When someone in your life is thinking about suicide, it can seem overwhelming. You may be unsure of what to do next, may not know whether to take the talk of suicide seriously, or may fear that something you say or do will make it worse. The good news is that reaching out to that person is always the best choice. The even better news is that if you reach out in a caring way and offer hope, you may just save a life.
People who are suicidal do not want to die. For most suicidal people, the pain and suffering they are feeling is so unbearable that they are simply looking for a way to make the pain go away. Suicide becomes the answer—the “solution” to the pain. Unfortunately, suicide is a long-term solution to what is typically a short-term problem. And, as anyone who has lost a loved one to suicide will attest, suicide does not make pain go away. It simply transfers the pain to everyone left behind, and those loved ones spend their lives coping in the aftermath.
More than 90 percent of people who die by suicide have an unrecognized or untreated (or insufficiently treated) mental disorder, most often depression and anxiety. The reality is that both of these disorders, and many others, are highly treatable. However, more than two-thirds of people suffering from mental disorders do not receive any professional care. Stigma prevents people from reaching out for help. In fact, research shows that people who have severe mental disorders find the stigma associated with the disorder more debilitating than the illness itself! Imagine if that were true for other illnesses. What if someone in your life had cancer, but found that other people’s negative reactions and blame were harder to cope with than the cancer itself? It is hard to imagine such a scenario, but that is the reality people with mental illness often face.
In spite of the pressure from society to pretend that all is well, the reality is that most suicidal people do try to reach out to others. We sometimes think that suicide comes “out of the blue” and without warning, but the fact is that more than 90 percent of people who die by suicide demonstrate clear warning signs, and more than 80 percent of people tell someone else of their plans. Unfortunately, the most common response they receive is silence. The people to whom they reach out are often so afraid of saying or doing the wrong thing that they ignore the warning signs. How sad that we teach people CPR in order to save someone’s life when they are in physical distress, but we fail to teach them the Psychological First Aid they need to help those whose distress is emotional.
The good news is that reaching out to others does not have to be hard. Asking direct questions, such as “Are you coping okay?” “Are you thinking about giving up” or “Are you thinking about suicide?” sends clear messages to others that they can talk to you about the very difficult and painful thoughts and feelings they are having. Warning signs, such as talking about suicide, withdrawing from others, giving away prized possession, putting one’s affairs in order, or increasing use of alcohol or other substances can also signal increased risk. There are many risk factors and warning signs for suicide, but the most important rule of thumb is to follow your gut feelings. Essentially, as you talk with someone you are concerned about, if it doesn’t feel right, it isn’t right. Listen to your heart. Don’t try to rationalize or justify what you see or hear. If you are concerned, reach out and do something. Don’t wait. Act now, or find someone who can.
If you are concerned about someone else, try reaching out in a private setting, with words that express your concern. You might try something such as, “I notice that you have stopped coming to choral practice, and you seem really down lately. That has me concerned. I care about you, and this isn’t like you. Are you doing okay? Are you feeling depressed? Sometimes when people feel depressed, they may have suicidal thoughts or feelings. Are you having these?” The exact words you choose are less important than the implicit message you send. Reaching out and expressing care and concern is the key. People who are suicidal often feel alone and believe no one cares if they live or die. Your words can send a strong message of hope.
If the person you ask responds with a “yes,” then your role is to get them to a competent mental health professional who can complete a comprehensive suicide risk assessment and get them the mental health care they need. It is not your role to play therapist or provide solutions. Instead, ask them about suicide, listen to what they say, and refer them to professional help. Never agree to keep suicidal thoughts or attempts a secret. Getting the person to professional help is the key to saving a life. Most of the time, suicidal people are relieved that someone has noticed and cares about them. Sometimes, all they need is permission and encouragement to go for help.
Of course, there are times that even if you believe a person may be thinking about suicide, they deny that this is the case. In these instances, you might try a “gently persistent” approach. Try something along the lines of: “Are you sure? Because I want you to know that I care and I want to help you get the help you need. I know you are struggling, but you don’t have to face this alone.”
In the end, however, whether the person responds “yes” or “no” to your questions about suicide may not change your next steps. If you are seriously concerned for anyone’s welfare, then the reality is that the person would benefit from professional mental health care. Why wait until a problem escalates to thoughts of suicide before something is done? If you help them find professional mental health care now, you may help prevent a distressing situation from escalating to suicide. It is also possible that the person is in fact thinking about suicide, but afraid to let you know or reluctant to say it out loud. Again, a competent mental health professional will be able to assist.
The critical message is: Don’t be afraid to ask others if they are suicidal, and don’t be afraid to get them the help they need. Talking about suicide will not “put the idea” their heads. In fact, even if they are not feeling suicidal at the moment, reaching out to someone who is in distress reminds that person that other people care. The caring voice that you offer provides hope. Hope prevents suicide.
IF YOU BELIEVE SOMEONE IS IN IMMINENT DANGER OF COMPLETING SUICIDE OR HAS MADE A SUICIDE ATTEMPT, GET EMERGENCY HELP:
- Don’t leave the person alone.
- Call 911 or your local emergency number right away.
- 1-800-273-TALK (8255)
- (veterans, press 1)
- En Español
About the authors
Dr. Paul F. Granello is a Licensed Clinical Counselor in Ohio, a member of the American Counseling Association and an Associate Professor in Counselor Education at The Ohio State University. He has published articles regarding his areas of interest which include: suicide and treatment of underlying disorders, wellness, at-risk youth and psychotherapy outcome evaluation.
Dr. Darcy Haag Granello is a Professor of Counselor Education at The Ohio State University and a member of the American Counseling Association. Her research interests include cognitive development of counselors, college suicide prevention and stigma reduction.