What to do when you think someone might be suicidal

While you may be able to identify and assist a loved one in crisis, you can’t possibly be expected to provide them with the unique counseling they may need. Instead, you can help by calmly, directly and sympathetically asking them about suicide and helping them connect with mental health services that are available in your community. And doing so might just save their life.

Look for the warning signs.

It’s not always easy to determine if someone you care about is at immediate risk of suicide, but they may show one or more of the following warning signs:

  • Previous suicide attempts
  • Poor performance at work and/or school
  • Giving away prized possessions
  • Sudden and extreme changes in eating habits /losing or gaining weight
  • Comorbid mental health disorders
  • Withdrawal from family and/or friends
  • A sudden increase in positive mood (after other indicators of suicidal thoughts or long-term depression)
  • Sudden change in physical appearance and/or personality
  • A feeling of disconnection from loved ones/a sense of overwhelming loneliness
  • Talking about wanting to die or to kill oneself, even in a “joking” manner
  • Talking about being a burden to others
  • Sleeping too little or too much/extreme changes in sleeping patterns
  • Showing rage or talking about seeking revenge
  • Increasing the use of alcohol or drugs
  • Excessive risk-taking
If you see these signs, let them know you care, keep them safe, and do whatever you can to connect them with mental health services. If you think they’re in immediate danger, contact the National Suicide Prevention Lifeline at 1-800-273-TALK (8255) or text “4HOPE” to their Crisis Textline at 741741.

How to talk to them

Ask them “Are you thinking about killing yourself?”

Research shows that asking people if they’re thinking about suicide is essential to knowing their intent. Research also shows that once someone who’s struggling with suicidal thoughts is given the chance to have an open conversation about it, they may feel a sense of relief and take the opportunity to seek help.

Keep the conversation going

If they have answered “yes” it’s important to follow that statement up in a caring way and try to connect them with resources. If you think they’re in crisis or they express an immediate desire or plan to attempt suicide, don’t leave them alone. Do your best to connect them with proper mental health services immediately.

Below are some examples of helpful and non helpful statements to make to someone who is suicidal.
Make observations rather than stating opinions.

Non-helpful statement: “You don’t ever want to hang out anymore.” Helpful statement: “I’ve missed you at the last few game nights. What have you been up to?”

Ask open-ended questions.

This gives them the chance to tell you more. Non-Helpful Statement: “Have you been busy lately?” Helpful Statement: “How has work been going?”

Paraphrase the information they share with you.

This shows that you are really listening to what they’re sharing and it gives them a chance to clarify or expand on it. Example: “I’ve just been so exhausted after all the drama at work that I need to get home and relax.” Paraphrase: “So there’s a lot of stressful stuff happening at work?”

Validate their feelings.

This normalizes their negative experience while also suggesting that its manageable. Example: “I feel like I have no say in anything right now. My boss micro-manages me at work and then I come home and my family does the same thing – giving me 100 more things to work on and do!” Validating response: “I feel the same way sometimes. Dealing with a lot of outside control can be really hard. I understand why you haven’t felt like going out lately.”

Ask “the” question and follow up on it.

Non-helpful ask 1: “Have you thought about hurting yourself?” Non-helpful ask 2: “You wouldn’t kill yourself, right?” Helpful ask 1: “I care about you a lot and I want to help keep you safe. So I feel like it’s important to ask, ‘Are you having thoughts of suicide?’” Helpful ask 2: “It sounds like you’ve been having a really tough time. And I want to be here for you in whatever way you need. So I want to ask, have you had thoughts of suicide?”

Connect them with mental health services

Connecting someone you care about with mental health services may seem excessive or even scary, but it can be the very best thing for them. It can not only give them access to the immediate help they need, but also give them a way to deal with the issues they’re facing long term. To help with the search here is a provider list.

National Suicide Prevention Lifeline 1-800-273-TALK

Provides 24/7 access to crisis counselors who can provide support and/or advice when someone has an immediate need. It is important that the Lifeline is not a replacement for behavioral health counseling.

Crisis Textline Text “4HOPE” to 741741

Provides 24/7 access to crisis counselors for people who prefer to engage through texting. Everyone is guaranteed a response within 5 minutes. This is not a replacement for behavioral health counseling.

Ohio Department of Mental Health & Addiction Services

Maintains an Ohio Mental Health Provider Map. Just click on your county too see available mental health providers in your area.

Ohio Department of Medicaid

Has a searchable list of health providers who accept Medicaid. Too search for mental health providers in your area, select your county and then under “Provider Type” click “Clinical Counseling”, “Mental Health Clinic”, or “Psychology.”

Be their advocate

To make the process of helping someone seek mental health care easier and more successful, try these tested tips:

Normalize the experience.

Explain that receiving counseling or other mental health services may not be what they think (lying on a couch and telling your life story, for example), and that it’s helped millions of people successfully address everyday challenges and negative thinking patterns. You might even share how mental health care helped in your own life or those of others you know.

Emphasize the Long-Term Benefits.

Let them know that effective mental health services can do more than help them overcome their current challenges; it can lead to long-term personal growth.

Let Them Make Decisions About What Services to Seek Out.

Allowing your loved one to make the decision about what services to seek out can provide them with empowerment and a sense of control. If you have personal experience or recommendations, it’s OK to provide them. But let them decide who to talk to and how to engage them. Just make sure the connection is made.

Applaud Their Courage.

Ensure them that it’s a sign of courage and strength to seek mental health care.

Offer to go With Them.

By offering to join them for their appointment you’ll likely decrease their anxiety and make it easier for them to connect with their provider. It’s a simple act, but it can greatly increase the probability that they will follow through.