Suicidal thoughts – where to get help right now

• ambulance10177Emergency Medical Services
• local_police10111South African Police Service
• sos112Universal Emergency (mobile)
• psychology0800 029 999SADAG Mental Health Crisis Line
• science0861 554 911Poisons Information Helpline

The South African Depression and Anxiety Group runs national crisis helplines staffed by trained counsellors, including a 24-hour suicide crisis line. Their current numbers are listed on sadag.org, and they also respond by SMS for people who cannot speak freely. Calling is free from most networks.

1. 1Tell one person. A friend, a family member, a neighbour, a colleague, a counsellor on a helpline — anyone. Not being alone with it is the single thing that changes most.
2. 2Put distance between you and the means. Give tablets, a firearm or car keys to someone else to hold. This one step saves lives, because these crises come in waves and passing the peak matters.
3. 3Do not drink alcohol or use other substances tonight. They lower the barrier at exactly the wrong moment.
4. 4Get to a safe place with other people in it, even if you do not want to talk.
5. 5Make a plan only for the next few hours. Not for your life, not for tomorrow. Only until morning.

• Take it seriously. People who talk about it are at real risk, and that is not attention-seeking.
• Ask directly whether they are thinking about ending their life. Asking does not plant the idea; it usually brings enormous relief that somebody finally said it out loud.
• Listen without arguing them out of it, and without telling them what they have to be grateful for.
• Ask whether they have a plan and whether they have the means. Help them put the means out of reach.
• Stay with them, or make sure someone else does, and help them contact a helpline or a clinic.
• Do not promise to keep it secret. Say instead that you will help them get help.

At a public clinic or emergency department you will be assessed by a nurse or doctor, asked about what has been happening, and helped to work out what you need next. That may be treatment for depression, referral to a psychologist or psychiatrist, help with a practical crisis, or admission if you are not safe. Mental health care is part of ordinary healthcare in South Africa and is available in the public sector.

• Bring someone with you if you can. It helps to have another person who can say what has been happening.
• Say plainly that you are having thoughts of ending your life. It changes how urgently you are seen.
• If you are already on medicine for depression, bring it. Some treatments take weeks to help, and the first weeks can be a difficult period that needs support rather than stopping.
• Suicidal thoughts are a symptom, not a character flaw, and they respond to treatment.