ACT

If SOMEONE YOU KNOW is thinking about suicide, there is help

Adults may show verbal, behavioral, situational, and other signs of suicide. If you are a friend or family member, these signs should prompt you to take action and get help.   The following are signs to be aware of. Source: Osgood, N. 1985, Suicide in the Elderly, A Practitioners Guide to Diagnosis and Treatment, Aspen Publications

Verbal Signs:

Direct:

  • I’m going to end it all
  • I’m going to kill myself

Indirect:

  • What’s the point of going on?
  • Who cares if I am dead anyway?
  • You would be better off without me
  • Soon you won’t have to worry about me anymore

Behavioral Signs:

  • Purchasing or owning a gun
  • Stockpiling pills
  • Making or changing a will (if it does not seem reasonable)
  • Giving away possessions
  • Unexplained behaviors or rejection of friends or family
  • Substance, medication or alcohol abuse
  • Loss of understanding, judgment or memory
  • Talking or writing about death, dying or suicide when these actions are out of the ordinary for the person
  • Feeling hopeless
  • Feeling rage or uncontrolled anger or seeking revenge
  • Acting recklessly or engaging in risky activities—seemingly without thinking
  • Feeling trapped-like there’s no way out. Feeling anxious, agitated or being unable to sleep, or sleeping all the time
  • Experiencing dramatic mood changes

Situations Which May Precipitate Suicidal Thoughts:

  • Recent move
  • Death of a spouse, child, or friend
  • Diagnosis of a terminal illness
  • Recent arguments with family members
  • Serious problems in relationships

Symptoms Which May Accompany Suicidal Thinking:

  • Depression
  • Depression accompanied by anxiety
  • Significantly increased tension and agitation
  • Dependency
  • Isolation
  • Rigidity

Remember to Acknowledge - Care - Tell (ACT)®

Talking with someone about your concern involves addressing a major stigma about mental illness.  If you need guidance regarding how to talk with someone you are concerned about, contact Riverside Mental Health Center’s Emergency Line (781) 769-8674, your medical provider, clergy, the Samaritans (877) 870-HOPE (4673), or the National Suicide Prevention Lifeline (800) 273-8255. 
The following are guidelines of the Acknowledge, Care, and Tell (ACT)® approach:

Acknowledge:

Speak directly and tell the individual that you are worried that he/she may be thinking about hurting or killing him/herself (70% of individuals with suicidal intent give some warning signs).  You cannot make anyone more suicidal by talking, but you can reduce the isolation and bring hope and help.

For example, you could say the following:

“This is hard to say, but I think you may be considering killing yourself and I am very worried.”
State the behaviors that give you this concern.

For example:

“You have made comments about how hopeless you feel and you have withdrawn from all of your friends.”
Ask if he/she has a plan.

For example:

“I want to know if you have been thinking about killing yourself. Do you have a plan? What is the plan?”

Care:

  • Let the person know that you care and want to help.
  • Provide reassurance that he/she is not alone, and can and will feel better no matter how he/she feels now.
  • Stay with him/her or find a responsible adult to stay with him/her until help arrives.

Tell:

  • If the individual is willing to get help tell him/her that you are calling an emergency service provider.
  • If the individual is unwilling to get help have someone stay with him/her and call the Riverside Emergency Services (781)769-8674 or (800) 529-5077. Explain the situation to the emergency clinician who can determine whether this individual should be evaluated against his/her will. The clinician can have a section 12 order issued which mandates that the town’s emergency services bring this individual to an emergency room to be evaluated.  Discuss with the emergency service provider the best way for you to manage the situation until the town’s emergency services arrive.

Keep in Mind:

  • It is not your responsibility to determine whether an individual is at risk and what to do, but only to let someone with knowledge and training know the specifics about your concerns.
  • The thoughts of an individual at risk of suicide are often significantly distorted and irrational. Consequently, he/she may not have good judgment.

GET HELP NOW

Hurting yourself is NEVER the answer. There is help available…talk to someone now

For immediate help call
9-1-1

Riverside Emergency Services
781-769-8674

Newton Wellesley Hospital
617-243-6000

Samariteen Hotline
1-800-252-TEEN (8336)

Samaritan Helpline
1-877-870-HOPE (4673)

National Suicide Prevention Lifeline
1-800-273-TALK (8255)