Suspecting a loved one might be having thoughts of suicide can be scary. Many people are worried they may say the wrong thing and make the situation worse, which leads them to saying nothing, or feeling unprepared when their loved one discloses their thoughts and feelings. Desire to avoid this conversation is natural. However, this avoidance is not helpful to either person. There is a common misconception that asking someone if they are having thoughts of suicide will make them begin to think about it or think about it even more. In actuality, addressing this directly allows the person to express their honest thoughts and feelings, knowing they are supported and listening to. People experiencing suicidal thoughts often worry how their loved ones will react, and a combination of fear, guilt, and shame prevent them from seeking support. Being given the opportunity for open, honest communication decreases the likelihood they will continue to keep their feelings inside, and instead can bring people closer together. Once the subject has been addressed, risk and safety can be discussed in a direct and realistic way. Here are a few ways to have the conversation:
Kate Boudet, M.A.
1. Be direct.
Avoid euphemisms like “being done with this” or “ending it”. Instead, ask “Have you been having thoughts of killing yourself”? This ensures both people know exactly what is being asked and there is no room for misunderstanding.
2. Ask if they are experiencing thoughts, urges to act on the thoughts, and/or have been making plans of how they would kill themselves.
This gives an idea of the level of urgency and support needed. Knowing a loved one is having thoughts of suicide is scary, and if there are no urges to act on the thoughts or plans being made, this is not an immediate emergency. Instead, this indicates the person needs support and finding mental health care resources (like therapy at TFI) is the appropriate next step. Reacting as if thoughts are actions can cause your loved one to experience shame of disclosing their thoughts and potentially prevent them from disclosing their thoughts and feelings in the future. If they are having strong urges to act on suicidal thoughts, or have made an action plan, more immediate action is required and assessment by a trained professional is needed.
3. Ask if they feel they are able to keep themselves safe and not act on their urges.
If they say no, or you do not feel convinced by their yes, appropriate next steps would be to contact emergency resources like the suicide prevention lifeline (by dialing 988 on your telephone) or going to the nearest emergency room.
4. Create a safety plan.
What activities could they do instead of thinking about suicide, or acting on their plan? Who can they contact when they are having these thoughts? How can you both make sure they don’t have access to objects or materials (ie. sharps or medications) they may have urges to use to kill themselves? It’s great if their safety plan makes them feel better, however it is not necessary. An effective safety plan is simply one that keeps them from engaging in harmful actions.
5. Ask what common situations prompt these thoughts.
Are there common locations or events in which they notice they experience suicidal thoughts? Figure out if these are things that can effectively be avoided or if there are ways to problem solve experiencing these things when in lower levels of distress. This is best done in conjunction with a therapist trained in suicidality, so effective coping and safety are continuously monitored.
