WHAT YOU NEED TO KNOW
Make safety a priority for your relative recovering from
Remember that safety cannot be guaranteed by
anyone—the goal is to reduce the risks and build
supports for everyone in the family. However, it is
Ultimately, please reach out for help in supporting your
family member and yourself through this crisis. See the list
below of hotlines, information, and support organizations
a suicide attempt. to help you and your family member move forward with
important for you to believe that the safety plan can
Research has shown that a person who has attempted your lives.
help keep your relative safe. If you do not feel that it
to end his or her life has a much higher risk of later Remember that the emergency department is open 24
can, let the emergency department staff know before
dying by suicide. Safety is ultimately an individual’s hours a day, 365 days a year to treat your family member,
you leave. if the problem continues and if your family 2,3 member’s
responsibility, but often a person who feels suicidal
Maintain Hope and Self-Care—Families commonly medical team is unavailable to provide the needed care.
has a difficult time making good choices. As a family
member, you can help your loved one make a better provide a safety net and a vision of hope for their
choice while reducing the risk. suicidal relative, and that can be emotionally exhausting. 2
Contact Alcoholics Anonymous at 212-870-3400 or www.aa.org Contact Narcotics Anonymous at
818-773-9999 or www.na.org Contact Al-Anon (or Alateen for youth) at 757-563-1600 or www.al-
Never try to handle this situation along—get support anon.alateen.org
Reduce the Risk at Home—To help reduce the risk 3
To learn more about ACT, contact NAMI at 1-800-950-NAMI (6264) or www.nami.org/act.
of self-harm or suicide at home, here are some things from friends, relatives, and organizations such as the
to consider: National Alliance on Mental Illness (NAMI), and get
• Guns are high risk and the leading means of death
professional input whenever possible. Use the TO LEARN MORE ABOUT SUICIDE A Guide for Taking Care of
resources on the back pages of this brochure, the
AND TO GET HELP, CONSIDER THE
for suicidal people—they should be taken out of the
home and secured.
Internet, family, and friends to help you create a for Your Family Member
support network. You do not have to travel this FOLLOWING RESOURCES.
• Overdoses are common and can be lethal—if it is road along. after Treatment in the
necessary to keep pain relievers such as aspirin, In a crisis, contact:
Advil, and Tylenol in the home, only keep small 1-800-273-TALK(8255); Emergency Department
MOVING FORWARD TTY:1-800-799-4TTY(4889)
quantities or consider keeping medications in a
Emergency department care is by nature short-term and
locked container. Remove unused or expired Suicidal thoughts and actions
crisis oriented, but some longer-term interventions have National Suicide Prevention Lifeline
medicine from the home. generate conflicting feelings in
been shown to help reduce suicidal behavior and A 24-hour, toll free crisis hotline that links callers
• Alcohol use or abuse can decrease inhibitions and thoughts. You and your relative can talk to the doctor to a nearby crisis center. The Lifeline accepts family members who love the
cause people to act more freely on their feelings. about various treatments for mental illnesses that may calls from non-English speakers. person who wishes to take his or
As with pain relievers, keep only small quantities of help to reduce the risk of suicide for people diagnosed www.suicidepreventinlifeline.org. her own life. That is why this
alcohol in the home, or none at all. with illnesses such as schizophrenia, bipolar disorder, or guide was developed for you. It
depression. Often these illnesses require multiple types FOR MORE INFORMATION ABOUT
Create a Safety Plan—Following a suicide attempt, will give you some important
a safety plan should be created to help prevent another of interventions, and your relative may benefit from a SUICIDE AND MENTAL ILLNESS: points on how to take care of
attempt. The plan should be a joint effort between second opinion from a specialist.
American Association of Suicidology yourself and your family member
your relative and his or her doctor, therapist, or the If your relative abuses alcohol or other drugs, it is also following a suicide attempt and it
emergency department staff, and you. As a family A resource and education organization dedicated
important to seek help for this problem along with the will provide resources to help
member, you should know your relative’s safety plan to the understanding and prevention of suicide.
suicidal behavior. Seek out a substance abuse specialist.
and understand your role in it, including: www.suicidology.org or call 202-237-2280. you move forward.
Contact your local substance abuse treatment provider
• Knowing your family member’s “triggers,” such as by calling 1-800-662-4357 or visiting American College of Emergency
an anniversary of a loss, alcohol, or stress from www.findtreatment.samhsa.gov, or contact groups like
Physicians (ACEP) A national medical
relationships. Alcoholics Anonymous (AA) or Narcotics Anonymous
society committed to advancing emergency
(NA) to help your loved one; Al-Anon may be a good
• Building supports for your family member with care through continuing education, research, www.theadvocacyalliance.org
resource for you as a family member.2 If it is available in
mental health professionals, family, friends, and and public education. www.acep.org or call Toll Free 1-877-315-6855
your area, an integrated treatment program like
community resources. 1-800-798-1822.
Assertive Community Treatment (ACT) may provide Developed by the U.S. Department
• Working with your family member’s strengths to better outcomes that traditional care for some severely American Foundation for Suicide of Health and Human Services
promote his or her safety. ill individuals.3
Prevention Dedicated to advancing the
Contact Alcoholics Anonymous at 212-870-3400 or www.aa.org Contact Narcotics
• Promoting communication and honesty in your Anonymous at 818-773-9999 or www.na.org Contact Al-Anon (or Alateen for youth) at 757-563- public’s knowledge of suicide and its prevention.
1600 or www.al-anon.alateen.org3 To learn more about ACT, contact NAMI at 1-800-950-NAMI
relationship with your family member. (6264) or www.nami.org/act. www.afsp.org or call 1-888-333-AFSP.
W HAT H APPENS IN THE E MERGENCY D EPARTMENT ?
who may have information. Emergency department have a clear understanding of what will take place
GOAL Finally, a doctor may assess in more detail the actual
over the next 3-10 days, while a court decides on
suicide attempt that brought your relative into the personnel should try to contact the medical profes-
The goal of an emergency department visit is to get sionals who know the situation best before making the next steps for treatment.
emergency department. Information that the treat-
the best outcome for the person at a time of crisis– decisions.
ment team should look for includes the presence of If your relative has a hearing impairment or does
resolving the crisis, stabilizing the patient medically
a suicide note, the seriousness of the attempt, or a Other important information about your relative’s not speak English, he or she may have to wait for
and emotionally, and making recommendations and
history of previous suicide attempts. history to share with the emergency department staff someone who knows American Sign Language or an
referrals for follow-up care or treatment. There are
includes: interpreter. It is generally not a good idea to use a
several steps in the process, and they all take time. Inform the emergency department • A family history of actual suicide – mental health family member to interpret in a medical situation.
When someone is admitted to an emergency depart- personnel if your relative has: professionals are taught to pay attention to this If the emergency department’s treatment team,
ment for a suicide attempt, a doctor will evaluate because there is an increased risk in families with
• Access to a gun, lethal doses of medications, the patient, and you do not feel hospitalization is
the person’s physical and mental health. Emergency a history of suicide. necessary, then you should all be a part of developing
or other means of suicide.
department staff should look for underlying physical • Details about your relative’s treatment team – a follow-up treatment plan. In developing a plan,
problems that may have contributed to the suicidal • Stopped taking prescribed medicines. a recent change in medication, the therapist is on consider the following questions:
behavior, such as side effects from medications, • Stopped seeing a mental health provider vacation, etc. This information is relevant for emer-
untreated medical conditions, or the presence of or physician. gency department staff because if they do not feel Questions Family and Friends Should Ask
street drugs that can cause emotional distress. While hospitalization is best, they need to discharge your About the Follow-up Treatment Plan
• Written a suicide note or will. family member to a professional’s care.
emergency department staff prefer to assess people
Ask your family Ask the treatment
who are sober, they should not dismiss things people • Given possessions away. • If the person has an Advance Directive1, review this
member: It is important team: This includes the
say or do when intoxicated, especially comments about • Been in, or is currently in, an abusive with the emergency department treatment team. If to be honest and direct with doctor, therapist, nurse,
how they might harm themselves or others. relationship. you have a guardianship, let them know that as well. your questions and answers. social worker, etc.
ASSESSMENT • An upcoming anniversary of loss. You may want to get permission from the staff and
• Do you believe profes- • Do you feel safe to
After emergency department staff evaluate your family your relative to sit in on your relative’s evaluation in sionally that my family leave the hospital, are
• Stated abusing alcohol or drugs.
member’s physical health, a mental health assessment the emergency department to listen and add informa- member is ready to leave you comfortable with
should be performed, and the physician doing the • Recovered well from a previous tion as needed. Your role is to balance the emergency the hospital? the discharge plan?
exam should put your relative’s suicidal behavior into suicidal crisis following a certain type department staff’s training and the interview of the • Why did you make the • How is your relationship
context. The assessment will generally focus on three of intervention. patient with your perspective. The best emergency decision(s) that you did with your doctor, and
areas: department decisions are made with all the relevant about my family member’s when is your next
information. care or treatment? appointment?
1. What psychiatric or medical conditions are present? WHAT THE EMERGENCY DEPARTMENT
• Is there a follow-up • What has changed since
Are they being or have they been treated? Are the NEEDS TO KNOW: HOW YOU CAN HELP NEXT STEPS AFTER THE EMERGENCY appointment scheduled? your suicidal feelings or
suicidal thoughts and behavior a result of a recent Can it be moved to an actions began?
Confidentiality and Information Sharing DEPARTMENT
change, or are they a longstanding condition? Family members are a source of history and are often earlier date?
• What else can I/we do
2. What did the person do to harm himself or herself? key to the discharge plan. After your relative’s physical and mental health are • What is my role as a to help you after you
Have there been previous attempts? Why did the Provide as much information as possible to the thoroughly examined, the emergency department family member in the leave the emergency
person act, and why now? What current stressors, emergency department staff. Even if confidentiality personnel will decide if your relative needs to be safety plan? department?
including financial or relationship losses, may have hospitalized-either voluntarily or by a commitment.
laws prevent the medical staff from giving you informa- • What should we look • Will you agree to talk
contributed to this decision? Does the person If hospitalization is necessary, you can begin to work for and when should we with me/us if your
regret surviving the suicide attempt? Is the person tion about your relative, you can always give them
with the receiving hospital to offer information and seek more help, such as suicidal feelings return?
angry with someone? Is the person trying to information. Find out who is doing the evaluation and
support and to develop a plan for the next steps in retuning to the emer- If not, is there someone
reunite with someone who has died? What is the talk with that person. You can offer information that gency department or else you can talk to?
may influence the decisions made for your relative. your relative’s care. If involuntary hospitalization is
person’s perspective on death? contacting other local
necessary, the hospital staff should explain this legal resources and providers?
3. What support systems are there? Who is providing If you ever again have to accompany your relative to
procedure to your relative and you so that you both
treatment? What treatment programs are a good the emergency department after an attempt, remember Remember: It is critical for the patient to schedule
match for the person? What does the individual to bring all medications, suspected causes of overdose, 1
Advance directives are legal documents that allow someone to give directions for future medical care or designate another person
a follow-up appointment as soon as possible after
and any names and phone numbers of providers
to make medical decisions if one is unable to competently make such decisions. For more information, contact the National
discharge from the emergency department.
and the family feel comfortable with? Disability Rights Network (NDRN) at 202-408-9514 or www.ndrn.org.