Supporting someone with suicidal thoughts

The 2023 annual report from the National Confidential Inquiry into Suicide and Safety in Mental Health (NCISH) reported 68,357 suicides in the general population in the UK between 2010 and 2020, an average of 6,214 deaths per year.

Between 2010-2020, there were 18,403 suicide deaths in the UK by patients (i.e. people in contact with mental health services within 12 months of suicide), an average of 1,673 deaths per year, 27% of all general population suicides.

Suicide is preventable and we should work together to ensure that every person we know is protected from the risk of suicide and its damaging impact on so many lives.

Supporting Someone with Suicidal Thoughts

1. Warning Signs

It is important to familiarise yourself with the signs that a loved one or friend may be considering suicide. These include:

• A change in normal routine, including eating or sleeping patterns.
• Expressing thoughts of suicide — for example, making statements such as “I am going to kill myself,” “I wish I were dead”, saying goodbye to people as if they won’t be seeing them again.
• Looking for ways to end their life such as stockpiling medication.
• Withdrawing from others and wanting to be left alone.
• Expressing feelings of helplessness and hopelessness about the future.
• Being preoccupied with death, dying or violence.
• Feeling trapped or hopeless about a situation.
• Increasing use of alcohol or drugs.
• Self-destructive behaviour, such as drugs, taking unnecessary risks or driving recklessly.
• Giving away belongings or getting affairs in order when there is no other logical explanation for doing this.

2. Difficult Situations

Perhaps your loved one is going through a difficult, challenging period in their life which may prompt mental health difficulties. These might be:

• Financial worries
• Relationship issues
• Work related stress
• Loss including loss of a job or a family member or loved one through bereavement
• Loneliness and isolation
• Mental illness
• Physical illness

3. Effective Communication

It is important to be non-judgemental and empathetic and allow the person to express their distress. Asking simple, open questions can encourage them to be honest about how they are feeling.

• Ask open questions which require more than a ‘yes’ or ‘no’ answer. Some good examples include “Tell me how you are feeling”, “What is life like for you right now”. Give them time.
• Take them seriously. It is a common myth to believe that someone who talks about suicide doesn’t intend to act upon those feelings. Always assume they are telling the truth.
• Do not judge, no matter how shocked, scary or upsetting it is to hear their feelings.
• Direct questions about suicide like ‘Do you feel like life is not worth living?’ or ‘Do you feel like ending your life?’ can help someone talk about how they are feeling. Asking someone if they feel suicidal may not feel like the right thing to do but it is the recommended approach. Some people worry that this might indirectly encourage the person who is feeling suicidal to act on their feelings, but in reality research has shown that speaking openly about suicide decreases the likelihood of the person acting on their feelings.

4. Encourage them to seek medical help

Sometimes people do not seek help for many reasons, including due to a fear of stigma, fear of being admitted to hospital or being started on medication. Let them know that it is okay to receive help from trained professionals and assure them that you will be there to support them on their journey.

5. Offer practical help

There are lots of practical things you can do to support someone who is ready to seek help. For example:

• Ask them if there are any tasks you could help with. This may include supporting with household chores, arranging childcare for them, offering a lift, etc.
• Help to write down lists of questions that the person you’re supporting wants to ask their doctor or nurse.
• Help them to organise paperwork, for example making sure that they have somewhere safe to keep their prescriptions and records of appointments.
• Go to appointments with them, if they want you to – even just being there in the waiting room can help someone feel reassured.

6. Encourage them to continue to take their treatment

It is important that they continue to take medication or any other forms of treatment. Sudden discontinuation of medication sometimes can increase the risk of suicide. If they would like to come off their medication, it is important that they first discuss this with their GP.

7. Discourage illicit drugs or alcohol

People often tend to turn to illicit drugs or alcohol to cope with distress. This is counterproductive as drugs and alcohol often acts to depress mood and worsen suicidal feelings.

8. Intervene if there is a serious risk to someone’s life

If there is an immediate danger to someone’s life, call 999 for an ambulance immediately or go to the nearest accident and emergency department.

Do not leave the person alone, remove any means of suicide available, including potential weapons, medications, alcohol and other drugs and even access to a vehicle. Give as much information as possible to the 999 operator and be as clear as you can when giving your address and telephone number.

Looking after yourself

Supporting someone else who is really struggling with their mental health and having suicidal thoughts can be difficult and emotionally draining. Making sure that you look after your own wellbeing can mean that you have the energy, time and distance to help them.

Below are some things to consider to help look after your own wellbeing:

• Ensure that you eat, drink and sleep well
• Take regular breaks
• Set small goals and celebrate them together
• Continue to do the things that you enjoy
• Talk to someone you trust about how you’re feeling
• Seek help as required. Find someone to talk to, maybe friends, family, GP or professionals

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