CVMA-ACMV

Recognizing the Signs of Suicide

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Recognizing the Signs of Suicide

It is often not easy to recognize signs and symptoms of suicide for what they are. Signs and symptoms are usually not given in a direct and easy to understand way.  People with thoughts of suicide are usually telling us in other ways. What we see, hear, and sense from them makes us think about the possibility of suicide. They are warning signs. The safeTALK1 and ASIST2 training in suicide alertness and intervention, developed by the Centre for Suicide Prevention3 calls these invitations to remind us that they expect a response from us. Invitations can include actions, words, physical signs and feelings. Some common invitations3,4 that can be warning signs include:

Actions

  • Giving away possessions
  • Withdrawal from friends, co-workers, family (social isolation)
  • Loss of interest in activities and things that are important to them, ignoring patients
  • Being noticeably fatigued
  • Reckless behaviour, taking risks
  • Acting more aggressive or stressed out than usual (e.g. lashing out at people, being overly cynical about clients)
  • Extreme behaviour changes (e.g. being very happy or elated after a period of depression)
  • Self-harm including substance/alcohol abuse and misuse
  • Not showing up for work as often or being absent for long periods of time
  • Tidying up personal affairs, arranging for the care of children, livestock or pets “just in case something should happen”

Words

  • “I just can’t do this anymore”
  • “Things would be better if I wasn’t around;” “They would be better off without me”
  • “I am a burden to everyone”
  • “They will be sorry that I am gone”
  • “I can’t see the point of living anymore”
  • “There’s something I gotta’ do right now”

Physical

  • Lack of interest in appearance and personal hygiene
  • Sleep disturbances, being tired all the time
  • Change/loss of sex interest
  • Change/loss of appetite/weight
  • Physical health complaints
  • Marked changes in behaviour, attitude, or appearance

Feelings

  • Desperation
  • Anger or guilt
  • Numbed emotions or expressing apathy
  • Expressing feelings of hopeless, helplessness, worthlessness, apathy, sadness or loneliness
  • Trapped

Some warning signs require more immediate action than others.
If someone is talking about wanting to die or kill oneself and/or looking for a way to kill oneself, or already having a plan, call 911.


If you are having thoughts of suicide tell someone. Decide who you will tell – someone who will help you and take you seriously. If you can’t decide on someone, call the Suicide Support Line at 1-833-456-4566 or text 45645. This is available for anyone in Canada. It is a crisis line for immediate help. It connects people to their local crisis centre.


How to talk to a co-worker you think may be suicidal:

  • stay calm
  • don’t judge
  • ask them if they are feeling suicidal

Mention you have noticed changes in their behaviour and that you are concerned about them: 
"Tammy, you seem overwhelmed and worried with all the extra sick patients you’ve been dealing with lately. I notice you look really tired and have been skipping lunch with all of us more than usual. I am concerned. Are you okay?"

Ask them directly if they have thoughts of suicide and if they have a plan to kill themselves:
"Tammy, sometimes when people are worrying, feeling overwhelmed, are fatigued, and withdrawing from others, they are thinking about suicide. Are you thinking about suicide?"

Connect them with their provincial veterinary employee family assistance plan (see Appendix A) or their workplace employee family assistance plan or other mental health professionals or resources in your community. Suicide rarely comes on its own. Often there are compounding issues like family, financial, or health issues. The employee family assistance plan providers can help by providing e-services, resources and face-to-face support on child/elder care, legal issues, mental health counseling, addiction, alcohol/drug use just to name a few. At any time if you or someone else is feeling suicidal, call the Suicide Support Line at 1-833-456-4566 or text 45645. It connects people to their local crisis centre.


References and Resources

  1. safeTALK Suicide Alertness for Everyone. This three-hour workshop emphasizes the importance of recognizing the signs, communicating with the person at risk and getting help or resources for the person at risk. Visit livingworks.net to find a training near you and to learn more about safeTALK
  2. ASIST Applied Suicide Intervention Skills Training. This is a two-day intensive, interactive, and practice-dominated course designed to help people recognize and review risk, and intervene to prevent the immediate risk of suicide. It is the most widely used, acclaimed and researched suicide intervention training workshop in the world. Visit livingworks.net to find a training near you and to learn more about ASIST.
  3. The workplace and suicide prevention. Centre for Suicide Prevention. suicideinfo.ca. The Centre for Suicide Prevention website has many different types of resources, from infographics to in-depth editorial articles.
  4. Manitoba Farm and Rural Stress Line supportline.ca
  5. Canadian Mental Health Association Preventing Suicide Resources cmha.ca/documents/preventing-suicide

This checklist was written by Dr. Kathy Keil. Dr. Keil studied cognitive and neuropsychology in her undergraduate and graduate psychology degrees prior to attending veterinary school. She is not a licensed psychologist. She has training in Mental Health First Aid, safeTALK suicide awareness, ASIST suicide intervention and is licensed to teach safeTALK. She regularly teaches suicide awareness and basic intervention skills to veterinary professionals and ways for them to take care of their own mental well-being. She is a member of the ABVMA Member Wellness Committee and a technical services veterinarian with Merck Animal Health. She is the leading force behind the Merck-CVMA “It’s Time to Talk about Mental Health in Vet Med” Awareness Campaign.