Sunday, May 3, 2009

My Friend Talks of Suicide

“Laura” writes:

Dear Dr. Einhorn:

I am a 13 year old girl with a friend that talks of suicide. She
refuses to tell her parents, and I live too far away from her to talk
to them. I know she needs help, but she will not talk to her parents.
Will you please see if there is anything you can do?
I realize you are very busy, but if there's anything at all, please
respond to this email.
Thank you so very much,
Laura D.

Dr. Einhorn replied:

Well, you could call her parents, Laura. Or you could talk to your parents and ask one of them to call her parents.

Laura replied:

Yes, however they don’t believe she is serious, and my parents have never met her before, as I met her at summer camp.

Dr. Einhorn discusses:

Laura’s concern for her friend and feeling of helplessness come through clearly in her question, and this is often the position that friends, family, and even professionals are in when caring for adolescents, or adults, who are, to any degree, suicidal. There is lots of help that can be brought to the suicidal person--including therapy, medication, outpatient and inpatient programs, and support from friends and family--but often the person herself, or, as Laura indicates is the case here, her family, don’t take the risk seriously enough. And it is a serious risk: suicide is rated as the third largest cause of death for adolescents.

Of course, we can only talk in generalities here, because we have no information about the people involved. We don’t know, for example, whether Laura’s friend is talking about suicide as a way of expressing her emotional overload, maybe blowing off steam, without really intending to do anything (in which case she still seems to be in need of help), or whether she is seriously at risk for self-harm. So, the question becomes, not what Laura can do for her specific friend, but what someone in Laura’s position might consider doing to follow through on her concern.

Laura feels like there’s nothing that she can do and she’d like me to step in and do something here. But this is a situation in which I have no “standing,” to borrow a legal term; I don’t know any of the people involved, and they don’t know me. Laura is the person who knows the girl who talks of suicide, so, like it or not, she is the person faced with the choice about what to do. She’s reached out to me, hoping to pass this “ball” to someone who can carry it better than she can, but the truth is that no one can carry it better than she can at the moment. That’s one of the problems and challenges of knowing someone who is suicidal. If you do something to try to help them, your attempt to help might be rejected as inappropriate, interfering, or silly. If you don’t, and the person does make a suicidal attempt, or, actually commits suicide, you might regret not at least having spoken up in some way to try to help. There is no easy way to deal with a situation like this.

I can think of a couple of options that Laura might consider, and readers might think of others. She could advise her friend to talk to a school counselor, who would then be in a position to evaluate the seriousness of her talk and call her parents to advise them to get treatment for their daughter. This might be the easiest path for all concerned if the girl would talk to the counselor. If she won’t, and Laura is still concerned, she can still talk to her parents and ask them to call the girl’s parents, even though they don’t know each other, to express parent-to-parent concern. That might help the friend's parents take a second look at their daughter's state of mind and risk for self-harm. Sometimes students will anonymously advise counselors in schools that a fellow student is making suicidal statements, but I don’t know that Laura would even know what school to send an anonymous letter to. And of course that could always boomerang on her, if it prompts intervention that the girl or her parents resent.

One issue that this raises is what the responsibilities and limits of friendship are. That’s a question that each one of us has to answer for ourselves, in different relationships, sometimes over and over again. It’s a real challenge, and no fun at all, to have to deal with this question in this relationship at this time, but that is the place where Laura’s life has taken her, even at her young age.

It’s a shame that adolescent suicide is such a problem in our society, and it’s worth our time to ask why that should be; what pressures are adolescents responding to? Answering that is beyond the scope of this Q and A, but I’ll appreciate any thoughts that readers care to contribute.

As for you, Laura, you are to be commended for your caring in raising this issue about your friend and reaching out for help, and supported as you seek within yourself for the wisdom to find, and the courage to do, the right thing; whatever, in this situation, that may be.

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