How to Recognize and Help When Someone is in Distress

Watching a friend, student or family member struggle with emotional problems can be challenging and frightening. You may wonder, “How can I tell if this is really serious?” “How can I best help my friend?” or “What will the college do in a situation like this?” Following is some information about common misperceptions about mental health and suicide, signs that someone is experiencing a crisis, ways to help, and campus resources.

Myth: People who talk about suicide won’t actually attempt suicide.
Fact: 70-75% of people who attempt or commit suicide give some verbal or non-verbal clue about their intentions. Some signs someone may be thinking about suicide include:

• Direct references to thoughts of suicide or death (“I wish I were dead,” “Everyone is better off without me”)
• Statements of intent or plans to attempt suicide
• Obtaining weapons or other means of committing suicide
• Giving away possessions
• Saying good-bye
• Vague references to unusual thoughts (“I’ve been having stupid thoughts,” etc.)
• Depression, or symptoms of depression
• Expressions of despair and hopelessness (“I don’t think things will get better,” “I don’t know if I can do this anymore,” “Life is pointless”)
• Erratic attendance or neglect of usual responsibilities such as going to class or work
• Neglecting hygiene, appearance, or necessary functions such as eating and sleeping
• Withdrawal or isolation from social relationships and/or activities
• Extreme mood swings or changes in personality
• Impulsivity and/or violence

Myth: Asking someone if they are considering suicide might put that thought into their head.
Fact: Asking someone about suicide is not going to give them the idea if they haven’t already been thinking about it. In fact, asking directly lets that person know that you are willing to hear about their pain and to help them.

Myth: Once people start thinking or talking about suicide there’s no way to stop them.
Fact: People who consider suicide don’t generally want to die – they just want their pain to stop. If you think a friend may be thinking about suicide you can:

• Approach your friend directly, at a time when you can speak in private, and say you are concerned/worried (“I’m concerned about you.  If something is wrong, I’d like to help.”)
• Give specific examples of their words and behaviors that you’re concerned about (“I’ve noticed you haven’t sat with us at lunch for the last several days.”)
• Invite them to talk about it (“Would you like to talk about what’s going on?” “Are you OK?”). Then listen openly to what they have to say.
• Remind them that depression, suicidal feelings, and other mental health concerns are treatable. A great resource is Cornell’s Counseling Center – they offer free, short-term counseling to Cornell students and have information to help refer students who may need or want services off-campus.

 
Myth: There is no connection between suicide and alcohol use.
Fact: Use of alcohol (or other drugs) can increase someone’s impulsivity while decreasing their inhibitions and ability to think rationally. People who are drinking during or in response to an emotional crisis may be at greater risk for suicidal or other risky acts.

Myth: The college kicks out students who have made suicide attempts
Fact: Any time a student is a serious risk to themselves or others, including if a student has attempted suicide, the college’s first concern is to be sure that student is safe, not to kick them out of school. In many cases the college may require documentation from a health professional who has evaluated the student to assess the student’s readiness to be in the academic environment and give recommendations for how the college can best support the student. In the vast majority of cases the college is going to work with that student to help get back on track academically and to make sure that a good support network and safety plan are in place.

How can I tell if someone is experiencing a crisis or might be suicidal?
Some signs that someone may be experiencing general emotional distress or in crisis include:

• Change in behavior, mood
• Change in appearance, hygiene
• Change in sleeping or eating  
• Change in substance use 
• Change in work &/or school attendance &/or completion
• Isolation/withdrawal from friends, family
• Talking about suicide or being preoccupied with thoughts about death
• To see if you are experiencing signs of depression take our free, on-line depression screening

What are some things to avoid doing?

There are a few things that aren’t so helpful when a friend is in crisis. Some things not to do include:

• Don’t act like you have all the answers or offer clichés or simple advice (e.g., “Don’t worry, be happy”, “What you should do is …”).
• Don’t promise to keep secrets – if someone says they will talk to you about an issue “only if you promise not to tell anyone,” it’s important to be up front in saying you cannot make that promise because you care about them and want them to get any help that they may need. You don’t want to keep a secret and regret it. 
• Don’t act shocked by what someone tells you.
• Don’t assume the situation will resolve itself.
• If someone is expressing thoughts of suicide, do not leave them alone to the best of your ability. For example, ask someone else to make a call for help or sit with them while you call for assistance.

What should I ask someone if I think they might be suicidal?

• Ask directly if they are considering killing themselves. Ask more than once if the answer is unclear. (e.g., “Have you thought of not wanting to live anymore?” “Are you thinking about killing yourself?”  “Have you thought about how you would do it?”)
• Ask them if they have a plan for how they will attempt suicide
• Ask if they have the means
• Ask if they have taken any steps toward implementing their plan

What should I do if the person says “yes”?

First, take any expressed suicidal intent seriously. If the person says they’re thinking of killing themselves, and especially if they have a specific plan and a means of doing so, the best thing you can do for them is to get help. Let them know you are calling for help and elicit their cooperation if possible. If you suspect the person may be suicidal but they are being vague or refusing to discuss it, it’s better to get help to be on the safe side. The quickest way to get help on campus is to call Campus Safety at (319) 895-4299. Campus Safety will be able to contact on-call professional staff and emergency responders.

 
What should I do if I’m worried about someone and just not sure how to respond?
There are several resources available to assist you in figuring out how to best help your friend. The staff at the Counseling Center (Ebersole Building, 895-4292) are available to consult with members of the Cornell community. They can talk with you about what you’re observing, strategies for responding, and specific resources to share. You can also contact the Dean of Students (1^st floor Old Sem, 895-4234). In addition to taking the steps described above the Dean may enlist the help and support of others who have connections to that student.

In addition to the above, if you are concerned by a friend's Facebook posting there are other ways to report and support a friend online.  Check out this video from Facebook to learn more.