Provide the opportunity and a safe environment for the person to talk
Many distressed people do not choose to talk about their feelings unless invited to do so. People often send out a small signal during a conversation (verbally or non-verbally). It is important to let them know that you have ‘heard’ and that you are interested to know more.
Use open questions that encourage discussion, rather than closed questions which can encourage simple Yes or No answers.
Encourage the person to explore and describe what is going on for them
Provide opportunities for people to talk about how things are going for them. Many people do not raise mental health concerns because of the stigma surrounding mental illness and ‘not coping’.
Many people do not disclose suicidal thoughts because of the pervasive stigma that is attached to being diagnosed with a mental illness or to ‘not coping’. Respect and never dispute whatever feelings and experiences the person conveys. It is not helpful to give glib advice, argue or criticise when a person expresses distress, confusion, agitation, hopelessness or suicidal feelings.
Be open and respectful of people’s experiences and feelings even if they are very different from your own. Listening well is fundamental. It involves giving your full attention and showing that you are interested.
Be open to diversity and difference
If people experience stigma in their everyday lives, they are often quick to notice negative attitudes towards them. It is vital that stigma is not experienced in the very setting where help is being sought – from anyone.
Stigma is an important issue in mental health and suicide prevention. When anyone experiences stigma they can feel dismissed, misunderstood, alone, hostile, or frightened. This contributes to mental health problems.
It is crucial that people do not experience stigma in the settings from which they seek help. Stigma can surround issues such as age, gender, ethnicity, sexual preference, poverty, disability as well as mental health.
Many people who live with a mental illness report that the associated stigma is as difficult to cope with as the illness itself.
Mental health problems are common
At least 20% of a GP’s consultations are likely to relate to anxiety of depression. Most people who suicide or attempt suicide have seen a primary care professional in the weeks/months before the event. Where mental health issues are present, ask specific questions about suicidal thoughts.
Do not panic or be afraid
Specifically mentioning suicide and raising it in an appropriate way, will not escalate the possibility of suicide. E.g. You’ve said that you sometimes feel ‘there’s no point’. Are you having thoughts about suicide?
Give the person information and consult about their preferences. Ask permission if you need to forward information to relevant people or would like to speak with significant people in their life.
If you do not feel able to engage effectively with a person who might be at risk, suggest another practitioner whom you would like them to see. Facilitate the appointment and check on safety issues in the interim. Stay involved – referral is part of management.