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 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.
Ask them if they’re having thoughts of suicide.
Just asking someone a question like this may seem too simple or too scary, but 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.
Engage them in conversation.
Asking a family member or friend about thoughts of suicide isn’t easy, but there are some well-tested tips you can use to start and navigate a caring conversation. And that conversation can make a difference.
If they say 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.
Make observations rather than stating opinions.
You may have noticed that a loved one is more angry, lonely or tense than usual. When you check in with them, try to make a statement about what you’ve observed rather than what you think is happening.
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.
Yes or no answers probably won’t tell you much about how a person is really feeling, so try to ask open-ended questions that give 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.
When you re-state or paraphrase something someone says, it shows that you’re 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.
Validation is a fancy word for showing someone that you understand what they’re going through. It normalizes their negative experience while also suggesting that it’s 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.
It’s important to ask a direct question about suicide. Don’t beat around the bush by asking similar questions that could mean something else, and try not to ask the question in a way that suggests you want them to say no.
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 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.
Finding the help they need.
There are lots of local, state and national suicide prevention resources and providers. These are some of the organizations and sources that can help you find them.
- The National Suicide Prevention Lifeline provides 24/7 access to crisis counselors who can provide support and/or advice when someone has an immediate need. You can call 1-800-273-TALK (8255) and be connected to someone right away. It’s important to note that the Lifeline is not a replacement for behavioral health counseling, but it can help get someone you care about through a crisis until they can get access to formal counseling.
- The Crisis Textline also provides 24/7 access to crisis counselors for people who prefer to engage through text messaging. Everyone is guaranteed a response within 5 minutes. You or the person you’re trying to help can text “4HOPE” to 741741. Once again, this is not a replacement for behavioral health counseling, but it can offer more immediate professional assistance.
- The Ohio Department of Mental Health & Addiction Services maintains an Ohio Mental Health Provider map. Just click on your county to see available mental health providers in your area.
- The Ohio Department of Medicaid also has a searchable list of health providers who accept Medicaid. To search for mental health providers in your area, select your county and then under “Provider Type,” click “Clinical Counseling,” “Mental Health Clinic,” or “Psychology.”