It can be challenging to know exactly what to say or do when someone tells you they are stressed, having a difficult day, struggling with their mental health, or having suicidal thoughts.
It’s important to note that talking about suicide will not give someone thoughts they did not already have. Rather, it will let them know you are there for them and open for any conversation. You will be a source of support if things become difficult in the future.
The most effective way to prevent suicide is to increase awareness of the warning signs and to intervene by reaching out to the person in distress.
RECOGNIZE the Warning Signs
Warning signs may help you determine if someone is at risk for suicide, especially if the behavior is new, has increased, or seems related to a painful event, loss, or change. It’s important to recognize the warning signs—and know how and when to take action:
Take immediate action if you recognize the following:
- Talking about wanting to die or to kill oneself
- Looking for a way to kill oneself, such as searching online or buying a gun
- Talking about feeling hopeless or having no reason to live
If the danger of self-harm seems imminent, call 911. Stay with the person (or make sure the person is in a private, secure place with another caring person) until you can get further help. Provide any background information that may be helpful. Continue to stay in contact with the person and pay attention to how they’re doing.
Continue to express your concern if you notice the following:
- Talking about feeling trapped or in unbearable pain
- Talking about being a burden to others
- Increasing the use of alcohol or drugs
- Acting anxious or agitated or behaving recklessly
- Sleeping too little or too much
- Withdrawing or feeling isolated
- Showing rage or talking about seeking revenge
- Displaying extreme mood swings
ASK if the person is thinking about suicide. Be direct and use specific words:
- Have you had thoughts of suicide
- Do you ever feel so bad that you think about suicide?
- Do you have a plan to kill yourself or take your life?
- Have you thought about when you would do it (today, tomorrow, next week)?
- Have you thought about what method you would use?
Here are some conversation starters:
- “You haven’t seemed like yourself lately. Is something going on?”
- “Your stress level is off the charts. I want to help.”
- “I’m worried about you. Are you ok?”
LISTEN without judgment. Let the person talk without interruption and make them feel heard. AVOID the following:
- Minimizing their problems or shaming a person into changing their mind
- Sharing your opinion or jumping to conclusions
- Trying to convince a person suffering that it’s not that bad or that they have everything to live for. It may increase their feelings of guilt and hopelessness
- Arguing, preaching, or challenging the person
- Making promises (like keeping their secret)
Don’t feel like you must give advice, problem-solve, or know all the answers. Just talking with someone as they try to navigate their distress can be very powerful.
If they say they are NOT suicidal, reassure the person that you are not there to judge them or do anything that makes them uncomfortable. You only want to understand their thoughts and feelings, so tother you can make the best choice for their health. Remind them that if they ever have suicidal thoughts, you are there to listen and are ready and prepared to help.
RESPOND with compassion and care. It is not your role to solve the issue, but you can triage resources for support.
- Remain calm and convey care
- Acknowledge that they are in pain and that their pain is REAL
- Stay with the person
- Remove sharp objects or lethal means
- Go with the person to the ER or mental health clinic
- In an Emergency, call 911. Don’t leave the person alone
Try this in-the-moment grounding technique: Invite the individual to be seated with you. Ask them to identify three objects they can see. Have them identify the color of each object and the textures. Then ask them to identify three sounds they can hear.
See if they are comfortable with slowly breathing with you for a moment. Offer to slowly count as they inhale and exhale.
Grounding helps a person override their body’s sympathetic nervous system and adrenal reactions that occur when they experience acute distress. It helps them to refocus on the safety of the environment around them, especially when their body is responding to a perceived threat.
Here are some helpful phrases:
- “You are not alone. I’m here for you.”
- “I may not understand exactly how you feel, but I care about you and want to help.”
- “We will get through this together.”
FOLLOW-UP with the person. Support their transition from crisis to recovery. The initial event is often just the beginning of their journey. Here’s how you can help them overcome challenges after a mental health crisis:
- Recognize people often experience increased loneliness or despair
- Continue to follow up and show continued support by checking in
- Encourage self-care such as physical activity, hobbies they enjoy, mindfulness exercises, etc.
- Provide reminders about the support and resources available through their Assistance Program.
You don’t have to do it alone. Your Assistance Program is here to help. Services are free, confidential, and available to you and your family members. You can access them 24/7 by visiting Member Support.
SOURCE: National Council for Suicide Prevention
