Guidelines

for

Responding

to

North Heights Community Care Department

Written by Mindy Bak. Edited by Steve Wiese and Jean Bearden.

Suicide

Threats

Now may the God of hope

fill you with all joy and

peace in believing,

that you may abound in hope

by the power of the Holy Spirit.

Romans 15:13

Table of Contents

Seeing the Symptoms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1

Critical Signs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2

Ask the Question . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3

Insisit on an Anti-Suicide Pact . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3

Plan? Yes. Means? Yes. Time? Yes. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4

Responding to Suicide Threats . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5

What We Know About Suffering and Depression . . . . . . . . . . . . . . . . . . . .5

What the Bible Says About Suffering . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6

What We Know About Depression . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .7

Guidelines for Those Who Minister Amidst Despair . . . . . . . . . . . . . . . . . .8

Satan’s Role In Suffering . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9

Protocol for Prayer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11

As You Pray . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .12

Suicide Happens When the Pain ofDepression Exceeds the Resourcesfor Coping

No matter how much the Christian wants to function well, if they are bowed down under aweight they cannot lift, they will collapse and feel life is not worth living; will-power has noth-ing to do with it (of course they would cheer themselves up if they could).

Spiritual intervention that is wise, informed, sensitive and tenderly courageous is required—now. If someone has come to you with concerns of hopelessness, depression, or suicide, you areGod’s first line of defense. Trust God to guide your words, prayer, care, and actions.

Seeing the SymptomsBiological • Relational • Spiritual

1. BIOLOGICAL SIGNS OF DEPRESSION• Change in appetite or unintentional weight loss or weight gain• Insomnia/hypersomnia: persistent trouble falling asleep or staying asleep,

early waking, or excessive sleeping• Agitation or acting-out behavior: loss of temper, unusual defiance, high-risk or

destructive behaviors, restlessness, or irritability• Lack of energy and fatigue• Low motivation: it’s just hard to get moving

—Diminished libido• Mood variation: a repeated pattern of worse in the morning and better at night, or

better in the morning and worse at night. • Memory problems

—Difficulty concentrating and making decisions• Tearfulness, weepiness

2. RELATIONAL SIGNS OF DEPRESSION• Social isolation and withdrawal from usual activities• Disconnections from family and friends• Preoccupation with self

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3. SPIRITUAL SIGNS OF DEPRESSION• Feeling far from God• Devotional time is dry, distant, absent or avoided• Worship/church is no longer fulfilling or meaningful• May feel that God couldn’t love them, that their sins are too great to be forgiven, that

they are too worthless for God to care

Critical Signs

1. Sudden change in behavior, especially calmness after a period of anxiety

2. Serious allegations: crime or misconduct charges, divorce or end of a relationship

3. Giving away belongings, pets, possessions

4. Disconnecting from friends, job, usual contacts

5. Attempts to “get one’s affairs in order,” making plans to care for the children

6. Family history of mental health or substance abuse problem

7. Showing sudden interest in insurance, wills, burial plots

8. Direct or indirect threats to commit suicide

You should be especially concerned about the previous signs if the person has tried to commitsuicide before, or if the person has had a close relative commit suicide.

Almost every person has an occasional fleeting thought of suicide, but the suicidal individualponders it.

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Ask The Question

If the individual says, “I’m so depressed, I can’t go on,” ask the question—“Are you having thoughts of suicide?”

You are not putting ideas in the person’s head; you are showing him/her that you care, that it isokay to share this pain with you.

If the answer is YES, you can begin asking a series of next-questions:

1. PLAN – Have you thought about how you would do it?2. MEANS – Have you held the (means) in your hands and considered actually doing it?3. TIME SET – Have you thought about when you would do it?

95% of all individuals talking about suicide will answer no at some point in this series orindicate that the time is set for some date in the future. This will be a relief for both of you.

Talking and praying about their problems for a length of time will give suicidal people relieffrom the deep aloneness that leads to suicide – they will feel better – so will you.

This does NOT mean the person IS better – simply that their body chemistry (and irra-tionality) has momentarily slowed down – the problems may persist.

Insist on an Anti-suicide Pact

1. PLAN – Who will we/you call for help?2. MEANS – What will it take for you to get to this appointment/ class/ fellowship?3. TIME SET – What day THIS WEEK will you do this?

May I call you to follow-up? 4. YOU MUST – Get their phone number. Share it with North Heights staff.

You must insist on an anti-suicide pact.

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Plan? Yes. Means? Yes. Time? Yes1. Immediate action is required.

• Do not ask if the person wants help. Say, “We need help.” Immediately invite help intothe situation.

• A person who shares suicidal feelings is asking you to care – even if they are beggingyou not to take action.

2. Call or wave a staff-person, supervisor, prayer-captain, etc.,into the situation.

3. Agree to call for help.

(usually the person just entering the situation can assist with the call while coun-selor/minister remains present)This may take the form of:• A 911 call• An escort to an emergency room• Accompanying a family member or friend as they provide escort to an emergency

room• A call to a Pastor, or a suicide line for help (while you are still there with this person)

4. See Ministries for Ongoing Care (page 19.)

• NEVER allow this person to leave without taking some action to secure help• Get help (for yourself ) during this intervention. • Debrief and pray (during and) afterward.

Most suicidal people don’t want to die; they want to stop the pain.

• The impulse to end it all, however overpowering, does not last forever. • If you suspect someone is suicidal, help them get help.

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Responding to Suicide Threats

What to say & what not to say in the face of suffering

• Do say, “God can help.”(This says, “God has not abandoned you.”)

• Don’t say, “Just think positive.”(This says, “Your thoughts control God.”)

• Do say, “God loves you very much right now - no matter how you feel about him.”(This says, “God is not as fickle as we are. His steadfast love endures forever.”)

• Don’t say, “You’ll feel better tomorrow.” (This may be true but it says, “Your troubles are no big deal to me; you’re all alone.”)

• Do say, “God is not afraid of what you’re really thinking.”(This says, “God’s shoulders are big enough to bear it all. And I will help you lift it to theLord of salvation; you are not alone.”)

• Do ask, “May I pray for you right now?” (This says, “I’m not just wishing you well, I’m standing with you before the Lord.”)

What We Know About Suffering andDepression

Most individuals who seek prayer, counseling, or healing ministries from the Church are encoun-tering a serious personal crisis of body, mind, or spirit. A crisis in any of life’s arenas will neces-sarily impact the others: physical illness can lead to depression, depression may result inphysical illness, the loss of a job can lead to an interruption of faith, a spiritual crisis may lead tofamily crisis and depression.

Because we live in a society that often views pain and suffering as avoidable obstacles totrue happiness, those to whom you minister may view their suffering as the work of the enemyand God’s inactivity.

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It is important to note that while Satan will prey upon us when

we are down, suffering can simply be the result of living in a

broken world.

• When a drunk driver injures our loved one, it is not that we have allowed Satan in busimply that Satan is at work in the world bringing chaos into every life.

• Even God-fearing, devoted Christians are sure to encounter this world’s brokenness. • It will be tempting for individuals to focus on life’s unfairness and thus to experience

suffering as overwhelming, unmanageable, intolerable.

Christians who blame their suffering on Satan may:

• Create excuses for not persevering through the changes a circumstance requires—and God desires.

• Lock themselves into a cycle of despair and guilt, blaming themselves for Satan’s holdrather than turning to God for release.

• Look for a quick-fix from God when, in fact, God may want the individual to work diligently on a spiritual overhaul which might include any and all of the following: surrender to biblical principles and the Lord’s leadership, forgiveness, repentance, relinquishment of strongholds or deceptive practices and poor coping strategies, and asubmission to soaking prayer.

What the Bible Says About Suffering

Consider it pure joy, my brothers, whenever you face trials of many kinds, because you knowthat the testing of your faith develops perseverance. Perseverance must finish its work so thatyou may be mature and complete, not lacking anything. (James 1:2-4)

Suffering is a school for character, a place (not of God’s abandonment, but) of God’s abidingpresence. The more a Christian is beaten down, the greater will be the armies of God rallying toour defense, carrying us, defending what we are too weak to defend, giving life where we onlysee death.

This is God the Father’s specialty – raising the dead to new life. Those who suffer will under-stand more profoundly than those who have it easier – what it is to be saved by God.

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Hebrews 12:4-12 says,

My son, do not make light of the Lord’s discipline, and do not lose heart when herebukes you, because the Lord disciplines those he loves, and he punishes everyonehe accepts as a son. Endure hardship as discipline; God is treating you as sons. Forwhat son is not disciplined by his father?

If you are not disciplined (and everyone undergoes discipline), then you are ille-gitimate children and not true sons. Moreover, we have all had human fathers whodisciplined us and we respected them for it. How much more should we submit tothe Father of our spirits and live! Our fathers disciplined us for a little while as theythought best; but God disciplines us for our good, that we may share in his holiness.

No discipline seems pleasant at the time, but painful. Later on, however, it pro-duces a harvest of righteousness and peace for those who have been trained by it.Therefore, strengthen your feeble arms and weak knees. ’Make level paths for yourfeet,’ so that the lame may not be disabled, but rather healed.

What We Know About Depression

Untreated Depression is the #1 cause of Suicide

1. Depression is treatable–and suicide is preventable. • Major depression is the leading cause of U.S. disability

2. Depressive disorders affects nearly 10% of Americans, more than 20-million people(30,000 individuals a year). • More than 90% of all suicides are related to a mood disorder or other psychiatric

illness. • The elderly have the highest rate of suicide.

3. Suicide is the third leading cause of death for 15- to-19-year-olds, after accidents andhomicide.• Nearly twice as many women (12%) as men (7%) are affected by a depressive

disorder each year. • Men are more likely to succeed at an attempted suicide (80% of men will

utilize a gun). • When people are suicidal, they often mistakenly believe that they are doing their

friends and relatives a favor.• About one-third of people who attempt suicide will repeat the attempt within 1 year.• About 10% of those who threaten or attempt suicide eventually do kill themselves.

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Depression is a medical illness in which a person has feelings of sadness, discouragement,and a lack of self-worth. The person will have self-talk that includes these themes: I’m no good,my life is not good, and my future is hopeless. It is also a Spiritual disease that robs believers ofa sense of God’s presence and help.

• Christians may feel guilty for feeling depressed or suicidal, believing they are not wor-thy of Christ’s intervention.

• Christians may, in shame, hide the reality of their struggle and sense only God’s abandonment.

Untreated depression is the #1 cause of suicide by Christians.

A person manifesting 4 or more symptoms qualifies as depressed.• See pages 1-2 for a list of common symptoms.• If these symptoms persist for more than two-weeks, medical evaluation is warranted. • A depression continuing for months is considered major and requires in-depth inter-

vention by specialists. • Think of it as a diabetic who requires insulin to survive; a person suffering from

depression may require chemical intervention to live.

This is not a spiritual shortcoming - it is part of a holistic approach to wellness -many Christians need to be told this.

Guidelines for Those Who Minister Amidst Despair

1. We do not wish for suffering, nor do we flinch in the face of it, but we lean wholly onChrist. • We do not believe that “God only gives us what we can handle” —

to the contrary, we believe ”Life always gives us more than we can handle on ourown, and Christ is there to help us bear it.”

2. As ministers of the Gospel, we are Christ’s light in the darkness which says — lean here,on God, on his Community, on a present hope that you may not fully grasp — but whichgrasps you!

3. Ministers of Christ submit themselves to the leadership of the Holy Spirit and thus discernwhether healing from this suffering is part of a longer journey that must be tended or onewhich will give way immediately to prayer or healing proclamation of Scripture.

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4. Ministers pray daringly for specific healing as the Lord leads, and do not rush to judgmentfor self-glorification or aggrandizement. While it is a moment beyond compare to be usedof the Lord to cast out a spiritual stronghold, or to be God’s vessel for miraculous healing,it is of equal consequence to be the Lord’s servant in the abiding ministry which, aftermuch perseverance, gives way to healing.

5. Ministers of the Gospel disrespect the world’s presumption that suffering is useless,destructive, and evil, but grasp—through much personal suffering—perseverance, heal-ing, and reflection that God does and will work mightily in the lives of those who suffer. • Certainly we would not have prematurely removed Joseph from his prison cell, or Paul

from his three days of blindness, or Jesus from the cross. • We trust that God will have the final word in God’s time.• We rejoice in the hope of the glory of God. Not only so, but we also rejoice in our suffer

ings, because we know that suffering produces perseverance; perseverance, character; and character, hope. And hope does not disappoint us, because God has poured out his love into our hearts by the Holy Spirit, whom he has given us. (Romans 5:3-5)

Satan’s Role in Suffering

I want you to be wise about what is good, and innocent about what is evil. The God of peacewill soon crush Satan under your feet. The grace of our Lord Jesus be with you. (Romans 16:20)

Satan works:1. To create confusion – about who is in charge. God is.

• Your enemy the devil prowls around...looking for someone to devour. Resist him...and God who called you in Christ ...will himself restore you. (1 Peter 5:8–11)

2. To create chaos – a sense that no one is in control (except the evil one). God alone is in control of the Christian’s life. • The devil may nip at our heels, but, as baptized believers, we belong only to God, and

must only command, “In Jesus Name - get behind me Satan.” (Matthew 16:23and Colossians 3:17)

3. To create desperation – a feeling that nothing will ever be any different. God is the great giver of new beginnings.• This is what the Sovereign LORD says to these bones: ’I will make breath enter you, and

you will come to life. I will attach tendons to you and make flesh come upon you and

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cover you with skin; I will put breath in you, and you will come to life. Then you will know that I am the LORD.’ (Ezekiel 37:5–6)

• God has always been, and will always be, in the business of performing HOLY CPR—able to resuscitate even the lifeless soul! God will again breathe life into the weary.

4. To create hopelessness – a certainty that this world (and those in it) would be betteroff without you. God who gives life never steals hope.• Satan alone is the Father of Lies. • Jesus told us, “I am the way and the truth and the life. No one comes to the Father

except through me.” (John 14:6) We hold to the truth which does not deceive or cre-ate hopelessness. Encourage others: Do not surrender to the feelings—walk in thetruth even though you do not feel it.

5. To create a sense of haste. God is patient.• Satan would prefer an individual not have time for things to look better, not take the

time to work through the suffering.• Escaping suffering looks like: alcoholism, chemical-use, cutting, self-destructive and

other-destructive behaviors, near-fatal recklessness, and suicide.• God’s love is patient and persevering. God is not in a hurry and will give a person

whatever time they need. If a person feels they have to resolve a matter quickly (bytaking their life), surely Satan’s urgent cry for haste is speaking loudly and the voice ofour God who is patient needs amplification.

• The Lord is not slow in keeping his promise, as some understand slowness. He is patient with you, not wanting anyone to perish, but everyone to come to repentance. (2 Peter 3:9)

If a person feels that they are in a serious spiritual battle against the enemy, theyshould:

• Seek frequent Christian fellowship. 1 John 1:7• Leave no sin unrepented. Psalm 51 may be useful.• Use the Word of God to fight off attacks. Ephesians 6:17–18• In the midst of an attack, they ought know to refrain from taking any action that would

bring harm to themselves or others. The darkness and lies will pass, and they will beglad that they didn’t let the Devil have the final say.

• Cling to Romans 8:38–39: Nothing can separate us from the love of God that is in ChristJesus . . . Neither angles nor demons nor anything in creation.

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Protocol for PrayerTrust in the LORD with all your heart, and lean not on your own understanding; in all yourways acknowledge Him, and He shall direct your paths. (Proverbs 3:5-6)

Ministers must first submit to God’s heart and allow the Lord to lead their work.Often ministers of God are dealing with matters of spiritual life and death - in the instance ofdepression/ suicide, ministers are called to tend the threat to both body and soul. It is naturalthat we would want to hurry up and see the other person healed. As ministers of Christ, however, we want neither to delay nor hurry the Spirit’s work.

• Do not lecture on the value of life or offer false assurances aimed at “making it all better.”

• Do not try to “cheer them up”" which will only confirm their feelings of isolation andabandonment.

• Offer empathy, not sympathy.

• Take care not to criticize or shame them. Because feelings of depression often go “under-ground” in the Christian community where they cannot be healed or prayed over—suchfeelings are ready fodder for the enemy.

• Do not make another’s problems your own or claim to share the same diagnosis. Even ifyou do, this moment is not about you. Speak out of your understanding but do not be distracted from the ministry at hand.

• Try not to get angry with the depressed individual for failing to see things as yousee them.

• Although prayer is confidential—do not make a promise of secrecy.

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Before beginning prayer (follow the usual North Heights guidelines), ask the individual:• To name their symptoms (cares, concerns, worries)• To name (if they are able) the underlying causes of their symptoms• To name what they want the outcome to be (often the outcome must also be submitted

to the Lord)• Spend a moment in silence, seeking the Lord’s discernment – then begin to pray accord-

ing to the Spirit’s prompting

As You Pray

We are hard pressed on every side, yet not crushed; we are perplexed, but not in despair; per-secuted, but not forsaken; struck down, but not destroyed . . . Therefore we do not lose heart.Though outwardly we are wasting away, yet inwardly we are being renewed day by day. Forour light and momentary troubles are achieving for us an eternal glory that far outweighsthem all. So we fix our eyes not on what is seen, but on what is unseen. For what is seen istemporary, but what is unseen is eternal. (2 Corinthians 4:8-9,16-18)

Welcome the Holy Spirit and submit to the Spirit’s strategies for receiving the Word of God forthis precious child of His. Ask for wisdom, knowing God will give it liberally. Ask for a provisionof comfort, knowledge, understanding and truth to set this person free.

• Be specific as you ask from the Lord - name in turn the physical, emotional, and spiritualroots and symptoms.

• Press in for healing - claim Scripture as God gives you utterance. Claim the promises fromGod’s Word that the Spirit brings to mind.• Remember this is not about you, what you know, or even what you are accustomed to

praying. This is about the Holy Spirit’s prompting.• Pray in the Name of Jesus Christ, that every assignment of the enemy would be disman-

tled, rendered powerless.• Declare that no weapon formed against this person can prevail. • Ask God to place a hedge of protection and a holy wall around this person – claim

the power of Christ over all.

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• Ask for faith for this person to trust God's presence especially in the valleys ofpain and suffering

• Proclaim God's power to enter the dark-tombs of life and abide with us at length in thesesorrowful places. Reclaim God's power to raise the dead to life.

• Ask the Lord to heal the sorrow and anger and restore Christ-like emotions that the spiritof fear which has long over-shadowed this person - may be lifted. • In the name of Jesus, break the power of shame, isolation, hiddenness and denial.

• For the weapons of our warfare are not carnal but mighty in God for pulling down strongholds, casting down arguments and every high thing that exalts itself against the knowledge of God, bringing every thought into captivity to the obedience of Christ, and being ready to punish all disobedience when your obedience is fulfilled. (2 Corinthians 10:4-6)

As the Lord leads, consider prayers that:

• Ask the Lord for a gift of knowledge - to determine the true diagnosis behind any linger-ing infirmities.

• Ask to receive the mind of Jesus Christ to discern the keys to this person's healing. Ask theLord if:• any deeper inner healing is needed, • any more repentance if needed,• any of the enemy's lies remain, or if deliverance is needed.

• Give thanks in advance to the Lord, that he can move mountains.• Ask for a new impartation of the love of God that casts out fear. • Pray resurrection power to bring new life and patience for new life• Pray for a new vision of value as a "child of God".• Pray that what the enemy has stolen will be restored 100-fold.

Pray a Cleansing Prayer when the prayer has concluded. Pray that nothing you have heard,touched or seen would have a hold on your Spirit. Ask Jesus to tend your mercy-heart that youwould remain steadfast in prayer. Seek-out the person for continued care.• Finally, in spite of your best efforts, know that an individual may go on to complete a

suicide plan. Their desire to escape may be too overwhelming. The individual is responsi-ble for their death, not you; even so, you can expect to experience overwhelming feelingsof grief. Seek support, counseling and cleansing prayer for your self.

The Lord is the strength of my life and I am not afraid.(Psalm 27:1)

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MINISTRIES FOR ONGOING CARE

After the crisis-point, you may want recommend one of these North Heights ministries:

North Height’s On-Call Line• 651-797-7488 • After Hours: 651-646-4393

Counseling Clinic: 651-797-7852

Women's Ministry: 651-797-7848

Pray for the Cure: 651-797-7868

Divorce Care: 651-797-7852

Grief Support Group: 651-639-8226 or 763-571-1193

Tuesday-Thursday Prayer Ministry: 651-797-7800 (then, dial 0)

MINISTRIES BEYOND THE CHURCH THAT MAY HELP:Send an anonymous e-mail to www.samaritans.org

Call 1-800-SUICIDE: (1-800-784-2433)

Teenagers, call Covenant House NineLine: 1-800-999-9999

North Heights Community Care DepartmentWritten by Mindy Bak. Edited by Steve Wiese and Jean Bearden.