How to support a family member who’s thinking about suicide

When a family member is contemplating suicide, or if someone you love has attempted suicide, it can be difficult to bring up the topic. Cultural or social conventions may hold you back. You may not know what to say or how to connect the person with appropriate care.

But it’s nerve-wracking because it matters. If you’re worried about a loved one or a friend, the discomfort and the hard conversation is worth it if you get that person the help that they need.

Read below for some tips to help you navigate these issues.

Is it OK to talk to a suicidal person about suicide?

Yes. There’s often a misconception that raising the topic of suicide will introduce the idea or increase risk. Don’t let this fear keep you from reaching out.

Should I look for specific signs of suicide risk?

Focusing on risk factors for suicide hasn’t been shown to reduce suicide rates, so family members shouldn’t feel responsible for catching warning signs. Instead, empower the at-risk person to help manage their own well-being and act if they tell you they’re struggling.

Further, there are limits to relying on warning signs for suicide prevention. Some people who die by suicide show no observable warning signs.

However, if you do notice that a friend or family member seems different or “off,” it’s OK to check in and ask them how they’re doing.

What are some ways to support a family member who’s contemplating or has attempted suicide?

• Ask open-ended questions. Instead of asking if they’re thinking about suicide, let them know you’ve noticed they’re struggling and ask what’s been going on. This can foster a supportive environment and give your loved one the freedom to share their experience.
  • Listen – this is their story, and they’re trusting you with it.
  • Be present – give your full, undivided attention.
  • Be open-minded – show a willingness to see things from their perspective.
  • Be neutral – put aside your own views and remain nonjudgmental.
  • Be aware – pay attention to both the person’s words (verbal cues) and unspoken signals (non-verbal cues).
• Move on to more specific questions if your family member is receptive. Ask if they’ve had thoughts that they’d be better off dead or considered ending their life. As much as possible, try to keep the conversation open-ended so your loved one can control what they share and don’t share.
• Keep the focus on the person at risk. If you interject your own experiences or advice too soon, this shifts the focus away from your family member and may come across as invalidating.
• Ask what the person needs. Discuss the type of support they want, such as check-ins or making the environment safer by securing firearms or medications. Allow the person who is at risk to guide these decisions.
• Avoid stigma and shaming. Support should be nonjudgmental and empowering. People who are suicidal are not broken or weak but are experiencing a crisis. Avoid referring to suicide as “cowardly” or “selfish” or saying things like, “Don’t you know how much that would hurt others?”
• Plan meaningful activities to do together.
• Help connect them with appropriate resources.
• Don’t give advice about suicide methods. This can be harmful.

When is it appropriate for a family member to intervene?

A person is at imminent risk of suicide if they’ve developed a plan and have the intent and means to enact the plan. At this stage, immediate emergency intervention is necessary, and outpatient care or informal support is not appropriate. Encourage the person to call the Suicide & Crisis Lifeline at 988 or go to a hospital for evaluation. Call 911 if necessary to keep someone safe or if someone has made a suicide attempt.

Someone at lower risk might be depressed or have suicidal thoughts. This is when family members can help with supportive conversations and other interventions.

When should I reach out for further support for a suicidal family member?

Reach out for help if you feel responsible for preventing harm or keeping someone alive. There are limits to how much a layperson can help, especially in a crisis situation.

Stay with them until professional help arrives, especially if they express immediate risk, such as saying, “I can’t do this anymore” or “I’m worried I might kill myself if I’m alone.”

What’s a crisis response plan and how should a family go about developing one?

Crisis response plans save lives by preventing suicide attempts and providing time for treatment to occur, whether that be hospitalization, outpatient mental health care or spiritual or community supports.

They can be helpful for people who express thoughts of being better off dead or wanting to die. They also can benefit people with a history of suicide attempts and ongoing suicidal thoughts.

These plans include short-term interventions of about 30 minutes that can provide relief from pain and suffering, so an at-risk person has time to think through a problem and consider solutions.

Ensure that the at-risk person has control over the development of these plans, and that they include the coping strategies that they find helpful.

Crisis response plans can be handwritten on an index card or saved on a smartphone, and typically include several key steps:

1 Identifying the indicators of intense emotional distress for the family member at risk.

These can be things we do (e.g., pacing, crying), things we feel (e.g., sadness, anger), things we think about (e.g., “It’s never going to get better,” “I can’t take this anymore”) or things we experience physically (e.g., headaches, muscle tension).

2 Identifying things the family member can do to calm down or self-distract from the situation.

Some people like to go for a walk, some like to listen to uplifting music, others like to watch funny TV shows and others will play games. There are lots of options. The key is finding things that work for the family member.

3 Thinking about positive things in life that make life worth living.

These are typically people or things in our lives that elicit joy, hope or other positive emotions, such as family members, friends, pets and enjoyable activities. Taking some time to remember and think about these things can help us keep perspective when feeling overwhelmed.

4 Identifying people who the family member can contact when upset.

These people can be friends or loved ones who help us during crises. We don’t necessarily need to tell this other person that we’re in crisis and need urgent help. In many cases, just talking with someone or spending time with someone can help us to take our minds off what’s bothering us and even feel better.

5 Having contact information for professional and crisis support services.

Prepare in advance a list of mental health professionals, local hospitals and the 988 crisis hotline.

How might family members be impacted by a loved one attempting or contemplating suicide? When should they reach out for their own help?

People can experience a range of emotions, including anxiety, fear, sadness and anger, when they learn about a family member who’s contemplating suicide. There’s no right or wrong time to seek help for yourself. This help and support can come from many sources: other family members, friends, members of one’s faith community and trusted co-workers. Some people also find it beneficial to attend support groups or individual counseling on their own.