Communicating with Youth Experiencing Depression or Suicidality

Research shows that once depression is recognized, help can make the difference for 80% of people who are affected. Despite this however, there remains an astounding number that do not get the help they need. For youth with depression who may have difficulty recognizing the condition or knowing how to seek help, this leaves them particularly vulnerable. In Canada, the youth suicide rate stands at the third highest in the industrialized world. Suicide is among the leading causes of death in Canadian youth ages 15 to 24 years, with 4,000 people losing their life prematurely by suicide each year. Distress/crisis line call responders are in a unique position to offer teens an anonymous forum for speaking about the issues that concern them. It is an opportunity to pay attention to them and to listen to them. Dr. Fiske, the presenter in this video on Communicating with Youth Experiencing Depression or Suicidality, says that “a complaint is a poorly worded request”. In other words, a person in distress may be saying how bad things are, and if you listen carefully, he or she is telling you what they want or how something ‘should be’. This gives clues to what might matter to the caller and where to begin in the conversation to help them. Questions for Further Consideration: How do your skills measure up when you consider the level of difficulty of some of the calls that are received on a distress/crisis line? It is important to remember that the key to knowing how to talk to youth is to pay attention to them – they will let you know how to talk to them. Employ the skills of active listening, particularly the use of empathy to make a connection with how the person feels. Listen to what the person can tell you about what matters to them. Try to understand who you are speaking with on the helpline and concentrate to learn and understand as fully as possible. Remember that when you ask people questions, you wait for their answers. Try hard to ‘let go’ of those assumptions that can get in the way of really listening. Be aware of your own biases and remain ‘teachable’ - do not assume that people are like you or who you at first, may think they are. Use words that engage and give recognition that helps make people feel that they matter. Talking with teenagers can seem like a challenging task at any time, so how does one make sure to stay focussed on meeting the needs of the young person when on a help line call? Remember that the risk of suicide goes up when someone perceives their pain and distress as intolerable or inescapable. As a distress/crisis line worker, understand that there is a fine line or vital difference between ‘intolerable’ and ‘just barely tolerable after all’, and try to help the caller look for the small real differences that could be possible - that could help a person to be hopeful and to keep going. Suggest that there may be a limit to how long an intolerable situation may last and focus on anything that could connect the person to reasons for living and to see real possibilities. When the callers see the problem as: Use language to suggest that it is: Permanent Temporary Unchanging Fluctuating Out of their control Predictable, subject to client influence and choices Unbearable More tolerable at some times All-powerful One of the important things in their lives What resources are available that could help a young person who has feelings of depression or suicide? Dr. Fiske indicates that ‘the troubled person needs to experience her- or himself as being more than the sum of the problems. Only then will the person be motivated to deal with his or her problematic sides’. She suggests that the distress/crisis line call responder assume that callers make choices and take actions that make a difference. Ask directly about reasons for living, for example, ‘What keeps you going?’, ‘What helps you fight back?’, or ‘If there was one thing that might be worth living for right now, what would it be?’ This helps them discover their internal and external resources – what has helped them in the past. To discover relationship resources that the caller may have, ask questions like, ‘Who would argue with you about your life being hopeless, or that suicide is the only way to change things?’, or Who would want you to live?’, or ‘What would your parent/friend/teacher/employer say was most important to you?’. Ask about a possible positive future, for example ‘If a miracle happened...what would be different?’ Be aware of community resources in your area that you could introduce to the caller. Glossary of Terms: Affiliation: to be closely connected with a group or to something (such as a program or organization) as a member or partner Perception of Burdensomeness: A person’s feeling that she or he is a burden or bothersome to others and that things would be better if they were gone Continuum: a range or series of things that are slightly different from each other and that exist between two different possibilities Acquired Ability to die by suicide: one of the major risk factors related to suicide that involves taking into account all of the things (circumstances, events) that accumulate over time that make a person feel they are ready to commit suicide Resources: a source of support, an available means that someone has and can use when it is needed (i.e.: internal resources– personal skills, abilities; external – support from other places; relationship resources – friends, family, others in their life that are a source of support)