What do people say about suicide hotlines

Preventing suicide - what professionals and laypeople can do

As part of a program run by the World Health Organization, Germany has committed to reducing the number of suicides by ten percent by 2020 compared to 2013. The federal government is providing 3.5 million euros in research funding for this purpose. Almost a million of these go to the Frankfurt program for the prevention of suicides using evidence-based measures, or FraPPE for short.

The city of Frankfurt hopes to reduce the suicide rate by a whole third. Andreas Reif is project manager and director of the psychiatric university clinic in Frankfurt. He coordinates the various suicide prevention activities in the city.

Those at risk of suicide must be brought into treatment

A 24-hour hotline will be set up in Frankfurt for this purpose. In addition, there are emergency consultation hours with the aim of ensuring that those at risk of suicide can get medical treatment quickly and easily. This is supplemented by a short psychotherapy specially tailored to suicidality.

It is also very important to train specialists so that they know better how to recognize those at risk and how to help them. General practitioners in particular should recognize when a patient is at risk of suicide and react accordingly. Because almost all those at risk of suicide do not go to psychologists or psychiatrists who have more experience with such cases.

Suicidal companions go through different phases

Suicide candidates often go through different phases. In the so-called consideration phase, they play with the idea of ​​killing themselves, but the risk is not yet very high. They are often depressed. General practitioners should ask such patients if they are considering suicide. In most cases, however, those affected do not seek help from a doctor during this phase. In the following phase, the ambivalence phase, people tend to seek medical help. They often feel very driven and very restless. They suffer a lot. There is an ambivalence between this “I actually want to live, but the way it is, I don't want to live anymore”.

Recognize an acute risk of suicide

In such a phase the risk of suicide is moderate to high. The psychiatrist Christiane Schlang trains doctors in suicide prevention. She recommends asking those affected if they suspect that they have thought about a method. Is there an immediate risk that the patient will put their plans into practice?

If someone then, says Christiane Schlang, "yes, I have the rope in the garage or I have collected pills or I have already set a day, then of course there is the highest level of alert."

How people talk about their suicidal thoughts

Not only doctors should pay attention to whether a person is at risk of suicide. Even laypeople should pay attention, says psychiatry professor Barbara Schneider. She is the chairwoman of the German Society for Suicide Prevention. There is the myth that when someone talks about suicidality that they are not actually killing themselves. That is wrong, says Barbara Schneider. Usually this is a call for help and support. As a rule, a planned suicide is reported. Directly and often indirectly, in that someone affected says we don't see each other anymore and makes such hints. Still others withdraw completely, completely breaking off contact. You should also look there.

How laypeople can help those at risk of suicide

You should also pay attention if someone seems depressed for days or says much less than usual without a reason being apparent. According to Barbara Schneider, it is always important to establish a relationship with the other person and to establish contact. As a layperson, you should ensure that those affected go to a counseling center, a clinic or a doctor.

Laypeople can and should be gatekeepers. This is what suicide experts call people who come into contact with people at risk and can show them the way through the right gate. Gate keepers are of course doctors and nurses who deal with many people who are not doing well. But ultimately everyone can get into this situation.

Suicides are not based on the opening times of advice centers

Once the risk of suicide has been identified, the helpers, relatives or those affected must be able to turn to where they can get help quickly. The telephone counseling is available around the clock and does a good job. But that's not always enough for those affected, says Ute Lewitzka, head of the suicide prevention research department at the University of Dresden. Important institutions such as the crisis service or the social psychiatric service are usually open Monday to Friday from 8 a.m. to 4 p.m. But many crises do not happen during opening hours, but mainly at night or on weekends. According to Lewitzka, it is very important to get people through the night and win this time.

Here, too, the FraPPe project aims to improve the situation. There is to be a 24/7 hotline that can also transfer urgent cases quickly to one of the psychiatric clinics.

Gender differences in suicide attempts

In many western countries, including Germany, men are at great risk, especially old men. Experts call this the Hungarian pattern because it is particularly pronounced there. There are obvious reasons why old men kill themselves far more often than others. They may become lonely if their wife dies before them. In women, the rate of suicide does not increase as much with age. Andreas Reif, the head of the Frankfurt University Psychiatry, has another explanation as to why more men die from suicide, even though women make many more attempts: "The tendency towards serious measures simply seems to be more common in men. Death by suicide, for example, death by hanging, is something that women shy away from. Intoxication is chosen much more often, but I don't think that a consideration of the probability of death plays a role."

More frequent hotspot suicides

Suicide candidates often kill each other in the same way, often in the same places. Experts call them hotspots. Protective measures such as attaching safety nets to bridges or cordoning off tracks near psychiatric hospitals often lead to a significant decrease in suicide attempts in these areas.

Andreas Reif and his team from the FraPPe project in Frankfurt are looking for such hotspots. They do geo-analyzes to see whether there are certain places, certain buildings, certain regions or neighborhoods that lead to an accumulation of suicide or attempted suicide.

The media has an important role to play in reporting on suicides

As a rule, the media do not report or only report very briefly about suicides in order to prevent copying. It is recommended that suicide should not be portrayed as suicide or in a melodramatic way, but rather as the result of a psychiatric illness that could have been avoided through consistent treatment. It works: after reporting on the depression and suicide of goalkeeper Robert Emke, understanding of depressed people has increased significantly.

How can you tell that people want to kill themselves?

The German Depression Aid has put together alarm signals that relatives and friends should take seriously:

  • Suicide threats and announcements. The prejudice that a person who talks about suicide does nothing to himself is wrong.
  • Great hopelessness and statements such as: "It all makes no sense at all ...", "At some point there has to be an end.", "Something has to happen now ..." Especially with depressed people, these are indications of a serious hazard.
  • Many people want to get their affairs in order before they commit suicide. For example, they give away valuables, draw up their wills or say goodbye to their friends and relatives. Caution: Those who are determined to commit suicide often appear calmer, more stable and less desperate. This can lead to the deceptive conclusion that the person affected is finally getting better.

What specific things can you do to prevent suicide?

  • Talk to the suicidal person about it. The fear that this could provoke suicide in the first place is wrong. As a rule, it is a relief to be able to talk to another person about the tormenting thoughts.
  • Get professional help! You can seek help from a doctor, psychotherapist or a clinic.
  • Show your counterpart that you are there for them. Accompany the person at risk to the doctor or clinic. At night this can be the psychiatric emergency room, but also the medical emergency service.
  • If a person is in immediate danger of suicide, but can no longer be approached, the emergency doctor should be informed for his protection. Important: do not leave the affected person alone until the emergency doctor arrives.

SWR 2018

Manuscript for the broadcast

If your mind is about killing yourself, various organizations offer help and ways out:

Telephone counseling: 0800 - 111 0 111 or 0800 - 111 0 222. There employees can be reached around the clock, worries and fears can be shared with them. The telephone counseling also offers a chat: telefonseelsorge.de

For children and young people there is also the "number against Kummer" - available Monday to Saturday from 2pm to 8pm at 11 6 111 or 0800 - 111 0 333. E-mail advice for young people is also available on the U25 Germany website and on Jugendnotmail .

Help - also in Turkish - is available on the Muslim pastoral telephone "MuTeS" on 030 - 44 35 09 821. The staff there are available 24 hours a day.

The German Society for Suicide Prevention has listed an overview of other offers at suizidprophylaxe.de.

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