Suicide Prevention: Speak up so others don't act out Published Aug. 11, 2008 By Chuck Roberts Landstuhl Regional Medical Center Public Affairs LANDSTUHL REGIONAL MEDICAL CENTER, Germany (AFPN) -- A canoe plummets over a waterfall and crashes into boulders below. Moments earlier, as it nears the precipice, a bystander almost yells out a warning but assumes the canoeist is in control of the situation and remains quiet. Prior to that, several hikers watch the same person paddling obliviously past numerous signs indicating rough water ahead. As in the scenario above, speaking up and intervening early can save the life of a friend, colleague or loved one contemplating suicide, said Maj. (Dr.) David Reynolds, chief of clinical health psychology at Landstuhl Regional Medical Center. "It belongs to everyone," the Air Force psychologist said of responsibility to intervene. "If you're concerned someone you know is contemplating suicide, don't keep silent." Intervention is critical, Doctor Reynolds said, because it can help change the perception of a person contemplating suicide who thinks of taking his life as a long-term solution to what may be only a short-term problem. The vast majority of people don't commit suicide because they want to kill themselves, he said, but as a way to end the torment of not being able to cope with their problem. Common problems include separation, disabling physical conditions, alcohol abuse, feared legal repercussions, emotional rejection or any overwhelming situation people feel they can't escape from. "It can rock your world," Doctor Reynolds said of the emotional impact some face as the gulf widens between reality and their belief in how things should be happening. As an example, he cited the case of a young Airman who was seriously distraught because he had not become the millionaire he'd envisioned himself by his mid-20s. Signs or symptoms of someone contemplating suicide can include withdrawal from society, giving away personal belongings or actions as obvious as saying final goodbyes. In one blatant incident, an Airman kept a book about how to conduct suicide in full view of her colleagues. No one came forward and the young Airman ultimately committed suicide. There was a time when people hesitated broaching the subject of suicide for fear of placing the thought in someone's mind. But if you have enough suspicion and concern to think about approaching the subject with someone, Doctor Reynolds said, it's almost certain the idea has already been contemplated. When confronting someone, Doctor Reynolds said consideration should be placed on "how" or "what" to ask. A direct question such as, "Are you thinking about committing suicide?" may draw a negative response. A more meaningful response might be elicited by phrasing the question in a different way, such as "Are you thinking of hurting yourself?" or "When was the last time you thought about committing suicide?" If someone indicates he or she contemplating suicide, you should help ensure that person receives counseling. But at any level of care from friends or healthcare professionals, Doctor Reynolds said the key is attempting to find out what the problem is and helping the person see there are alternatives other than suicide and help him or her see beyond the immediacy of his or her problem. That was the case with one suicide victim who, upon receiving the news he had prostate cancer, acted on his immediate reaction to end his life. If he had taken the time and opportunity to speak with a healthcare professional, Doctor Reynolds said his outlook might have changed given the knowledge that recent medical history points to the disease as treatable and curable in many cases. But someone who is suicidal often sees problems with tunnel vision and visualizes his or her problems as worse than others. The magic question Doctor Reynolds said you want to help that person answer is: "What is the one thing that would make life better so you wouldn't feel the need to commit suicide?" For example, if a relationship suddenly ends while someone is deployed, the servicemember may be convinced he or she has lost the only person he or she will ever love again. A friend can point out countless others have been through the same experience and have gone on to discover love again. And once someone is identified and receiving treatment, Doctor Reynolds noted the importance in keeping track of how he or she is getting along and remaining aware of how his or her problem is being resolved. The good news about suicide prevention is that it works, said Doctor Reynolds, noting that suicide rates among servicemembers are statistically less than their civilian counterparts. For more information about suicide prevention, visit: National Suicide Prevention Lifeline Army Behavioral Health Suicide Prevention Resource Center