Is the risk high, low, or medium? The risk has to be quantified. But when a person is wavering between living and dying, a risk score often misses what actually matters: human proximity.

What does help, is something that is both old, and modern at the same time: proximity. Real, human, closeness is more important than a risk score. It’s not really a technique, more a way of being. An invitation to explore together what the desperation is trying to tell you.

Don’t pretend to be brave, but stay curious

 In practice you see this over and over again: when you stop trying to calculate the risk, and start listening to someone, something happens. People relax, and space is created. They start to reveal their story – often incoherent, full of pauses, tears, and irritation. Everything comes out at the same time. But that story points us in a certain direction.

You don’t have to be a hero, you don’t have to know exactly what to do. The only thing you have to do is stay curious.

• What’s the root of this pain?
• Why is the pain unbearable
• What are the suicidal tendencies trying to tell us?

These are not ‘interventions’, but just basic human effort.

Hope is an unruly type of care

Hope isn’t just a pretty icing on a cake. Neither is it saying that everything will be alright. Because nobody knows whether it will be, and it often doesn’t feel like this.

Hope is something completely different. It’s the silent promise: “I’ll stay with you, even if you can’t carry this load on your own, I’ll help you carry it.”

It’s a simple gesture – staying with them, not looking the other way, asking another question, helping them search for something – has a bigger impact than any statistic or risk score whatsoever. People can feel that. They feel like they matter. And sometimes that is just enough to want to keep going.

It’s better to look again than to build on old assumptions

 A person is a dynamic being. But still diagnoses, treatment plans, and assumptions stand for years and years, like monuments made out of stone, whilst the person themselves has long moved on.

That is why it’s useful to keep observing the situation: the diagnosis, the story, former experiences, physical complains, possible traumas, medication, side effects, situation at home, everything. And then explore together whether the situation has changed.

People often feel calmer and safer by just having someone there, to help them think, without judgement or haste.

An emergency plan as a strong foundation

 An emergency plan – and let’s just call it that – is a small, manageable document you create together. It’s not a form you fill in because it’s protocol, but a summary of a conversation you’ve had.

• What can help if it goes wrong?
• Who can you call?
• What can you try yourself?
• What do you need to avoid?
• What words or situations can make your situation worse?
• What is the reason that, despite everything, you are still here?

The plan is essentially a promise in the form of a document: we will face the situation together, you are not alone.

The professional is also only human (thank god!)

Working with people who are suicidal is tough. Also for healthcare professionals. It affects you, makes you emotional, and it can make you insecure. And that’s OK. You don’t have to be the flawless expert. In fact, people will be able to tell when you’re pretending to not have any humanity.

Healthcare professionals dare to be more present, to listen more, and to not panic. And that can make all the difference to a person who’s wavering.

Human proximity in suicide prevention

You can’t solve a suicidal crisis can’t be solved with a trick, a test, or a treatment plan. It’s an intense, personal, emergency situation. And because it’s personal, it requires a human approach: proximity, recognition, exploring and searching together, and trying to find purpose.

• We don’t have to be perfect
• We just have to be willing to sit next to someone who can’t remember how to stand

And that is oddly enough often the most powerful sort of care there is.

Note from translator: If you struggle with suicidal thoughts, help is available in the UK. The Samaritans offer a 24-hour helpline at 028 9066 44220, and the National Suicide Prevention Helpline UK are available from 6pm to midnight every day at 0800 587 0800. Help is available in other countries too. Find the number online, or contact your GP or another healthcare professional.