MHM Magazine

Issue 3 | 2021 | MENTALHEALTHMATTERS | 17 MHM withstand the pain they’re enduring and are exhausted at the continuous fight against them. It’s for this reason that it’s important they: • Don’t keep all of their emotions inside, as this can result in them losing control over their behaviour. • Remember they don’t have to deal with this all alone – help can be available if they ask for it. People often don’t reach out due to the fear of being seen as weak or a burden. Acknowledge that it is very difficult to do so, but remind them that reaching out shows enormous strength and then validate them for sharing with you. 2. Let it out - Discuss the need for them to find ways to let their thoughts and feelings out, so they can gain perspective. Letting these feelings out doesn’t take them away, but it does help to feel less overwhelmed. Help identify healthy ways they can let their feelings out, directly (e.g. with a psychologist, a trusted adult, journaling) and indirectly (e.g. art, music, exercise etc). 3. Shift focus to what can be controlled – Explain what they can and can’t control. They can’t control what they think and feel (if they could, they most likely wouldn’t be suicidal), so it’s important for them to shift their focus to what they can control, which is what they pay attention to. Clients need to understand that while these thoughts and feelings are very intense, the urge to act on them does eventually go down, especially if they’re able to shift their attention onto thoughts that are more helpful to focus on and believe in the moment. It’s very difficult to shift focus to more helpful thoughts in these moments, so it helps to have already written some down (e.g. list of reasons for living) that they can refer to whenever needed. If the teen is willing, they should collect some loving messages from friends/ family. They can use these to remind themselves to believe what their loved ones are telling them, instead of what their own thoughts are saying. Healthy distractions also help enormously when trying to shift focus away from suicidal thoughts and feelings. Teenagers are highly susceptible to impulsivity, so it’s really important to have immediate alternative activities they can engage in that are not harmful to themselves, while the impulse to act on their suicidal thoughts goes down. For great ideas they can download Calm Harm app and/or google DBT distress tolerance skills. 4. Don’t try manage alone – Sometimes the urge to act on suicidal thoughts are very high and distractions won’t be enough to prevent an attempt. So it’s essential they’re not left alone in these moments and they don’t have access to anything that could be used to harm themselves. The first thing on a suicide safety plan needs to be people / organisations that the teen is willing to contact should they feel they’re unable to prevent themselves from acting on their suicidal desires. They should identify at least three contacts (including SADAG) and they must have the actual contact numbers on the prevention plan, for ease of access. There’s an app called My3 which is specifically designed for this, so if they’re keen they can download that app to add to their toolkit of suicide prevention methods. Creating a suicide safety plan is obviously not full proof and it’s not to say that your anxiety for your client will just vanish once you’ve shared these coping strategies. I find it helpful to remember that most individuals in these situations have no one to talk to, as they fear how their loved ones will react. They’re then left to deal with very frightening thoughts and feelings they don’t know how to handle, all alone. So it’s important to never underestimate the value of being able to directly discuss these issues with your clients and provide them with a non-judgmental space to explore how they can cope with these difficult thoughts and feelings. What they decide to do in the end is up to them, but at least you were able to provide them with more than just one choice of how to deal with their painful experiences. References available upon request