You're standing in the kitchen or maybe sitting on a parked car's bumper, and suddenly the air feels heavy. Someone you care about just dropped a hint—or maybe a whole hammer—that they don't want to be here anymore. Your stomach drops. Your heart starts doing that frantic hummingbird thing against your ribs. It's terrifying. Most people think they need a PhD or a crisis counselor badge to handle this, but honestly? You don't. You just need to stay in the room.
When it comes to helping someone who is suicidal, the biggest mistake we make is looking for the "perfect" thing to say. There isn't a script. In fact, if you sound too much like a brochure, they’ll probably tune you out. Research from the American Foundation for Suicide Prevention (AFSP) consistently shows that the simple act of connection—just being a non-judgmental human—can literally break the momentum of a crisis.
Why "Are You Thinking About Killing Yourself?" is the Best Question
It sounds brutal. It feels like you’re putting a loaded gun in their hand by even mentioning it. But that’s a myth. One of the most dangerous misconceptions is that asking about suicide will "plant the seed." It won't. If someone is already in that dark place, the seed is already there. By asking directly, you're actually giving them a relief valve. You're saying, "I see how much you're hurting, and I'm not scared to talk about the scariest part of it."
Avoid the euphemisms. Don’t ask if they’re "thinking of doing something silly" or "hurting themselves." Self-harm and suicide are two different beasts. Be blunt. Use the word. "Are you thinking about suicide?" or "Are you thinking about killing yourself?" If the answer is yes, take a breath. Don't panic. Or rather, don't let your panic drive the bus. They need you to be the anchor right now.
The "Checklist" That Isn't a Checklist
Forget those neat 1-through-5 lists you see on posters. Real life is messy. You need to assess the immediate danger without sounding like an interrogator.
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Think about it this way: You're looking for three things—Plan, Access, and Timeframe.
Does this person have a specific method in mind? Do they have the pills, the weapon, or the rope in their house right now? Have they decided when it’s going to happen? If they tell you they have a plan and the means to do it tonight, this isn't a "let's talk it out over coffee tomorrow" situation. This is a "we are going to the ER or calling a mobile crisis unit right now" situation. According to Dr. Thomas Joiner, a leading expert on suicide, the "desire" for death is one thing, but the "acquired capability" is what makes it high-risk. If they've done the math on how to do it, the risk level just spiked.
Listen Like Your Life Depends on It (Because Theirs Does)
We have this desperate urge to fix things. We want to tell them why life is worth living. We want to remind them of their kids, their dog, or that trip to Italy next summer.
Stop. When someone is in a suicidal crisis, they aren't looking for a travel agent or a motivational speaker. They're looking for a witness. If you start listing "reasons to live," it often backfires. It makes them feel guilty. It makes them feel like you aren't actually listening to how much pain they’re in. Instead, try saying things like, "I can't imagine how heavy that feels," or "Thank you for trusting me with this." Basically, just sit in the mud with them for a minute. Don't try to pull them out of the mud until they feel like you actually understand how deep it is.
Reducing Access: The Practical Magic of Safety
If you're helping someone who is suicidal, the most effective physical intervention is "lethal means reduction." It’s a fancy term for getting the dangerous stuff away from them. Harvard T.H. Chan School of Public Health has found that if you can delay a suicide attempt by even a few minutes, the person's urge to die often passes or decreases in intensity. Suicide is frequently impulsive.
- If they have a firearm, ask if you can hold onto it or if it can be locked in a safe they don't have the key to.
- If it’s medication, offer to keep the bottles at your house and bring them their daily dose.
- Sometimes it’s as simple as staying with them so they aren't alone with their thoughts and their tools.
You aren't being "controlling." You're creating a buffer. You're buying them time. Time is the most valuable currency in suicide prevention.
The Limits of Your Power
You've gotta hear this: You are not a locked psychiatric ward. You cannot watch someone 24/7 forever. There’s a limit to what one friend or family member can do. If the person refuses to get help and the threat is imminent, you might have to call for professional backup. This might make them mad. They might feel betrayed. But it's better to have a mad friend who is alive than a "loyal" friend who is mourning.
In many areas, you can call 988 (in the US and Canada) or text 741741. These aren't just for the person in crisis; you can call them too. Ask them, "Hey, I'm with a friend who says they want to end it. I don't know what to do next. Help me." They will talk you through the steps.
Moving Toward Professional Care
Once the immediate "I'm going to do this tonight" heat has cooled down, the work shifts. This is the long game. Support looks like helping them find a therapist who specializes in DBT (Dialectical Behavior Therapy) or CAMS (Collaborative Assessment and Management of Suicidality). These are evidence-based treatments that actually work for chronic suicidality.
Don't just send them a link. Offer to sit in the waiting room. Offer to drive. Insurance forms are a nightmare even when you're feeling great; when you're suicidal, they're an impossible mountain. Be the person who holds the map while they climb.
Actionable Steps for Right Now
If you are currently with someone who is struggling, or you’re worried about a conversation you’re about to have, follow these immediate steps:
- Remove the distractions. Turn off the TV. Put your phone away. Give them your absolute, undivided attention.
- Ask the "S" question. "Are you thinking about suicide?" Clear, direct, and non-judgmental.
- Listen without fixing. Let them talk for 10 minutes without you offering a single piece of advice. Just say "I'm here" and "Tell me more."
- Identify the "Means." Ask if they have a plan. If they do, and they have the tools, do not leave them alone.
- Collaborate on a safety contact. Instead of saying "Promise me you won't," ask "Who are we going to call if the feeling gets too strong tonight?" Put the 988 number in their phone right now.
- Secure the environment. If there are weapons or stockpiled medications, get them out of the house or under lock and key.
- Follow up. The day after a crisis is often the loneliest. Send a text. Drop off a sandwich. Show them that the "dark version" of them didn't scare you away.
Helping someone through this is exhausting. It takes a toll on your own mental health. Make sure that once your friend is safe, you have someone to talk to, too. You can't pour from an empty cup, and you certainly can't pull someone out of a pit if you're falling in yourself. Reach out to a professional or a support group for "supporters." You're doing the hardest, most important work there is. Stay steady.