staff, resigned from his position to teach, preach, and write about faith and health. Dr. Sleeth has spoken at more than one thousand churches, campuses, and events, including serving as a monthly guest preacher at the Washington National Cathedral. Recognized by Newsweek as one of the nation’s most influential Christian leaders, Dr. Sleeth is the executive director of Blessed Earth and author of numerous articles and books, including Hope Always: How to Be a Force for Live in a Culture of Suicide, which releases from Tyndale House Publishers in May 2021. Matthew lives in Lexington, Kentucky, with Nancy, his wife of forty years.