How to have difficult conversations around suicide

Suicide has been a taboo topic for a long time. An old school of thought is that talking about suicide can give depressed individuals ideas of self-harm, but this is untrue. Others might feel they won’t know what to do if the person says they do have suicidal feelings or thoughts, so they avoid broaching the topic.  

Suicide and the Defence Force 

Within the veteran community, research1 suggests that the age-adjusted rate of suicide is 21% higher in ex-serving males, and 127% higher in ex-serving females, compared to their Australian general population counterparts. The Royal Commission into Defence and Veteran Suicide is currently investigating the culture and systemic issues faced by Australian Defence Force members and veterans that too often result in loss of life to suicide.  

The loss of an occupation, support, and connection to the Defence Force can result in increased feelings of loneliness, isolation, hopelessness, and depression in veterans which may be emotional precursors to suicide events. Other factors that may increase the risk of suicide include acute psychosocial stressors (i.e., involuntary discharge) and mental health conditions like anxiety disorder, depression, PTSD, traumatic brain injury, and substance abuse.  

Starting the difficult conversation 

When starting a conversation with someone who you think may be suicidal, it’s important to ask the person directly if they are feeling suicidal or have been thinking about suicide. Discussing suicide openly by stating what you’ve noticed and asking how the person is feeling can give the person the opportunity to take the first steps towards getting the help they need. You don’t need to fix the problem, but rather just listen and engage empathically and without judgement.  

Conversation starters could simply be: ‘I’ve noticed you haven’t been yourself lately, is everything okay?’ You can be specific about the changes you’ve noticed. If you think something is wrong but they insist they’re okay, then trust your instincts.  

If necessary, ask them directly whether someone in their support network knows about your concerns and the changes you’ve noticed. You may have to encourage them to talk to someone, either a family member or a health professional, about what they are experiencing.  

Tips from a psychologist: 

What to do if you have observed suicidal behaviours or signs that worry you: 

1. Pick a time and place for an in-depth conversation where you can give your full attention to the other person.
2. Engage your full attention to while talking to them. Avoid minimising or dismissing their thoughts and feelings and provide reassurance that you are there for them. Show respect and be as understanding as possible about their situation.
3. Ask directly about suicide and talk about the changes in them that you have noticed. If the person reveals they are thinking of suicide and have a plan it is critical you seek professional help as soon as possible. It is okay to call 000 in these moments.
4. Remember you don’t have to take it on alone. Tell them you take this seriously and you can’t keep this information to yourself. You don’t need to deal with this situation alone so encourage the person to get professional help and support them to do so. 

If you or someone you know is in crisis and need immediate support, contact 000 or attend your nearest hospital. For 24-hour support, phone Open Arms: 1800 011 046 or Lifeline: 13 11 14.  

Written by Tamsin Wallace, Mates4Mates Psychologist 

1Australian Institute of Health and Welfare. (2020). National suicide monitoring of serving and ex-serving Australian Defence Force personnel: 2020 update.