When it comes to many situations, we’re unlikely to be first responders: Natural disasters, house fires, and roadside accidents are likely to have trained professionals on the scene quickly.
But when for mental health crises, we are likely to be the first ones to notice a change in behavior or functioning of those close to us. Each day, over 129 Americans take their own life. Of those, one in five had expressed their suicide intent to someone they knew.
There is no perfect protocol for responding to a loved one who you suspect is suicidal, and many individuals show no warning signs at all. But if you do spot warning signs of suicide, from talking about it directly to withdrawing from others or expressing a lack of purpose or hope, there are steps you can take to respond and help.
Words matter in these situations, so consider avoiding these DON’T statements—and TRY these alternatives instead.
DON’T say: Are you having negative thoughts?
TRY: Have things gotten so bad that you’ve thought about suicide?
These conversations are incredibly difficult for all involved, and asking this question won’t be easy. However, it’s best to be as direct as possible and get specific about their mental state. Open-ended questions like “are you having negative thoughts?” invite vague responses, leaving you unsure if they do have suicidal intent. Asking a yes or no question helps you better and more quickly understand the scope of situation, ask additional clarifying questions if needed, and determine what action you may need to take.
DON’T say: You need professional help.
TRY: Have you considered seeing a therapist? Would you like me to go with you?
Even if you think a mental health professional could provide the help they need, stating it in this manner could be far from beneficial. They’ve chosen to confide in you, and with this blunt declaration, you may make them feel like they’ve made a mistake in doing so. It may affirm feelings that they have of being “different” or “other” if you don’t think that you can help them at all. Additionally, it’s often not that simple. Even if they’ve wanted to see a therapist or other professional, barriers like access, cost, and stigma can get in the way. If you genuinely want to know if they’ve considered seeing a professional, ask gently, and if you’re comfortable, offer to go with them.
DON’T say: It would be selfish to leave all of us who love you behind.
TRY: I want you to know that we all love you and want to help you feel better.
As eloquently stated in this op-ed reflecting on the suicide of Penn student Madison Holleran, suicidal people are “actually some of the most generous people you’ll ever meet because they’re keeping themselves in pain only for the sake of others.” It’s not that they don’t love you the same way you love them—it’s that their agony has reached an unendurable level and suicide seems appealing in spite of their love for their family and friends. It’s better to remind them that not only do you (and others) love them, but you are also committed to helping them feel better. You’re squarely in their corner, and will help them fight.
DON’T say: Your life isn’t that bad. You have so much to live for.
TRY: I hear you, and am here for you. How can I help?
While you may not be able to put yourself in your loved one’s shoes, avoid being dismissive or invalidating their feelings with statements like the first one. They’ve opened themselves up to you—in itself no easy task—and the best thing to do is make them feel heard, understood, and aware that you want to help. Tell them that they are not alone, and you want to be a partner in their struggle, then ask them how you can best do that.
Additional tips:
Call for help if you need it
If this conversation escalates to a point where you feel that you need additional support, please call the National Suicide Prevention Hotline: 1-800-273-8255. If you feel that they may harm themselves or others imminently, please call 911 immediately. Don’t leave them by themselves if they have access to lethal means.
Follow up
After this initial conversation, follow up them regularly. Let them see that you meant what you said, and you are there for them and willing to continue to help them. Simply reaching out to check in can help increase their feelings of connectedness.
Check out additional resources
By Monika Roots
Chief Medical Officer, Sanvello
Dr. Roots practiced as a child, adolescent, and adult psychiatrist. She was also a Clinical Adjunct Assistant Professor at University of Wisconsin-Madison and was most recently the Vice President of Health Services and Behavioral Health for Teladoc Health. In 2016, Teladoc Health acquired her business, CogCubed, a behavioral health analytics company. Dr. Roots earned her MD from University of Sint Eustatius School of Medicine and completed psychiatry residency and fellowship in child/adolescent psychiatry at the University of Minnesota.