Module 3: Talking about suicide Risk: How you ask makes a difference

Responding to “No’s”

So, you asked about suicide and the person you are concerned about answered. Now what? Is a “no” really “no” or just a “maybe”?

How you respond to a “no” is extremely important: don’t automatically accept the first “no,” and do not express relief when you are told no. Both of these can be counterproductive both short and long term in your dialogue.

The First “No”

A person might say no to questions about suicide and suicide risk at first. Suicide and mental health are clearly not comfortable things to talk about for most people. Many people will not immediately respond fully or truthfully about something so deeply personal as depression, suicidal ideation, or life changing events. In addition to their actual response, be on the lookout for pauses, averting their eye contact (more than they have been normally) and a reluctance to answer certain questions. Some may hedge on fully explaining how suicidal they really are because of the taboo topic and the fear that they may be forced into hospitalization against their will.

The best thing to do when you receive a ‘no’ is to circle back around and ask about risk factors, or warning signs, or triggering events. If the dialogue becomes uncomfortable, you might consider talking about some of the positive, the protective factors, or even about things that are only slightly related, or not at all, to your main goal of determining risk, then circle back in, as rapport is re-established, and ask again, perhaps in a slightly different way.

Conversational repair

Remember the discussion about establishing rapport? Rapport is the key to getting people to open up. However, even in the best of conversations, things can happen. When things go awry and a faith member begins to disengage from dialogue, we engage in what is sometimes called ‘conversational repair’—that’s when we move away from the topic of a conversation and focus on re-establishing rapport: we focus on fixing the current conversation before turning back to understanding the person.

If you have an established relationship with this member, you’ll know when they’re glossing over something or avoiding talking about difficult subjects. You can gently point out that you’re there for them, and that they can talk about the hard subjects or thoughts they’re having. (A good example of this is in Pastor Molock and Allie Warner’s assessment video, at 00:20, when Pastor Molock says, “You know, we’ve kind of been down this road before, where you have that smile, and your smile is saying one thing but your eyes are saying something else. This is Reverend Sherry; what’s really going on?”)

You may want to ask them the same question a second time, to be thorough. Follow your instincts as a faith leader – if you suspect that someone is saying “no” just to avoid a topic, then go further with them – ask the questions again later on in the conversation.

Closing the door, accidentally

Recall how we discussed the importance of opening the door and establishing rapport with a faith member prior to entering the dialogue about suicide and suicide risk. By accepting an initial “no” answer, you may prematurely “close the door” on the suicide conversation. Another way you can close the door accidentally is by expressing relief at their initial “no.”

FL: “Have you been having thoughts of killing yourself?”
FM: “No, not really, um, no I haven’t.”
FL: “Phew, good, I’m really glad and thought you were likely okay but wanted to be sure.”

What a faith member likely hears here is: wow, he’s really glad I said no, I better not bring this up again. A relieved response, even if meant to be supportive and positively reinforcing of the person, is quite likely to shut the door on any open discussion of the topic now and is likely to make it less likely he or she will approach you in the future.

So, take the first no, or the first few “no’s” with a grain of salt, circle back around on the question, approach it from a few different angles, until you are satisfied that the faith member is not at risk and is being open with you. And definitely don’t shut the door by responding in an overly relieved way or in any other way that conveys that you really didn’t want to talk about it or that you view suicide and suicidal ideation as something wrong or that you are uncomfortable talking about.

Remember, you were concerned for a reason….you’ve asked about their well-being because of this concern…even if it seems like things are okay, there’s likely something else going on that merits follow up. Just think of all of this as a way to increase your connectedness to the faith member, to improve your rapport. Toward the end of a discussion, consider making a statement such as, “I want you to know that if you really are having any of those thoughts lately or in the future, I hope you can feel comfortable talking to me about them.” This clearly leaves the door open, reaffirming that you care.