How to Help Someone with Suicidal Thoughts

Why Should You Take Suicidal Thoughts Seriously?

When someone expresses suicidal thoughts, it is a way of communicating deep suffering. While it may not always mean they have decided to end their life, it could also be a serious intention to act. Thoughts and plans about suicide should always be taken seriously because the step between thought and action varies for each person.

When someone close to you mentions wanting to die or talks about suicide, it can be shocking and frightening. Your first instinct might be to dismiss it or hope it passes. However, mental health research consistently shows that taking these expressions seriously is one of the most important things you can do.

The distance between suicidal thoughts, concrete plans, and action differs significantly between individuals. Some people may have thoughts for years without acting on them, while for others, the progression can be rapid. Most people who experience suicidal thoughts remain ambivalent until the very end and are receptive to help in various forms.

As a friend, family member, or colleague, you should understand that even a small intervention can make a significant difference. It is always better to do something than to do nothing. A caring conversation can be lifesaving for someone who is struggling. Talking about suicide is not dangerous – on the contrary, it serves as a protection for life by opening channels of communication and reducing isolation.

Understanding the Pain Behind the Words

Suicidal thoughts typically arise from overwhelming emotional pain rather than a desire for death itself. The person often feels trapped, hopeless, or believes they are a burden to others. Understanding this helps frame your response: you are not trying to argue against their decision, but rather to acknowledge their pain and offer connection.

Research from the American Foundation for Suicide Prevention shows that most people who survive a suicide attempt report that they did not truly want to die – they wanted the pain to stop. This distinction is crucial because it means that if the pain can be addressed, the desire to die often diminishes.

How Do You Ask Someone About Suicidal Thoughts?

Ask directly and compassionately: "Are you thinking about suicide?" or "Are you having thoughts about ending your life?" Research consistently shows that asking about suicide does NOT increase the risk – instead, it provides relief and opens vital communication. The key is to ask calmly, without judgment, and be prepared to listen.

Many people hesitate to ask directly about suicide because they fear they might "plant the idea" or make things worse. This is one of the most harmful myths about suicide. Decades of research have definitively shown that asking someone about suicide does not increase their risk – it actually reduces it by providing an opportunity to talk about their pain.

When you ask the question, it communicates several important things: that you are paying attention, that you care, that you are not afraid to discuss difficult topics, and that you are a safe person to confide in. For many people struggling with suicidal thoughts, simply being asked allows them to finally share what they have been keeping inside.

How to Frame the Question

There is no single "right" way to ask, but some approaches are more effective than others. Here are examples of direct, caring ways to initiate the conversation:

• "Are you thinking about suicide?" – Simple and direct, shows you are not afraid of the topic
• "Are you having thoughts about ending your life?" – Clear and compassionate
• "Sometimes when people feel this way, they think about suicide. Is that something you're experiencing?" – Normalizes the experience while asking directly
• "How are your thoughts about life and death right now?" – Opens the conversation in a broader way

Avoid vague questions like "You're not thinking of doing anything stupid, are you?" This phrasing implies judgment and makes it harder for the person to be honest. Similarly, avoid asking "You wouldn't hurt yourself, would you?" in a way that suggests you expect them to say no.

What to Do After You Ask

When the person responds, your first task is simply to acknowledge what you have heard. Resist the urge to immediately offer advice, solutions, or reassurance. Instead, focus on listening and showing that you understand the weight of what they are sharing.

If they confirm they are having suicidal thoughts, stay calm – even if you feel scared inside. Your calm presence helps create safety. You might say things like "Thank you for telling me" or "I'm glad you trusted me with this." Remember that for someone who has been keeping these thoughts secret, often in shame, simply speaking them aloud to a caring person can provide significant relief.

How Should You Listen and Respond?

Listen actively without judgment, interruption, or immediately trying to fix the problem. Let the person express their feelings at their own pace. Use open-ended questions like "Can you tell me more about that?" and "How are you feeling right now?" Your presence and willingness to hear their pain matters more than having perfect words.

For someone experiencing suicidal thoughts, the opportunity to talk about their feelings and be truly heard can be profoundly healing. Often, these individuals experience intense feelings of loneliness, hopelessness, and powerlessness. It can feel as though there is a vast darkness inside them that no one else can see or understand.

Your role as a listener is not to fix their problems or convince them that life is worth living. Rather, it is to be present, to create a space where they feel safe enough to express what they are experiencing, and to reduce their sense of isolation. This sounds simple, but it requires patience and the willingness to sit with discomfort.

Active Listening Techniques

Active listening means giving your full attention and showing that you are engaged with what the person is saying. Here are specific techniques that help:

• Give undivided attention: Put away your phone, turn off distractions, and make eye contact (if culturally appropriate)
• Use open-ended questions: "How does that feel?" "Can you tell me more?" "What happens when you have those thoughts?"
• Reflect back what you hear: "It sounds like you're feeling completely exhausted by this" or "I hear that you feel like there's no way out"
• Tolerate silence: Do not feel you need to fill every pause. Giving time to think and formulate responses has value in itself
• Validate their feelings: "That sounds incredibly painful" or "It makes sense that you would feel overwhelmed given everything you're dealing with"

What to Avoid Saying

Certain well-intentioned phrases can actually make someone feel worse or more misunderstood. Understanding what to avoid is as important as knowing what to say:

• "You have so much to live for" – This dismisses their pain and suggests they should not feel the way they do
• "Think about what this would do to your family" – Increases guilt without addressing their suffering
• "Other people have it worse" – Minimizes their experience and adds shame
• "Suicide is selfish" – Adds judgment when they need compassion
• "Things will get better" – While true, this can feel dismissive when someone is in acute pain
• "I know how you feel" – Unless you have experienced suicidal thoughts yourself, this can feel inauthentic

Showing You Care

While listening attentively, it is also important to express your care and concern. You have the right to include your own feelings in the conversation – not to make it about you, but to remind the person that their actions affect others and that they matter to you.

Here are examples of caring statements that can help:

• "I'm here for you, and I want to help"
• "You're not alone in this – I'm not going anywhere"
• "I care about you and about what happens to you"
• "I hear how much pain you're in, and I'm so sorry you're feeling this way"
• "It sounds incredibly lonely when you think like that. I want you to know I'm here"

A person experiencing suicidal thoughts can become so absorbed in their own suffering that they may forget their actions affect others. Gently reminding them of your connection and care can be grounding without adding guilt.

How Do You Assess the Level of Risk?

Ask if they have a specific plan, method, timeframe, or have made preparations. The more concrete and detailed the plan, the higher the immediate risk. Questions like "Do you know how you would do it?" and "Have you set a date?" help you understand the urgency. If they have a concrete plan with available means, this is a crisis requiring immediate professional intervention.

Understanding the level of risk helps you determine what kind of response is needed. Not all suicidal thoughts require the same intervention – some people may need ongoing support and encouragement to seek therapy, while others may need immediate emergency services.

It might feel uncomfortable to ask detailed questions about someone's suicidal plans, but this information is crucial for their safety. Remember: asking these questions does not increase risk. It helps you understand the situation and respond appropriately.

Questions to Assess Risk

When assessing risk, you want to understand several factors:

• Frequency: "How often do you have these thoughts?" (Constant thoughts indicate higher risk than occasional ones)
• Specificity: "Do you have a plan for how you would do it?" (A specific method indicates higher risk)
• Timeline: "Have you thought about when this would happen?" (An imminent timeframe requires immediate action)
• Access to means: "Do you have access to [the method they mentioned]?" (Available means increases risk)
• Preparations: "Have you made any preparations, like writing notes or giving away belongings?" (Active preparations indicate high risk)
• Previous attempts: "Have you ever tried to end your life before?" (Previous attempts are the strongest predictor of future attempts)

Why Is Removing Access to Means Important?

Means restriction – removing or securing access to methods someone might use to harm themselves – is one of the most effective suicide prevention strategies. Many suicidal crises are brief, and if the person survives the immediate crisis, they often do not go on to die by suicide. Removing access to lethal means during this vulnerable period can save lives.

Research consistently shows that reducing access to lethal means is a highly effective suicide prevention strategy. Studies of people who survived suicide attempts reveal that for many, the period of acute risk is relatively brief – often minutes to hours. If someone cannot act on their impulse during this window because means are not available, the crisis often passes.

Contrary to what some might assume, most people do not simply switch to another method if their preferred method is unavailable. This is because the suicidal crisis is often tied to a specific plan, and when that plan cannot be executed, the person often seeks help or the intensity of the crisis diminishes.

Practical Steps for Means Restriction

If someone has shared that they are thinking about suicide, and particularly if they have a specific method in mind, work with them (and their family if appropriate) to limit access:

• Medications: Remove or lock up all medications, including over-the-counter drugs. A trusted family member or friend can hold onto them
• Firearms: If there are firearms in the home, they should be removed and stored elsewhere, such as with a family member, friend, or at a gun shop
• Sharp objects: Secure or remove knives, razors, and other sharp implements if there is concern about cutting
• Car keys: In some cases, limiting access to vehicles may be appropriate
• Alcohol and drugs: Remove these as they lower inhibitions and impair judgment

When and Where Should You Seek Professional Help?

Seek immediate emergency help if the person has a specific plan with means available, has already harmed themselves, or is in acute crisis and refusing voluntary help. For less urgent situations, help them connect with a mental health professional, crisis line, or primary care provider. Offer to accompany them to appointments as support.

While your support is valuable, professional help is often necessary for someone experiencing suicidal thoughts. Mental health professionals have training and resources that can provide more comprehensive care. Your role is to bridge the gap – to provide immediate support and help connect them to appropriate professional services.

Emergency Situations

Call emergency services (or your local emergency number) immediately if:

• The person has already harmed themselves
• They have a specific plan, timeline, and access to means
• They are in acute crisis and refusing to accept help voluntarily
• They have taken medications or substances with the intent to harm themselves
• They have access to firearms and are expressing intent to use them

Do not leave the person alone in these situations. Stay with them until professional help arrives. If possible, have someone else call emergency services while you stay with the person.

Non-Emergency Professional Help

For situations that are serious but not immediately life-threatening, help the person connect with:

• Crisis hotlines: Available 24/7 in most countries, staffed by trained counselors
• Mental health professionals: Psychiatrists, psychologists, counselors, and therapists
• Primary care providers: Can assess, provide initial treatment, and refer to specialists
• Community mental health centers: Often provide services on a sliding fee scale
• Hospital emergency departments: For urgent but not immediately life-threatening situations

Offer to help them make the appointment, accompany them to the visit, or stay on the phone while they call a crisis line. Many people feel unable to take these steps alone, and your support can make the difference between getting help and not.

How Do You Provide Ongoing Support?

Recovery from suicidal thoughts takes time, and ongoing support is crucial. Continue to check in regularly, even after the immediate crisis has passed. Do not assume they are fine just because the acute crisis is over. Consistent, caring contact helps reduce isolation and reinforces that they matter to you.

Supporting someone with suicidal thoughts is not a one-time event. The person who reaches out often becomes an important ongoing support in the person's recovery. Research shows that follow-up contact, even simple check-in messages, can significantly reduce the risk of future suicide attempts.

Staying Connected Over Time

Here are ways to maintain supportive contact:

• Regular check-ins: A simple text or call asking how they are doing shows you care and have not forgotten
• Be patient with the process: Recovery is not linear – there will be good days and bad days
• Include them in activities: Invite them to social events even if they often decline. The invitation itself matters
• Celebrate small wins: Acknowledge their progress and efforts, even small ones
• Remember significant dates: Anniversaries of losses or difficult times may be particularly hard

Do Not Keep Secrets

If someone shares suicidal thoughts with you, do not promise to keep it completely secret. Be clear that you care about their safety and may need to involve others who can help. You can say something like:

"Thank you for trusting me with this. I care about you too much to keep this completely to myself if I think you need more help than I can provide. The most important thing to me is that you stay safe."

If you are a young person and a friend shares suicidal thoughts with you, it is especially important to tell a trusted adult. You might say: "I care about you so much that I need to find someone who can help you better than I can. That's the best thing I can do for you."

Your friend may initially be angry, but remember: you may have saved their life. That is worth any temporary upset.

What Causes Suicidal Thoughts?

Suicidal thoughts typically arise from a complex interaction of factors including mental health conditions (especially depression and anxiety), personal crises, trauma, substance abuse, chronic pain or illness, loss, and feeling like a burden. Understanding these factors helps you approach the person with compassion rather than judgment.

Suicidal thoughts rarely have a single cause. They typically emerge from a combination of biological, psychological, social, and environmental factors. Understanding these underlying causes can help you be more empathetic and may also help the person identify areas where intervention could help.

Mental Health Conditions

Mental health conditions are present in the majority of people who experience suicidal thoughts. The most commonly associated conditions include:

• Depression: Feelings of hopelessness, worthlessness, and being trapped are core symptoms that can lead to suicidal thinking
• Anxiety disorders: Overwhelming anxiety can feel unbearable and lead to thoughts of escape
• Bipolar disorder: Both depressive episodes and mixed states carry elevated suicide risk
• Post-traumatic stress disorder (PTSD): Trauma can lead to persistent pain that feels inescapable
• Borderline personality disorder: Emotional dysregulation and fear of abandonment can contribute to suicidal crises
• Schizophrenia: Command hallucinations or delusional thinking can contribute to suicide risk

Life Circumstances

Various life circumstances can trigger or exacerbate suicidal thoughts:

• Loss: Death of a loved one, end of a relationship, job loss, or loss of identity
• Chronic pain or illness: Ongoing physical suffering can feel unendurable
• Financial problems: Debt, bankruptcy, or inability to provide for family
• Legal problems: Facing arrest, trial, or incarceration
• Trauma: Recent or past abuse, assault, or traumatic events
• Bullying or harassment: Persistent mistreatment, especially in young people
• Displacement: Having to leave one's home, community, or country

Substance Use

There is a strong connection between substance use and suicide risk. Alcohol and drugs can:

• Lower inhibitions, making someone more likely to act on suicidal thoughts
• Impair judgment and problem-solving abilities
• Worsen underlying mental health conditions
• Create or exacerbate life problems (relationship, financial, legal)
• Lead to isolation and shame

If someone is using substances and expressing suicidal thoughts, this combination significantly increases risk and urgency.

How Do You Take Care of Yourself?

Supporting someone with suicidal thoughts is emotionally demanding. It is normal to feel scared, helpless, exhausted, or even angry. Take care of your own mental health by talking to trusted people about your experience, setting appropriate boundaries, and seeking professional support if needed. You cannot help someone else if you are not taking care of yourself.

When someone you care about expresses suicidal thoughts, it naturally triggers strong emotional reactions. You may feel fear, anxiety, sadness, frustration, helplessness, or even anger. These are all normal responses to an abnormal situation. It is important to process these feelings rather than suppress them.

Normal Reactions to Supporting Someone in Crisis

Common emotional responses include:

• Fear: Worry about saying the wrong thing or not being able to prevent tragedy
• Helplessness: Feeling like nothing you do makes a difference
• Exhaustion: Emotional drain from sustained worry and support
• Anger: Frustration at the situation or sometimes at the person
• Guilt: Questioning whether you did enough or did the right things
• Grief: Mourning for the person's suffering or for how the relationship has changed

All of these feelings are valid. During your conversations with the person in crisis, try to remain calm, but afterward, it is essential to process your own emotions.

Self-Care Strategies

Taking care of yourself is not selfish – it is necessary for you to continue being able to help:

• Talk to someone: Share your experience with a trusted friend, family member, or counselor
• Set boundaries: You cannot be available 24/7. It is okay to say you need to rest
• Share the load: Involve other supportive people so the responsibility is not all on you
• Maintain your routines: Continue activities that support your own wellbeing
• Seek professional support: Consider counseling for yourself if the situation is affecting your mental health
• Join a support group: Groups for family and friends of people with mental health conditions can be helpful

What Resources Are Available?

Numerous resources exist for both people with suicidal thoughts and those supporting them. Crisis hotlines are available 24/7 in most countries. Mental health organizations offer information, support groups, and referrals. Professional treatment including therapy and medication can be highly effective. Early intervention leads to better outcomes.

Both for the person experiencing suicidal thoughts and for you as a supporter, knowing what resources exist is essential. Help is available, and reaching out is a sign of strength, not weakness.

International Crisis Resources

Crisis lines exist in most countries. They are typically available 24/7 and staffed by trained counselors who can provide immediate support and guidance. Visit our Emergency Numbers page to find crisis resources in your country.

Types of Professional Treatment

Effective treatments for suicidal thoughts include:

• Cognitive Behavioral Therapy (CBT): Helps identify and change negative thought patterns
• Dialectical Behavior Therapy (DBT): Particularly effective for emotional regulation and crisis management
• Medication: Antidepressants and other psychiatric medications can reduce suicidal thoughts
• Crisis intervention: Short-term intensive support during acute periods
• Safety planning: Developing a personalized plan for managing suicidal thoughts

Organizations and Support Groups

Many organizations provide education, advocacy, and support for suicide prevention:

• International Association for Suicide Prevention (IASP): Global organization promoting suicide prevention
• World Health Organization (WHO): Provides international guidance on suicide prevention
• National and local mental health organizations: Offer resources specific to your region
• Support groups for survivors: Groups for those who have lost someone to suicide or survived attempts
• Peer support programs: Programs connecting people with lived experience