How To Support Someone With Suicidal Thoughts
Trigger Warning: This article goes into depth about the topic of suicide and also alludes to specific questions to ask a person struggling with suicide. Please read at your own discretion.
*This article is for informational purposes only and is not intended for use as a replacement for professional mental health treatment. If you are in crisis, please call 911 or contact your local emergency line, do not leave a message here as this blog is not continuously monitored.
September 10 is Suicide Prevention Day and this week is Suicide Prevention Week.
I’ve worked in mental health for over a decade, and if there’s one thing you never really get *used* to, it’s coming face to face with a person struggling with the pain of depression and suicidal thoughts.
Suicide prevention means a lot to me. I lost my own brother to suicide nearly a decade ago. It was the most painful experience of my life and the pain of that type of loss is something that you may get used to but it never really goes away. You can believe me when I say I never want someone to experience the pain of losing someone in their lives to suicide.
If there’s one question I get asked repeatedly that holds a certain urgency and fear for most people, it’s “How do I help someone with suicidal thoughts?” Honestly, it’s a great question. Most people have little to no clue how to handle a situation with a suicidal person. I didn’t, until I began my mental health work years ago volunteering at the Suicide Prevention Hotline. After extensive training, I was the voice on the phone someone would speak to when they were in their darkest moments with little will to live.
I mourn the loss of Anthony Bourdain, Robin Williams, Kate Spade, Chester Bennington, and so many others. There is a palpable void in our world with them gone too soon. In light of so many suicides that have caught us off guard and collectively broken so many of our hearts, today I’d like to share with you my best tips on how to support someone with suicidal thoughts. If there’s someone you know who could use these tips, please do them a favor and share.
When someone is voicing a desire to self-harm in any way, take them seriously. I repeat: Take. Them. Seriously. DO NOT:
minimize their feelings, i.e. “It’s not that bad”
tell them everything is going to be ok.
Tell them they are being selfish
Tell them they are being manipulative
Tell them they are just trying to get attention
Make them feel like this is something they need to cover up. You don’t hide a broken leg, nor would you hide suicidal thoughts. You get treatment and care.
The most important thing we all need when we are suffering is to feel we are heard, cared for, and understood. One of the biggest mistakes people make is thinking that the person who is expressing suicidal intent is just doing it for attention. Don’t do this. Even if you have your doubts that the person will actually do themselves harm, you have to understand that when someone is saying they want to hurt themselves, those statements reflect real suffering. Always take a person’s suicidal feelings to be true.
Take a breath and manage your own feelings of anxiety.
Ultimately, while you are not responsible for the outcome of another person’s decisions, the best thing you can do is channel your energy, presence, and focus on the person you’re trying to be there for. All you can do is support them as best you can and the rest is up to them.
When people try to be supportive without keeping their own anxiety in check, they say things like “It’s not so bad” or “You’re gonna be ok”. While well intentioned, these statements are dismissive of the other person’s pain and suffering. Instead of rushing to offer solutions, try just listening. You can take it a step further by offering reflective statements that repeat what the person has said but in your own words. If they say “I’m so upset and I just want to drive off a bridge” a reflection statement would be “I’m hearing you say that it feels so badly for you that it makes you just want to quit, to end it all.” You can also make empathic statements like “I’m so sorry for the pain you’re going through” or “I don’t want you to feel this way” or “Thank you for having the courage to share with me. That means so much.”
Have the courage to ask hard questions.
If you suspect someone has suicidal thoughts but they haven’t said so directly, find out by asking them plainly: Have you have thoughts about wanting to hurt yourself or about not wanting to be around? I know this can seem scary, or at the least somewhat awkward, but self-harm is not something you dance around. If they say “No” then there’s a level of relief, and if they say “Yes” then you can be clear.
If they say yes, then it is a good idea to follow up and ask for specifics. The 3 components of suicidality to ask about are
Intent: What specific thoughts have you had about hurting yourself? (i.e. ‘I’d like to shoot myself”)
Plan: How did you think you might do it? (i.e., “I’d use a gun”)
Means: Do you have access to the means to do it? (“Yes I have a gun” or “No I don’t have a gun”.)
When a person has very serious intent, as well as the plan and means to carry out the plan, they are considered to be at greatest risk of self-harm and likely in need of hospitalization, or a comprehensive safety plan that reduces access to their intended means.
When a person has some intent, but has perhaps a vague plan and little to no access to the means to carry it out, treatment will often focus on addressing the person’s feelings of despair and depression, in addition to exploring medication options which may also provide some relief.
Offer real help and enlist others to help, too (as it seems appropriate.)
There is a lot that you can do to help someone going through an acute period of suicidal thinking. Ideally, multiple people can team up together to support the person struggling with suicidal thoughts. It can be difficult to be the sole caretaker for someone in distress, so it’s best to make sure there’s a support team of family, friends, and loved ones that’s communicating with each other.
Things you can do to be a supportive friend:
Help them make plans to be around people (and not alone) as much as possible.
Help them create a list of ways they can cope (you can put things on the list like watching their favorite movies, reading books, taking a walk, calling people that love them, etc.)
Help them list the reasons and people they want to live for.
Reach out to other trusted friends who would be willing to help support them & coordinate efforts.
Text them daily to check in, send encouragement, and ask how they are doing.
Help them fill up their schedule and stay busy for the next 2-3 days.
Offer to help find them a therapist and schedule the initial appointment.
If they have a therapist currently, offer to contact the therapist to fill them in on the current situation.
Within reason and without putting yourself at risk, ask to remove items that pose a safety risk, such as medications, weapons, etc. This is best done alongside the person who is having the suicidal thoughts, with their support. (It is imperative that you do not put yourself in harm’s way when attempting to remove an item that can be used for self harm).
Follow up with a phone call/text/or in-person check in to make sure they are alright. Be specific and set a reminder on your phone for when you intend to check on them. When checking in, ask specifically if they are feeling suicidal. (Note: Following through is crucial. When someone is in a fragile state, being flaked on can trigger harmful self talk and make things worse.)
Tell them how much they mean to you and others.
Help them to sift through the negative self talk and distinguish truth from reality.
Help them remember who they are. Write them a letter of encouragement that they can read when their thoughts are making them feel worthless. Consider getting others to write as well. Honor their strength for sharing.
Ask them to make commitments for their health. You can say something like “If you are having these thoughts again, do you promise to call me?”
Offer to drive them to the hospital if they aren’t able to verbally commit to their own safety (this is called safety contracting)
When it comes to helping with any of the above, the most important thing is to trust your gut and only do what you feel comfortable doing to help. Make sure the only commitments and promises you make are ones you are willing to follow through on.
Practice good boundaries.
When a person you know may be struggling, it’s healthy and appropriate to have healthy boundaries with the way you step in to help. This means that you do not do anything you don’t feel comfortable with, nor do you offer to help in ways that are not healthy for you. Helping others should not put us in situations that are harmful to ourselves or others. Bad boundaries aren’t good for you, and they aren’t good for the person you’re trying to help.
Suicide prevention is important. But ultimately living a life with purpose and meaning is what makes life worth living. Your care and concern for people helps them remember that they matter. At the end of the day, suicide and depression can be incredibly complex. What isn’t complex is choosing to love all the people in your life better on a daily basis.
Were these tips helpful? Please let me know in the comments below, or subscribe!