How to Help Someone Who Might Be Considering Suicide

If you suspect someone you know is contemplating suicide, it's vital to intervene immediately. Suicide, the intentional act of ending one's life, is a serious threat, even for those who may not fully understand the finality of death. Whether your friend expresses suicidal thoughts directly or you simply have a gut feeling, it is important to take action to save a life. Reach out to the National Suicide Prevention Lifeline in the U.S. at 1-800-273-TALK (8255) or 1-800-SUICIDE (1-800-784-2433), or contact the UK Suicide Prevention Helpline at 08457 90 90 90 for guidance and resources. Experts agree that suicide is linked to both health and social issues, and it can be prevented by raising public awareness.

Understanding the Root Causes of Suicide Prevention Suicide prevention is most effective when risk factors are minimized or overlooked, and protective factors are enhanced. To intervene in a suicidal situation, focus on strengthening these protective factors, as there is limited control over risk factors.

• Risk factors include a history of suicidal tendencies and mental health disorders; please refer to Section 3: 'Understanding Suicidal Trends' for more details.
• Protective factors include clinical treatment, support from family and community, guidance from healthcare professionals, and developing skills to cope with issues and resolve conflicts.

Show that you care. The best protective factor against feelings of isolation (a serious risk factor) is emotional support and connection with friends, family, and the community. Someone contemplating suicide needs to feel a sense of belonging to life, so you should demonstrate to them that they are an important part of your life. Think of ways to support them or relieve stress in their life.

Take an interest in the hobbies of teenagers or young people. If the person you’re worried about is young, learn about their special interests so you can engage in conversations about them. The goal is to show them that you truly care and value their interests and advice. Ask open-ended questions that encourage them to share their passions and interests with you.

• You might ask questions like: 'How did you learn so much about (fill in the blank)?' 'Can you tell me more about that?' 'I really like your style; how do you choose your clothes? Do you have any fashion tips for me?' 'I watched the movie you mentioned, and I loved it. Do you have any other movie recommendations?' 'What’s your favorite movie, and why do you like it?' 'Is there a hobby or activity you could devote your entire life to?'

Help older adults feel useful. If you know an elderly person contemplating suicide because they feel useless or like a burden to others, try to help them feel valuable or reduce their burden.

• Ask them to teach you something like cooking, knitting, or playing cards.
• If they have health or mobility issues, offer to take them somewhere or bring them a home-cooked meal.
• Show interest in their life or seek their advice on a problem. You can ask questions like: 'What was life like when you were young?' 'What’s your favorite memory?' 'Of all the changes you’ve seen in the world, which one stands out the most?' 'What would you do to help someone who’s being bullied?' 'How did you cope with feeling overwhelmed as a parent?'

Don’t hesitate to talk about suicide. In some cultures and families, suicide is considered a taboo subject that people avoid discussing. You may fear that talking about suicide with someone will encourage them to follow through with their thoughts. These concerns may make you hesitant to address the topic directly. However, it’s important to challenge this notion because the truth is the opposite; talking openly about suicide can help the person in crisis reconsider their decision.

• For example, in a suicide prevention project in a high-suicide rate Native American community, some eighth-grade students admitted they had considered suicide until they participated in open discussions on the topic. These discussions broke the cultural taboo, but they helped each participant choose life and pledge never to contemplate suicide again.

Prepare to talk to someone about suicide. After learning about suicide and reinforcing your relationship with the person considering it, get ready to talk to them. Create a comfortable and safe environment for the conversation.

• Minimize potential distractions by turning off electronics, silencing your phone, and arranging for roommates, children, or others to be in a separate, safe space.

Be Direct. Avoid judgment or accusations, and listening openly will make the conversation more intimate. You certainly don't want a barrier between the two of you; prevent this by showing that you are open and genuinely care about them.

• You may feel frustrated when talking to someone in crisis who struggles to think clearly, so remind yourself to stay calm and be empathetic.
• The best way to remain open is not to have pre-set reactions ready for the person. Ask a few simple questions like 'How are you feeling?' or 'What’s been bothering you?' and allow them to open up. Avoid arguing or trying to convince them that things are not as bad as they believe.

Speak Clearly and Honestly. Being overly cautious or hesitant when discussing suicide is ineffective. Be straightforward and clear about your thoughts. Consider starting the conversation with a three-step approach: reinforce your relationship, explain what you’ve noticed, and show your concern. Then, ask them if they’re thinking about suicide.

• For example, 'Hoa, we’ve been friends for three years now. You’ve seemed really down lately, and I’ve noticed you’ve been drinking more. I’m really worried about you, and I’m afraid you might be thinking about suicide.'
• Or 'Child, since the day you were born, I promised myself I would always be there for you. Lately, I’ve noticed you haven’t been yourself, and sometimes I hear you crying. I would do anything not to lose you. Have you been thinking about suicide?'
• Or 'You’ve always been a role model for others, but recently you’ve mentioned hurting yourself. You mean a lot to me. If you are thinking about suicide, please talk to me about it.'

Allow Them to Be Silent. After starting the conversation, the person may initially remain silent. They may be surprised that you 'read their mind' or taken aback that their actions made you think they might be considering suicide. They may need some time to collect their thoughts before they’re ready to respond.

Be Patient. If the person dismisses your concerns by saying 'No, I’m fine' or doesn’t respond, show your care once more. Give them another chance to respond. Stay calm and don’t pressure them, but remain firm in your willingness to listen and help them talk about what’s troubling them.

Let Them Speak. Listen to what they have to say and accept their emotions, even if it pains you to hear them. Don’t try to argue or lecture them on what they should do. Offer them a few choices for continuing hope and moving through the crisis, if possible.

Recognize the emotions of the other person. When discussing someone's emotions with them, it's crucial to accept those feelings instead of trying to 'reason' or convince them that their emotions are unreasonable.

• For instance, if someone tells you that they intend to commit suicide because a pet they loved recently passed away, telling them they're overreacting would be futile. If they tell you they've lost someone they truly loved, don't tell them they're too young to understand what love is or that there are many other guys out there for them.

Avoid trying to 'challenge' the person. While this may seem obvious, you should never challenge or encourage someone to commit suicide. You might think it's a way to make the person realize how foolish they are or even give them a chance to understand that they actually want to live. However, your 'push' could truly prompt them to take action, and you might end up feeling responsible for their death.

Thank the person for opening up to you. If someone admits they have suicidal thoughts, show your gratitude that they trusted you enough to share this with you. You may want to ask if they have confided in anyone else and whether those individuals have been supportive in helping them cope with their emotions.

Encourage them to seek help from others. Suggest that the person call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255) to speak with a trained professional. That expert can offer coping strategies to help the person navigate through the suicidal crisis.

• Don't be surprised if they refuse to call the hotline, but make sure to write down the number or save it in their phone, so they can call it if they change their mind.

Ask if the person has a plan for suicide. It's important to encourage friends or loved ones to share detailed information about their suicidal intentions with you. This may be the most challenging part of the conversation as it makes the intent feel more real. However, knowing the specific plan will allow you to minimize the risk of a successful suicide attempt.

• If the person has gone as far as to have a detailed plan, you need to assist them immediately.

Thỏa thuận với người có ý định tự tử. Trước khi kết thúc cuộc nói chuyện, hãy trao đổi lời hứa. Bạn sẽ hứa rằng bạn sẽ luôn sẵn sàng nói chuyện với cô ấy bất cứ lúc nào, không kể ngày hay đêm. Đổi lại, hãy yêu cầu cô ấy hứa rằng cô ấy sẽ gọi điện cho bạn trước khi định tự tử.

• Có thể lời hứa đó đủ để khiến cô ấy dừng lại và tìm kiếm giúp đỡ trước khi tự tử.

Hạn chế tối đa cơ hội làm tổn thương bản thân trong trường hợp gặp khủng hoảng. Đừng để người đó một mình nếu bạn cho rằng cô ấy đang bị khủng hoảng. Hãy tìm kiếm sự hỗ trợ ngay lập tức bằng cách gọi 911, một chuyên gia can thiệp khủng hoảng hoặc một người bạn mà bạn tin tưởng.

Loại bỏ tất cả những phương tiện có thể tự làm tổn hại bản thân. Nếu ai đó đang trong khủng hoảng và có ý định tự sát, hãy hạn chế tất cả các phương tiện để giảm khả năng tự làm tổn hại bản thân của họ. Đặc biệt, cần loại bỏ tất cả những vật dụng nằm trong kế hoạch tự sát.

• Hầu hết nam giới tự sát đều sẽ chọn súng để kết liễu mạng sống của mình, trong khi phụ nữ thường có xu hướng tự đầu độc bản thân bằng thuốc hoặc chất độc.
• Ngăn không cho người đó tiếp cận với súng, thuốc, chất độc, dây đai, dây thừng, dao hoặc kéo sắc, dụng cụ để cắt như cưa, và/hoặc bất cứ thứ gì có thể tạo điều kiện cho người đó tự sát.
• Mục tiêu của bạn là loại bỏ các phương tiên để tự sát nhằm trì hoãn quá trình tự sát để người đó có thời gian bình tĩnh lại và lựa chọn sống tiếp.

Kêu gọi sự giúp đỡ. Người đang gặp khủng hoảng có thể sẽ yêu cầu bạn giữ bí mật về cảm giác muốn tự sát của họ. Tuy nhiên, bạn không nên cảm thấy bắt buộc phải tuân thủ theo yêu cầu này; đây là việc có thể đe dọa đến tính mạng của một người vì vậy gọi cho một chuyên gia kiểm soát khủng hoảng để xin giúp đỡ không phải là hành động vi phạm lòng tin của người đó đối với bạn. Có thể bạn sẽ muốn cho ít nhất một trong những nguồn giúp đỡ dưới đây biết:

• Đường dây Ngăn chặn Tự sát Quốc gia của Mỹ 1-800-273-TALK (8255).
• cố vấn của trường hoặc lãnh đạo tinh thần như thầy tu, mục sư hoặc giáo trưởng
• bác sỹ của người đang gặp khủng hoảng
• 9-1-1 (nếu bạn cảm thấy người đó đang gặp nguy hiểm)

Recognizing the Seriousness of Suicide. Suicide is the ultimate act in overcoming the human instinct for self-preservation.

• Suicide is a global issue; in 2012 alone, approximately 804,000 people took their own lives.
• In the United States, suicide is a leading cause of death, occurring once every five minutes. In 2012, there were over 43,300 suicide-related deaths in the country.

Understanding the Process Leading to Suicide. Although the decision to commit suicide can be impulsive and occur suddenly, it is often a cumulative process that people only recognize after it is too late. The stages of suicide include:

• Stressful events leading to feelings of sadness and depression
• Contemplating suicide, with the person questioning whether to continue living
• Formulating a specific suicide plan
• Preparing for suicide, including gathering means and distributing belongings
• Attempting suicide, with the person trying to end their life

Paying Attention to Symptoms of Depression and Anxiety After Major Life Changes. People of all ages may feel anxious and depressed after undergoing significant life changes. Most can recognize that this is a temporary phase. However, some may become so immersed in their despair and self-pity that they can't see beyond the present moment. They lose hope and can't find a way out of their emotional pain.

• Individuals who contemplate suicide often wish to end their temporary suffering through a permanent (unchangeable) solution.
• Some even believe that wanting to die means they are mentally ill and that if they are mentally ill, suicide is inevitable. This is completely false for two reasons. First, people without mental disorders can also commit suicide. Second, individuals with mental health problems are still valuable people with a lot to offer.

Taking Suicide Threats Seriously. You may have heard that people contemplating suicide never vocalize their intentions. This is a misconception! Those who openly discuss suicide might be asking for help in the only way they know how, and if no one offers support, they may give in to the overwhelming darkness that is consuming them.

• In a recent study, 8.3 million adults in the U.S. admitted having suicidal thoughts last year. 2.2 million had a specific suicide plan, and 1 million attempted suicide without success.
• It is believed that for every successful suicide, there are 20 to 25 failed attempts. Among individuals aged 15 to 24, there are 200 unsuccessful suicide attempts for each successful one.
• Over 15% of high school students in the U.S. surveyed admitted to having suicidal thoughts. 12% had a concrete plan, and 8% attempted suicide.
• These statistics show that if you suspect someone may be contemplating suicide, you are likely correct. It is better to assume you're right and offer help.

Don't assume that your friend is not the "type of person" who would end their life. Suicide prevention would be much easier if there were a clear profile of the person who is likely to take their own life. Suicide can affect anyone, regardless of nationality, race, gender, age, religion, or socioeconomic status.

• Many people are shocked to learn that even children as young as 6 and elderly individuals, who feel like a burden to their families, are capable of ending their lives.
• Do not assume that only people with mental health issues commit suicide. While those with mental illnesses have a higher suicide rate, ordinary people can also take their lives. Additionally, individuals diagnosed with mental disorders may not openly share their condition, meaning you may not know their mental health status.

Recognize trends in suicide statistics. While anyone can experience suicidal thoughts, certain patterns can help identify groups at higher risk. Men are four times more likely to commit suicide, but women are more likely to express suicidal thoughts, talk about it, and attempt unsuccessfully.

• Native American populations have a higher suicide rate compared to other ethnic groups.
• Adults under 30 are more likely to contemplate suicide than those over 30.
• Among teenage girls, the Hispanic group has the highest suicide rate.

Recognize risk factors for suicide. It's important to note that, as mentioned earlier, individuals contemplating suicide do not fit a single mold. However, understanding risk factors can help you identify if someone you know may be at risk. Those at higher risk for suicide include individuals who:

• have previously attempted suicide
• suffer from mental health disorders, especially depression
• abuse alcohol, drugs, or painkillers
• have chronic health issues or pain
• are facing financial or employment difficulties
• feel isolated or lack social support
• are dealing with emotional struggles
• have had a family member commit suicide
• have been victims of racism, violence, or abuse
• are experiencing feelings of hopelessness

Be cautious of the three most serious suicide risk factors. Professor Thomas Joiner identifies three key suicide risk factors: feeling isolated, feeling like a burden to others, and learning how to harm oneself. He refers to this as a "rehearsal" for suicide rather than a cry for help. He explains that those at the highest risk of suicide often:

• lose the sense of physical pain
• are no longer afraid of death

Recognize warning signs of suicide. Warning signs differ from risk factors (listed above) in that they indicate an imminent risk of attempted suicide. While some people may end their lives without any warning, most individuals who attempt suicide will show signs or say something that signals to others that something is wrong. If you notice one or more of the following dangerous signs, it is important to intervene immediately to prevent a tragedy. Some warning signs include:

• changes in sleeping or eating habits
• increased use of alcohol, drugs, or painkillers
• difficulty functioning, thinking clearly, or making decisions
• expressing extreme sadness or depression
• feeling lonely or as if no one cares about them
• talking about feelings of worthlessness, hopelessness, or lack of control
• complaining about pain and an inability to envision a future without suffering
• threatening to harm themselves
• giving away valued possessions
• sudden happiness or energy after a long period of depression

• Understand that patience is key when dealing with someone in this situation. Don’t rush them to make decisions or share everything with you. Always approach serious matters like death with tact and sensitivity.
• Try to understand what led to their decision. Suicide is often linked with depression, which is a state of emotional turmoil that can be hard for those who haven’t experienced it to grasp. Listen carefully and try to understand why they feel this way.
• Life events that might contribute to suicidal thoughts include the loss of a loved one, job/house/money/self-esteem, health changes, divorce or break-ups, coming out or being outed as LGBTQ+, sexually transmitted diseases, surviving a natural disaster, and more. Again, if you realize someone is going through such experiences, stay alert to the gravity of the situation.
• Listen to them and their concerns. They need someone who will truly listen.
• If the person is not in immediate danger, talking is the best way to help in this moment.
• If you are a teenager concerned about a friend or family member contemplating suicide, talk to a trusted adult or call a hotline immediately for support for both of you. Don’t keep it a secret! This burden is too much for you to bear alone, and it will worsen if your friend actually follows through despite promises made during your conversation.
• Just listen. Don’t try to make them feel better or offer advice. Be silent and really listen to them.
• Encourage them to keep talking. Create an atmosphere full of empathy and understanding. Tell them how much you love them and how much you would miss them if they were no longer around.
• Conditions that can lead to suicidal thoughts include depression, PTSD, body dysmorphia, mental illness, substance abuse, alcoholism, and more. If you know someone dealing with any of these conditions and they mention suicide, help them find immediate support.

• If you feel that someone is in an immediate crisis, seek help right away, even if they haven’t asked for it.