This blog post is part of the 3rd Annual Suicide Prevention Awareness Month blog tour. If you are having thoughts about killing yourself, please call the National Suicide Prevention Lifeline at 1-800-273-8255 or text HOME to 741741.
Today (September 10) is World Suicide Prevention Day. As a clinical psychologist, I take suicide seriously. I was saddened to hear that “I want to kill myself because of debt” was a top search on another personal finance blog.
While many bloggers will be bringing awareness to suicide and debt, as a clinician I hope my contribution will be to discuss suicide prevention.
This post was inspired by Melanie Lockert of Dear Debt who created the Suicide Prevention Blog Tour to raise awareness of suicide and debt, as research suggests that incidents of indebtedness are high among those who complete suicide.
I’d like to give a special thanks to my dear friend and colleague, Dr. Stephanie Miller for her contribution to today’s post. Dr. Miller is a clinical psychologist with expertise on suicide prevention. She has published multiple peer-reviewed articles on the subject. She is also one of the earliest and most earnest supporters of The Debt Shrink.
Suicide Risk Factors
Clinicians look for risk factors. We know that there are many risk factors for suicide, including older age, male sex, Caucasian race, depressive disorder, intractable pain, substance abuse, feeling of being a burden or of not belonging, and lack of social support.
Less often, however, do we think about debt as a risk factor. A systematic review and meta-analysis by Richardson and colleagues (2013) found that debt was associated with depression, suicide attempts, and completed suicides. Although I do not ask my patients about debt, during intake sessions I do inquire about psychosocial stressors, including financial strain.
I have watched a number of recent documentaries about the rise in suicide rates in countries such as India and Greece, where many are facing financial burdens that seem insurmountable.
Less attention is given to the people facing large student loans or other debts who don’t see any other way out.
Mental Health Disorders
I truly believe that, although it may take some time, it is possible to get out of debt. However, if someone with debt is experiencing suicidal ideation, it’s not enough to talk about getting out of debt.
It’s important to note that even when someone is experiencing a life crisis, such as debt, divorce, or disability, more than 90% of people who commit suicide have a diagnosable mental health disorder.
Any Mention of Suicide should be taken Seriously
The first thing to do is to try to get that person help from a licensed mental health provider, such as a psychologist or psychiatrist. If someone is expressing thoughts of killing him/herself and has an urge to act on those thoughts, hospitalization may be needed to keep that person safe.
Suicide Safety Plan
If you or a loved one is experiencing suicidal ideation, it is important to work with your therapist to create a Suicide Safety Plan.
The Safety Plan will include identifying times you are at increased risk for suicidal ideation, knowing your warning signs, and having a plan for things you can do and people you can call to get through times of crisis.
The safety plan also includes strategies to make the environment safer (e.g., temporary removal of firearms when in crisis).
Be aware of the times you are more likely to experience distress. Triggers may include:
- Receiving a bill or past due notice in the mail
- Paying bills
- Running out of money before your next paycheck
- Getting calls from debt collectors
- Having utilities shut off or facing eviction/foreclosure
- Friends asking you to participate in an activity that you cannot afford
- Arguing with your partner about money
How do you know when you are upset? Do you:
- Anger easily?
- Isolate yourself from other people?
- Drink or eat more or less?
- Sleep more?
- Stop exercising?
- Watch depressing shows or listen to sad music?
- Call out sick from work or cancel plans?
- Go shopping/Spend excessively?
When you experience triggers or notice warning signs of distress, it is important to distract yourself to help you get through that moment.
Distractions may include doing things you once enjoyed* (even if you’re not in the mood) such as:
- Listening to upbeat music
- Going for a walk or run
- Playing with a pet
- Watching a comedy
- Playing cards, board games, or computer games
- Doing crossword puzzles
- Watching or playing sports
- Fixing something
- Organizing your home or office
- Taking a hot shower or bath
- Preparing and eating a good meal
- Sitting outside and appreciating nature
(*notice that these activities do not require money or involve risky behavior like alcohol/substance use)
Distractions can also include going to safe places,* such as to a:
- Botanical garden
- Pond to watch the ducks
- Animal shelter/sanctuary
- Local little league game or high school practice
- Friend’s house
(*again, these places do not require money or risky behaviors, read more about ideas for free activities)
When you experience triggers or notice warning signs of distress, it is also important to seek support. Social support can come in different forms:
Talk to someone about how you are feeling such as a
- Friend or Cousin
- Parent or Sibling
- Personal or Professional Mentor
- Licensed therapist
Talk to someone who can make you laugh or just distract you such as
- Your co-worker who has a way to make you smile (Stacey)
- A neighbor
- Your child/grandchild or niece/nephew
- Anyone who always has chocolate (Stacey)
Or attend a support group such as
- Debtors Anonymous
- Alcoholics Anonymous or Narcotics Anonymous
- Gamblers Anonymous
- National Alliance on Mental Illness
what are your reasons for living
No matter how large or small, think about any and all reasons for living. For some people, their reasons for living might include:
- People in their life, such as family members or friends
- Religious beliefs against suicide
- Wanting to live, even though things are tough now
- and hope that with help things can get better
- Their purpose, such as their work or helping other people
- wanting to find a purpose even if they don’t yet know what it is
- Curiosity about how things will work out if they just hang on
If you or a loved one is experiencing suicidal ideation, it is important to put as many barriers as possible between the person and any means.
- Firearms should be temporarily removed from the home. If someone refuses to let a trusted other take possession of their firearm, limiting access to it should be discussed.
Limiting access can include storing the firearm and ammunition separately, keeping both in separate locked containers, using a gun lock, giving the lock keys to a trusted other, and/or disassembling the firearm.
- Household cleaners or poisons should also be removed from the home.
Use vinegar and rubbing alcohol to disinfect surfaces. Use liquid dish soap to clean the toilet (it won’t remove stains, but will clean the toilet and help it smell good). Look up recipes for non-toxic bug killers.
- Cords, ropes, belts and anything else that one can use to hang oneself should be removed from the home.
Check the garage, attic, closets, and drawers.
- Knives and razors should also be removed.
Consider using butter knives or plastic knives and safety razors when someone in the home is in crisis.
- Take the keys to the car.
If someone has expressed ideation of using a vehicle to kill him/herself, take all sets of keys until the crisis period is over.
- Dispense medications as needed and secure extras (including over-the-counter medications) in a locked cabinet to prevent overdose.
Follow FDA recommendations to dispose of unused or expired medications.
- Alcohol and drugs can limit one’s inhibitions. Many suicide attempts occur on impulse.
Remove any intoxicating substances from the home.
If you or someone you love has thoughts of suicide, there are people here to help.
- Go to your closest emergency department
- Call 911
- Dial 211 to be connected with Essential Community Services in your area
- Call the National Suicide Prevention Lifeline 1-800-273-8255
- Veterans: text 838255 or visit VeteransCrisisLine.net
- Anyone: text HOME to 741741
TO FIND A LICENSED THERAPIST
There are a number of psychotherapies that research has shown to be effective at treating depression. There are also treatments for shopping or gambling addiction.
If you do not have insurance or are looking for high-quality, low-cost care, check your local university. Most clinical or counseling psychology graduate programs have a “Psychological Services Center” that offer evidence-based treatments by graduate students supervised by licensed clinicians.
There is no such thing as false hope. Even when it’s hard to see any light at the end of the tunnel, there is always something that can be done to help.