For every person who dies by suicide, 280 people think seriously about it but don’t act, according to the National Suicide Prevention Lifeline.
There's not one answer to what makes someone move from thinking about suicide to planning or attempting it, but feeling connected to other people can help.
If someone seems different, don't ignore it
The most important thing you can do is look for a change in someone's behavior that suggests they are struggling. It could look like a friend who would always pick up your calls but now seems to be avoiding you. Or a family member who was an adventurous eater now barely eating or skipping meals.
Trust your gut. If you’re worried, believe your worry. Changes in behavior are some of the most telling indicators, but it's also important to look for specific warning signs:
• Talking about wanting to die or to kill themselves
• Looking for a way to kill themselves, like searching online or buying a gun
• Talking about feeling hopeless or having no reason to live
• Talking about feeling trapped or in unbearable pain
• Talking about being a burden to others
• Increasing the use of alcohol or drugs
• Acting anxious or agitated, behaving recklessly
• Sleeping too little or too much
• Withdrawing or isolating themselves
• Showing rage or talking about seeking revenge
• Extreme mood swings
Don't be Afraid To Ask Then Act
The most important thing you can do if you think someone may be suicidal is to ask. It may be hard, but it works. Don't buy into the disproven idea that there's nothing you can do to help, or that bringing up suicide might do more harm than good.
In a private setting, ask the person you're worried about directly if they're thinking about suicide. Studies have shown that it does not "plant the idea" in someone who is not suicidal but rather reduces risk. It lets the person know you're open to talking, that there's no shame in what the person may be feeling. If a person tells you they're thinking about suicide, actively listen. Don't act shocked. Don't minimize their feelings. Don't debate the value of life itself. Focus on their reasons for living. You could ask questions such as, "What's kept you safe up to this point?" or "What stops you from killing yourself?"
Keep them safe: Determine the extent of the person's suicidal thoughts.
"Are you thinking about killing yourself? Do you have a plan? What were you thinking of doing? Do you have the materials to do that? Have you gathered those things? Where are they? What could I do to help you stay around until this passes?" If a person does have a plan, it's important to take action to remove the lethal means.
Be there: If someone tells you they're thinking about suicide, continue to support them. Ask them to coffee. Give them a call. Some people will eventually stop having suicidal thoughts and feelings, others will continue to struggle throughout their lives.
Help them connect: Encourage them to seek additional support. That could mean calling the Crisis Hotline (800-621-8504), suggesting they see a mental health professional or helping them connect with a support group.
Follow up: Keep checking in. Call them, text them. Ask if there's anything more you can do to help.
Pay special attention when someone is going through a difficult time
You can check in on people based on what you know about them. All those warning signs that I’ve listed for what makes a person look suicidal are fairly generic and hard for us to be able to spot unless you routinely work with suicidal individuals. However, you know when a person is having relationship problems or going through a divorce – you know when somebody has serious financial loss. ... These are very human recognizable signs that people could be needing help.
If someone makes an attempt and survives, continue to be there
One of the risk factors for suicide is a prior attempt. Studies show that suicide survivors often experience discrimination and shame and may struggle to talk about their feelings because they are worried people will judge or avoid them.
If someone you know is a suicide survivor:
• Check in with them often.
• Tell them it's OK for them to talk about their suicidal feelings.
• Listen without judgment.
• Tell them you want them in your life.
• If they start to show warning signs, ask directly if they're thinking about suicide.
You don’t need to have all the answers
It's important to encourage someone who is having suicidal thoughts to call the Hotline (800-621-8504), find a support group or reach out to a therapist, particularly one who specializes in evidence-based suicide prevention techniques (like at Hele