TW: Discussions of suicide and suicidal ideation
A study done in during the COVID-19 pandemic revealed that 21% of HK secondary school students surveyed were experiencing suicidal ideation. Suicide is the second most common cause of death in 15-24 year olds worldwide, and in Hong Kong, more children die of suicide than in accidents. Let’s talk.
What does it mean to be suicidal?
There are two types of suicidal ideation: passive and active.
Passive suicidal ideation means having thoughts of suicide but no plan or drive to carry it out. Someone passively suicidal might talk about wanting to die or not making it past a certain age. They may fantasise about dying, but have no plan to. Even so, any and all thoughts of suicide deserve to be taken seriously.
It’s easy for passive suicidal ideation to turn into active. Active suicidal ideation is when someone has a clear intent and plan to die. This is considered an urgent emergency. Call a crisis line and get help immediately.
Warning signs
Some common warning signs and risk factors of suicide include:
Verbal indicators, such as “You’d be better off without me.”
Talking about feeling lonely, hopeless, a burden, or being in pain
Talking about wanting to die, or fixating on death
Isolation from family and friends
Reckless behaviour, such as increased substance abuse
Extreme mood swings
Some warning signs of active suicidal ideation include:
Giving away prized possessions
Tying up loose ends, like writing a will or paying off debt
Saying goodbye to friends and family
Acting suddenly as if a weight has been taken off them — although this may at first seem like a positive sign, it could also indicate that they’ve stopped deliberating and made the choice to attempt suicide
Again, these signs indicate that someone has a plan to die, which is considered an emergency. If you notice these, tell a trusted adult, call an emergency service, and, if possible, don’t leave the person alone. You should also get the person to a hospital for a risk assessment and psychological check-up.
How to help someone who is suicidal
It’s a common misconception that talking about suicide with someone can give them the idea to do it. However, studies have shown that discussions about suicide do not lead to an increase in suicidal ideation, and being able to talk about it can actually be a relief.
Suicide is a scary topic. It isn’t easy to bring it up, and some part of you might not want to know if someone is considering suicide, but if the warning signs are there, you have to ask. Ask them directly, “Are you having suicidal thoughts?” or “Sorry for asking, but I care about you. Have you thought about killing yourself?”
Do:
Listen without judgement.
Remind them that you care about them.
Encourage them to seek professional help. Offer to help them find and contact a counsellor or therapist.
Ask if they have a suicide safety plan (https://www.getselfhelp.co.uk/docs/SafetyPlan.pdf) or help them make one.
Ask them how they would like you to help.
Thank them for trusting you.
Check in on them. Don’t just have your door open for them—be with them. Ask them how they’re doing, invite them to events, include them in conversations. Show them that you care with your actions, and not just your words.
Don’t:
Don’t invalidate them. Don’t tell them that they should have recovered by now, that other people “have it worse”, or that they’re faking it for attention. Pain is personal and subjective, and nobody has the right to tell anyone else what they should be feeling.
Don’t try to guilt them. Don’t tell them that suicide is selfish or wrong, that they should be doing more to help themselves, or that they’ll hurt people if they die. Judgement is unneeded and will only shut down communication.
Don’t forget your own boundaries. It might seem harsh, but you have to put yourself and your own mental health first. Remember that no matter how much you want to help, they and their actions are not your responsibility. Make sure that your own support network is strong and that the person you are helping has other resources to turn to.
If you are suicidal
If you’ve seen yourself in this post or you’ve been in a dark place recently, remember that there are always other options. No matter how overwhelming the hopelessness or pain is, you are not alone. No matter how long you’ve felt like this or how hard it will be, you can recover. You can survive.
There are always people who want to help you, and if you can’t see a way out, they will be there for you. Reach out to someone, anyone—even if it’s just the hotline.
24/7 Hotlines
You can reach out to any of the below at any time.
Police: 999
Samaritans (multilingual)
Hotline: 2896 0000
Email: jo@samaritans.org.hk
Samaritan Befrienders (Cantonese): 2389 2222
Open Up (English & Cantonese)
Online chat service: www.openup.hk
Facebook/Instagram: hkopenup
Whatsapp/SMS: 91 012 012
Youth Outreach (Cantonese, English, and Mandarin): 90881023
Sources:
Are you thinking about suicide? How to stay safe and find treatment. (2018, January 31). Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/suicide/in-depth/suicide/art-20048230
Cool Minds. (n.d.). Emergency Hotlines. Coolminds HK. Retrieved August 29, 2021, from https://www.coolmindshk.com/en/emergency-hotlines/
Fuller, K. (2020, September 30). 5 Common Myths About Suicide Debunked. NAMI: National Alliance on Mental Illness. https://www.nami.org/Blogs/NAMI-Blog/September-2020/5-Common-Myths-About-Suicide-Debunked
Hammond, C. (2014, January 13). Does discussing suicide make people feel more suicidal? BBC Future. https://www.bbc.com/future/article/20140112-is-it-bad-to-talk-about-suicide
Jorm, A., & Kitchener, B. (2018, July 25). How to ask someone you’re worried about if they’re thinking of suicide. The Conversation. https://theconversation.com/how-to-ask-someone-youre-worried-about-if-theyre-thinking-of-suicide-100237
Risk of Suicide. (n.d.). NAMI: National Alliance on Mental Illness. Retrieved August 29, 2021, from https://www.nami.org/About-Mental-Illness/Common-with-Mental-Illness/Risk-of-Suicide
Samaritans Hong Kong. (n.d.). Samaritans Hong Kong. Retrieved August 29, 2021, from https://samaritans.org.hk/
Scott, E. (2020, September 10). The difference between active and passive suicidal ideation. Metro. https://metro.co.uk/2020/09/10/world-suicide-prevention-day-the-difference-between-active-and-passive-suicidal-thoughts-13248301/
Warning Signs of Suicide. (n.d.). SAVE. Retrieved August 29, 2021, from https://save.org/about-suicide/warning-signs-risk-factors-protective-factors/
What You Must Know About Suicide. (n.d.). Stanford Children’s Health. Retrieved August 29, 2021, from https://www.stanfordchildrens.org/en/topic/default?id=what-you-must-know-about-suicide-1-4134
Zhao, S. (2015, July 10). More Hong Kong children commit suicide than die in accidents, study reveals. South China Morning Post. https://www.scmp.com/news/hong-kong/health-environment/article/1835675/suicide-biggest-cause-unnatural-death-hong-kong
Zhu, S., Zhuang, Y., Lee, P., & Wong, P. W. (2021). The changes of suicidal ideation status among young people in Hong Kong during COVID-19: A longitudinal survey. Journal of Affective Disorders, 294, 151–158. https://doi.org/10.1016/j.jad.2021.07.042
Writer: Katherine Yan
Editor: Jennifer Pun
Artist: Ran Zhao
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