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Evening friends. As always I'm just after a view as I want to be helpful in my own clumsy way and not wanting to sabotage another post but I think people will know who I'm talking about. How do you respond to "extreme" posts about feeling suicidal, wanting to slit your wrists etc.? Lots of us have been in a mess (me included) and had those thoughts - possibly non-intrusive but more to do with despair - so do we suggest A&E as it sounds like a real crisis? I can't think of any alternative unless you are a client of a CMHT's crisis team? Best wishes, Phil.

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It's tricky Phil. Because the forum is largely anonymous (and, as such, details such as home addresses aren't in the public arena) when a member presents in apparent crisis, it's difficult not to feel powerless. It's not a case, for example, of raising one's concerns with a local crisis team. All we can do (I guess) is to suggest a visit to A&E should the compulsion to act upon self-harming thoughts become overwhelming. And, aside from that, listen and empathise where possible.

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Yes Phil I would say suggesting a trip to the hospital and presenting to the crisis team would be the best bet. If the sufferer is aware that they're definitely suicidal and not having intrusive thoughts about suicide as of course the two are very different and if someone is having intrusive thoughts about suicide I suppose presenting at hospital would be a compulsion! I've had both and felt that actual suicidal ideation was very different from when I suffered with suicide intrusive thoughts although both very scary! Xx

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I agree that it's tricky sometimes.

Reading a forum post is very different to being in the same room as someone where there are visual clues and a greater ability to judge mood and state of mind. All we have to go on is what is written, any previous knowledge of the person, and our gut instincts. It can be difficult (or impossible) to be certain if the person is letting off steam, making a cry for help, or genuinely suicidal. In a single person it might vary from day to day, or even from one post to the next as their environment changes, or as thoughts intensify and wane.

For anyone unsure how to react to a post about self harm, rule number one is put your own mental health first, second and third.

Remember there is no obligation to answer any post on the forum and there's no shame in leaving a post for someone else to answer if you're feeling unsettled in yourself at the time or if a particular post makes you uneasy. There will always be someone else along shortly who is feeling well and strong that day and for whom answering is just like posting any other reply. Nobody should be burdened by a sense of responsibility or guilt (something many people with OCD experience) whether they choose to reply or to skip it entirely.

If unsure whether the person is genuinely suicidal, it's ok to ask them. Discussing suicidal thoughts doesn't tip people into acting and often the opposite is true. Bottling up feelings can lead to a worse outcome than talking openly about what's going through your mind. 

If you do decide to reply to a post about self harm, rule two is to go with your gut instinct. Be kind, be honest, and if you feel concern in response to what they've written, share the fact you're concerned with them and advise them to seek help from a local source such as a mental health crisis team, Samaritans, an A&E department, or a doctor on call (NHS 111 in England, NHS Wales Direct, or NHS 24 in Scotland), or even a family member.

Being stuck on the other end of a written internet connection with no personal details can feel very dis-empowering. Encourage the poster to make contact with a flesh and blood person or a warm voice on the end of the phone. This is hugely important. You can't physically do anything on the forum other than offer words of comfort or advice, but people are much less likely to self harm if they aren't alone. 

If your gut instinct sees something between the lines which suggests the person is simply ruminating on a suicidal theme, or has a different agenda (some examples might be a cry for help, attention seeking, no intent but confused and unable to articulate more specifically how they really feel or what help it is they are seeking etc...) then it's ok to ask if your instincts are correct or off-base.

As long as you word your reply with due consideration for a person who is in a state of acute distress then you won't cause any harm, and reaching out with a calm and reasoned response might help the person to calm themselves.

Hope that gives people some guidelines to follow and perhaps some confidence whether to reply or leave the post alone depending on what they feel is right for themselves at the time. :) 

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7 minutes ago, snowbear said:

Remember there is no obligation to answer any post on the forum and there's no shame in leaving a post for someone else to answer if you're feeling unsettled in yourself at the time or if a particular post makes you uneasy. There will always be someone else along shortly who is feeling well and strong that day and for whom answering is just like posting any other reply. Nobody should be burdened by a sense of responsibility or guilt (something many people with OCD experience) whether they choose to reply or to skip it entirely.

Such good advice. ?

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