How to Help Someone Who Is Contemplating Suicide

How to Help Someone Who Is Contemplating Suicide

Know when to speak up and what to say.

Suicide is more common in our country than murder, says Jeff Sommers, MD, a psychiatrist from Henrico Doctors' Hospital in Richmond, Virginia. “We have a significant murder rate, so when you put that into perspective, it demonstrates just how important it is to talk about this issue and support those who need help.”

In fact, over 42,000 people complete a suicide each year in the US. But even though it affects so many Americans, it’s common to shy away from discussing suicide. Some people might even hesitate to speak up when a loved one is at risk because they’re not sure how to approach the subject.

Dr. Sommers weighs in on how to recognize suicide red flags and reach out to someone who may be thinking about ending their life.

Warning signs of suicide
The thoughts and events leading up to a suicide attempt are unique for each person and there’s no way to know for sure whether someone will complete a suicide. However, there are certain behaviors that could indicate a person’s considering it.

One of the biggest signs? When someone makes comments about wanting to die. They might not say they’re considering suicide outright, but they could make comments like, ‘I just want the pain to stop,’ or, ‘Everyone would be better off if I were gone.’ Even if they say these things casually, don’t let it slide.

“Whenever someone makes a statement related to suicide, you must take it seriously,” says Sommers. “If he or she is verbalizing suicidal thoughts, they need to be in contact with a mental health professional.”

Other warning signs include withdrawing from friends, having dramatic mood swings, participating in dangerous or reckless behaviors and increasing drug or alcohol use,” he adds. “Teenagers tend to be more action-oriented, making them prone to reckless activities. The elderly are more likely to stop following their treatments or taking their medications. They may become preoccupied with death and start giving away their personal items, too.”

These behaviors should be taken seriously in every case. But they’re especially concerning in someone at risk for suicide, such as people with:

  • A history of attempted suicide
  • A mental illness like depression, a substance abuse disorder, bipolar disorder or schizophrenia
  • A recently deceased spouse
  • A high-risk profession like law enforcement, medicine or the armed forces
  • A family history of suicide

Even if someone doesn’t fall into one of these high-risk categories, you should still respond to suicide warning signs. When in doubt, it’s always better to talk to the person, rather than risk losing them.

Don’t hesitate to speak up
It’s a myth that discussing suicide could “put the idea” in a person’s head. If they’re truly at risk, the idea is already front-and-center.

“In reality, asking someone if they’re thinking about killing themself demonstrates how much you care, and that their life matters to you,” says Sommers. “It lets them know you empathize with the fact that they feel miserable. Isolation is also a risk factor for suicide, so reaching out can help them feel less alone.”

Not sure what to say? Start the conversation with an open-ended question like:

  • It sounds like the last few months have been really tough for you. How are you coping with everything?
  • You don’t seem like yourself. How are you feeling?
  • How have you been doing lately? 

Give them time to express whatever is on their mind, but at some point in the conversation ask, “Are you having thoughts of suicide?” Be direct. It’s important to show that it’s okay to discuss this topic.

Don’t judge or argue
Once you open the conversation, let the other person do the talking. “You need to actively listen,” says Sommers. “Give them your complete, respectful attention. Don’t judge or criticize. Put your own needs on the back burner. Just doing that can sometimes feel like a gift to the person—it’s more helpful than you may think.”

“As you listen, try to gather important information,” he adds. You want to determine if they have a plan to carry out suicide. If they’re actively trying to kill themself, call 911 immediately and stay with them until help arrives. Don’t leave them alone for any reason, but remove all possible weapons like firearms, wires and sharp objects from their reach.

Even if the person isn’t actively attempting suicide, they should still speak to a mental health professional right away. If they’re already in counseling, go ahead and dial their therapist.

Another option is to call the National Suicide Prevention Helpline at 1 (800) 273-8255. A professional can de-escalate the situation and help you take the next appropriate step. Often, that means bringing the person to an emergency room. At the ER, they can access the support, resources and medications they need to ease their symptoms.

“If you’ve called for an ambulance and you’re waiting together, reassure them that you're not going to leave their side,” says Sommers. “You can try to get them to think about their relationships and to envision something worth living for. But you should also continue to be an active listener. Pledge your unwavering support and then just listen.”

It’s also a good idea to travel with the person to the ER. If they’re under a great deal of stress, they might not be able to answer questions correctly or understand what their doctors are saying. You can take notes, help answer questions and continue to provide emotional support.

Resources that can help
Contact these organizations for more information and support.

National Suicide Prevention Lifeline: Call the 24-hour helpline at 1 (800) 273-8255 or chat online. Also find resources for members of the LGBTQ+ community, Native Americans, veterans, disaster survivors, loss survivors and other high-risk communities.

The American Foundation for Suicide Prevention: Learn how to make a safety plan, get help after a suicide attempt and more.

The Substance Abuse and Mental Health Services Administration: Find self-help, peer support groups and treatment facilities in your area.

The Trevor Project: Help for LGBTQ+ youth considering suicide, along with their family, friends and teachers. Help is available 24-hours by online chat, text or phone at 1 (866) 488-7386.

Vet Call Center: Call centers are open around the clock for military personnel and their families. Dial 877-WAR-VETS.

Medically reviewed in January 2019.

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