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Depression & Mental Health Blog
April 20, 2020
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Differentiating True Threats of Self-Harm and Suicide From Cries For Attention

In this blog, we discuss some truly deep, life-or-death decisions that friends, family and loved ones have to make when they know that someone in their circle is hurting. Unfortunately, these extremely difficult decisions have incredibly important consequences. Sometimes we struggle thinking that if we give into empty cries for attention, whether it be from a child or adult, we will enable that person to continue bad behavior. However, if our intuition is wrong, and the threat of self-harm or suicide is real, the consequences can be fatal. With such high stakes, what can we do? Oftentimes, we dismiss mental anguish as a “normal part of life.” The stigma associated with mental health issues is still very real. This is especially true because crises affect individuals in very different ways. While money and finances, for example, may be a very important and serious issue for one, they may not be a priority for someone else. That does not mean that the pain is any less real. Further, some often find it difficult to understand and sympathize when somebody is suffering from anxiety and depression. Unfortunately, when we don’t give mental anguish and mental health the attention they deserve, the situation can often devolve into physical trauma and can be fatal in the worst of cases.

So, What to Do?

The answer is strikingly straightforward, but often very difficult to put in motion. The bottom line is that we must stop trying to distinguish between true thoughts of self-injury or suicide and cries for attention in the form of threats of self-harm –no-one but the subject themselves is truly qualified to make a definitive decision on intent. We can only assume, based on what we know. Destructive behavior in any form must be taken at face value - seriously. It is important to understand that attempted suicide, thoughts of suicide, self-harm and cries for attention can happen in children, adolescents and adults. They may manifest differently, but the same base emotions are still present. In other words, there is a person in need – they need help.

Next Steps

If you are going to get it wrong, better to be safe than sorry. Any talk of self-harm or suicide should be taken with the utmost importance and urgency.
  • Whether you are hearing this distressful talk in person, or experiencing it over the phone or online, calling 9-1-1 is the route to take. Don’t worry about how your friend or child may feel about what they may call a “betrayal” – you need to look out for them, even if there is some doubt about their true intent.
  • Try to be as calm as possible. It is very easy to get caught up in a whirlwind of emotions when you hear that someone you love is threatening such horrible things. If you are with the individual, stay with them, unless your safety is in question. If on the phone or online, engage them as you seek help. It’s best not to aggravate the situation by berating them or trying to convince them that what they’re saying is foolish. Rather, remain positive and seek help.
  • Once in the system, a mental health professional should assess your friend or loved one to determine if there was an intention to act upon the threat of self-harm. If this is the case, a temporary psychiatric hold may be appropriate. Each state has its own process. These are the first steps toward comprehensive mental health treatment.
Even if it is determined that there was no real intent behind the suicidal or self-harm threat, your loved one has a problem. They need evaluation by a qualified professional. Further, while there was no intent this time, next time may not be the same.

When You Just Can’t Help

There are times that we try our best, but we just can’t help. The problems facing our family member or loved one may be so great that they truly believe the only way out was by ending their life. As someone close to them, we often think of how we could have prevented it or done something differently to change the circumstance. Feelings of anger, despair, guilt and confusion may all be present and may last weeks or even months. This is a time to speak to those around you and get professional counseling to work through the emotions and cope with a new reality. In the meantime, do not take for granted that your friend or loved one may have a mental illness. Support them with love and compassion and try to get them into psychiatric or therapeutic care. Doing so allows them to address their underlying issues and get them on track to improving their mental health and life. If you or someone you know has thoughts of suicide please call The National Suicide Prevention Lifeline at 1-800-273-8255. Live chat is also available.