Often, when people are worried about someone they love, they don't say anything. Not because they do not care, but because they are afraid of saying the wrong thing.
That fear is understandable and it is also the main obstacle standing in the way of help. You do not need training or a script. You simply need to be willing to ask a direct question and then listen to the answer.
September is set aside every year to make these conversations a little more ordinary. Keep reading to learn what you can do.
What to Watch For
Changes are usually the signal, not any single behavior. Someone who has always been quiet being quiet is not a warning sign. Someone who used to call every Sunday and then goes silent for a month could be a cause for concern.
Behaviors to pay attention to:
- Pulling away from people, plans, or activities they used to care about
- Talking about being a burden, feeling trapped, or having no reason to keep going
- Sleeping far more or far less than usual
- Drinking or using substances more heavily
- Giving away belongings or putting affairs in order without an obvious reason
- A sudden calm after a long stretch of distress
- Increased irritability, agitation, or recklessness
Grief, job loss, a serious diagnosis, divorce, financial strain, and isolation can all raise someone’s risk for suicide. So can a recent loss of someone they loved.
Ask the Question Plainly
The most common anxiety is that asking about suicide will plant the idea. It does not. Research has consistently found the opposite: asking directly tends to bring relief, because it tells the person their pain is visible and they are allowed to talk about it.
You can ask simply, “Are you thinking about suicide?” No softening, no hinting. If that feels too abrupt, lead with what you noticed. “You have seemed really low lately and I have been worried about you. Are you thinking about hurting yourself?”
Then stop talking and let them answer.
How to Listen Well
Many people's instinct is to fix things, reassure the person, or list all the reasons they have to keep living. What tends to help more is staying in the conversation without flinching.
- Take what they say seriously
- Don't offer advice unless they ask for it
- Do not promise to keep it secret, and say so honestly if it comes up
- Stay with them if they are in immediate danger, and help them get connected to support
- Offer something concrete, like driving them to an appointment or sitting with them while they make a call
If someone is at risk, reducing access to whatever they might use to harm themselves is one of the most protective steps a family can take. A professional or crisis counselor can walk you through that conversation.
Where to Get Help
The 988 Suicide and Crisis Lifeline is available around the clock, free, across the United States. You can call or text 988, or chat online at 988lifeline.org. It is not only for emergencies and it is not only for the person in crisis. Family members and friends can call for guidance on how to help someone else.
If someone is in immediate danger, call 911 or go to the nearest emergency room.
Know What Your Coverage Includes
Mental health care is a covered benefit under most health insurance plans sold today, including ACA Marketplace plans and most employer-sponsored plans. Many people never use it because they assume it is not included or they don't know where to start and how to access help.
There are a few things you may want to check before you need them:
- Whether your plan covers therapy and psychiatric care, and what your share of the cost is
- Which providers are in network, and whether telehealth counseling is available
- Whether your employer offers an Employee Assistance Program, which often includes free confidential sessions
Finding this out on a hard day is much harder than finding it out on an ordinary one.
Small Things Can Make a Difference
Suicide prevention isn't always about a grand gesture or a dramatic save. You don't have to say just the right thing or be the person who solves all their problems. Simple actions of connection can make a difference for someone who is struggling with suicidal thoughts. Check in with a friend who may be struggling, be there to remember a hard anniversary, send a supportive text, or better yet: pick up the phone and call. Let them hear your voice, ask questions, be present, and listen. No perfect words needed. These are not small gestures to someone who feels invisible or isolated.
If you are unsure what your health plan covers for mental health care, our office is glad to help you figure it out. Call us and we will look at it together.
