When Someone Talks to You About Suicide
by Elizabeth Tracey, Senior Medical Writer

When a co-worker, spouse, child or friend talks to you about suicide, no matter the context of the conversation, there's only one thing to do: take it seriously. As someone in distress confides his or her feelings to you, remember that the most important thing you can do is listen.

According to the National Mental Health Association, eight out of ten people who eventually take their own lives give some advance indication of their intentions. Many people talk about suicide well before they try to end their own life or “practice” for an eventual suicide attempt.

Listen carefully to what the person is saying if and when they talk to you about suicide, even if they are not relating the topic to themselves at the moment,” says Karen Swartz, M.D., assistant professor and a member of the psychiatry staff at John Hopkins. “No talk of suicide and no attempt, however mild or ineffective it may seem, should be ignored or dismissed,” Dr. Swartz says. Recognizing another's suicidal intentions and acting on your recognition may well prevent a needless tragedy.

Dos and don'ts

“Nothing may be more distressing to someone than hearing a loved one or friend talk about killing himself or herself,” Dr. Swartz notes, “but you may be one (or the only) person who can help him change his course of action. It's a difficult spot, and you should encourage the person to see a mental health care professional as soon as possible. In the meantime, try to find out if there is a detailed plan for committing suicide. If there is, the risk of suicide is both greater and more immediate. Suicidal thinking must be taken seriously and should be evaluated by a professional.

“It is important to know what to do if you find yourself confronted by such talk,” says Dr.
Swartz, who offers the following suggestions for responding to someone who talks to you about suicide:

• Talk to the person in a nonjudgmental way.
• If you can, transport the person to an emergency room or mental health professional's office yourself.
• Remove guns, medications or any other materials that might be used for self-harm.
• Let the person know you care about his or her well being, that these suicidal feelings are temporary and that problems can be solved.
• Don't act shocked when someone talks to you about their suicidal thoughts.
• Don't use maxims like, “You have so much to live for” or “Your family will be devastated.”
• Don't leave someone alone if he or she is in imminent danger of suicide.
• Don't promise to keep secrets or confidences for the person.
• Don't try to counsel the person yourself.

Warning signs

Mental health professionals have identified a number of warning signs that someone is contemplating suicide:

• Verbal threats (“I don't think I'll be around” or “My family is better off without me”)
• Sudden risk-taking or daring behavior
• Dramatic personality changes
• Lack of interest in future plans
• Giving away of prized possessions

Clearly, any history of previous suicide attempts should be kept in mind, because people who have made previous attempts are at a higher risk for committing suicide.

One of the most important risk factors for suicide is depression. Statistics indicate that up to 70 percent of suicide victims suffered from depression or bipolar disorder. Signs that someone is depressed include a change in appetite, weight or sleep patterns; loss of interest in activities that were previously pleasurable; fatigue and feelings of worthlessness or guilt.

When you notice several of these symptoms nearly every day for at least two weeks, depression may well be the cause. Mention to the person whose behavior has changed that you've noticed the changes; try to break through any resistance to talk about it. Early intervention often allows depression to be treated much more effectively, so encourage the person to seek professional advice.

If you know it, keep in mind the family history of someone you think may be suicidal. Mood disorders run in families, and people whose parents have taken their own life are at increased risk of suicide. Men are four times more likely to commit suicide than women, and people you would describe as impulsive, including teenagers, have a higher risk of making suicide attempts.

Suicides can often be prevented with the intervention of caring people. Trust your instincts and express your willingness to help. However, the key is getting someone you are worried about to a trained professional; friends and family should not be in the position of determining if suicidal thoughts or statements are serious.

 Last Updated: 9/18/2003
The Johns Hopkins University 1996-2003.  All rights reserved.  This information is not intended to provide advice on personal medical matters, nor is it intended to be a substitute for consultation.