There are many ways we can help friends and family who are experiencing suicidal thoughts. Suicidal thoughts occur frequently, and are a sign that support is needed. They often indicate underlying mental health needs, which can be treated and/or supported. To help a loved one:
Who is impacted by suicide?
Suicide is the second leading cause of death in people aged 10 through 34, the fourth leading cause of death for those age 34 to 54, and the tenth leading cause of death in the U.S. 46% of those who die by suicide have a diagnosed mental health need, and 90% experience symptoms of a mental health need. 78% of people who die by suicide are male. 2SLGBTQQIAA+ youth are 4x as likely to attempt suicide as heterosexual youth. Transgender adults are 12x more likely to attempt suicide than the general population. Suicide rates in the U.S. are high among American Indian/Alaskan Native and non-Hispanic white people. It is the leading cause of death for those who are locally jailed.
What are the warning signs?
Comments like “I want to disappear,” “I wish I wasn’t alive,” and “Nothing matters” can be early signs. Other signs include: talking about death/wanting to die, increased use of substances, aggression, agitation, rage, stating no reason to live, talking about being a burden, researching ways to die, sleeping too little or too much, changes in mood, including mood swings, impulsive or dangerous behaviors, withdrawal from friends, family, and previously enjoyed activities, losing interest in future plans, collecting/saving pills, buying a weapon, giving away belongings, saying goodbye, and organizing to “tie up loose ends.”
What are the risk factors?
Some risk factors for suicide include: substance use, intoxication, family history of suicide, recent death by suicide of a friend, family member, or acquaintance, access to weapon, trauma or abuse history, being bullied, social isolation, recent tragedy or loss, prior attempts, barriers or stigmas preventing the individual from requesting help, and chronic stress.
How can you help?
Ask and listen with support, not judgment. Given the trepidation around suicide, it is not surprising that our first inclination may be to avoid discussion about it. However, research shows that kindly and gently asking someone about their suicidal thoughts helps to reduce them. Ask direct questions. It is ok and important to directly ask someone if they are thinking of suicide. Ask if they experience thoughts of suicide, have a plan, and have intent to act. Speak with openness and warmth. People tend to feel more hopeful, and less suicidal, when someone listens empathically and without judgment. Do not argue or make statements that suggest disapproval. Do not make threats, raise your voice, or retreat. Instead, express compassion, care, and concern. Listen and validate.
Reduce access. When you ask a suicidal friend of family member about their suicidal thoughts, ask if they’ve thought about how they might harm themselves. Then, remove, lock away, and prevent access to anything they are considering using to harm themselves. For children, strongly consider open doors with locks removed, video monitors, and safety locks (e.g., for knives, scissors, razors, and medications). Know where your children are and who they are with, especially if you have safety concerns.
Support. One of the best ways you can support a suicidal friend or family member is to help them reduce their isolation. Help them connect with other friends, family members, community members, and mental heath providers. Help them engage in activities they have tender to enjoy. And, once you start talking, keep talking. Follow up, check in, and show willingness to listen and support. If you are a parent of a child experiencing suicidal thoughts, seek parenting support for yourself, and therapy for your child. Medication management may also be beneficial.
Create a crisis plan. In a non-urgent situation, engaging therapeutic and psychiatric support is an excellent step. You can also help your friend or family member create a crisis/safety plan. This should include trusted people to contact, crisis hotlines, and quick access to emergency resources. The safety plan should be accessed when the individual feels unsafe due to suicidal thoughts. In an urgent situation, as a friend or family member, you should call for emergency support if those with suicidal thoughts express intent or share an actionable plan. If you are unsure of the risk, it is always best to access emergency support.
Stay present. Avoid leaving a suicidal person alone. If the person express intent or a plan stay with them, or make sure another safe person does, until crisis support can be accessed. If you have concerns about safety, call 911 or take the individual to the nearest ER.
There is hope. Suicidal thoughts can be treated and can improve. Protective factors include open communication, and feelings of connection. If you are concerned for yourself or a loved one, please do not hesitate to reach out to a mental health provider for support.
Resources for this blog:
Additional suicide resources:
Suicide and Crisis Lifeline: 988
The National Suicide Prevention Lifeline: 1-800-273-TALK (8255)
Crisis Text Line: Text HOME to 741741
Montgomery County Crisis Center: https://www.montgomerycountymd.gov/HHS-Program/Program.aspx?id=BHCS/BHCS24hrcrisiscenter-p204.html
DC Mobile Crisis Unit: https://dbh.dc.gov/service/access-helpline
VA crisis numbers: https://dbhds.virginia.gov/library/community%20contracting/csb-emergencyphoneno.pdf
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Janelle McCarthy, LGPC
Licensed Graduate Professional Counselor