You may have encountered someone in your life — at work, at a social event, a family member or a significant other — who does not seem OK.
Identifying that someone needs help but being unable to identify how to help them may be a difficult position to be in, especially for empaths. There's a balance between honoring someone’s privacy and being supportive.
At Crisis Text Line, we help people at some of their lowest points all day, every single day, via text message. You could say we’re experts in knowing what questions to ask to help people in their moments of crisis.
Over the last six years, we’ve collected and analyzed the anonymized data. Data allows us to understand crisis all over the country and build the best product for our Crisis Counselors and texters. Our research helps us identify how to best help people in crisis.
Does asking about suicide increase suicidal tendencies?
Overwhelmingly, we’ve found that it is essential to lead with empathy and ask direct questions when people are in emotional pain. And the most important question to ask texters in crisis: “Do you have thoughts of death or dying?”
That’s right. While the common assumption has been that inquiring about suicidality can increase suicidal tendencies, the data says that asking about suicide does not increase potential suicidality.
In reality, asking about thoughts of death or dying can open the door to a conversation that could save a lot of lives.
Our data shows that simply asking someone if they are OK opens the door for someone to feel they can ask for support and get help. It is about offering a safe and nonjudgmental space for someone to seek help.
At Crisis Text Line, we use a simple formula to assess if a texter has a plan, means, and timeframe to take their life. We always lead with an “expression of care” to let people know that we're listening and are here to support.
We found that assessing suicide risk with an "expression of care" was most likely to reduce a texter's suicidal feelings.
After using artificial intelligence to analyze our dataset of 75 million text messages — collected since Crisis Text Line launched in 2013 — we found that assessing suicide risk with an "expression of care" was most likely to reduce a texter's suicidal feelings.
Expression of care is simply letting someone know that you are there for them and want to keep them safe. “I care about you. With all that you have going on, are you thinking about ending your life?”
Our data shows when we ask about suicidal thoughts after building rapport and using the “expression of care” method, there’s no increased risk to the texter’s safety. In fact, it’s twice as effective in de-escalating a texter’s thoughts about dying than other methods.
As long as you’re validating, responding with empathy, and giving your texter room to explore their challenges, asking directly about thoughts of death and dying won’t cause them to feel more suicidal.
Our data and research show that some texters who experience thoughts about death or dying demonstrate little to no detectable signs of suicidal thinking.
This could be for a number of reasons:
Suicide can be hard to talk about. Our data shows it’s easier for texters to respond to a direct, empathetic question about suicide than it is to bring up the topic on their own.
For 67 percent of texters, their conversation with Crisis Counselors is the first time they’re sharing something they’ve never told anyone before. They may not have the words yet to describe what they’re feeling.
Because we’re providing support through text messages, it’s not possible to see physical signs of hopelessness, sadness, and pain. We may need to ask the texter directly about their thoughts of death or dying to provide them with the opportunity to express themselves.
That’s why we ask about suicide in every conversation.
If you’re looking to help the people in your life, there’s good news for you here, too. The number one thing that makes the biggest difference in a conversation about suicide?
Empathy. That’s right.
Empathy is a tool we all have and it’s seriously game-changing in even the hardest conversations. Even better, empathy is something all of us can show for each other. It’s totally free. And, it’s something everyone can show anytime, anywhere. All it takes is a few kind words.
Volunteer with Crisis Text Line
Crisis Text Line provides free, 24/7 support for those in crisis. Text CRISIS to 741741 from anywhere in the U.S. to text with a trained Crisis Counselor.
Crisis Text Line trains volunteer Crisis Counselors to help people move from a hot moment to cool and calm.
Think you have what it takes to become an Empathy MVP? Apply to become one of our volunteer Crisis Counselors and start saving lives in no time at crisistextline.org/volunteer.
Becka Ross is the Chief Program Officer at Crisis Text Line. She supports Crisis Text Line's Crisis Counselors as they help texters move from a hot moment to cool and calm. Becka recently relocated from Chicago to New York with her husband and two children.
A version of this story originally ran in Issue 10 of the Goodnewspaper in February 2020. The Goodnewspaper is our monthly print newspaper filled with good news.
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