Resources for Suicide Prevention, Intervention and Postvention

If you are contemplating suicide or know someone who is, call 911.

Or in the United States, call the National Suicide Prevention Lifeline: 1-800-273-TALK (8255). In Canada, the Canadian Association for Suicide Prevention maintains an up-to-date list of distress lines by province and territory. Be sure to get help. If someone is thinking of taking their own life, it’s not a secret to keep. Know that there is hope! Pastors will also want to find out the best number for their local helpline and keep it at the ready.

The Mental Health Task Force of CRC and Reformed Church in America Disability Concerns ministries has curated resources on suicide prevention, intervention and postvention. In addition, we created a bulletin insert and worship resources (attached) to assist congregations in thinking about this painful but important subject that touches so many people. See links below to order printed copies of the bulletin insert from your denominational office.

 The following is a quick reference list of signs that may indicate someone is at risk for suicide. Risk is greater if a behavior is new or has increased and if it seems related to a painful event, loss, or change:

• Talking about wanting to die or to kill oneself.
• Looking for a way to kill oneself, such as searching online or buying a gun.
• Talking about feeling hopeless or having no reason to live.
• Talking about feeling trapped or unbearable pain.
• Talking about being a burden to others.
• Increasing the use of alcohol or drugs.
• Acting anxious or agitated; behaving recklessly.
• Sleeping too little or too much.
• Withdrawing or feeling isolated.
• Showing rage or talking about seeking revenge.
• Displaying extreme mood swings. (Source of all above signs: National Suicide Prevention Lifeline Wallet Card - Suicide Prevention: Learn the Warning Signs)
• Person starts giving away personal items.
• Sudden change for the better or worse.

What do we mean by the terms suicide prevention, intervention and postvention?

Suicide prevention refers to diminishing the risk of self-inflicted harm with the intent to end life. It may not be possible to eliminate completely the risk of suicide but it is possible to reduce this risk. Intentional efforts to reduce the risk (i.e. education), in addition to the presence of natural protective factors (i.e. social support and connectedness), can aid in suicide prevention.

Suicide intervention refers to a direct effort to prevent someone from intentionally attempting to end their own life.

Suicide postvention refers to measures occurring after a suicide has taken place that address the needs of those affected. Postvention can take many forms, but its purpose is to support those affected to cope with the loss, reduce the risk of suicidal behavior and support healthy recovery in the aftermath of a suicide. Postvention also serves as prevention when it promotes healing of those affected which then can reduce their risk of suicide.

What is mental illness?

Mental illnesses can take many forms, just as physical illnesses do. Mental illnesses are disturbances that affect mood, thinking and behavior; interfere with daily functioning at work, school and in the community; and contribute to problems in relationships. Although the causes of mental illnesses are not fully known, research shows that genetic, biological and life-event factors are involved. Research also confirms the positive impact support and friendship has upon the life of someone living with a mental illness.

The great majority of people who experience mental illness do not die by suicide. However, of those who do die by suicide, more than 90 percent have a diagnosis of a mental illness. People who die by suicide are frequently experiencing undiagnosed, undertreated or untreated mental illness, most often depression.

A word about language regarding suicide

Pastoral sensitivity extends to using careful and thoughtful language when we talk about suicide. Some words and phrases can bring additional pain and further stigmatize people in tragic circumstances. This increases the shame, secrecy and isolation people experience and makes it even more difficult for people affected by suicide to reach out for help. The Mental Health Commission of Canada lists this helpful guide regarding the language we use:

• Death by suicide or died by suicide are preferred phrases that can offer comfort and provide support for healing.
• Committed suicide and completed suicide imply a negative judgment or a criminal offense, while successful suicide implies accomplishment.
• Suicide survivor can refer to those who have experienced their own suicidality or those who are bereaved by suicide.
• Some survivors prefer the terms suicide attempt survivor, survivor of suicide loss or survivor bereaved by suicide.

With any language we use, it is important to convey a tone of compassion and understanding and above all to talk about.

A faith perspective on life and suicide

Life is a precious and good gift from God to us. We are called to protect life and to honor the sacredness of life by not harming ourselves or others. Suicide speaks to the tragic brokenness and pain in human life. Because of mental illness or life’s complex circumstances, some people are filled with despair, torment and hopelessness, and they may attempt suicide or die by suicide. A common thought among people of faith is that if you died by suicide you will be sent to hell, or that suicide is an unforgivable sin.  

A more helpful faith perspective on suicide begins with the affirmation that nothing, including suicide, can separate us from the love of God in Christ Jesus our Lord (Rom. 8:38-39). While we don’t support the act of suicide, we should not condemn or shame the person or their loved ones. God does not judge the life of a person by one single action. People who attempt suicide need support, love and therapy, not condemnation. The church is challenged to address the value of life, to speak realistically about the pain in people’s lives and to offer hope in Christ’s presence and strength.

Reasons people may think about taking their own lives

There’s no single cause for suicide. Suicide most often occurs when stressors exceed current coping abilities of someone suffering from a mental health condition. Depression is the most common condition associated with suicide, and it is often undiagnosed, undertreated or untreated. Conditions like depression, anxiety and substance problems, especially when unaddressed, increase risk for suicide. Yet it’s important to note that most people who actively manage their mental health conditions lead fulfilling lives.

Just as there are factors that can reduce the potential for someone being at risk of suiciding, there are risk factors that can predispose them. The following is a list of risk factors which are characteristics or conditions that increase the risk that a person may try to end their life:

• Mental health conditions, including depression, bipolar (manic-depressive) disorder, schizophrenia, borderline or antisocial personality disorder, conduct disorder and anxiety disorders
• Substance abuse disorders
• Serious or chronic health condition and/or pain
• Stressful life events, which may include a death, divorce, or job loss
• Prolonged stress factors, which may include harassment, bullying, relationship problems and unemployment
• Access to lethal means, including firearms and drugs
• Exposure to another person’s suicide, or to graphic or sensationalized accounts of suicide
• Previous suicide attempts
• Family history of suicide attempts (Source: American Foundation for Suicide Prevention)

Resources

Prevention Resources

Prevention refers to increased awareness, education and interpersonal support regarding the behaviors and risk factors that may result in suicide.

• Know the warning signs of suicidal thoughts or behaviors and the factors that may put someone at risk of suicide.
• Learn how to talk openly and honestly about suicide. Don’t be afraid to ask questions such as “Are you having thoughts of suicide?” or “Do you have a plan for how you would take your life?”
• Be prepared. If someone has had suicidal thoughts in the past, it's a good idea to have a crisis plan just in case. One of the best things you can do if you know or suspect that someone is contemplating suicide is to educate yourself. Learning about suicide, what the warning signs are and how it can be prevented can help you understand what you need to do as a member of their support system. Take an online training course through an organization such as be nice., which provides free training in four steps (Notice, Invite, Challenge, Empower) and the QPR Institute, which outlines three steps one can learn (Question, Persuade, Refer) to assist a person contemplating suicide.
• People struggling with depression and/or thoughts of suicide may benefit from working with someone else to create a personal safety plan such as this one. 
• Join with others on September 10, National Suicide Prevention Day, for a National Day of Prayer for Faith, Hope and Life. Resources specific to faith communities are available through the Faith.Hope.Life webpage of the Action Alliance for Suicide Prevention.
• Reformed Church in America and Christian Reformed Disability Concerns ministries have created a printable bulletin insert (attached) about suicide that can be used on National Suicide Prevention Day or during Disability Emphasis week (October 8 or 15). If you represent a congregation of the Christian Reformed Church or Reformed Church in America and would like us to send you printed copies of this insert, contact your denomination office (CRC Disability Concerns or RCA Disability Concerns) with your request.

Intervention Resources

Intervention refers to direct efforts to prevent someone from intentionally attempting to end their own life.

It may take many forms:

• Taking threatening comments seriously. Know (in advance) the community referral resources available for mental health crisis intervention and firmly connect the member with appropriate resources.
• Talking openly and honestly about suicide. Don’t be afraid to ask questions such as “Are you having thoughts of suicide?” or “Do you have a plan for how you would end your life?” Calmly ask simple and direct questions, such as “Can I help you call your psychiatrist?” rather than, “Would you rather I call your psychiatrist, your therapist, or your case manager?”
• Identifying and interrupting the crisis and directing a suicidal person to the proper care.
• If you are concerned about suicide and don’t know what to do, call 911. In the United States, call the National Suicide Prevention Lifeline: 1-800-273-TALK (8255). In Canada, the Canadian Association for Suicide Prevention maintains an up-to-date list of distress lines by province and territory.
• The Columbia-Suicide Severity Rating Scale (C-SSRS) supports suicide risk assessment through a series of simple, plain-language questions that anyone can ask. The answers help users identify whether someone is at risk for suicide, assess the severity and immediacy of that risk and gauge the level of support that the person needs. Take an online training course through an organization such as be nice., which provides free training in four steps (Notice, Invite, Challenge, Empower) and the QPR Institute, which outlines three steps one can learn (Question, Persuade, Refer) to assist a person contemplating suicide.

Postvention Resources for Faith Communities after a Suicide

Postvention refers to “activities that reduce risk and promote healing after a suicide death.” It may take many forms:

• Providing a time for family and friends to debrief after a suicide.
• Providing sustained and sensitive pastoral care that does not induce guilt or blame or answer the question “why?”
• Postvention can be prevention for at-risk persons who might contemplate suicide.
• Connecting survivors with appropriate grief support and professional mental healthcare.

Suicide postvention answers questions such as: What do you do after someone dies by suicide? How do you communicate this information with others? What language do you use? What does pastoral care and follow-up care look like for those bereaved by suicide?

One of the most helpful resources for postvention care for faith communities is found in a document called Coming Together to Care, gathered for communities in Texas. The chapter Suicide Postvention with Faith Communities and Funeral Homes is found on pages 82-88 in the Coming Together to Care document. There you will find information about:

• Support for and Care of Survivors
• Suggestions for Pastoral Care and Spiritual Support Following a Suicide
• Obituaries/Death Notices
• Memorial Service and Funeral Guidelines

We welcome your feedback about this page. If you have suggestions about these resources, ideas for additional resources, or other comments, please comment below by September 1.

The resources on this site are provided for informational purposes only and should not be used to replace the specialized training and professional judgment of a healthcare or mental healthcare professional. Christian Reformed or Reformed Church in America Disability Concerns ministries cannot be held responsible for the use of the information provided. Please always consult a trained mental health professional before making any decision regarding treatment of yourself or others. Self-help information and information from the Internet is useful, but it is not a substitute for professional assistance.