Triggers are abandonment, child rearing, responsibilities of motherhood, fear of abandonment, lonlieness.
Seems to pick inappropriate partners; in long-term, one must ask, are there issues Mary engenders over time with romantic relationships?
Substantive emotional stability; lack of intimacy; feelings of rejection.
Clearly — initial steps are to work through the feelings of suicide and find a way to get Mary on a treatment program with a professional.
Mary needs to either seek immediate help from a psychiatrist; perhaps who can prescribe either anti-anxiety medication or screen for anti-depression. Mary may be in enough of a crisis that emergency psychiatric treatment may be needed; checking herself in to a local hospital or at the very least finding a medical assessment as quickly as possible.
Crisis intervention — critical that Mary get help; initial issues to cover are: self-esteem, that suicide is not a solution, find ties to the world that Mary can actualize; distract Mary from the negative by asking about the positive; emphasize the future can hold a great deal of motherhood, etc.
There are a number of variables — first, trust and empathy must be established; Mary is suffering but needs to know that there are steps that can be taken to help the pain end. Something in the brain chemistry MUST change for Mary to feel better.
Patience, perserverence are necessary — compassionate intervention (see below).
Mary perceives that she has little choice, and that she is on the brink — her money situation is dire, her relationships are all but naught, and her physical health is deteriorating along with her mental health.
Mary seems to have lost the spark, the will, to actualize. Lack of eating, lack of relationships, lack of external stimuli are forcing her inward.
Options for Mary
Important not to lecture Mary, but through appropriate questioning probe areas of interest to her and allow her to see that there are options for care, regular treatment, and people who want to see her succeed.
Explore her strengths: ask about what she is good at, what she has passion for, etc. Build upon the positives, build upon the fact that she KNEW she needed help — the first step was making the call.
Encourage dialog, offer to set up appointment or send someone over to pick her up immediately to take to ER; use resource list to ensure that Mary is seen by someone. The point is to keep Mary talking, keep the dialog up, ensure that.