How to Help Someone Suicidal

Steps

1. Listen. The key to preventing suicide is to listen. You never know when or how someone will reach out for help. Listen carefully, and be prepared to deal with indications that suicidal thoughts might be present. And always keep in mind that suicidal behavior is a cry for help and that you can do something to both help and stop their intentions.^[1]
   • Try to turn off the part of your brain that wants to relate their experiences to an experience of your own. They are not in a position to be able to correlate your outcome with the state of feelings they're currently experiencing and it might just cause them to feel more frustrated and misunderstood if you try to "hijack" their experience by substituting your own.
   • As well as listening, take their threats seriously. Anyone who expresses suicidal thoughts should be taken seriously; studies have shown that 75 percent of people who committed suicide said and did things to indicate their intention in the weeks leading up to the act.^[2]
2. Keep an ear out for hints that they may be thinking about suicide. Listen carefully. Some phrases that may indicate suicidal thoughts include:
   • "Nothing is working for me right now,"
   • "I just can't sleep at night,"
   • "No one seems to care about me anymore,"
   • "Nobody would miss me if I died,"
   • "You wouldn't miss me if I were gone," (preparing you to let go of them)
   • "I just don't think that I can go on."
   • Note that these are not all inclusive indicators though, nor are they exhaustive of the possible things a person feeling suicidal might say. Use your best judgement and reasoning to determine what is going on behind their words.
   • Other indicators include giving things away and finding a new home for a pet or pets. Discovery of a hoard of medication or books/website history of searches about (lethal) doses of over-the-counter or prescription drugs.^[3] Social isolation, neglect of personal welfare, feeding mismanagement, decline in performance at school or work, major personality change to sadness/pain, etc. are other indicators.^[4]
3. Ask them if they are thinking about suicide. This is a critical point. Many people wishing to commit suicide will reach out for help. By asking this critical question though, you will give them a chance to relieve that stress and connect to another person. Be tactful in the way you ask it though. Instead of asking, "Are you thinking about killing yourself?" try, "Are you considering harming yourself?"
   • It is a myth that talking to someone about suicide will cause them to do it.^[5] Open discussion of a very real and very final topic is an important way of helping the person see the consequences and perhaps to really come to terms with the finality of suicide. Many suicidal people harbor fantasies about nobody missing them, and talking about this can really bring it home that they most certainly would be missed.^[6]
4. Understand the problem. Many of us are raised to feel that suicide is a terrible thing to do. Do not let this judgment come out immediately in your words or actions; indeed, the assumption that people who commit suicide are crazy is very misplaced, as up to only 10 percent of those commit suicide suffer from delusional beliefs about reality.^[7] The person you are talking with will be seriously considering suicide. To make them seem crazy for even thinking about it will only drive a wedge in between you and them. The trick here is to understand why they are thinking about considering suicide. Try to ask questions like:
   • "What kind of things are driving you to do that?"
   • "If it's that serious, something has to be pushing you over the edge. What is it?"
   • Never assume that a person's problems are trivial, or "not enough to warrant committing suicide over".^[8] You are not in their head, you won't always be aware of the varied experiences and internal pain that have driven them to this point, so assuming that the problems are not a big deal from your perspective can be a dangerous approach.
5. Understand that many people thinking about suicide feel that their life is no longer under their control. If you ask a question like, "Why would you want to do that?", you seem to place the blame on them and this line of questioning or pressuring will likely drive them further away.
6. Ask about what prevents them from committing suicide. Once you have listened to what has led them to this decision, try to change the subject to things that are preventing them from committing suicide. Some good ways to do this are by asking questions like, "Something is preventing you from doing this though. What could that be?" or "I'm sure there's a few positive things going on in your life. What are they?" Focus on their responses. The key to being successful is getting them to convince themselves there are reasons for living. By asking these directed questions, you are getting them to focus first on why they want to die, and second, on why they want to live. You are forcing them to provide their own answers. Do everything you can to avoid interjecting with your own opinion. This is about them.
7. Get them to weigh both options. After they have listed reasons for dying and living, guide them through the process of weighing both options. Your role will increase here. Bring up things they may have mentioned. For example, if they have children, ask about how they think their children would feel about losing their parent. Try not to use colloquialisms or platitudes. For example, if they are dealing with an extremely bad break-up or divorce, try not to use the phrase, "there are plenty more fish in the sea," because this will seem scripted, and insincere. Instead, try something like, "I understand the difficulties there, and I know it has a significant impact on you. Is there anyone else though that you might be interested in?" Work to guide them towards choosing life. This takes great skill and patience though, so be prepared.
8. Work to convince them to choose life. Ask them about goals and aspirations they might have. Get them to focus on these instead of their reasons for dying. They need you to help them see what they have to live for. You must get them to tell themselves these things though.
9. Create a plan to keep them safe. If they have constructed a means to commit suicide, ask them for the equipment they would use. Namely, if they planned to overdose on prescription medication, ask them to hand over the medication. It is beneficial to get them to agree to seek further help and do things to improve upon where their life is going. Work with them to create plans for the next 24, 48 and 72 hours. For example, help them agree to spending more time with family and friends in the next 24 hours, seeking professional help in the next 48, and following through with said plans within the 72 hours. Be sure to keep in close contact as well to follow up on these timelines.
   • Don't allow the person to hold you as an emotional hostage by insisting that you agree not to tell others.^[9] Suicidal contemplation is one of the rare moments in life when breaking confidences is essential to help ensure that the person gets the help needed to save his or her life.^[10] Offer to be with them during receiving of professional help if this will settle their concerns and fears.^[11] Also realize that shouldering this alone is not a wise choice; you can get professional help in total confidence, so be reassured that privacy of everyone involved will be maintained.^[12]
   • Don't leave the person alone.^[13] If you know they're on the brink, organize for someone (preferably yourself) to be with them constantly until this can be worked through. Detoxify the home or area they're in by removing all means for committing suicide. If you can't do this and be with them, call on a friend or family member to do this part.
10. Follow through on everything. If someone opens up to you on a sensitive issue like suicide, they have put complete trust and faith in you. Be sure to follow up, continue talking to them and encouraging them. We all need support sometimes, and a situation like this is your chance to provide that support. If you ever get discouraged, know that you are saving a person's life, and the rewards of that are invaluable.
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    Get them some help. Remember that suicide is a life and death situation and that it would be appropriate to contact the authorities. However, do not let them know that you are calling authorities. They may feel like their time is up and they can't trust you anymore.
    • If the conversation is taking place online, wait for the right moment to call 911 unless they tell you they are about to carry through with the act. Wait for the right time; usually in the middle of telling you a story.
    • Do everything that the dispatcher says. Give the dispatcher any information you have: the person's full name, the phone number of the person, address, school/workplace, any and all information. If you get any new information, let the dispatcher know immediately.
    • Ask someone for help calling 911 if you have to.
    • Know that you are doing something to save lives, a service that is priceless.
    • Ask for adult help or therapy if needed.
    • Look out for signs on the internet or from someone that has experience so you can watch out for them.