Maria feels suicidal.
I was excited to start university downtown; to take the train there, make new friends and learn new things. It’s just… things aren’t going the way I thought they would. The school is huge and so chaotic; I’m overwhelmed. Everyone seems to already have friends, except for me. I feel down a lot of the time and have been missing a lot of classes and getting poor marks on assignments. I want to talk to my parents about it, but I’m afraid they will be disappointed. This lost feeling isn’t new for me and, in the past, I would have a drink or take some pills to help me feel better. Now I can’t get feeling better no matter how much I drink or how many pills I take. The stress keeps building and building and I’m so tired and alone. Sometimes, I think about suicide.
Maria needs an OT.
SUICIDAL THOUGHTS OR BEHAVIOURS can affect people of all ages, cultures, education, and income levels. While they differ from person to person, they are often predicated by overwhelming feelings of hopelessness and helplessness. Some risk factors for suicide include previous suicide attempts, family history of suicidal behaviour, serious physical or mental illnesses, substance use problems, significant loss or life changes, lack of social support, or family violence. The Canadian Mental Health Association (CMHA) reports that, in Canada, approximately 4,000 people die by suicide each year.
The occupational therapist helped Maria to:
Create a suicide safety plan. Proactively and openly talk about Maria’s suicidal thoughts in a series of scheduled consultations in a non-judgmental environment. Support Maria in articulating her personal reasons for living and what has helped her to stay alive. Talk through Maria’s personal warning signs for feeling suicidal and develop coping strategies, building on things that have worked for her in the past like going for a walk or watching a funny show. Remove any means of suicide from her surroundings. Identify people who are sources of support in Maria’s life, and how she can contact them. Ensure Maria has emergency numbers on her phone and knows of available community resources.
Learn conflict management strategies. Practice effective listening, identify points of disagreement, learn how to clearly express needs. Use role-play conversation to help Maria feel more confident sharing her situation with her parents. Make a plan to talk to her parents at a specific time in a relaxed setting.
Set up a manageable routine. Identify preferred activities and daily goals in order to create a balance of self-care, studying and leisure activities. Develop a schedule of classes and other daily activities. Check in with friends and family daily. Keep all appointments and consider taking a parent or sibling along to provide support and help with asking questions and taking notes.
Connect with university services. Find the on-campus mental health supports which could include a counselling service in person, by phone or online. Identify available resources for students using substances. Meet with Maria’s course supervisor to discuss options for reducing her course load and study requirements, possibly moving to part-time classes to allow more time for a more balanced and healthy recovery.
Learn relaxation skills. Practice deep breathing as a calming strategy when feeling stressed. Look into beginner yoga classes.
Improve sleep environment. Create a calm space in Maria’s bedroom by removing the TV and electronics. Move Maria’s study space to the living room so Maria can truly focus on sleep when going to bed.
Because of occupational therapy, my mind is calmer.
The Canadian Association of Occupational Therapists (CAOT) provides a searchable national directory of occupational therapists for all Canadians to find the occupational therapy services they need.
Occupational therapy. Making the everyday possible.