I spent a couple of years working on the crisis unit of a medium/maximum security prison. This was the place where inmates who were suicidal, homicidal, or gravely disabled were placed until they either stabilized and went back to the yard or were shipped off for longer term care. And one of the first things I learned was that, “I’m suicidal” could mean a whole lot of different things.

A lot of the time, it means exactly what the person said; my life is no longer worth living and I want to end it all. It was often triggered by a loss (my mom died and I didn’t get to go to her funeral) or a relationship ending (my girlfriend said she’s wait until I got out but I found out she’s seeing another man). 

But it could also mean something else:

I have a drug debt I can’t pay and can’t stay on the yard.

I want to drop out of a gang and I don’t know how. 

I am angry.

I want to transfer to another prison and I think this is my best shot.

I am afraid of my cellmate or a custody officer.

This is my way of getting attention and/or exerting some control over my life.

Obviously, these motives have nothing to do with depression, mental illness, or ending one’s life; it is an attempt to solve another problem by threatening suicide. In a prison setting, this is often viewed as a manipulative suicidal threat and is the kind of threat that angers custody officers and, when used repeatedly by the same inmate, creates cynicism in mental health professionals as well. 

Dying for Attention

Although not common, the same thing happens outside of prison. Few people use the threat of suicide to get attention, which is why people should always take a suicide threat seriously. No matter what the motive, it is not normal to talk about suicide no matter how stressed out a person is. 

It is far better to take a suicidal threat seriously – even a repeated one, even when you don’t actually believe the person means it – than to roll the dice and lose.

But what if the person seems to routinely use the threat of suicide to manipulate someone else? “If you break up with me, I’ll kill myself.” “If you really cared whether or not I lived or died, you’d move in with me.”  “If you go visit your parents. I might not be alive when you get back.” When we call someone “manipulative,” we are often accusing them of using threats, emotional coercion, or inducing guilt to get what they want. And few things are more powerful than being told you are responsible for someone’s life – or death.

So what do you do if you are on the receiving end? If you have a relationship with a chronically suicidal person, get some professional help so you can get some emotional distance and figure out what is best for you. When faced with a threat of suicide, call the National Suicide Prevention Hotline (1-800-273-TALK) or contact your local emergency number. You can also offer to drive him or her to the emergency room. Communicate that you care about him or her, value his or her life, and you want to help him or her get the help s/he needs. 

The second is to set clear boundaries by what you do rather than what you say. Do not argue about how serious the person is or call him or her “manipulative”; the last thing you want is for him or her to feel backed into a corner and make an attempt just to prove you wrong. Empathize with how s/he is feeling (upset, scared, angry, desperate) but make it clear that you will not give in to a threat. Put the responsibility for living or dying back in the hands of the person who is threatening you; you love and care for them, but you both deserve a relationship that is based on trust and respect, not threats.    

A Threat of Suicide is Always a Cry for Something

Suicide threats are symptomatic of a serious problem, whether the person really wants to end his or her life or not. Even the inmates who were not really interested in taking their lives were often in trouble; in prison, you can be killed for not paying a drug debt or trying to drop out of gang. These inmates did not have suicidal concerns, but they did have genuine safety concerns.    

Outside of prison, the rare person who uses suicide to try to manipulate others also has a serious problem. Suicide threats that feel manipulative are the ultimate in lose-lose. If someone calls his or her bluff, s/he may feel forced to do something drastic to “prove” that s/he was serious. Even if it works in the short term, and the person gives in to the threat, s/he will eventually alienate the people s/he is trying to control and create anger and resentment and ultimately face the abandonment or rejection s/he is trying to avoid in the first place. 

When we dismiss a suicidal threat as “manipulative,” we are minimizing the reality that anyone who relies on these tactics to influence other people needs help learning healthier ways of getting their needs met. If this person is someone you care about, get some support, take care of yourself, and remind yourself that you are dealing with someone who needs immediate professional attention much more than s/he needs your acquiescence.