|Topic||What happens now?|
|Publisher||Mental Health Foundation and Ministry of Health, 2018|
You are not alone – you can get through this
Life after a suicide attempt may at first feel chaotic and without direction, but with time and the right support you can find your way back to a life filled with hope, connection and a new sense of purpose and meaning.
Getting your life back on track after attempting suicide is not easy. It takes time to recover, physically and emotionally. It's natural to have many feelings, thoughts and concerns. You might not know what to do or what to say.
This factsheet is a starting point for working through some of the questions that can come up after a suicide attempt. And it offers ideas about what may assist you in regaining a sense of control and getting back on track.
If you have just attempted suicide, it’s important to see a doctor or mental health worker at either a hospital or clinic to make sure your physical and mental health are both okay.
It’s important for you to see a medical professional as soon as possible, even if the attempt does not appear life threatening.
If you have gone to hospital, it can be a daunting experience. The waiting, the busy environment, and the lack of control over the situation can be unsettling.
The Ministry of Health has some good advice about what to expect and how to cope with a busy hospital environment.
At hospital, medical staff will look at any physical injuries first. After these have been treated, they will then arrange for a mental health worker to come and talk about what was happening before the attempt.
This assessment will look at:
This is really just a conversation to look at what has happened, why and if any current risks remain. Using the information from this discussion the health professional will assist you to make plans for the next few days and talk about what might be helpful in the coming weeks. They might also make appointments or recommend you make contact with an appropriate health service.
If you go to a local medical clinic, a family doctor (GP) will discuss your situation and determine if further medical tests are needed. Once they are satisfied there are no physical problems, they will talk more about what has been happening, what supports are available at home, and if there are any risks of further harm. They might also suggest going to see a counsellor.
The GP’s goal will be to put plans in place to ensure you have support over the following days and weeks. They will probably suggest you return for follow-up appointments to monitor how you are going and whether you have enough support.
The GP will probably encourage you to return for follow up appointments over the coming weeks, and will use these appointments to monitor how you are coping and whether you have enough support.
Immediately after a suicide attempt you might find it hard to think clearly or remember details of conversations. You may also find it’s hard to talk about what has happened or to describe to others how you are feeling.
Consider involving someone you trust in conversations and meetings with the health professional. They can be a second pair of ears and provide extra information in discussions.
You have the right to tell health professionals when you don’t want them to discuss your situation with others in your support network.
All health professionals are legally required to maintain their patient’s confidentiality but there are some exceptions. These include if:
If you do not give permission for information to be shared, people supporting you can still give information to health professionals, as well as ask for advice and information about their role and what to expect, etc.
If you are 16 years or under it's important for a whānau member or carer to know what has happened so that they can support you. This does not mean that they will hear every detail of your conversations, but the health professional can provide them with information that helps them to support you and keep you safe.
If you’re unsure how confidentiality works, ask the health services staff to explain it to you and your support people so that everyone understands what information will and won’t be shared.
With the right support in place you should be able to go home. If you do not feel safe to return home, say so, and ask what other options are available. It can be helpful to write this information down so that you can refer to it again later. Often it can be hard to remember things when you are tired or stressed.
Before you head home make sure you have an understanding of:
How a health professional responds to you will depend on their personal attitude towards suicide and their level of skill, confidence and comfort in responding to suicide attempts. Time pressures within the clinic or hospital may also affect the amount of time that they can spend with you.
Consider the advice that the health professionals offer you, talk openly about any worries that you have, and ask questions so you fully understand your options for moving forward.
If you do not feel safe to return home, say so and ask what other options are available.
The first few days after your suicide attempt are critical and will often raise a range of big issues and questions such as:
There are no clear-cut answers but there are several things you can do to make it easier.
Surround yourself with people who you trust, who will listen to you without judgment and who you enjoy being with.
Different people may have different roles. For example:
There is room for a whole range of people in your support network but make sure you identify at least one person you feel that you can talk with about how you are feeling.
You may or may not want to talk about what has happened or what led up to your suicide attempt. It's common to feel unsure, worried and even distressed about what to say to others.
When you are ready, it's important to talk about what has happened with people you trust. This allows others to be there for you and provides a chance to work out where to go from here.
It's important to start thinking about what you (and those close to you) will say to others. It can be useful to have a clear agreement about what should be shared and with whom. By sharing some information about what has happened you might also find that this helps to reduce gossip and speculation.
Often a short message about what has happened and how you are now coping is enough for most people. It could be something like, “Things have been really tough for me lately and I attempted suicide. I just wanted to let you know what I have been dealing with and that I am trying to get back on track.”
Learn from others – reading about other people who have managed difficult times can be inspirational.
There are many different types of support groups in New Zealand that you can also go to for assistance and to find someone to talk to.
Don’t be afraid to let people know what you need from them. It might be that you just want to be listened to, or that you would like to talk about something other than your suicide attempt.
A health professional can help to address the feelings or situations that led up to your suicide attempt. You can talk openly about what has happened and find new ways to cope with difficult decisions, experiences or emotions.
You might find sessions with a health professional useful to:
Even if you don’t think it will be helpful to link in with a health professional consider having a couple of sessions to try it out.
Finding a health professional that you are comfortable with can take time. If you don’t feel comfortable with the first health professional you can talk to them about how you are feeling or you can try a different health professional. No matter what you decide it is important to keep trying.
After a suicide attempt you may be prescribed medication to help improve your mood. Unlike antibiotics some of these medications take time to take effect; anywhere between 2 to 4 weeks. Sometimes medications can make you feel worse.
When starting a new medication you should have regular reviews with your doctor so they can monitor your progress and check for any side-effects. It’s also important to talk to your support network and doctor about how you’re feeling.
It may take several tries before you find a medication that suits you, so continuing to see the doctor while this is sorted out is essential. If you decide to stop taking your medication, it’s best to do so slowly, with supervision by your doctor.
If you seek support or guidance from alternative or complimentary practitioners, community or religious leaders, it is wise to tell them all about the other types of services or advice you are getting. They can then consider this information before deciding what other supports may be useful.
You might not know why, or even if, you wanted to end your life. You might feel confused by what has happened. The reason for your attempt will perhaps become clearer as you work through your thoughts and feelings in the next few days and weeks.
Understanding why you attempted suicide and how this now affects you can take time, but it is an important step in finding your way back.
Some of the reasons others have given for attempting suicide have included:
There is no right or wrong way to feel following a suicide attempt.
A suicide attempt is often associated with intense psychological pain along with negative feelings that seem endless and impossible to escape from. Stressful life events may be the trigger for these feelings and can include:
And sometimes there appears to be no obvious life events or experiences that have led to a suicide attempt.
Some mental health conditions and medications will also increase the likelihood of someone experiencing intense out of control thoughts and feelings, but attempting suicide does not always mean a person was experiencing a mental health problem.
It’s possible that people may be fearful of saying the wrong thing. Here are some things that could guide your conversations with them:
Returning to your previous work or study is an important sign that you are getting back on track but it can be difficult to explain why you have been away.
It may be useful to discuss the possibility of:
If you don’t have close relationships with the people you work or study with you may not want to talk about what has happened; you might want to keep your personal and work/study life separate. However, by letting someone know (such as managers, supervisors, study coordinators), you create opportunities to receive additional support.
By law, under the Human Rights Act, workplaces and teaching institutions are required to make reasonable adjustments to support people who have been or are unwell. Before returning to either work or study, you may wish to get advice, or find out about your rights and/or what supports are available from services such as:
It's common for suicidal thoughts to return after your suicide attempt. It’s not a sign you have failed or that you are not recovering. Recovery from a suicide attempt is about building strategies and confidence in managing thoughts about death and suicide if or when they return.
Some people find that their suicidal thoughts can return in response to situations of significant stress or tension. Often the hardest time to manage thoughts about suicide or death is in the period immediately after an attempt or after discharge from hospital. It’s important to make sure you have thought about how you will respond if you become suicidal again.
Many people find it is useful to prepare a safety plan. A safety plan is a series of steps that you follow if you start to feel suicidal again.
Often a health professional will work with you to develop a safety plan, but you can also do one yourself. It includes:
Read more about coping with suicidal thoughts.
Having connections to other people and things you find important can protect you against suicidal thoughts or make it easier to manage if such thoughts return.
It is not uncommon for people to feel disconnected from life and those around them leading up to a suicide attempt. This can be a good time to reconnect with the things that are important to you. Work with people that you trust to help identify ways to reconnect with things you find meaningful. It can also be a time to discover new things that are important to you.
In the short-term, this could mean:
In the longer-term, this could mean:
Other things to consider are:
After a suicide attempt it can be hard to see what the future holds. It might help to see this time as a turning point; an opportunity for you to find your way back. You will still have ups and downs. However, by focusing on the potential for change following your darkest times, and accepting the assistance of others, you can create opportunities that offer hope and direction for your future.
This online resource was developed by bringing together the wisdom and experiences of people affected by suicide and combining it with what we know to be helpful. The people involved in the beyondblue project, Finding your way back, talked about suicide being a part of their past, but that it was not going to define their future. They wished the same for you, that you can look to the future with a sense of hope and take a step towards the life you want to live.
(Source: Finding your way back - a resource for people how have attempted suicide, (adapted to include NZ law and terms) with kind permission from beyondblue).
If someone has just attempted suicide or you're worried about their immediate safety, do the following:
To support someone trying to recover from a suicide attempt, be prepared to be there, offer support and stay involved. Recovery can take time.
You might need to be prepared to have difficult conversations about what's going on in their life and how they are feeling.
Remember to take care of yourself when you are caring for others:
It’s important to involve others to help you and the person you're supporting – don't try to do everything yourself.
To build a support network: