What to do with someone who is suicidal
How The 5 Steps Can Help Someone Who is Suicidal
En Español
The five action steps for communicating with someone who may be suicidal are supported by evidence in the field of suicide prevention.
Ask
How – Asking the question “Are you thinking about suicide?” communicates that you’re open to speaking about suicide in a non-judgmental and supportive way. Asking in this direct, unbiased manner, can open the door for effective dialogue about their emotional pain and can allow everyone involved to see what next steps need to be taken. Other questions you can ask include, “How do you hurt?” and “How can I help?” Do not ever promise to keep their thoughts of suicide a secret.
The flip side of the “Ask” step is to “Listen.” Make sure you take their answers seriously and not to ignore them, especially if they indicate they are experiencing thoughts of suicide. Listening to their reasons for being in such emotional pain, as well as listening for any potential reasons they want to continue to stay alive, are both incredibly important when they are telling you what’s going on.
Help them focus on their reasons for living and avoid trying to impose your reasons for them to stay alive.
Why – Studies show that asking at-risk individuals if they are suicidal does not increase suicides or suicidal thoughts. In fact, studies suggest the opposite: findings suggest acknowledging and talking about suicide may in fact reduce rather than increase suicidal ideation.
Be There
How – This could mean being physically present for someone, speaking with them on the phone when you can, or any other way that shows support for the person at risk. An important aspect of this step is to make sure you follow through with the ways in which you say you’ll be able to support the person – do not commit to anything you are not willing or able to accomplish. If you are unable to be physically present with someone with thoughts of suicide, talk with them to develop some ideas for others who might be able to help as well (again, only others who are willing, able, and appropriate to be there).
Listening is again very important during this step – find out what and who they believe will be the most effective sources of help.
Why – Being there for someone with thoughts of suicide is life-saving. Increasing someone’s connectedness to others and limiting their isolation (both in the short and long-term) has shown to be a protective factor against suicide. Thomas Joiner’s Interpersonal-Psychological Theory of Suicide highlights connectedness as one of its main components – specifically, a low sense of belonging. When someone experiences this state, paired with perceived burdonsomeness (arguably tied to “connectedness” through isolating behaviors and lack of a sense of purpose) and acquired capability (a lowered fear of death and habituated experiences of violence), their risk can become severely elevated.
In the Three-Step Theory (or more commonly known as the Ideation-to-Action Framework), David Klonsky and Alexis May also theorize that “connectedness” is a key protective factor, not only against suicide as a whole, but in terms of the escalation of thoughts of suicide to action.
Their research has also shown connectedness acts as a buffer against hopelessness and psychological pain.
By “being there,” we have a chance to alleviate or eliminate some of these significant factors.
Help Keep Them Safe
How – First of all, it’s good for everyone to be on the same page. After the “Ask” step, and you’ve determined suicide is indeed being talked about, it’s important to find out a few things to establish immediate safety. Have they already done anything to try to kill themselves before talking with you? Does the person experiencing thoughts of suicide know how they would kill themselves? Do they have a specific, detailed plan? What’s the timing for their plan? What sort of access do they have to their planned method?
Why – Knowing the answers to each of these questions can tell us a lot about the imminence and severity of danger the person is in. For instance, the more steps and pieces of a plan that are in place, the higher their severity of risk and their capability to enact their plan might be.
Or if they have immediate access to a firearm and are very serious about attempting suicide, then extra steps (like calling for emergency help or driving them to an emergency department) might be necessary. The Lifeline can always act as a resource during these moments as well if you aren’t entirely sure what to do next.
The Harvard T.H. Chan School of Public Health notes that reducing a suicidal person’s access to highly lethal means (or chosen method for a suicide attempt) is an important part of suicide prevention. A number of studies have indicated that when lethal means are made less available or less deadly, suicide rates by that method decline, and frequently suicide rates overall decline. Research also shows that “method substitution” or choosing an alternate method when the original method is restricted, frequently does not happen. The myth “If someone really wants to kill themselves, they’ll find a way to do it” often does not hold true if appropriate safety measures are put into place.
The Help Keep Them Safe step is really about showing support for someone during the times when they have thoughts of suicide by putting time and distance between the person and their chosen method, especially methods that have shown higher lethality (like firearms and medications).
Help Them Connect
How – Helping someone with thoughts of suicide connect with ongoing supports (like the 988 Lifeline) can help them establish a safety net for those moments they find themselves in a crisis. Additional components of a safety net might be connecting them with supports and resources in their communities. Explore some of these possible supports with them – are they currently seeing a mental health professional? Have they in the past? Is this an option for them currently? Are there other mental health resources in the community that can effectively help?
One way to start helping them find ways to connect is to work with them to develop a safety plan.
This can include ways for them identify if they start to experience significant, severe thoughts of suicide along with what to do in those crisis moments. A safety plan can also include a list of individuals to contact when a crisis occurs.
Why – Impact of Applied Suicide Intervention Skills Training on the National Suicide Prevention Lifeline found that individuals that called the National Suicide Prevention Lifeline were significantly more likely to feel less depressed, less suicidal, less overwhelmed, and more hopeful by the end of calls handled by Applied Suicide Intervention Skills Training-trained counselors. These improvements were linked to ASIST-related counselor interventions, including listening without judgment, exploring reasons for living and creating a network of support.
Follow Up
How – After your initial contact with a person experiencing thoughts of suicide, and after you’ve connected them with the immediate support systems they need, make sure to follow-up with them to see how they’re doing.
Leave a message, send a text, or give them a call. The follow-up step is a great time to check in with them to see if there is more you are capable of helping with or if there are things you’ve said you would do and haven’t yet had the chance to get done for the person.
Why – This type of contact can continue to increase their feelings of connectedness and share your ongoing support. There is evidence that even a simple form of reaching out, like sending a caring postcard, can potentially reduce their risk for suicide.
Studies have shown a reduction in the number of deaths by suicide when following up was involved with high risk populations after they were discharge from acute care services. Studies have also shown that brief, low cost intervention and supportive, ongoing contact may be an important part of suicide prevention.
Please visit our Follow-Up Matters page for more.
Share the #BeThe1To steps in your community. Find out how.
For more information, press/media inquiries, or partnership opportunities, please contact Hannah Collins at [email protected].
Help Someone Else : Lifeline
If someone you know is struggling emotionally or having a hard time, you can be the difference in getting them the help they need. It’s important to take care of yourself when you are supporting someone through a difficult time, as this may stir up difficult emotions. If it does, please reach out for support yourself.
Do They Need Your Help?
Some warning signs may help you determine if a loved one is at risk for suicide, especially if the behavior is new, has increased, or seems related to a painful event, loss, or change. If you or someone you know exhibits any of these, seek help by calling the Lifeline.
- Talking about wanting to die or to kill themselves
- Looking for a way to kill themselves, like searching online or buying a gun
- Talking about feeling hopeless or having no reason to live
- Talking about feeling trapped or in unbearable pain
- Talking about being a burden to others
- Increasing the use of alcohol or drugs
- Acting anxious or agitated; behaving recklessly
- Sleeping too little or too much
- Withdrawing or isolating themselves
- Showing rage or talking about seeking revenge
- Extreme mood swings
How Can You Help Them?
It can be scary when a friend or loved one is thinking about suicide. It's hard to know how a suicidal crisis feels and how to act. Call 988 at any time for help if a friend is struggling.
Contact a Lifeline Center
Never keep it a secret if a friend tells you about a plan to hurt themselves. Call 988 so that you can find out what resources are available in your area, or encourage your loved one to call.
Calls are routed to the Lifeline center closest to your area code that can provide you with local resources.
Use The Do's and Don'ts
Talking with and finding help for someone that may be suicidal can be difficult. Here are some tips that may help.
Be Aware Of Suicidal Feelings
People having a crisis sometimes perceive their dilemma as inescapable and feel an utter loss of control. These are some of the feelings and thoughts people experience in crisis. If you or a friend are feeling this way, call us anytime at 988.
Use the 5 Action Steps
These evidence-based action steps provide a blueprint for reaching and helping someone in crisis.
#BeThe1To
Practice Active Listening
Hearing someone talk is different from actively listening to what that person is saying. Active listening requires concentration and understanding. Improving your listening skills is easy to do with practice and these helpful tips.
Get More Info
The federal Substance Abuse and Mental Health Services Administration offers additional resources for multiple audiences.
Visit SAMHSA Online
Social Media Safety
Find ways to support people in crisis online, build guidelines for your digital community, and learn how to report someone in crisis on different social media platforms.
Get in touch
Call the Lifeline
Get help & support for suicide
If you’re in emotional distress or suicidal crisis, find help in your area with Find a helpline.
If you believe that someone else is in danger of suicide and you have their contact information, contact your local law enforcement for immediate help. You can also encourage the person to contact a suicide prevention hotline using the information above.
Learn more about personal crisis information with Google Search.
Google’s crisis information comes from high-quality websites, partnerships, medical professionals, and search results.
Important: Partnerships vary by country and region.
| Country | Hotline organization | Website | Phone number |
|---|---|---|---|
| Argentina | Centro de Asistencia al Suicida | www.asistenciaalsuicida.org | (011) 5275-1135 |
| Australia | Lifeline Australia | www.lifeline.org | 13 11 14 |
| Austria | Telefon Seelsorge Osterreich | www.telefonseelsorge.at | 142 |
| Belgium | Center de Prevention du Suicide | www.preventionsuicide.be | 0800 32 123 |
| Belgium | CHS Helpline | www. chsbelgium.org | 02 648 40 14 |
| Belgium | Zelfmoord 1813 | www.zelfmoord1813.be | 1813 |
| Brazil | Centro de Valorização da Vida | www.cvv.org | 188 |
| Canada | Crisis Services Canada | crisisservicescanada.ca | 833-456-4566 |
| Chile | Ministry of Health of Chile | www.hospitaldigital.gob | 6003607777 |
| China | Beijing Suicide Research and Prevention Center | www.crisis.org | 800-810-1117 |
| Costa Rica | Colegio de Profesionales en Psicologia de Costa Rica | psicologiacr.com/aqui-estoy | 2272-3774 |
| France | SOS Amitié | www. sos-amitie.org | 09 72 39 40 50 |
| Germany | Telefon Seelsorge Deutschland | www.telefonseelsorge.de | 0800 1110111 |
| Hong Kong | Suicide Prevention Services | www.sps.org | 2382 0000 |
| India | iCall Helpline | icallhelpline.org | 9152987821 |
| Ireland | Samaritans Ireland | www.samaritans.org/how-we-can-help | 116 123 |
| Israel | [Eran] ער"ן | www.eran.org | 1201 |
| Italy | Samaritans Onlus | www.samaritansonlus.org | 06 77208977 |
| Japan | Ministry of Education, Culture, Sports, Science and Technology | www. mext.go.jp | 81-0120-0-78310 |
| Japan | Ministry of Health, Labor and Welfare of Japan | www.mhlw.go | 0570-064-556 |
| Malaysia | Befrienders KL | www.befrienders.org | 03-76272929 |
| Netherlands | 113Online | www.113.nl | 0800-0113 |
| New Zealand | Lifeline Aotearoa Incorporated | www.lifeline.org | 0800 543 354 |
| Norway | Mental Helse | mentalhelse.no | 116 123 |
| Pakistan | Umang Pakistan | www.umang.com.pk/ | 0311-7786264 |
| Peru | Linea 113 Salud | www.gob.pe/555-recibir-informacion-y-orientacion-en-salud | 113 |
| Philippines | Department of Health - Republic of the Philippines | doh. gov.ph/NCMH-Crisis-Hotline | 0966-351-4518 |
| Portugal | SOS Voz Amiga | www.sosvozamiga.org | 213 544 545 963 524 660 912 802 669 |
| Russia | Fund to Support Children in Difficult Life Situations | www.ya-parent.ru | 8-800-2000-122 |
| Singapore | Samaritans of Singapore | www.sos.org | 1-767 |
| South Africa | South African Depression and Anxiety Group | www.sadag.org | 0800 567 567 |
| South Korea | Korea Suicide Prevention Center중앙자살예방센터 | www.spckorea.or | 1393 |
| Spain | Telefono de la Esperanza | www.telefonodelaesperanza. org | 717 003 717 |
| Switzerland | Die Dargebotene Hand | www.143.ch | 143 |
| Taiwan | 国际生命线台湾总会 [International Lifeline Taiwan Association] | www.life1995.org | 1995 |
| Ukraine | Lifeline Ukraine | lifelineukraine.com | 7333 |
| United Kingdom | Samaritans | www.samaritans.org/how-we-can-help | 116 123 |
| United States | 988 Suicide & Crisis Lifeline | 988lifeline.org | 988 | nine0033
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Helpline
Information about the unified all-Russian children's helpline
0444 8-800-2000-122 .
When calling this number in any locality of the Russian Federation from fixed or mobile phones, children in difficult life situations, adolescents and their parents, other citizens can receive emergency psychological assistance, which is provided by specialists of services already operating in the constituent entities of the Russian Federation that provide services for telephone counseling and connected to a single all-Russian number of children's helpline.
Confidentiality and free of charge are the two main principles of the children's helpline. This means that every child and parent can anonymously and free of charge receive psychological assistance and the secrecy of his call to the helpline is guaranteed.
Working hours of the children's helpline in the constituent entities of the Russian Federation
(as of October 1, 2013)
Name of the subject of the Russian Federation 9Arkhangelsk region 09. 00-22.00 | |||
| 22 | with Nenets Autonomous Okrug | daily 09.00-17.30 | |
| 23 | Vologda region | around the clock | |
| 24 | Kaliningrad region | daily0039 | around the clock |
| 35 | Chechen Republic 08.30-20.00 | ||
| South Federal District | |||
| 37 | Republic of Adygea | ||
| Kalmykia | Pon-Pen. 8.00-17.00 | ||
| 3 | |||
| 80 | Magadan region | Pon.-Pon. 10.00.22.00 | |
| 81 | Sakhalin Region | ||
| 900 | |||
| 83 | Chukotka AO | Mon-Fri 09.00-22.00, closed 16.00-22.00 | |
Infographics. The principle of operation of a single federal helpline number for children, adolescents and their parents
Information from the regions about the work of the children's helpline
12/28/2016
What to do when there is a problem, but there is no one to tell about it?
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