If you or someone you know may be considering suicide, contact the 988 Suicide & Crisis Lifeline by dialing 9-8-8, or the Crisis Text Line by texting HOME to 741741.

If your loved one is struggling with feelings of depression, distress, or thoughts of suicide, you might be wondering how to help. 

You might feel worried about what to say, or afraid to do the wrong thing. 

The good news is that we don’t have to be trained mental health professionals, we don’t have to give expert advice, and we don’t have to completely understand why someone feels the way they do to help someone who is struggling emotionally.

In fact, Kelly Smith, LADC I with HBH says that, “Many people who are suicidal just want someone to talk to who will listen to them without judgement. Practice active listening and show your loved one that you’re there for them.”

With suicide mortality rates continuing to rise in the US, making it the second leading cause of death in people aged 10–34 and the fifth leading cause in people aged 35–54, it’s imperitive that we know how to identify the warning signs for suicide (listed below), and how to intervene effectively with someone at risk of suicide. 

In honor Suicide Prevention Awareness Month– a time to raise awareness about suicide prevention and share messages of hope- we’ve asked three of our trained clinicians at HBH to discuss: how we can support someone at risk of suicide, and when it’s time to get help from mental health professionals or agencies specializing in crisis intervention and suicide prevention. 

Know the warning signs and risk factors for suicide

As family members and friends, we can help to prevent suicide by learning the warning signs and risk factors for suicide, being alert to the warning signs, providing caring support, connecting them to professional mental health services, and asking directly if our loved one has considered hurting themselves.

What are the warning signs for suicide?

Warning signs are changes in mood and behavior which indicate that a person might be considering suicide:

• Talking about wanting to die or to kill oneself;
• Looking for a way to kill oneself;
• Talking about feeling hopeless or having no purpose;
• Talking about feeling trapped or being in unbearable pain;
• Talking about being a burden to others;
• Increasing the use of alcohol or drugs;
• Acting anxious, agitated, or reckless;
• Sleeping too little or too much;
• Withdrawing or feeling isolated;
• Showing rage or talking about seeking revenge; and
• Displaying extreme mood swings

What are the risk factors for suicide?

Risk factors are characteristics or conditions that make it more likely that an individual will attempt or die by suicide:

• Mental disorders, particularly mood disorders, schizophrenia, anxiety disorders and certain personality disorders
• Alcohol and other substance use disorders
• Hopelessness
• Impulsive and/or aggressive tendencies
• History of trauma or abuse
• Major physical or chronic illnesses
• Previous suicide attempt
• Family history of suicide
• Recent job or financial loss
• Recent loss of relationship
• Easy access to lethal means
• Local clusters of suicide
• Lack of social support and sense of isolation
• Stigma associated with asking for help
• Lack of health care, especially mental health and substance abuse treatment
• Cultural and religious beliefs, such as the belief that suicide is a noble resolution of a personal dilemma
• Exposure to others who have died by suicide (in real life or via the media and Internet)

Here’s how to help your loved one at risk for suicide:

1. Talk to your loved one

Kaitlin Corson, LMHC with HBH says that if you’re concerned that your loved one may be struggling emotionally or having a hard time, take the first step to reach out and make contact. 

“Ask your loved one how they are feeling and prepare yourself to listen. If you’ve noticed any warning signs in your loved one- changes in behavior or mood- present your concerns with compassion and without judgment,” says Kaitlin. 

Before starting a conversation you’ll want to: 

• Create a safe space

Find a private and comfortable place to talk to your friend or loved one. Take time to turn off your phone and close the door, to prevent interruptions.

• Get comfortable feeling uncomfortable

Many people feel anxious and awkward when talking to someone about suicide and other self-harm behavior. But the more uncomfortable talking about suicide gets, the harder it becomes for people experiencing these feelings to open up and share their concerns. 

Notice and acknowledge your feelings. Do your best to ground yourself before you start the conversation. Take some deep breaths and focus your attention on compassion. 

Starting a conversation can sound like: 

• “Recently, I’ve noticed a change in your mood, and I’m wondering how you are feeling?”
• “I’ve noticed that you’re not spending time with your friends or family lately, and I’m wondering how you are doing?” 

During the conversation it’s important to:

• Ask open-ended questions

Open-ended questions get the conversation going and invite someone to express their thoughts and feelings. Examples are, “How have you been feeling lately?” “What are your concerns about…”

• Practice active listening

Kelly Smith, LADC I says that the best way to support a loved one dealing with negative thoughts or thoughts of suicide is to practice active listening.

“Active listening is when one person speaks and the other person openly listens without judging or interrupting the other person,” says Kelly. “When someone actively listens they don’t sympathize or give advice they simply just listen.”

When the person is done speaking, paraphrase what the person just said back to them, to show them that you were really listening. 

• Take suicidal statements seriously

“Take the person seriously,” says Alexandra Malin, LMHC and Clinical Supervisor with HBH. “Don’t ignore even indirect references to death or suicide.”

Research shows that fifty to seventy five percent of suicides give some warning intentions to a friend or family member.

• Ask direct questions about suicide

“Many people are worried that using the word “suicide” could put an idea in someone’s head, but the opposite is true,” says Kaitlin Corson.

“Asking someone directly if they’re feeling suicidal can help them talk about their feelings and show them you care.”

You can ask:

“Are you thinking about suicide?”

“Have you had thoughts about suicide?”

2. Help your loved one gain access to professional mental health support

Many people feeling depressed, distressed, and in crisis don’t seek help or professional support on their own. 

Before a suicide crisis occurs: If you’ve noticed that your loved one is struggling emotionally and showing warning signs of suicide or self-harm behavior, talk to your loved one about finding help from a licensed mental health professional. 

Let your loved one know that mental health professionals are trained to help people understand their thoughts and feelings, and learn effective ways to manage their moods and suicidal thinking. 

Alexandra Malin, LMHC says that family members and friends can offer to help their loved one find a licensed mental health professional, schedule an appointment, accompany them during the appointment, or offer to bring them/pick them up from the appointment.

If you are concerned for your loved one’s immediate safety, call 911.

If you’re concerned but it’s not an immediate emergency, make sure your loved one has a safety contact available at all times, whether it’s a mental health professional or a loved one. 

Another great resources is the 988 Suicide & Crisis Lifeline: by dialing 9-8-8, or the Crisis Text Line by texting HOME to 741741.

If the crisis has passed, or your loved one wasn’t actively suicidal but has suicidal thoughts, encourage them to get appropriate psychological or medical help.

3. Reduce access to lethal means

“If someone in the home has expressed feelings or thoughts of suicide, has previously attempted suicide, has been engaged in self-harm behavior, or is experiencing a crisis, it’s important to keep the home as safe as possible,” says Kaitlin Corson. 

You can keep the home safe by: 

• Making sure guns or other weapons are not accessible at home
• Keeping alcohol and other drugs out of the home
• Storing medications safely: work with your loved one and their mental health care team to make sure they do not have access to large quantities of medications
• Locking up pesticides and other household chemicals
• Removing access to sharp objects (knives, razor blades) if possible

4. Create a safety-plan or keep a copy of your loved one’s safety-plan

A safety plan, a key component of suicide prevention, can help keep someone safe when they are feeling distressed, depressed, and suicidal. 

You can help your loved one create a suicide safety plan by identifying people and services they can contact during times crisis, activities that both soothe and comfort them when they are overwhelmed, and a list of reasons to continue living. 

If your loved one has created a safety plan with a trained clinician or other mental health professional you can ask your loved one if they are willing to share it, so you can keep a copy of their safety plan on hand.

5. Keep crisis lines readily-available

Family members and friends should keep crisis line numbers handy. 

Crisis text line provides free, 24/7 crisis support and trains volunteers to support people in crisis.

• Text: TX to 741741 for free, 24/7 crisis support in the U.S.

• Visit: crisistextline.org

The 988 Suicide and Crisis Lifeline

• Call or text: 9-8-8

• Chat online: 988lifeline.org
• Support for people who are deaf and hard of hearing: Use your preferred relay service or dial 711 then 988

6. If it’s a crisis, be there

• If you become aware that your loved one is in immediate risk for suicide, do not leave them alone.
• Call 911 and tell them that your loved one is actively suicidal and at immediate risk of physical harm and/or death.
• If your loved one is amendable and not actively trying to harm themselves, then you can encourage them to seek immediate help from an emergency room, physician, or mental health professional. 
• Keep yourself safe. If your loved one is angry, threatening, or aggressive, call 911 while making sure you and others are safe.

7. Follow up

Always follow up with someone at risk for suicide and/or experiencing thoughts of suicide. You can send them a text, mail them a card, or give them a phone call.

“Consider checking-in on them often in-person and engaging them in activities they enjoy or previously enjoyed. Try to be a shoulder to cry on and listen if they want to vent or speak their mind,” says Alexandra Malin.

No matter what it looks like, this type of contact can increase their feelings of connectedness and remind them of your care.

The take-away

Suspecting that someone is at risk for suicide can be daunting and disorienting, but there are preventative measures that we can all take to support those at risk for suicide. 

If you or someone you know is having suicidal thoughts, contact the 988 Suicide and Crisis Lifeline for free and confidential support.

Additionally, we know that therapy is a leading suicide prevention method. Working with a trained mental health professional allows people to confront and cope with emotional pain in a connected and confidential manner. 

Our counselors, therapists, and psychiatrists at HBH are here to help individuals who are in distress, depressed, and suicidal, as well as those connected to a person in crisis. 

We serve the entire Massachusetts community with our offices in Amherst, Franklin, West Springfield, and Wilbraham Massachusetts. We also offer online teletherapy services to accommodate your schedule and preferences. 

Contact us today at (413) 343-4357 and begin your road to recovery.

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