What to do if someone you know is thinking about suicide

I often get asked about what a friend or family member can do if a loved one communicated that he or she is thinking about suicide. This issue is not addressed nearly as often as it should be, hence I wanted to provide some information for those who might notice signs of suicidal behavior in others and are unsure of what to do about it.

It can be very intimidating to discover that someone you know is thinking about suicide. Nowadays, this is often communicated through social media, such as Facebook or Twitter. Please, please do not take these lightly as the person who posted that he or she is thinking about suicide is likely to be at a high risk for doing it.

Here’s what you should know:

• Suicide is more likely to happen around the holidays, especially Thanksgiving and Christmas
• Military service members and Veterans are at higher risk for suicide than other members of the population. In fact, more Veterans from the Iraq and Afghanistan wars (known as OEF/OIF Veterans) have completed suicide than the total amount of active duty service members who died in combat in these two wars. That means we are losing more people to suicide than to the war!
• It is estimated that roughly 22 Veterans die by suicide every day, that means nearly 1 suicide every hour
• Teenagers and young adults, as well as senior citizens, are at higher risk for suicide than adults ages 35-60
• Don’t assume that a child is not at risk for suicide. In fact, children as young as 6 have been known to die by suicide, so it is very important not to dismiss potential risks in children based on their age alone

Warning signs that someone is thinking about suicide:

• Talking about it or posting about it on Facebook, Twitter, or other social media website. This is the #1 predictor of suicide attempt, so if you see a Facebook post or hear someone talking about it, do something, don’t just ignore this. Suggestions on what to do are listed below and can also be found on The Suicide Prevention website
• Person is giving away his/her possessions or saying good-bye
• Person is very depressed and is withdrawn from others or lacks a strong support group
• Person is engaging in dangerous or self-destructive behaviors (excessive drinking, uncharacteristic risky sexual behaviors, violence or aggression). Most people usually pull away and don’t say anything when they see these behaviors in others, but usually when these behaviors occur (assuming that they are uncharacteristic of the individual), this suggests that a person is going through a hard time, doesn’t know how to handle it, and might possibly be thinking about suicide (especially if these behaviors began after a difficult life change, such as a divorce)

What to do if you suspect someone is planning or thinking about suicide:

ASK!!! Most people actually avoid asking about suicide because they believe that the person won’t want to talk about it or that talking about it can give them the idea to do it. This is actually not true and talking about it will allow the person to see that someone cares about them and can make a huge difference in determining whether they actually end up going through with it.

Remember that a person who is thinking about suicide is NOT crazy, they are just going through a hard time and you can help by just being there.

People often assume that people who are thinking about suicide are not willing to ask for help or go to see a mental health provider (a psychologist, for example) but that is not true. Helping your friend/family member find a mental health professional and assisting him or her with going in to the initial appointment can make a tremendous difference in whether they get the help they need

How to bring it up: Many people don’t know how to start this difficult conversation, The Suicide Prevention website gives great tips on this. I always suggest that you start in a compassionate and honest manner. For example, “I’ve been really concerned about you because I saw that post on Facebook, where you mentioned that you couldn’t handle it anymore” or “I wanted to see how you were doing, I noticed that you haven’t been yourself lately.”

Ask if they have a plan for how they’re going to do it. People are more likely to die by suicide if they have a plan and a way to carry out that plan. For military and Veteran populations, this plan tends to involve guns. Hence they are more likely to die by suicide, especially if they have access to those weapons. Find out if the person has a plan for how he or she wants to die by suicide, and if they do, find out what that plan is.

If there is a plan, ask if they are actually intending to go through with it. Most of the time, people are unsure about their decision to die by suicide and you can intervene by suggesting that they go see a mental health professional, giving them the phone # for the suicide hotline (1-800-273-TALK), and taking away the access to the weapons, pills, or any other intended means of dying by suicide. NOTE: This does not mean locking away all the knives in the house if the person intended to use a firearm. Going overboard and “baby proofing” the house can actually increase distress in the person who is considering suicide.

If the person is planning suicide and has access to the weapons, medications, or other intended means, ask the person if he or she would be willing to go to the emergency room. If so, call 911, they will send a team of experienced emergency workers, who will help. Most people don’t know about the 911 option, keep it in mind, tell your friend about it, as well as his or her loved ones. If your friend is not willing to be hospitalized but is intending on suicide, you can call 911 yourself and tell them what is happening. They can hospitalize someone who is planning to die by suicide and get them the help they need.

Be careful about being judgmental or putting guilt or blame on the person. That is, don’t give them lectures about how much suicide will hurt others, don’t say things like “look on the bright side” or “at least your situation is not as bad as…” Making such statements can actually make the situation worse because the person might feel guilty and misunderstood.

Instead of trying to talk the person out of it, offer empathy. Statements such as “I’m so sorry you’re going through this” and “you’re not alone, I’m here for you” are far more powerful than offering advice to “fix” the current problem that brought on the suicidal thoughts in the first place. For example, if the person is upset about his wife leaving him, don’t say that “there are other fish in the sea”, or that “she was a bitch anyway”, or offer to set him up with your cousin who recently became single. This is neither the time nor the place for this. The person just needs a friend to help him with a difficult life transition and you can be that person if you can offer empathy and support.

It might feel like you’re not helping if you’re not giving advice but you’re helping more than you know, much more, by being there, being present, being compassionate, and not judging or giving advice, than by any other means.

Helpful resources:

Here’s a powerful video about how one army soldier prevented another from suicide. This is an actual interview following actual events: