09.04.23
7 Ways to Support Someone With Suicidal Ideation
It doesn’t have to be a Big Serious Discussion every time.
If you or someone you know is in crisis, please contact the 988 Suicide & Crisis Lifeline.
When someone opens up about experiencing suicidal ideation, your first thoughts might include: OMG, are they OK? What should I say? What should I do? Also, what does that even mean?! Above all, you’re probably wondering how the heck you can possibly help. As one of many people who lives with suicidal ideation (an umbrella term for a ton of different thoughts and behaviors related to wanting to die), allow me to let you in on a secret: Supporting us can be way simpler than you think.
When helping someone with suicidal thoughts, be compassionate and available to lean on, says licensed therapist Mary Houston, LCSW, who has experience in crisis settings. Also, ditch any unrealistic goals. Stopping their suicidal thoughts is out of your hands and will make you feel overwhelmed and less likely to actually help, she adds.
Honestly, you don't even need to understand the nuances of suicidal ideation or say the perfect thing to whoever's struggling. While there are some safety protocols and general best practices for helping someone cope with ideation—you can still make a difference, says licensed clinical psychologist Kathryn Gordon, PhD, author of The Suicidal Thoughts Workbook. "Just being there for someone can have a huge impact.”
Whether someone just told you about their suicidal thoughts or you just want to be prepared, here are some specific ways—big and small—you can support them.
1. Ask open-ended questions.
There’s no denying suicide can feel like an intimidating or even scary subject to address, but if there’s a golden rule that suicide prevention experts swear by, it’s this: Don’t be afraid to discuss it directly. “A lot of people want to offer support but are terrified of bringing it up or putting ideas in somebody’s head,” says Houston. But if they opened up to you while shouldering the weight of suicidal thoughts, talking to them can lighten their load.
Dr. Gordon suggests starting by asking questions like, “Can you tell me what that’s like for you?” or “What kind of thoughts and feelings are you having lately?” When they respond, summarize what you’re hearing to make sure you understand, Dr. Gordon says. “You want to let them know you're a safe person to share feelings with, including the less socially acceptable ones,” adds Houston, and that can encourage them to come to you in the future—or simply show them you’re not judging or pulling away.
Through these conversations, you might learn what problems or circumstances are driving or intensifying their pain and potentially suss out if someone could be in immediate danger to themselves, Dr. Gordon says. When it comes to assessing the risk of an imminent suicide attempt, listen for mentions of a suicide plan, the means to carry it out, and the intention to do it. These are signs it might be worth reaching out to crisis support, like calling 988 (more on that later).
2. When in doubt, ask what’s actually helpful.
No two experiences of suicidal ideation are exactly the same, and effective support also differs from situation to situation. So you don’t need all the answers. Instead, give them the opportunity to communicate their needs by asking what you can do.
Of course, if anyone has ever asked you, “How can I help?” during a tough time, you know that accepting an assist can be super difficult, let alone coming up with specific things for them to do. If they don’t respond to that question or struggle to think of stuff you can get done, Dr. Gordon suggests asking if there are problems you can help solve (like running errands or finding a therapist) or feelings you can ease in the moment (like offering a distraction when they’re overwhelmed or company when they’re lonely).
3. Check in.
Just because someone clued you into how they’re feeling before doesn’t mean they’ll do it again, so circle back. “People who struggle with suicidal thoughts will often say they're reluctant to reach out,” Dr. Gordon adds. Following up can be as simple as saying, “I’ve been thinking about what you shared with me the other day—how have you been feeling since we talked?”
Keep in mind that it doesn’t have to be a Big Serious Discussion every time you broach the topic. “You don’t want to diminish it, but you can figure out a balance so it’s not this elephant in the room that you only talk about when you’re really, really worried,” Houston says. It doesn't have to be any different than how you’d check in with a friend going through a tough breakup, she adds. You don’t have to bring it up every time you see them, but touching base occasionally lets them know there's no expiration date on your willingness to talk about it.
On top of following up, keep an eye out for signs they might need extra support, like when they’re not responding to texts or seem to be drinking more than usual. Dr. Gordon says you can just ask them straight up like, “What can I keep an eye out for that will help me know you’re struggling?” or “What are the usual things that happen when your suicidal desire is intense?”
Speaking of…
4. Prepare for crisis situations, just in case.
Experiencing suicidal thoughts doesn’t mean someone is in immediate danger. In fact, many times, suicidal ideation takes a more passive (but still serious) form, with thoughts like, I don’t want to be alive, I want to fall asleep and not wake up, or I wish something would happen to me that kills me, Houston explains. But because it’s tough to predict if and when passive suicidal ideation will slide along the spectrum to an active crisis, Houston says it’s helpful for you and your loved one to have a game plan if things take a turn for the worse. And believe me, planning ahead is less stressful than googling, “help friend wants to die what do i do” in an emergency.
Luckily, there is a wealth of information out there on what to do in a crisis from suicide prevention organizations like the Suicide Prevention Resource Center or the American Foundation for Suicide Prevention. Prepping for a potential future crisis might look like brushing up on the basics, like the warning signs of suicide (saying they feel like a burden to others or hopeless about their future are red flags) or best practices (please, please don’t say, “But you’ve got so much to live for!” or “It gets better!”). You might also bookmark info on local emergency rooms, mobile crisis teams and centers, or relevant hotlines, like 988.
Depending on how close you and this person are, you might ask if they have a safety plan, a common therapeutic resource outlining the steps someone can take when they’re having suicidal thoughts. If they don’t, you can encourage them to fill out this worksheet. Either way, if you’re comfortable with the responsibility, consider offering to be part of their plan as someone they can call in a crisis.
5. Throw some low-pressure activities out there.
Research suggests that having a support system and feeling socially connected in general can play a big role in preventing suicide. But when someone is in the grip of suicidal ideation, making an effort to hang out—even with people we really like!—can feel impossible. So Houston recommends lowering the barrier as much as possible.
“Go beyond just, ‘Hey, how are you doing? Do you want to hang out?’ because it’s so easy for them to be like, ‘Oh, I’m fine, that’s OK,’” says Houston. Instead, suggest specific activities and time frames to make it easier to say yes. Think: “Hey, I’m free to come over on Friday after work if you want some company—we don’t have to do anything but watch TV or be on our phones,” or “Feel like driving around and listening to some music? I’m in the area, can I pick you up?!”
6. Offer to help with practical stuff.
Suicidal ideation can exacerbate many of the everyday stresses of being a human. Like, OK, I have to do the dishes on top of dealing with how I want to die? Awesome. Because they have to juggle tough emotions and daily tasks, being there for someone with suicidal ideation doesn’t always mean supplying emotional support, says Houston. Can you help them meal prep? Can you run that errand that’s been looming over them for a month? Can you sit with them as they catch up on their inbox?
This can also look like assisting with their search for additional support, like relaying their needs to their other loved ones (which could help divvy up the support), finding providers who can help them, requesting disability accommodations at work or school, seeking rental or meal assistance, and more. Even if favors like these aren’t addressing suicidal ideation directly, they can ease other stresses that might make the situation worse, says Houston.
7. Send “thinking of you” reminders.
Sending funny memes or “Good morning!” texts can make a surprising difference to someone who feels like no one cares—an all too common experience for people experiencing suicidal ideation, says Houston. So, as you go about your life, let them know they’re on your mind.
“Even if sending a playlist of songs or a picture of a fun time you’ve had together doesn’t solve the problem, little gestures that remind them that someone is there can actually be pretty powerful,” says Dr. Gordon. “It can poke holes in a belief that they’re alone or unworthy of help or a burden to others.”
Wondermind does not provide medical advice, diagnosis, or treatment. Any information published on this website or by this brand is not intended as a replacement for medical advice. Always consult a qualified health or mental health professional with any questions or concerns about your mental health.
