How to Talk to Someone who is Suicidal: Tools and Guidelines

Are you worried that your son, daughter, partner, or friend is in trouble and might be suicidal? The first thing that can help you is not being afraid to ask questions about suicide. It's important to get ready for this talk, and if you think it will be hard for you, find someone else to do it for you. But you should have this talk right away, because catching someone who is thinking about suicide early can save their life!

Direct questions don't "put ideas in their heads," as the myth says. Instead, they let them talk, vent, and feel like you care. Of these things, all of them can help them feel better and remember why they are living. It's important to know that about 80% of people who killed themselves talked to family or close friends first. It's important to have this talk at the right time, so if you think someone is suicidal, you should treat them right away and not ignore them or put off asking them about their plans.
You should get ready for this important talk ahead of time. We'll talk about how to prepare for this chat, what to say and not say, and what to do if you need professional help.

It's not true that people who talk about suicide don't do anything about it!
Lots of the time, people think that suicide thoughts are just empty words. This is where the idea that "people who talk about suicide don't do it" or "people who want to commit suicide won't talk about it, they'll just do it" comes from. Those statements are definitely not true. People who say things like "I'm sick and tired of everything" should be taken seriously, and we should find out what they really want.

Getting ready for the talk

You should get ready for this talk ahead of time so that you don't freak out over what's being said, which could stop the suicidal person from telling you about their plans. It should be said that you should call the police or the closest emergency room if there is an instant risk of suicide.

• When you should have this talk: As soon as possible: if you think this person is in trouble, you should start talking to them right away. Don't wait or put it off. Time can be very important.
• Picking a good spot for this talk: you should pick a place that is quiet and where you can talk without worrying that other people will hear what you are saying.
• How long should the talk be? You should clear your schedule for this talk so that you can talk at your own pace and not feel rushed. After this talk, don't plan to do anything important. Give yourself some room to move.
• Information and assistance: make a list of all the places you can get information and help ahead of time. If the person you're talking to agrees, give them this information or call one of the helplines on their behalf.
• Confidentiality: a person who is depressed will often ask you not to tell anyone, like their parents or partner, about their problem. It's important to remember that we can't offer privacy when someone is suicidal. It's okay to share with the person who is upset that we want to talk to in order to help them. Just say something like, "I need help to help you."
• Avoid giving advice; focus on listening: kindly and directly addressing someone without judging or criticizing them can help them share their thoughts and feelings with you and keep them from attempting to end their own lives.
• Communication that is honest, caring, and loving: be kind and understanding when you talk to them, and remember that it's important that the exchange is real and honest. Tell them you care about them, love them, and will be sorry if they hurt themselves. Remember to look them in the eyes the whole time you're talking to them and offer words of support while recognizing their pain and distress. You can show them you like them without saying a word. For example, you could smile, touch them, and be aware of your body language.
• Attention and patience: listen to this person carefully and give them your full attention while you talk. Do not use your cell phone. Get rid of background noises like the radio, TV, and street noises that might get in the way of the talk.

Some examples of what you should say in the talk

Meeting someone who wants to die is a sad thing to do. It might be hard to find the right words for this meeting. We have written down some lines that say the most important things that should be said in the meeting with the person who is suicidal. But it's also important not to be stuck on these statements, no matter what. It's more important to be emotionally present and put yourself in a position to be understanding and sensitive than to use the right words. One of the goals of this talk is to build trust, closeness, and hope for a better future. You should also show the other person that you are fully with them, that you understand their pain, and that you are willing and able to talk to them honestly, listen to them, and help them.

• "You are not alone".
• "You can be helped, and I want to help you".
• "You are important to me".
• "You are important to your family".
• "I understand you".
• "I'm here with you" or "I'll be with you".
• "I believe in you" or "I believe that the situation can improve".
• "There are ways to help you".

Being direct about suicide

Asking direct questions is very important because it lets us know what's really going on with this person. People often think that if we ask someone about suicidal ideas, we will "put thoughts into their heads." However, new studies show that this is not true. People who are upset can talk, share, and vent by being asked direct questions about the issue. This makes them feel liked and cared for. All of these things make them feel better, and their level of anxiety goes down. Once you've made the conversation safe and the environment open and honest, it's important to ask straight, short, and clear questions:

• Do you ever feel like giving up on everything?
• Have you ever thought that passing away would be better?
• Have you ever thought about having an accident or killing yourself?
• Are you planning to kill yourself?
• Are you going to kill yourself?
• Have you tried to kill yourself before?
• Would you have liked to sleep and never wake up?
• Have you been so emotionally sad lately that you wish you could die?
• People sometimes want to die when they feel like there is no way out. Do you feel the same way?

You should treat and help if you answered "yes" to any of these questions. First, keep an eye on the suicidal person to make sure they're not alone and can't get to anything risky. At the same time, get professional help. The professional who meets this person will decide what kind of care will work best for them, whether it's medication, therapy, or a mix of the two.

Remember: thoughts of suicide or death are not always very dangerous. Your goal is to figure out what the risk is and send this person to a professional who can rate the risk and change the treatment.

How hard it is to talk about suicide

Of course, it's awkward to ask someone about suicide thoughts. There are a lot of bad feelings that could come up because of this difficult situation, such as worry, awkwardness, and sadness. Because of this, it is definitely a hard job. It might help you to know that this talk has the power to save lives. You can help someone who is thinking about suicide by being honest and wanting to help them. This can make them feel like they're not alone and that someone is looking out for them. If this is something you need, there are many people who can help you and go with you. Of course, it's awkward to ask someone about suicide thoughts. There are a lot of bad feelings that could come up because of this difficult situation, such as worry, awkwardness, and sadness. Because of this, it is definitely a hard job. It might help you to know that this talk has the power to save lives. You can help someone who is thinking about suicide by being honest and wanting to help them. This can make them feel like they're not alone and that someone is looking out for them. If this is something you need, there are many people who can help you and go with you.

How important it is to get professional help

It's good to listen to someone who is upset, but it's also important to get them to get professional help. No matter how much you want to help, ease the pain, or save lives, there are times when only a professional can do so. So, one of the goals of this talk is to let the person who is struggling know that they are not alone, that you believe in them, that there is hope, that there are solutions, and that one of the most important ones is to get help from someone who specializes in suicidality.

What to do to get help

There is no set way to avoid suicide. If you get the right help, you can avoid it. Once you've heard, shown interest, become close, and built trust, it will be easier to convince the other person to get professional help, which will ease their pain and distress and keep them from committing suicide. You should take the initiative to deal with this. In other words, don't just give them your phone number so they can make a meeting. Based on our past, we think it's likely that this won't happen. Ask the other person if they really do plan to get professional help.

People who don't want to get help should be persuaded to do so, and it's important to stress that you will stay with them until they do. It is important that you follow through on this promise.

You could ask them what is stopping them from getting professional help and help them get past those problems if they don't want to get help.

Here are some more safety steps you should take after the talk

• Get help from professionals who can offer services such as therapy, counseling, and company.
• Don't let the person who is suicidal get to guns, knives, high windows, or anything else that could be used to kill them.
• Stay close to someone who is thinking about committing suicide until they no longer feel so.
• Tell them that an adult and responsible person, like a family member, will take care of them and make sure they keep getting help.
• Together with them, make a short list of things that will help them handle any situation and people or groups they can call if they want to kill themselves.

The requirement to report

You must tell someone if they tell you they want to kill themselves if they tell you. You might feel uneasy, especially if the person told you what they were planning based on trust and maybe asked you not to tell anyone else. No matter what, you have to do it. Sometimes the person who is suicidal may feel betrayed when you report them, but after some time has passed and their life has been saved, they will understand what you did and forgive you.

The following steps are very important to take if you don't call 100 or an emergency room:

• Talk to professionals who can help you with things like therapy, counseling, and accompaniment.
• Make sure the person who is distressed can't get to dangerous things like knives, guns, or high windows.

Written in collaboration with the national suicide prevention program staff. Helped with writing: Dr. Shira Barzilai, a clinical psychologist, a senior lecturer in the program for community-based mental health at Haifa University, and Nadav Horovitz, a psychologist with clinical specialization.