Talking About Suicide with People We Love

I’ve written before about discussing suicide with others, but I just made a memorial gift to the American Foundation for Suicide Prevention (AFSP) in recognition of someone who recently died by suicide, and it prompted me to think about the topic again.

Honestly, this is something I should probably address every year, since we continue to be in the middle of a long-term suicide epidemic; although the suicide rate decreased slightly in 2019 and 2020, it reached a new high in 2021, with more than 48,000 documented suicides. The suicide rate increased across most age groups in 2021, but the increases were particularly large among young adults and people over 74.

Talking about suicide: The basics

As I wrote before, the first thing to know about discussing suicide is that it’s best to be clear and direct. I ask, “Are you thinking of killing yourself?”

The first thing to know about discussing suicide is that it’s best to be clear and direct. I ask, “Are you thinking of killing yourself?”

People frequently worry that asking a direct question like that will somehow cause the other person to suddenly think about suicide, but there’s clear evidence that is never the case. On the other hand, asking a vague question, like “Are you doing OK?,” may miss the risk of suicide, especially if the person has decided to kill themselves but are feeling “OK” about it.

If they are considering suicide, especially if they have an imminent plan, ask them whether they’re willing to call the National Suicide & Crisis Lifeline at 988. In those cases, it’s also a good idea to stay with them or, if you’re not already with them, ask if you can come over; if coming over isn’t feasible, ask if there’s anyone else with them or whom they would feel comfortable asking to be with them. Ideally, they shouldn’t be left alone until either they confirm that they’re safe or they’re in contact with professionals who can keep them safe.

It’s also helpful to find out if they’ve told a healthcare provider, especially a psychiatrist or therapist, about their suicidal thoughts. If they have, I ask what they suggested doing in case of a crisis and whether they’d be willing to contact that provider for an emergency appointment.

If they aren’t already in treatment with a behavioral health professional, you might ask if they have access to an EAP or if they’re willing to call their insurance company for a referral.

Whatever they say, it’s essential to remain calm and empathic, and to thank them for talking about such a difficult topic. It’s also important to say that you’re asking because you care about them and want to be there for them in whatever way they’ll find most helpful.

Talking about suicide with people we love

In my personal life, I consider talking about suicide a crucial aspect of being a parent, so I talked about it when my kids were young and asked them directly about it starting when they were pre-teens.

In addition to asking if they had ever considered killing themselves, I asked them whether they would feel comfortable telling me if they were. Although they both said they would, I also told them that, even if they didn’t feel like they could tell me, they should tell someone: their mother, a teacher, an adult they trusted.

And I asked them to promise me they would tell someone if they were considering suicide.

I didn’t do this just once, either; I tried to ask them at least once a year, especially when they were going through significant stress or if they mentioned suicidal issues involving their friends or acquaintances.

I typically started the conversation with something like, “I know I’ve asked you about this before, but I want to check in on whether you’re thinking about suicide.” I’m matter of fact and direct, and they’ve said they understand why I check back in.

I always end by telling them that suicide is never a good option and there are always better choices. No matter how hopeless things seem, they always get better, and there are always other people who care and will help us through the hard times.

Talking about suicide with friends and other family members

I’ve taken a similar approach with friends who are struggling or depressed, especially with people I know who have considered suicide in the past. Although I’m not as good at checking in with friends regularly, I’ve asked a significant number of people in my life to promise me they’ll contact me if they’re thinking of killing themselves, and I’ve always been clear that I consider those to be open-ended promises. “Even if it’s been ten years since we talked, I expect you to contact me if you’re considering suicide. There’s no expiration date on that, as far as I’m concerned.” (I said the same thing to my kids.)

I also have friends and family members who know others struggling with suicidal ideas, and I have both given them my suggestions on how to talk with others about this topic and have checked in with them about how their friends and family members are doing. A number of my friends have children who wrestle with depression, and I check in with them regularly to see how both they and their kids are doing. It probably goes without saying, but being a parent whose child is suicidal is incredibly difficult, and the stigma around suicide – not to mention the judgments parents expect from others if their child is suicidal – makes it even harder.

I also suggest contacting the National Alliance on Mental Illness, or NAMI, to find a free local support group or resources (including resources en Espa?ol). Several of my friends have told me that services from NAMI have been literally lifesaving for them.

Making a difference

I’ve had these kinds of conversation more than thousand times over the decades, but I’m still anxious before I ask. They always go better than I expect, though, even when someone acknowledges they’re currently suicidal.

In any case, whether they’re considering suicide or not, asking about it is a great way to demonstrate that you care and that there are people around for them.

And, ultimately, that can make all the difference.

(You can also make a difference by donating to AFSP or NAMI.)

Whether they’re considering suicide or not, asking about it is a great way to demonstrate that you care and that there are people around for them.

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For more information, visit https://www.nami.org/Blogs/NAMI-Blog/September-2019/How-to-Ask-Someone-About-Suicide.

If you or someone you know needs help, call 988 for any mental health or substance use crisis.

You can also call 1-800-273-8255 for the?National Suicide Prevention Lifeline?or?text HOME to 741-741 for support from the?Crisis Text Line. The?National Helpline for alcohol and drug abuse?is at 1-800-662-4357. All three are free and available 24 hours a day, 7 days a week, every da

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This piece is not intended as medical or legal advice. Always speak with your medical provider before initiating a diet or exercise regimen or if you have medical questions. If you have legal questions, consult with an attorney.

This article represents my own opinions as a non-physician and does not reflect the opinions or positions of my employer.