suicide threats- how do you tell?

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How do you know (as a friend not as a nurse) when a threat is real? Is it possible? If said perosn has a history of claiming to have overdosed but hasnt according to blood tests and having had her stomach pumped, how do you know when this time she is for real?

Is it best to call paramedics every single time and feed her drama or to tell her to seek medical help and hope she does, she is an adult, its her choice and not your responsibility? And how do you set boundaries around such threats when they are ignored despite you not running when wolf has been cried?

NurseBaby'05, there wouldn't be any point in changing my numbers, other friends would give them to her. I do however have caller id and an answer phone :)

Cat123, sorry your having problems getting help.

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Specializes in orthopedics,geriatrics,med/surg.
NurseBaby'05, there wouldn't be any point in changing my numbers, other friends would give them to her. I do however have caller id and an answer phone :)

Cat123, sorry your having problems getting help.

Thanks, it has a lot to do with the location I am in.

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That is exactly what i did a couple of years ago with another friend, she was diagnosed as borderline i later found out, but i could not deal with all her games and she wasnt a close friend. This friend is treading on very thin ice at the moment, i cannot keep allowing her to break boundaries i set for my own well being but i am very reluctant to walk away while she is having a hard time, though i have been backing off a lot over the past year. It took me a long time to spot the manipulations and mind games she was playing, or maybe i just did not want to see them, either way i have bene pointing out to her for the past 6 or so months when i catch her at it. She knows i do not like it, and today i ahve told her that if it does not stop, or if she does not start to make an effort to change her attitude/behaviour then i would not continue to be her friend. I agonised over that decision before telling her, i know what it feels like to be extremely depressed and suicidal and be dumped by your friends, i had vowed i would never do that to a friend. On the other hand i have given her as much of my time and energy as i am able. I have set boundaries around unanounced visits, and calling 20 times until i give in and answer the phone. I have spent the last two years listening to her and her woes, making sugestions as to what might be helpful etc etc. I am not a mental health nurse, nor a counselor or whatever. I have compassion and empathy, but i can only take so much. I am fed up of watching her turn down professional help, skip appointments, refuse to take prescribed meds, playing games with everyone around her, and having tantrums when she doesnt get her own way. I am hopeing that this time she see's the light so to speak. She is going into a psychiatric ward again (i dont think they gave her much choice following this weekend). If she makes the most of it and starts to work with them and the community teams she has access to then no i wont walk away from her, yet. Unfortunatley i honestly don't believe her when she says she will make use of them. I have heard it all before and do not want to hear it anymore after this time. I am at this point incredibly thankful that she is a friend and not a member of my family i would be compelled to stick wiht and deal with. If i need to i can dissapear from her life, and then figure out how to deal with the guilt for doing so. Thank you for all your advice especially not knowing many of the facts.

NO ONE can ever tell for sure if someone will commit suicide. Tell your friend to get treatment and you can't be her therapist. There are some risk factors for suicide. Suicide attempts are behaviors the person believes will end in death. Parasuicidal behavior is cutting, scratching, non-lethal behavior but can lead to serious suicide attempts.

Risk Factors for suicide: previous attempts, white males over 65, drug or alcohol abuse, active psychosis, impulsivity, being chroonically or terminally in pain or ill, being divorced, widowed or single, etc. Hopelessness is almost always a predominant thought pattern in a suicidal person.

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I know it is quite difficult to feel as if you are abondoning a friend in her time of greatest need.......................................

But, you have to ask yourself if allowing her to break boundries is helping her. If not, then I think you should give consideration to whether being more insistent on your boundries wouldn't actually help your friend, as well as you.

Please do remember that your safety comes first. I'm not an RN yet, but I have been an EMT for several years, and I always assume the pt is serious about committing suicide, and will potentially harm me or my partners in the attempt.

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Treat the threats as real. Obtain help as available in your area. Set the boundries as suggested. Get a little stress counseling yourself. It does things to us when someome else attempts to put the decision and outcome of that decision on our shoulders for their life choices.

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Always treat the treats as real, Im not sure if your a nurse or other healthcare professional, if so you are required to make the call. I once had a problem myself about being suicidal, and was at the point where I did cuttings, and took meds. This was when I was 16. Now I look back and see how stupid I was. Thought I wanted to die but didnt, I just needed to talk to a professional. You never know when it will be real. So always treat it as it is. Your friend needs someone, dont make haste in leaving the relationship if you feel that you are not in danger.

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Is a patient really suicidal? I have worked in a mental health hospital for 21 years. My experience with suicides is that the patient who is the quietest and does not make threats are the ones to worry about. Multiple previous serious attempts are a clue also. If the patient scratches their arm - nothing serious. When patients have taken overdoses they usually admit that they were just trying to get "high". One patient sticks in my mind. She had been in and out of our facility for as long as I was there. Once she submerged her head in boiling water - was very scarred from that. Then, she cut off one of her hands. This pt was in-house when she succeeded in hanging herself from her locker. It was an ordinary day with no special significance. She ate her meals, did her evening care, went to bed as usual. On the first round, staff found her. You can not always tell. However, it sounds like you have made every effort to help your friend and you just have to believe that you have done your best. This person sounds typically borderline and if she would suicide, it would probably be by accident. Good luck!

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