Helping Your Loved One Who Is Suicidal (Part 1)

This guide will help families who have a loved one who is suicidal or has made a suicide attempt. It will provide information on understanding suicide, warning signs and action steps to take, and how to prevent future attempts and keep your loved one safe.

Warning Signs That May Indicate Suicidality

Warning signs that may indicate urgent suicidality include¹

• Looking for ways to kill oneself: seeking access to pills, weapons, or other means
• Talking about wanting to hurt or kill oneself, especially with a plan for how to do so
• Engaging in self-harm or nonsuicidal self-injury
• Saying goodbye to friends and family; giving away possessions

If someone is displaying the above warning signs and is about to, or in the process of making an attempt, get help immediately:²

• Don't leave the person alone.
• Call 911, and tell them your loved one is actively suicidal and at immediate risk of physical harm and/or death.
• If your loved one is amenable and not trying to actively harm themselves, you can bring them to the emergency room yourself and report that they are actively suicidal. Every emergency room is equipped to evaluate a suicidal individual and/or will connect you with needed resources. This is only an option if you believe that your loved one will not try to get out of the vehicle, in which case calling 911 is the safest option.
• Remove any firearms, knives, medications, or other means that can be tools for self-harm.
• Tell a family member or friend. Don't try to handle the situation alone.

988 Suicide & Crisis Lifeline

If your loved one is having thoughts about suicide and is about to, or in the process of making a suicide attempt, contact 988 Suicide & Crisis Lifeline (formerly the National Suicide Prevention Lifeline) at 988 or via Link opens in a new windowhttps://988lifeline.org. (The old Lifeline number 800-273-TALK [800-273-8255] will continue to work also.)

1. Understanding Suicide

When a friend or family member has suicidal thoughts or attempts suicide, it is a traumatic event that impacts the entire family. It is normal to feel scared, confused, or angry. If you are finding it difficult to determine whether or not your family member is at risk of suicide, seek help, and don't wait. Families and friends play a key role in suicide prevention. This guide will help you understand how to respond to your loved ones who are in emotional distress and struggling with thoughts of suicide, as well as how to help get them the necessary support and treatment.

Common Misconceptions about Suicide^3,4

Suicide is a major public health problem. It is the 10th leading cause of death in the United States, resulting in about one death every 11 minutes.⁵

Myth: Asking someone if they are suicidal may put the idea in their head.
Fact: Asking a loved one about suicide will not make them suicidal. In fact, the person who may be thinking of suicide may feel relieved to be asked about it and grateful to have a safe place to share their thoughts.⁶

Myth: A mention of suicide is not serious enough to require help.
Fact: When a friend or family member has thoughts about suicide, take their words seriously. When someone talks about hurting themselves, this is a warning sign to act and help them. There are many treatment options available that are effective in reducing suicidal thoughts and behaviors.^3,4

Myth: Treatments don't work anyway.
Fact: Many well-researched and effective therapies are available to help your loved one, from counseling to medications and other treatments.

Myth: People attempt suicide to gain sympathy.
Fact: A suicide attempt needs to be taken seriously. It is not an attempt to gain sympathy from others, but rather demonstrates significant distress and despair about life. In fact, if your loved one has attempted suicide, there is an increased risk that they may make another attempt. People are said to be at the greatest risk for another suicide attempt or death by suicide within one year after the initial attempt.^3,4

Risk Factors for Suicide

Pay attention to the risk factors for suicide:⁷

• A prior suicide attempt
• Mental disorders, especially depression, alcohol or drug dependence, and eating or conduct disorders
• Family history of suicide, trauma, and/or physical or sexual abuse
• History of psychiatric hospitalization and non-suicidal self-harm behavior
• Chronic physical illness, including chronic pain and/or traumatic brain injury
• Social isolation, loneliness or hopelessness, and feeling a burden to others
• Impulsive, reckless tendencies and aggressive or violent behaviors
• Loss and major events (e.g. relational, social, work, financial, or divorce)
• Live in areas where others have recently died by suicide
• Unwillingness to seek help or have trouble accessing help
• Access to lethal means (e.g. prescription medications, firearms, knives, and poisons)

References

1. Rudd, M.D., Berman, A.L., Joiner, T.E., Nock, M.K., & Silverman, M.M. (2006). Warning signs for suicide: Theory, research, and clinical applications. Suicide and Life-Threatening Behavior, 36(3), 255–262. doi: 10.1521/suli.2006.36.3.255
2. Bryan, H. (2012). Now what do we do? The emotional impact of a suicide attempt on families. Philadelphia, PA: Heidi Bryan Consulting. Retrieved January 10, 2023, from https://www.starsinc.com
3. Joiner, T. (2010, April 15). The myths about suicide. Cambridge: Harvard University Press.
4. Suicide Awareness Voices of Education (SAVE). (n.d.). Common misconceptions about suicide. Retrieved January 10, 2023, from https://save.org
5. U.S. Centers for Disease Control and Prevention (CDC), National Center for Injury Prevention and Control. (2020). Web-based Injury Statistics Query and Reporting System (WISQARS). Retrieved January 10, 2023, from https://www.cdc.gov/injury/wisqars/index.html
6. Bostwick, J.M., Pabbati, C., Geske, J.R., & McKean, A.J. (2016). Suicide attempt as a risk factor for completed suicide: Even more lethal than we knew. The American Journal of Psychiatry, 173(11), 1094–1100. doi: 10.1176/appi.ajp.2016.15070854
7. CDC. (2019, September 2). Risk and protective factors. Retrieved January 10, 2023, from https://www.cdc.gov