Suicide: Helping Someone Who Is Struggling

How Do We Help?

When talking with someone who is experiencing suicidal thoughts, it is always important to listen with compassion, openness, and curiosity. In this session, Conwell and Precht discuss the different concerns and approaches involved when loved ones support a person through suicidal thoughts and behavior.

Watch now to learn more about:

• Where to find support in having conversations around suicide
• How to approach a loved one who may be struggling
• How to navigate anxiety after a loved one’s suicide attempt

When someone—whether a parent, teacher, health care provider, or friend—sits with a person who may be having suicidal thoughts, it can be scary.

“It is uncomfortable for us to talk about [suicide] and maybe [it has to do with] our own histories,” says Precht.

“Maybe it’s our own lack of exposure or lack of skill. Maybe it’s the myth that if I talk about this, the person is going to become more suicidal. For some people, it's, ‘Oh, if I ask about this, if I talk about this, and they tell me that they are at risk, oh god, I’m going to have to do something, and I don’t know what to do.’”

According to Precht and Conwell, even if we feel uncomfortable, it’s important to acknowledge that the situation is anxiety provoking, and to be able to work to put anxiety aside.

“To listen is a powerful intervention in and of itself—it simply communicates that you’re interested and can bear hearing about their pain,” says Conwell.

Listening in this deep way provides connection and counters the suicide risk factor of isolation.

If communicating about suicide with someone who is having suicidal thoughts is something people need support in, the 988 Suicide and Crisis Lifeline provides guidance—not just for those who are at risk of suicide, but for the people supporting these individuals.

988 is available 24/7 via phone and text. The lifeline is staffed by professionals who can guide people in having conversations about suicide.

Parents, especially, may find such conversations frightening, and may wish to seek their own therapy for guidance on how to talk with their children at such times.

Precht explains that such conversations can involve:

• Asking the person directly about their thoughts and what they are experiencing (it can be as direct as, “Hey, are you thinking about this?”)
• Remaining neutral, compassionate, interested, and able to say, “I want to figure this out with you. We’re going to do what’s needed.”
• Taking next steps, such as getting their health care professionals involved, taking them to the emergency department, or calling 911

By fostering open, compassionate communication and knowing when to seek professional help, loved ones can play a critical role in supporting those facing suicidal thoughts.

Audience Questions

• Can you talk about the importance of getting involved to help someone who might be suicidal?
• Generally speaking, what should we do if we encounter someone who is suicidal?
• What are your thoughts on whether or not to ask someone if they feel safe or unsafe?
• Are there any special considerations when speaking to a relative about their state of mental health?
• How might a parent ask a child or teen about whether they’re having thoughts of self-harm or thoughts of harming others?
• What are your suggestions for a clinician whose patient reports being fine but shows potential signs of suicidality?
• Can you speak to the difference between being (actively) suicidal and having had thoughts of suicide?
• If it appears clear that a crisis is imminent, what should a concerned family member do?
• What is a safety plan and how does it work?
• How can a clinician motivate a patient to contribute to the creation of a safety plan when that patient is feeling hopeless?
• In the wake of a suicide attempt, how vigilant should a loved one be in terms of checking in with that individual? Other considerations a loved one should keep in mind?
• Do you have any suggestions for hospice workers supporting patients who are experiencing suicidal thoughts?
• Any tips for how to connect with patients during brief emergency room assessments?
• Where might clinicians and family members find safety planning resources?
• Can you offer some suggestions for having conversations about non-lethal self-harming?
• To what degree is communication key between family members and clinicians when it comes to addressing suicidality?
• Do you find that awareness of suicide and suicide prevention has improved in recent years?

The information discussed is intended to be educational and should not be used as a substitute for guidance provided by your health care provider. Please consult with your treatment team before making any changes to your care plan.

Resources

You may also find this information useful:

• 988 Suicide and Crisis Lifeline
• The Trevor Project
• Stanley-Brown Safety Planning Intervention
• Talk Away the Dark – AFSP
• Video: Suicide Prevention – Learning From Someone Affected by Suicide
• Video: The Power of Dialectical Behavior Therapy
• Suicide: Know the Signs and What To Do
• Everything You Need To Know About Grief and Loss
• Video: Suicide Assessment and Intervention in Clinical Practice – Application of the 988 Lifeline Model
• Access the full Heroes for Hope: Suicide Prevention course
• McLean’s suicide prevention resource hub

About Dr. Conwell

Yeates Conwell, MD, is a professor in the Department of Psychiatry at the University of Rochester Medical Center. He has served as founding co-director of the University of Rochester Center for the Study and Prevention of Suicide and has lectured and written extensively on suicide and depression in later life.

About Dr. Precht

Anna Precht, PsyD, is a clinical psychologist and a senior clinical consultant at McLean’s Arlington School, a high school for students with mental health challenges. She specializes in the use of evidence-based treatments including DBT and CBT.