How do you support someone experiencing suicidal thoughts? Expert tips

Despite increasing awareness of mental health, suicide is still associated with a great stigma, which leads to it being concealed in various ways.

“People often find a reason to walk away from a situation rather than approach the person they're worried about, and I think there are several common reasons why this is the case,” says Dr. Christine Moutier, chief medical officer at the American Foundation for Suicide Prevention.

Some of these reasons, such as considering suicidal thoughts selfish, contribute to stigma.

According to the World Health Organization, more than 720,000 people around the world die each year from suicide. It is also the third leading cause of death globally among young people between the ages of 15 and 29 years.

Before you talk to someone about suicide, realize that although you can provide support, this person's condition requires professional help that you may not be qualified to provide.

So, what can you do? Experts offer some advice.

Correcting misconceptions about suicide

Experts say that one of the most common myths that prevent people from starting a conversation about suicide is the belief that talking about it will increase the risk that a person suffering from psychological problems will end their life.

Dr. Moutier confirms that this myth has been refuted through numerous studies that have shown that discussing suicide does not increase the risk of committing it. In fact, it may sometimes reduce suicidal thoughts and behaviors.

Talking can also encourage people to open up and perhaps take action to get help.

If you're worried about saying something inappropriate, you can learn more about how to have meaningful conversations below. Even if you say something unhelpful, your loved one may appreciate your good intentions and give you another chance to try.

How do you spot someone suffering from a psychological crisis?

Warning signs of suicidal ideation can be difficult to spot, as even experts cannot always predict who is at risk, or whether and when they will actually attempt to end their life, Dr. Justin Becker, a clinical psychologist, told CNN in a previous interview.

Here are some signs and risk factors:

Behavioral signs

Drug or alcohol abuse.

Unusually reckless behavior that could lead to death, such as dangerous driving or excessive alcohol consumption.

Obsession with death or means of suicide.

Easy access to suicide methods.

Loss of interest in activities or studying.

Practicing or preparing for suicide, which may appear in the form of unusual behaviors related to weapons, pills, or other tools that may be deadly.

Giving away personal property.

Emotional or psychological signs

A personal history of suicidal thoughts or attempts.

Mental disorders and personality disorders, especially if treatment is not received.

Exposure to abuse or neglect, serious physical illness, job loss, financial distress, relationship problems, or other trauma and stressors.

Feeling hopeless.

Mood swings (including anger, sudden calmness, or playfulness, as the person may have made the decision to end their life and feel relieved as a result).

Lack of social support or feeling isolated.

Feeling like there is no reason to live.

Verbal signs

Comments indicating a feeling of not belonging or feeling like they are a burden on others.

Talking about wanting to commit suicide or die (whether by suicide or otherwise). Even if the person is joking about it, checking their status is still important.

Have difficult conversations

The American Foundation for Suicide Prevention offers a detailed guide for discussing suicidal behavior, including recommendations for specific statements, questions to ask, and steps you can take. The advice in this section is based on evidence and information from experts interviewed by CNN.

If you notice signs that someone is struggling, you can try making an appointment to reach out to them in person or by phone. Then you can start with a simple question: “How are you really doing?”

If the person doesn't mention any problems, ask them directly about suicide.

You can even use direct phrases like “kill yourself.” Although this may seem harsh, using direct language helps reduce the stigma associated with it, unlike other phrases.

In contrast, the question was phrased as follows: “You don't have suicidal thoughts, do you?” It may suggest that you're being judgmental, or that you're not really interested in having the conversation, Moutier said.

Dr. Michael Rosky, a clinical psychologist and senior director of the Newport Healthcare Center for Research and Innovation, says that if a person confirms that he or she is experiencing suicidal thoughts, or if they open up to you without asking, you may feel anxious or want to give them a long lecture about the impact of their death on others, or you may be overwhelmed by a desire to encourage them to feel grateful and realize that their situation could be worse, or to make them realize that they have many reasons to live, or to convince them That everything happens for a reason.

But experts believe that these responses may seem insensitive, or as an attempt to make him feel guilty. These responses may make the person feel more lonely, discouraging him or her from seeking to connect with others or seek help.

Rosky stresses that the most important thing you can do is control your feelings and thoughts and focus on listening more than talking.

Ask the person what he does and what things help relieve suicidal thoughts, and whether he has a suicide plan in mind. If he has a plan, he may need immediate help.

It is important to show your interest in knowing the details of his experiences and ask him whether he is receiving care from a psychologist.

His answers could influence how you approach future conversations or your efforts to provide support.

Even if you can't do anything based on this information, just chatting can be helpful, as it may prompt the person to think about what could improve their condition, or because the communication itself is positive.

Stay in touch

After that initial conversation, it may be difficult to know when to reach out because of life's busyness, or you may feel worried about getting too involved.

If a person confirms that he does not have a plan to commit suicide and no longer mentions his suicidal thoughts, this does not necessarily mean that his condition has improved.

Motier recommends communicating via text, phone call, or spending time together anywhere. It is not necessary to limit the conversation always to the subject of a person’s mental health, as he is still a human being with multiple aspects.

You can also ask the person directly how they feel supported.

When should more serious steps be taken?

Experts point out that professional intervention becomes crucial when a person's suicidal tendencies begin to transform from mere passive thoughts into an active desire to carry them out, especially if he has a previous history of suicide attempts.

At this point, you can strengthen your support for him as well if that is possible for you.

He may show other warning signs, including a sudden improvement in mood, according to Roski.

If you're wondering about the appropriate frequency of communication with someone who is at increased risk of suicidal tendencies, Motier recommends communicating daily or every other day.

However, if the person discloses that he has arranged a suicide plan, or if you have doubts about his safety, or you feel that the situation is beyond your ability to bear, then you should call 911 on his behalf or with him.

Sometimes, people in psychological crises may rely on just one person to share their concerns. However, Roski stresses that it is appropriate to involve other individuals, even if the person in question is against it, if their condition is getting worse.

Moutier adds that if you know that someone is about to commit suicide immediately or is already harming themselves, you should call emergency services.

Although being in the same place during an imminent or ongoing suicide attempt is rare, according to Moutier, you should never put yourself in danger if this happens.

Both Moutier and Rosky advise trying to apply basic techniques to reduce the severity of the situation as much as possible, such as speaking in a calm tone, moving the person away from the method of suicide used, and continuing to talk to him until help arrives.

When providing support to a loved one suffering from suicidal tendencies for a long time, you must be careful to take care of yourself as well.

Take some time for yourself, do activities you enjoy, and talk to a therapist if necessary.