Mental Health

Every day friends, family, and co-workers struggle with emotional pain. And, for some, it's too difficult to talk about the pain, thoughts of suicide, and the need for help. Though the warning signs can be subtle, they are there. By recognizing these signs, knowing how to start a conversation and where to turn for help, you have the power to make a difference – the power to save a life.

 

Know the Signs

Pain isn’t always obvious, but most suicidal people show some signs that they are thinking about suicide. The signs may appear in conversations, through their actions, or in social media posts. If you observe one or more of these warning signs, especially if the behavior is new, has increased, or seems related to a painful event, loss, or change, step in or speak up.

  • Teens

    • Reckless behavior

    • Changes in sleep

    • Giving away possessions

    • Anxiety or agitation

    • Increased alcohol or drug use

    • Talking about wanting to die or suicide

    • Feeling hopeless, desperate, trapped

    • Uncontrolled Anger

    • Sudden mood changes

    • No sense of purpose

    • Withdrawal

    • Giving away possessions

    • Talking about being a burden to others

  • Older Adults

    • Depression

    • Failure to take care of self

    • Hopelessness

    • Changes in sleep

    • Withdrawal

    • Preoccupied with death

    • Looking for means of self-harm

    • Increased substance abuse

    • Neglecting doctor’s orders

    • Saying goodbye

 

If any of these signs are present, call the National Suicide Prevention Lifeline at 1-800-273-8255.

  • Talking about death or suicide

  • Seeking methods for self-harm, such as searching online or obtaining a gun

  • Talking about feeling hopeless or having no reason to live

Find the Words

"Are you thinking of ending your life?" Few phrases are as difficult to say to a loved one.  But when it comes to suicide prevention, none are more important. Here are some ways to get the conversation started.

Start the Conversation

  • Be Prepared.  Visit the Reach Out section of this document for a list of national and local resources.  Before starting a conversation with someone you are concerned about, be prepared. Have a list of crisis resources on hand. Practice what you will say. Plan the conversation for a time when you won’t be in a hurry and can spend time with the person.

  • Mention the signs that prompted you to ask about suicide. This makes it clear that you are not asking "out of the blue," and makes it more difficult for the person to deny that something is bothering them.  "I've noticed that you've mentioned feeling hopeless a lot lately…"

  • Ask directly about suicide. Talking about suicide does NOT put the idea in someone's head and usually they are relieved. Asking directly and using the word "suicide" establishes that you and the person at risk are talking about the same thing and lets the person know that you are willing to talk about suicide.  "Sometimes when people feel like that, they are thinking about suicide. Are you thinking about suicide?"

  • Phrase the question in a different way. If they answer "yes" to your direct question about suicide stay calm, and don't leave the person alone until further help is obtained. Call 9-1-1 or the National Suicide Prevention Lifeline at 1-800-273-8255. "Are you thinking about ending your life?"

Listen, Express Concern, and Reassure

  • Listen to the reasons the person has for both living and dying. Validate that they are considering both options and underscore that living is an option for them.  "I can imagine how tough this must be for you. I understand when you say that you aren't sure if you want to live or die. But have you always wanted to die? Well, maybe there's a chance you won't feel this way forever. I can help"

  • Let the person know you care. Letting them know that you take their situation seriously, and you are genuinely concerned about them, will go a long way in your effort to support them.  "I'm deeply concerned about you and I want you to know that help is available to get you through this."

Create a Safety Plan

  • Ask the person if they have access to any lethal means (weapons, medications, etc) and help remove them from the vicinity. (Another friend, family member or law enforcement agent may be needed to assist with this.) Do not put yourself in danger; if you are concerned about your own safety, call 911.  "Do you have any weapons or prescription medications in the house?"

  • Create a safety plan together. Ask the person what will help keep them safe until they meet with a professional.  Is there someone you can call if you think you may act on your thoughts of suicide?"

  • Ask the person if they will refrain from using alcohol and other drugs or agree to have someone monitor their use.  "Do you have any weapons or prescription medications in the house?"

  • Get a verbal commitment that the person will not act upon thoughts of suicide until they have met with a professional.  "Please promise me that you will not harm yourself or act on any thoughts of suicide until you meet with a professional."

Get Help

  • Provide the person with the resources you have come prepared with. Call the National Suicide Prevention Lifeline anytime at 1-800-273-8255.  If you feel the situation is critical, take the person to a nearby Emergency Room or walk-in psychiatric crisis clinic or call 9-1-1.  "I understand if it feels awkward to go see a counselor. But there is a phone number we can call to talk to somebody. Maybe they can help?"

What Not to Say

  • Don't ask in a way that indicates you want "No" for an answer.  "You're not thinking about suicide, are you?" OR, "You're not thinking about doing something stupid, are you?"

 

Reach Out

You are not alone in helping someone in crisis. There are many resources available to assess, treat and intervene. Crisis lines, counselors, intervention programs and more are available to you, as well as to the person experiencing the emotional crisis.