Suicide

When someone takes their own life, the effects ripple out to friends, family, colleagues and the wider community. We can all play a part in preventing suicide by looking out for warning signs, reaching out and talking about it.

Why do people think about suicide?#

Sometimes life presents overwhelming situations that are very hard to cope with. Faced with these, some people may think about suicide without acting on those thoughts, while others may come to believe it is their only way to relieve unbearable pain. People who are thinking about suicide often feel hopeless and believe they are alone in their struggles.

What leads a person to consider suicide is complex and varies from one person to another. Some of the factors that may increase a person’s risk include:

• a history of mental health conditions, such as depression, anxiety, bipolar disorder or post-traumatic stress disorder (PTSD)
• physical illness or disability
• previous suicide attempts
• a history of substance misuse
• relationship problems, such as conflict with parents or a partner
• legal or disciplinary problems
• the recent death of a family member or close friend
• losing a friend or family member to suicide
• ongoing exposure to bullying, including cyberbullying

Protective factors#

While risk factors can increase the likelihood of suicide, there are also many protective factors that help by providing support and improving a person’s ability to cope with difficult circumstances. These may include:

• access to support and health care
• adaptive coping skills and a sense of competence
• effective problem-solving skills
• a supportive work environment
• positive relationships with friends, family and the wider community
• a sense of responsibility
• involvement in social and community activities
• belonging to a support group

Recognizing warning signs#

Someone who is thinking about suicide will usually give some clues or signs, though these can be subtle. Everyone is different and there is no certain way to predict how someone will act, but prevention starts with recognizing the warning signs and taking them seriously.

Warning signs may include:

• a sense of hopelessness, or feeling there is no future
• isolation or feeling alone – “No one understands me.”
• aggressiveness and irritability – “Leave me alone.”
• a negative view of self – “I am worthless.”
• drastic changes in mood and behavior
• frequently talking about death – “If I died, would you miss me?”
• self-harming behavior
• engaging in “risky” behavior
• substance abuse
• putting affairs in order, making arrangements or giving away belongings – “When I am gone, I want you to have this.”
• feeling like a burden to others – “You would be better off without me.”
• talking about wanting to die – “Sometimes I feel like I just want to die.”

How to start a conversation#

Speak up if you are worried that someone may be thinking about suicide. Talking about it can be challenging, but if you think someone may be at risk, the best way to find out is to ask. You will not put the idea in someone’s head by asking. In fact, giving someone the chance to express their feelings can ease isolation and pent-up distress, and may reduce their risk.

There is no single right way to show you care. Be open, direct and compassionate. You might start with:

• “You haven’t seemed yourself lately, and I’m worried about you.”
• “I have noticed you have been doing X, and I’m wondering how you’re going?”
• “I’d like to help you get through this. Is there something I can do for you?”

If the person isn’t ready to talk, you could say: “I want to help you, and I am here for you when you want to talk.”

Checking how serious the risk is#

To understand whether someone is at high risk, you can gently ask:

• Do you intend to take your life?
• Do you have a plan?
• Do you have a timeframe?

If the person answers “yes” to any of these, treat them as being at high risk and seek immediate help.

If you are having suicidal thoughts#

Having suicidal thoughts can be frightening. You may never have had them before, or they may have been there for a while and you are not sure what to do. You may feel ashamed to talk about them, or worry that people will judge you or not take you seriously. But talking to someone you trust can help you get the support you need.

• Let someone know how you are feeling. Share it with someone you trust, such as a family member, teacher, doctor or other health professional.
• Try to treat it like any other conversation. Describe what is happening, how you feel and what help you need.
• It is best to be direct, so they understand how you feel.
• Be prepared for their reaction. People who learn that someone is struggling can be confused or emotional at first. Just keep talking; together you can find a way through it.
• Ask them to help you find support. This could be in person, online or over the phone.
• Understand that others do care. If you tell friends about your thoughts, don’t expect them to keep it a secret. They will want to help you stay safe, and that usually means bringing in extra support.

Safety planning#

A safety plan is a structured plan, ideally made with support from a health professional or someone you trust, that you work through when you are experiencing suicidal thoughts, distress or crisis.

A safety plan usually starts with things you can do by yourself, such as reminding yourself of your reasons to live and distracting yourself with activities you enjoy. It then moves on to coping strategies and people you can contact for support, including friends, family and health professionals. Keeping your plan somewhere easy to reach, such as a safety planning app, means you can use it whenever you need it, and you can share a copy with trusted people so they can support you.

In an emergency#

If the situation is urgent and you are concerned someone is in immediate danger, do not leave them alone, unless you are concerned for your own safety. Call the person’s doctor or a mental health crisis service, or dial your local emergency number (for example 911 in the US and Canada, 112 across the EU and many countries, 999 in the UK, or 000 in Australia) and say that the person’s life is at risk. If the person agrees, you could go together to the local hospital emergency department for assessment.

If you are thinking about ending your life, please tell someone. Let them know you are having these thoughts and that you are worried. Ask for help. If you are in immediate danger, contact your local emergency services. If you just need to talk, reach out to a crisis support service or someone you trust.

Key points#

• Many factors can increase suicide risk, and many protective factors can help a person cope.
• Warning signs are often subtle; take them seriously.
• Asking someone directly about suicide does not put the idea in their head and can offer relief.
• A safety plan and support from trusted people and health professionals can help during a crisis.
• In an emergency, do not leave the person alone and seek immediate help.

Where to get help#