Self-harm can be considered a risk factor for suicidal ideation and suicide. However, there are many other risk factors to look out for. These can include:

1. A previous suicide attempt
2. A family history of suicide
3. Stressful life events. Such as divorce, financial struggles, losing a job etc.
4. Past trauma. For example, a traumatic childhood or abusive relationship (may also be due to a current abusive or toxic relationship)
5. Excessive use of drugs or alcohol
6. Feelings of hopelessness. Perhaps you often hear your loved one talk about how nothing matters or that nothing can help them.
7. Interpersonal problems. They may be experiencing issues with close friends, family, or their partner.
8. Increased isolation. You may notice them spending an unusual amount of time alone.
9. Existing mental health problems. They may have been previously diagnosed with mental health issues, such as anxiety or depression.
10. Having a concrete suicide plan. This is perhaps the most critical factor. The more concrete a plan is (including when, where and how they intend to make a suicide attempt), the more at risk that person is.

-Therapy Central

What to Say and Do

Knowing what to say when someone has suicidal thoughts can be incredibly difficult, and that’s completely normal! Despite feeling uncomfortable, it’s essential to talk to and connect with your loved one, understand their feelings, and show empathy, support and presence. Here are a few things you can say:

1. Ask direct questions. The first step is to find out whether your loved one is in imminent danger of carrying out a suicide attempt. Talking about it will not push them to act on their ideation and will likely reduce the risk by creating a space where your loved one can talk about it and express their distress if they feel like it. You can ask questions such as:
   
   
   • How are you coping with things in your life lately?
   • Are you thinking about suicide?
   • Have you tried to harm yourself before?
   • Have you thought about how or when you’d do it?
   
   
2. Empathize with them and let them know they’re not alone. You can do this by actively and empathically listening to everything they say. Try rephrasing what they’ve said back to them, to make sure you understand and that they know you’re present. Although you don’t know exactly how they’re feeling, you can express empathy by recognizing their pain. You can do this by saying something like, “It sounds like this is all very painful for you.”
3. Ask them about their reasons for living and dying. Try to explore the ‘living’ reasons more deeply. Doing so will help them reflect on what keeps them going, what goals they’d like to reach and what experiences they might still want to have in their lives. This can help broaden their perspective on their current situation and act as a factor protecting them from suicide.
4. If they’re comfortable, encourage them to get professional help. Knowing what to do to help someone who is suicidal is a challenging task, which can very quickly become overwhelming. The first step would be to ask them whether they have an existing crisis plan they might have put together with a professional in the past. If they do, you can offer your help using it. However, if they have never sought professional attention before, ask them calmly if they’d like your help with that. For example, by contacting their GP, phoning 111 or the Samaritans at 116 123.
5. If they’re in immediate danger, ensure they aren’t left alone. In cases of imminent or immediate danger, being alone can increase the chances of self-harm or suicide. In case of an emergency, call 988 or 911.

-Therapy Central

What NOT to Say and Do

Because this is such a sensitive situation, it’s essential to treat it carefully. Here are a few things to avoid when talking to your loved one who is experiencing suicidal thoughts:

1. Don’t try to solve their problems for them. Although you might be tempted to solve the issues your loved one is struggling with, this is unlikely to be a solution. On the contrary, it may burn you out and make your loved one feel even more powerless and not understood.
2. Don’t try to just cheer them up or distract them. Don’t tell them to ‘man up’, ‘snap out of it’ or ‘pull themselves together’. These terms may contribute to their shame and sense of helplessness. Instead, listen with empathy and without judgement to their narrative.
3. Don’t compare their experience with your own feelings. You may feel inclined to compare your feelings with theirs, saying things like “I know how you feel” or “I wouldn’t be okay if you were gone”. This might make them feel frustrated and misunderstood, as you can’t ever really know how they’re feeling. It also shifts the focus of the conversation onto yourself, when instead it should be entirely on your loved one. Follow their lead.
4. Don’t try to talk them out of suicide by telling them how much it will hurt their family and friends. Although this might seem like a good thing to say, it really isn’t. When someone is suicidal, it’s more than likely they are already experiencing feelings of immense guilt and shame. By reminding them of their friends and family, you risk making them feel more guilty.
5. Avoid stigmatizing terms. These include: ‘committed suicide’, ‘failed attempt’, ‘successful suicide’ etc. The word ‘commit’ may imply that suicide is a crime or a sin, reinforcing the stigma that suicide is selfish. Using words like ‘successful’ or ‘failed’ frames a tragic instance as something to be achieved.

SPTS is dedicated to increasing awareness, saving lives and reducing the stigma of suicide through specialized training programs and mental health resources that empower students, parents, school staff and community members with the skills needed to help youth build a life of resilience.

Are you concerned that someone you know maybe at risk for suicide?

Get to know the FACTS or warning signs:

Feelings
Expressing helplessness, sadness, feeling like a burden, emotional exhaustion and hopelessness.

Actions
Displaying severe/overwhelming pain or distress, aggression, risky behavior, online suicide searches.

Changes
Showing worrisome behavioral cues or marked changes in behavior. This includes withdrawal from friends or changes in social activities, anger or hostility, or changes in sleep.

Talk / Threats
Talking about, writing about, or making plans for suicide.

Situations
Experiencing stressful situations including things that involve loss, change, personal humiliation or disciplinary actions.

If you notice any of these warning signs, you can help!

SPTS Resources

Parent / Caregiver Toolkit

Why You Should Stop Saying "Committed Suicide"

A Message for Teens

When a Friend Dies by Suicide

When a Friend is Talking About Suicide