Pulling Back From the Brink: How Family Networks Help Prevent Suicide

The sudden realization that a loved one is struggling with suicidal ideation is a harrowing experience that shatters families. For 'A', the nightmare began with a phone call from her sister, stating that their mother had ingested pills, left a note, and was being rushed to the hospital emergency room by their father. Until that moment, the mother had been known as an independent, active woman, a mother of five daughters who worked for years in senior positions and served as the family's bedrock. However, in the months leading up to the suicide attempt, her mental state steadily deteriorated, leaving her family struggling to grasp the depth of her distress.

"I tried to encourage her, to tell her that everyone is having a hard time. I felt like I was talking to someone with a black screen in front of them, who couldn't hear anything I was saying," 'A' recalls. Shortly before October 7, the mother underwent complex back surgery. In the period that followed, coinciding with the outbreak of the war, her mental health began to spiral. "We thought it was related to the surgery and the situation in the country. We were all in survival mode," says 'A', whose husband was serving extended reserve duty. "We didn't understand the magnitude of the hour, and I think we couldn't really afford to process it either."

Following the first attempt, the family began dividing shifts so the mother would not be left alone. Yet a second suicide attempt soon followed. "We were completely lost, and also a bit hopeless," 'A' shares. "How can you convince a person to live if they don't want to? We tried so hard to keep her alive, but how much can you take?"

After the second attempt, the mother was referred for treatment under the "Networking" (Rishum) model implemented by the Meuhedet health maintenance organization. The initial session with the psychologist was attended by the mother, her father, and all five daughters. "The therapist asked each of us to tell Mom what happened to us when we heard about the suicide attempt," 'A' recalls. "I immediately thought to myself, does she know what she's doing? Does she want my mother to hear how terrible it was for all of us?"

However, the conversation unfolded quite differently than expected. "Each of us shared, we all cried, including my father," she says, emphasizing how moving it was to revert to being a daughter and allow her mother to listen. "Until then, we felt she was the weak one and we were the strong ones, that we couldn't tell her how hard things were for us." In subsequent meetings, the family learned to identify distress signals, discuss them openly, and establish agreed-upon channels to seek help. Alongside the mother's continued professional treatment, no further suicide attempts have occurred over the past six months.

The Danger After Discharge

"We tend to treat suicidality as a problem on the margins of life, but the data shows otherwise," says Yanai Zamir, a psychotherapist and head of the Meuhedet Suicide Prevention Unit in the Jerusalem District. According to a Ministry of Health report on causes of death in Israel, suicide was the second leading cause of death among young people aged 15-24 in 2022, following accidents among males and cancer among females. "Were you born a male? You are already at risk of dying from suicide. Did you make Aliyah? Are you LGBTQ? A teenager? In the third age? You are in a risk group. Suicidality meets us not only as part of mental illness or the result of a harsh life path," Zamir adds.

"Someone who wants to die does not want to end their life. They want to end a very great mental pain, until the only option they see before them is death," emphasizes Tal Levana, a senior clinical psychologist and deputy district physician. Even after a suicide attempt, the danger is far from over. A 2006 study found that 13.6% of patients who arrived at a hospital following self-harm repeated the behavior within a year.

Empowering the Support System

Alongside the ongoing danger, studies point to protective factors. "Next to the suicidal person are parents who are in immense helplessness, deep guilt, profound shame, and great frustration. They need help too," Levana explains. "And if we help them, we can thereby help the suicidal person as well." This understanding forms the basis of the "Networking" model, in which family members are equipped with tools to identify deterioration and act in time. "We want them to know when the patient starts climbing back up the risk continuum, to provide an immediate response and refer them back to us if necessary," Zamir explains.

'S' is also intimately familiar with this fear. Her husband, who spent years in a managerial role, experienced a severe blow to his status at work. Over time, he withdrew into himself, and during the war, as close family members served in the military, his distress intensified. At its peak, he began expressing a desire to end his life. "At first, I didn't believe him," she admits. "I thought he was just in a bad mood, that he was angry about something. Little by little, I understood he really meant it."

After he agreed to seek psychological treatment, the family participated in "Networking" sessions, joined by other close relatives who learned how to provide support. "It very much calmed me down to know there are other people with me who can help, and who know this is real and not just talk," 'S' says, describing one of the tools she received: "When he shares his feelings with me, I learned to say 'thank you for sharing with me,' without trying to fix the angry emotion he has at that moment."

Despite the active involvement of family members, Meuhedet emphasizes that clinical responsibility remains firmly in the hands of professionals. "We never place clinical responsibility on the family members. The responsibility is ours," Levana clarifies. The role of loved ones is not to replace therapists, but to notice shifts in a person's condition, listen to their distress, and help guide them to professional assistance on time.