When someone close to you talks about suicide, it can be deeply troubling and difficult to know how to respond. Part of you may want to comfort the person and another part of you may feel angry that they’re considering such a thing. You may feel scared that you’ll say the wrong thing. How you respond is very important: many suicides are preventable. Learning about suicide—and the warning signs—can help you recognise when and how to get the person the help they need.

Some facts about suicide

• Nearly 800,000 people die by suicide every year, according to the World Health Organization (WHO).
• It’s estimated that there are more than 30 attempted suicides for each death by suicide
• Suicide is among the 10 leading causes of death for most ages, and the most common cause of death among 15- to 44-year-olds in 2015-2017 in Australia.
• Suicide rates are highest for women between the ages of 45 and 49 and for men who are 85 and older.
• Over 90 percent of those who die by suicide have a diagnosable and treatable psychiatric disorder, such depression or alcoholism, or both.
• The suicide rate among Aboriginal and Torres Strait Islander peoples is more than twice the national rate, accounting for 5.2% of deaths in 2015, as opposed to 1.2% among non-Indigenous people.

Risk factors

Some situations increase the possibility that people will try to kill themselves. The risk of suicide rises with such factors as the following: 

• major psychiatric illnesses, including bipolar disorder and schizophrenia
• major depression and severe mood cycling
• anxiety disorders
• alcoholism and/or substance abuse
• certain personality disorders
• previous suicide attempt(s)
• a family history of suicide, mental disorder, or substance abuse
• physical, sexual, or domestic abuse (past or present as a child or an adult)
• physical illness and chronic pain
• isolation
• impulsive or aggressive tendencies
• feelings of hopelessness
• major losses (whether related to work, money, health, or relationships)
• easy access to guns, knives, medications, or other means of committing suicide
• certain cultural or religious beliefs, such as the idea that suicide is a noble way to resolve some difficulties
• lack of access to mental health care
• stigma about mental health care

Most people who are feeling depressed or desperate enough to consider suicide give clues as to how they are feeling. At times, it may be very difficult to see the clues or signs or to know what to do about them. But learning some of the warning signs can help you be better prepared to help someone who is struggling. Staying involved with someone you care about and talking openly about your concerns may help to prevent a more dangerous situation. 

Warning signs

There is no “typical” suicide victim. People may kill themselves whether they are young or old, male or female, rich or poor. Suicide occurs across all ethnic, economic, and social boundaries. But there are often warning signs that someone may be thinking about suicide. Here are some signs to look for: 

Spoken or written threats of suicide. Suicidal people may say things like, “I wish the pain would go away” or “Everyone would be better off if I were dead.” If the person talks about dying by suicide or has written notes or letters about it, always take it very seriously, especially if the person has made one or more suicide attempts in the past. Never assume the person “doesn’t really mean it.” 

High-risk behaviour. People who are thinking about suicide sometimes hurt themselves by engaging in drug or alcohol abuse, sudden sexual promiscuity, self-mutilation (such as cutting or burning), an eating disorder, and even criminal behaviour. Suicidal people may drive recklessly and put themselves and others in danger.

Watch for any drastic changes in mood or behaviour. Be especially aware of people who are in the beginning phases of recovery from drug or alcohol abuse. Surprisingly, many people kill themselves two to three months into their recovery because giving up drugs or alcohol can temporarily increase depression, and they don’t yet know how to cope without them.

If you believe or even suspect that someone you care about may be suicidal, don’t ignore your suspicions—make sure you address them… Asking about suicide will not suggest the idea to someone or encourage suicide.

Withdrawal and loss of interest. No longer enjoying activities that used to be enjoyable, isolating oneself from family or friends, and not taking care of personal appearance are all common signs of depression.

Recent important losses. A person may become suicidal as a result of problems or changes that make them feel trapped or helpless. These may include divorce, loss of child custody, job loss, a relationship breakup, moving to a new home or city, or the death of a loved one. People may also face a higher risk of suicide if they are experiencing stressors such as being incarcerated or dealing with a major life concern, including their sexual orientation or an unplanned pregnancy.

Major changes in sleep or eating patterns. Excessive fatigue, not being able to sleep or sleeping much more than usual, or a loss of appetite or eating much more than usual are all signs that someone may be suffering from depression. 

Obsession with death. Suicidal people sometimes show an unusual interest in death by the books or movies they choose or the websites they visit. They may do online research about ways to kill themselves. They may even spend time preparing for death by making out a will, planning their funeral, or making final arrangements. Having decided to die, they may give away prized possessions, start gathering excessive doses of medications, and show ambivalence toward things that used to be very important to them. They may also suddenly be in a happier or calmer mood as they make these plans.

What to do and say

If you believe or even suspect that someone you care about may be suicidal, don’t ignore your suspicions—make sure you address them. 

Take action right away. If it seems like the situation may be serious, get professional help immediately. Do not agree to keep suicidal information secret: you should break a confidence if necessary. You can always call emergency services (000) or take the person to the emergency department at the nearest hospital. Remind the person you’re there to help support them.

If you suspect that someone who lives far away is suicidal, it is appropriate and acceptable to call the person’s local police and ask that a wellness check be done on the person. Monitor and don’t leave a suicidal person alone. Safeguard potential means of suicide, such as guns, pills, and sharp objects. Help may be needed to get the person to a crisis centre, emergency department, or mental health centre for a crisis assessment. Follow up with the person afterwards to check on how they’re doing.

Ask about suicide. Asking about suicide will not suggest the idea to someone or encourage suicide. It can be difficult to ask, but it is very important and may be the only way to find out how much danger someone is in. Ask the question directly. You might say, “It sounds like things have been really hard for you and I want to help. Have you been thinking about killing yourself?” or “I’m really worried about you. Have you been thinking about suicide?” If someone has a definite plan and the means to commit suicide, you should consider the person to be at high risk. Remove or reduce availability of any means of suicide that the person may possess, such as access to pills, knives or other sharps, ropes, guns, or access to vehicles. 

Listen without judgement. By listening to someone who is struggling, you can help that person feel less isolated and more in control. Avoid debating whether suicide is right or wrong. The person may not be thinking rationally. Instead, ask the person to tell you why they feel the way they do. Try to stay calm. Say that you care, that you want to understand what’s going on, that you want to help, and that help is available.

Seek help from a professional. Get help from people or agencies specialising in crisis intervention and suicide prevention. Contact a doctor, a therapist, a 24-hour suicide hotline like Lifeline or Beyond Blue, a local crisis centre, your assistance program, or the emergency department at the nearest hospital immediately.

If a child or teenager is involved, talk with a teacher or school counsellor, too. Never try to help a suicidal person by yourself. Someone who is struggling needs a lot of attention and support—more than just one untrained person can give. Contact the program that provided this publication if you don’t know where to turn. Ask your manager or human resources (HR) department how to contact the program if needed.

If it seems like the situation may be imminent or otherwise serious, get professional help immediately. Break a confidence if necessary. You can always call 000 or take the person to the accident and emergency department at the nearest hospital.

Talking with someone who seems at risk of suicide

Approaching the subject of suicide with someone you care about may be hard to do. But voicing your concerns and giving the person support can be an important step toward helping them find the help they need. 

Tell the person that you care and are worried. You may think that someone you love knows how much you care, but reminding them can help them feel less alone.

Describe what you’ve noticed. Give specific examples. You might tell the person that they’ve seemed different or sad lately. Be clear about what behaviour you’ve noticed and why it troubles you.

Be willing to listen and provide support. Listen without interrupting and without making judgements. Sometimes emotions can be difficult to control, but, if possible, plan to stay calm and caring throughout the conversation. 

Ask concerned questions about the person’s feelings. It may be hard to hear some of the things they have to say, but it’s important to accept the pain they’re feeling. Avoid dismissing feelings or making comments such as, “Just don’t let these things get you down” or “You’ll get over it.” Instead, say things such as, “I know you’re in a lot of pain” or “I understand why this must be very difficult for you” or “I’m here to help.”

Discuss options and create a plan together. Suicidal people may feel suicide is the only option to their life circumstances. Giving other options can often help a person at risk feel more in control and more committed to get help when he’s in crisis. What do they need to stay safe in the moment? Where will they go to be safe? Who will they call?

The person may need a list of trusted friends, phone numbers, and a safe place to go. The list should include emergency numbers, such as those of the local emergency department, crisis centre, suicide hotline, and police department, and it should be added to their mobile phone contacts list and placed near the landline telephone. Ask the person to assure you that they will not harm themselves and will reach out if they feel upset.

Offer hope. Again, without dismissing the person’s feelings, let them know that you’ll be there to support them through this difficult time. Say you want them in your future and that you’re in this together. End conversations with, “See you tomorrow” or “I’ll call you tonight,” and be sure to follow through on what you promise. Remember, you’re not responsible for them, but you can support and do your best to get them help. No matter how involved you choose to be, you can only do your very best.

As much as possible, have conversations in person or on the phone. Avoid relying just on social media, email, or texting to stay in touch with someone who may be suicidal. Even if you usually kept in touch in those ways, call frequently and visit as often as you can. Digital communication doesn’t give you the visual and verbal clues that can help you understand the feelings of someone who may be thinking of suicide.

And it doesn’t let you offer a hug or touch on the arm that may comfort someone in distress. Use social media in addition to other forms of communication, not as a substitute for them. You can also use Skype or FaceTime for visual confirmation of how your friend or relative is going.

Finding support for the person you love and for yourself

Helping someone who is feeling suicidal can be extremely stressful. Make sure you have support for yourself from friends, family, or a trained counsellor. You may also consider joining a support group. Following are some resources: 

In an emergency, call 000. 

For non-emergency crisis support, call Lifeline Australia on 13 11 14 or Beyond Blue on 1300 22 4636 at any time

Contact a GP, counsellor, or psychiatrist, or your assistance program. Often these resources can direct you or your friend or relative to community resources, such as support groups. A primary care physician can also check for underlying causes of depression. Counsellors can provide talk therapy to help your friend or relative cope better with their feelings, and psychiatrists can prescribe medications specifically for anxiety and depression.

Helping someone who is feeling suicidal can be extremely stressful. Make sure you have support for yourself from friends, family, or a trained counsellor.

Seek support from friends or relatives. Friends and family members can provide advice and may even be able to answer some questions about depression (e.g., is there a family history?). They can also provide support by connecting the person with professional help.

Consider talking with a clergy member or spiritual adviser. If you or your friend or relative belong to a house of worship or identify with a faith tradition, talking with a spiritual leader or staff member responsible for spiritual or pastoral care can have several benefits. Some people may be more willing to talk about their problems with a clergy member than with their families. In situations where the individual has a strained relationship with his or her relatives, a clergy member may be better able to persuade the person to get counselling. Also, a spiritual leader may know of faith-based community resources or may be able to arrange for check-in calls or visits.