The hospital where I volunteer as a chaplain doesn't have a psychiatric ward. Psychiatric patients are held in our ER for medical clearance before being transferred to a local mental hospital.This population includes suicidal patients, who always get referred to me. I’m not a psychologist, but over time, I’ve developed three helpful strategies for these visits.
First, I always ask suicidal patients how they got to the hospital. Most of them either called 911 or called a doctor or therapist who called 911. In those cases, I’ll say something like, “That means you got yourself here, and you should be incredibly proud of yourself for doing that. You did what you needed to do to be safe, and you did that under really difficult conditions. When you're so depressed that you don't want to live anymore, calling 911 is as hard as walking to the hospital on a broken leg would be.” If the patient's someone especially likely to feel stigmatized – homeless, an addict or an alcoholic, a sex worker – I’ll add, “And you did what you needed to do to survive even though it meant coming to a place where you're scared people will look down on you. That takes a tremendous amount of courage.”
Suicidal patients, by definition, are filled with despair and self-loathing, and often see being at the hospital as further proof of their incompetence. Turning that around, telling them that getting to the hospital is an act of heroic strength, often means the world to them.
Second, sometimes suicidal patients ask me if I believe that suicides go to hell. Others have told me, “I know God loves me and won’t condemn me, and I hurt so much, so why can't I go to heaven now?” I’ve heard quite a bit of anecdotal evidence that belief in a loving, nonjudgmental God can actually increase the risk of suicide. And many patients who've lost loved ones, especially children, want to rejoin them.
When this issue comes up, I say, “I believe that God loves all of us and welcomes all of us when we die, but I don't believe in leaving early. Heaven isn't going anywhere. If you die a natural death in another thirty years, surrounded by friends and family, you'll go to the same wonderful place you’d go to if you died now. But if you go there now, you’ll never know what wonderful things might have happened here that you’ll never get to experience, or what good work you might have done here that God needs you to do.”
This is the theological version of that time-honored strategy, “Just stay alive for one more day. You can always kill yourself tomorrow.”This approach, like the first, helps patients turn the situation around, helps them see it a different way.
Third, I always emphasize to suicidal patients – and more generally to other psychiatric patients – that depression and other mental illnesses are real, physical maladies, not signs of personal weakness or wrongthink, and that they’re treatable. “You’re feeling so down right now partly because your brain isn’t working right: you literally can’t see any hope. That’s not your fault. It’s biochemistry, and you need to take medicine to fix it, just like you'd need to take insulin if you were diabetic. When the meds start working, things really will look better.”
I worship a God whose will is health and wholeness for everyone, and I try to be an instrument of that will. Because I have seen suicide in my family and among my friends,I feel most urgently called to hospital patients who feel most broken, who fear that they can never be put back together again. I strive to see them as whole, beloved and valuable, and to help them see themselves that way, even when their lives seem darkest. I don’t always reach them, but I always pray for them and leave them in God’s hands.
