Trigger warning: The following article contains references to self-harm and is intended to provide guidance for readers about how to care for yourself or those you know who may need help or support. If you are struggling, please contact the Counseling Center or Prevention Services immediately.

We’ve heard messages surrounding suicide prevention — reach out, don’t be afraid to ask for help, you’re not alone. While these messages are important, they do not address people who cannot access the help they need due to money, insurance or other barriers, or those who are already getting help but it is not enough to meet their needs. The prevalence of suicide and suicide attempts among college students means that these messages aren’t enough. So, what can we do?

To start, we need to make sure that those who are most at risk of suicide have what they need to stay safe. According to the National Institute of Mental Illness, making a personalized safety plan and removing access to things like pills, knives, or other items that could be used for a suicide attempt from those at risk can decrease the risk of acting on suicidal ideation.

For a safety plan, you can use your notes app or a piece of paper. The point is to make something that will be the most helpful for you. If you are not sure you need a safety plan, you could create a coping plan with a list of different skills that work well for you; if you are unsure of what skills to try, 99 Coping Skills is a great place to start. I personally have a “coping box” that I use, which has pictures, inspiring quotes and objects that have personal meaning.

Anyone can help prevent suicide. One great way to start is to be intentional with the language you use; instead of saying someone “committed suicide” say “they died by suicide” and never use terms like “successful attempt.” This takes blame away from the victim and avoids adding shame. Also, make sure to avoid discussing the specifics of how someone died by suicide, as this can glorify suicide and can infringe upon people’s privacy. Lastly, if you see posts online that discuss suicide methods, report and block them.

It is also important for anyone who either has or knows someone who has experienced suicidal ideation to learn the terms associated with suicide and suicide prevention. For example, passive suicidal ideation means someone is thinking about suicide or death but not actively making plans to die. On the other hand, active suicidal ideation means that someone has a plan, means and intent to end their life.

It is a common misconception that passive suicidal ideation is not dangerous or worthy of concern; even if someone is not actively trying to die, having suicidal thoughts can take an enormous psychological toll and can make it hard to participate in everyday life, and passive thoughts can sometimes lead to active ideation.

Another important point when it comes to suicide prevention is that sometimes counseling and safety plans simply are not enough. I know about this from personal experience; in my freshman year of college, I was hospitalized twice in a short-term inpatient facility. Unfortunately, the topic of hospitalization is often absent from the conversation on suicide prevention, which disadvantages those who may need that level of intervention and perpetuates stigma around suicide and mental illness. For this reason, I have compiled a list below of some tips if you or a friend is hospitalized for suicidal ideation. These are all things I wish someone had told me.

Tips for supporting a friend who has recently been or will be hospitalized:

• Visit them if you can and bring them clothes without strings, personal hygiene items, socks and anything they might find comforting, like a favorite blanket or pictures, books or magazines.
• Make sure they know you support them and their decision to prioritize their mental health and safety.
• Keep their information and location private unless you have their explicit permission to share.
• If you can’t visit them, call them. Most hospitals have designated phone hours, so find out what they are and what extension you’ll need to use.
• Write them an encouraging note and leave it somewhere easy to find so that they see it when they come back.
• Offer to clean/feed their pets/check their email while they are gone.
• Take care of yourself. Watching a friend struggle is hard, and it’s critical that you practice self-care and have your own boundaries. Consider talking to someone yourself if you aren’t already.

Tips if you have recently been or will be hospitalized:

• Make sure you have a follow-up appointment at the Counseling Center or NC State CARES. They have the resources to make sure your transition back to campus is easier, and they can connect you with other resources both on- and off-campus.
• Give yourself lots of compassion. It can be extremely hard to go back to the college environment after being in the hospital. Make sure you have a self-care plan as well as a safety plan, and make sure you have follow-up appointments with a psychiatrist or doctor, especially if you’ve had medication changes. When I came back after being hospitalized, I had major brain fog and had a hard time remembering how/when to do basic tasks, but I did not reach out to professors, which I definitely regret. If you need help reaching out to professors, ask someone at the Counseling Center, the Disability Resource Office or your case manager.
• Do some research and look at hospitals nearby to make sure they take your insurance and have the type of care/programming you need. Don’t be afraid to ask the Counseling Center for recommendations.
• Email your professors to explain your situation. If you are not comfortable sharing personal information, the Counseling Center can help you draft a general message to send. In my experience, most professors have been very understanding and accommodating. If they are not, you can always contact Student Ombuds or the Disability Resource Office. If you need to verify absences, consult the absence verification process.

Resources:

• Patient Safety Plan Template (from National Suicide Prevention Lifeline, 1-800-273-8255)
• Crisis Text Line (text HELP to 741741)
• Know the Signs (tips for recognizing signs of suicide and talking to someone who is struggling)
• How to report suicidal content on social media (guide to spotting warning signs and what to do)
• NAMI: Getting Treatment During a Crisis (provides information different mental health crisis services)
• NC State QPR (Question, Persuade and Refer) and QPR+ trainings (from Prevention Services and the Counseling Center, for students, staff and faculty to learn about the warning signs of suicide and how to intervene if they know someone who is struggling. QPR+ offers a more in-depth look at some of the causes and prevention methods. Trainings are free and are currently being held over Zoom)
• Suicide Safety Plan (app from ZeroSuicide that lets you make your own safety plan and includes resources for mental health emergencies)

Skye Sarac is a student programming intern in the Women’s Center who will graduate this semester.