How can I help someone who is experiencing suicidal ideation?

It can be terrifying to learn that someone you care about is struggling with suicidal ideation. You may feel an immense pressure to make the right decisions and protect the person from harm. You may worry about saying the wrong thing and making things worse. You may worry that your anxiety about the situation will prevent you from being an effective source of support for your loved one.

In this post, I want to provide some simple strategies to help get you out of your head if you are in a position to support someone who is experiencing suicidal ideation.

Regulate your emotions and listen non-judgmentally.

It is important to stay calm and regulated when talking with someone about their suicidal ideation. You want to make sure that they know you are a safe person to confide in–you won’t overreact, jump to conclusions, or panic. Often folks who are struggling with suicidal thoughts already feel burdensome to others, so it is crucial that your reaction does not reinforce this feeling.

This is also not the time to express judgements about the act of suicide. Shame is not an effective deterrent against self-destructive behavior. On the contrary, shame is a huge risk factor when it comes to suicide.

Be prepared to pause, slow down your thoughts, and listen to what your loved one has to say. Consider reaching out to someone to support you so that you can manage triggers and maintain your own mental health.

Don’t be afraid to ask. 

If you are talking with someone who is indirectly hinting that they are struggling with suicidal ideation, don’t be afraid to ask explicitly if they are thinking of killing themselves. You won’t implant the idea of suicide simply by saying the words. By being explicit in talking about suicide, 1) you send the message that you are a safe person to talk to, 2) you help to decrease shame that may be worsening their emotional state, and 3) you avoid ignoring your loved one’s signal for help.

Familiarize yourself with appropriate resources.

If someone in your life is struggling with suicidal ideation, do some digging into local resources that could meet their needs. You can support the person by helping them search for a therapist who can help, but most therapists are not able to promise availability in case of a crisis. Go a step further by finding out what kind of mobile mental health crisis units are available in your area. Do some research about the psychiatric services available at local hospitals. Locate services such as intensive outpatient programs (IOP) and partial hospitalization programs (PHP).

Here are some national phone hotlines that can help stabilize and provide resources in case of a crisis:

NAMI Helpline: 1-800-950-NAMI (6264)

Suicide and Crisis Lifeline: 988

National Mental Health Hotline: 866-903-3787

Give honest reassurance.

According to Joiner’s Interpersonal Theory of Suicide, the desire to complete suicide comes from a combination of perceived burdensomeness and a feeling that one does not belong. These are two feelings that you can address whenever a person is sharing with you about suicidal ideation. Focus on providing honest reassurance that they are valued and wanted, that you do not resent their need for support, and that they belong.

Remind them of their power to choose.

When people struggle with suicidal ideation, they often put off getting support because they worry about being institutionalized against their will. Of course, you cannot guarantee that this will not happen to your loved one if they reach out for help. But you can remind them that they have many options to consider for mental health support, and that they can choose to take proactive steps to avoid an escalation of symptoms that could result in institutionalization.

Rally support (with consent).

As mentioned above, your loved one needs to be reminded that they belong. Having people around can help them to feel less alone in their suffering, and more motivated to make life-affirming choices. Check with your loved one to see if they would be comfortable with you getting in touch with supportive members of their network. You could share that they are having a hard time, making sure not to violate your loved one’s boundaries or privacy.

Once again, providing support for someone who is experiencing suicidal ideation can be triggering, dysregulating, and scary. It is vital that, if you are in this situation, you also have the support you need to stay well. Just as your loved one should not be alone with their suffering, neither should you. Consider reaching out to a therapist to help you in providing this care.