How to talk about suicide, from a therapist

Suicide. It claims nearly 800,000 lives each year globally, ranking as a leading cause of death in the United States, yet few know how to even talk about it — much less how to support those struggling.

To help us better understand suicide, how to discuss it, and explain what resources are available, we asked one of our clinical experts and trained therapists, Dr. Marie Atallah, Clinical Communications Lead at Big Health, to guide us through this complex topic.

Suicide is not a crime

If we’re going to discuss suicide, we must first discuss how to appropriately talk about suicide. In recent years, mental health advocates have encouraged steering away from criminalizing language. An example of this is to say someone “died by suicide” or “completed suicide” rather than using the word “committed.” Another example is saying someone “died by suicide” or “survived a suicide attempt” rather than saying they had a “successful/unsuccessful suicide.” Words matter, and the intention should be to not place blame on the victim or define someone by their experiences. Proper terminology also helps reduce stigma on one of the most stigmatized topics in this day and age.

Suicide, like many other mental health topics, is something that is often ignored and misunderstood. But if we want to prevent it from happening, we need to understand how to navigate it — and that involves openly discussing it.

Suicide and mental illness

There is a powerful connection between suicide and mental health conditions. Studies have shown that both insomnia and anxiety disorders increase the risk that an individual will attempt suicide. To reduce this risk of suicide, it is of paramount importance to understand the role of mental illness and the impact it has on day-to-day life.

To do this, it’s crucial that people feel comfortable having open and honest conversations about their mental health and well-being with others. And it is vital that people know that it is okay to ask for help.

Warning signs

It’s important for people to familiarize themselves with common warning signs of suicide so that they can take appropriate action if someone is suspected of having suicidal ideations. Here are some signs to look out for:

• Withdrawing from social interactions
• Self-destructive behavior (reckless driving or drug use)
• Abnormal changes to routines
• Giving away belongings or “getting affairs in order”
• Increased alcohol or drug use
• Directly or indirectly talking about suicide (directly, such as “I want to die,” or indirectly, such as “the world would be better without me”)

Reacting and responding to suicidal ideation

So, what should you do if you’re in a situation where you suspect someone may be having suicidal ideations? Here are some questions to consider asking and recommendations to keep in mind when responding:

• “How are you coping with what’s happening in your life?”
• “It sounds like you’re going through a lot. Do you have thoughts of hurting yourself?”
• “Do things ever get so bad that you start thinking of attempting suicide?”
• Do your best to not judge or criticize.
• You can try to repeat back what you hear them saying; this communicates that you are listening and gives them the opportunity to correct any misunderstandings.
• Express empathy, even if you can’t relate (for example, “I can’t imagine how hard this is for you. I’d like to learn more to better understand.”)

If you suspect someone may have suicidal thoughts but aren’t sure, ask them directly. Many people fear that asking someone about suicidal thoughts will plant them into someone’s mind and drive them to act – which isn’t true. It’s better to discuss the topic openly and help establish a support system for the person struggling.

If you are in a situation where someone shares they are having suicidal thoughts, first and foremost, it’s important not to judge. Reacting with compassion is crucial, as you don’t want to make the person feel inferior or “abnormal.” Here are some appropriate responses to consider in this situation:

• “Thanks so much for sharing that with me. I can only imagine how hard that must have been for you to say.”
• “It sounds like things have been really challenging for you and you’re feeling like you want to escape.”
• “Nothing you’re going through changes the way I feel about you.”
• “I want to support you. When you have these thoughts, what are some things that help you feel safe?”

Seek immediate help if you encounter someone that has attempted suicide:

• Call 911 immediately or take them to the nearest emergency room if possible to do so safely.
• Stay with the person.
• Try to determine if the person is under the influence of alcohol or drugs.

While suicide isn’t the easiest topic to discuss, being informed on how to do so appropriately can make all the difference when helping someone who is struggling. Mental health should be held to the same standard as physical health, and we should be recognizing the signs and experiences that can lead to suicide as signs to reach out for help and relief, much in the same way one would seek care if they had heart palpitations or a high fever.

If you or someone you know is having suicidal thoughts or needs mental health crisis support, contact the Suicide and Crisis Lifeline by dialing 988.

Learn more about mental health literacy and how to recognize common signs of mental health conditions.