Cautionary Signs of Risk of Suicide & Recommendations

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The cautionary signs associated with risk of suicide may increase the risk but may not be the reason for a suicide. However, the more signs a person has may suggest an increased risk for suicide.

Cautionary Signs of Risk of Suicide
  • Talking about wanting to die
  • Finding the method and making a plan to kill oneself
  • Withdrawing from normal activities
  • Changing normal behavioral patterns
  • Becoming unusually isolated
  • Talking about being a burden to others
  • Expressing feelings of hopelessness or having no purpose
  • Talking about unbearable pain
  • Increasing use of alcohol and/or drugs
  • Irregular sleep patterns (too much or too little)
  • Acting anxious or reckless
  • Displaying anger, rage, a need for revenge
  • Showing extreme mood swings
  1. Ask Directly. "I have noticed that you have changed a lot lately and I am worried about you. I’m concerned that you may be thinking about killing yourself." Explain the behavior that you noticed and that led you to think this. The best thing you can do to get a suicidal person to talk about their feelings is to use the word "suicide" or "kill yourself." This lets the person know you are not afraid to talk about this scary topic. It also lets them know that you care enough to have noticed the way they have been behaving.
  2. Acknowledge their pain without sounding shocked. Listen! Offer empathy but not sympathy. "Sounds like you’re feeling a lot of pain right now." This phrase "right now" emphasizes that this feeling is temporary. Don’t act shocked. Let the person talk about their feelings.
  3. Be non-judgmental. Don’t debate whether suicide is right or wrong, or feelings are good or bad, or negate how they are feeling. Feelings just are and people are entitled to feel the way they do. Don’t deny a person’s feelings. Explore the negative feeling to see where it is coming from and what can be done to deal with the feeling. "From what you’re saying, it sounds like there are times when death feels like the only way out of pain."
  4. Stay with the person if he/she is having strong thoughts of suicide. "I really care about you and want to make sure you’re safe. I’d feel better staying with you tonight." Let the person know that you will help them or get help. Let them know you care and are available and that there are people available to help. Give support.
  5. Don’t dare him/her to do it. Show you understand. "I really feel honored that you trusted me enough to tell me this."
  6. Don’t ask "why." This encourages defensiveness. Ask instead for the person to tell you more. "Can you tell me more? I’d really like to know how you’re doing."
  7. Ask for additional sources of support and call those people (or person) together, or get permission to call. "I’m wondering if there are other people -a doctor, therapist, teacher, clergy or friend- whom you’ve felt comfortable with in the past or recently."
  8. Remind the person that help is available. Don’t offer glib reassurance. "I can hear that you’ve been going through a really rough time and it’s made you feel down, but there’s help out there. I’d like to help you find that support." Don’t tell the person everything will be okay or you shouldn’t be feeling this way. Do not offer a quick fix or a false promise that everything will be just fine or that their problems will go away.
  9. Take every threat of suicide seriously. Even if you think they just want attention, do not ignore it. A suicide threat may be the only way they feel that they can be taken seriously. Don’t take a chance they don’t mean it.
  10. Discuss their options with them. Talk about options and constructive ways to deal with the pain, but let them decide what to do. They need to take control of their lives. Your solutions may not work for them.
  11. Better to lose the friendship than the friend. If you’ve promised not to tell anyone, but you fear for a person’s life-TELL!
  12. Get help for yourself too. You may feel some strong emotions or confusion about what you heard or were dealing with and you’ll need to talk to someone.
  13. Get help from individuals or agencies that specialize in crisis intervention and suicide prevention. Take the person to a hospital or call 911 if you believe they are in an immediate crisis!
  14. CALL: National Suicide Prevention Hotline: 1-800-273-TALK (8255)

Reproduced with kind permission of Suicide Prevention Coalition of Long Island (SPCLI), 2011