How to support someone who’s suicidal

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EDITOR’S NOTE: If you or someone you know is struggling with suicidal thoughts or mental health matters, please call the 988 Suicide & Crisis Lifeline by dialing 988 to connect with a trained counselor, or visit the 988 Lifeline website . The International Association for Suicide Prevention and Befrienders Worldwide have contact information for crisis centers around the world.

Despite increasing awareness about mental health , suicide is often still heavily stigmatized and therefore concealed in various ways. Many people keep their suicidal thoughts to themselves, and families writing obituaries often obscure the cause of death when it’s suicide. Even friends and family who want to help may not know how.

“People oftentimes find a reason to turn away from the situation instead of moving towards the person they’re worried about, and I think there’s several really common reasons for that,” said Dr. Christine Moutier, chief medical officer of the American Foundation for Suicide Prevention.

Some of those reasons, such as considering suicidal thoughts to be selfish, contribute to stigma . Others are well-meaning but misguided, like fearing that talking about suicide will make things worse, or are due to a person’s lack of experience with the umbrella of suicidality (which includes suicidal thoughts, plans, attempts and deaths).

Suicide rates in the United States generally steadily rose from 2000 to 2018, and have fluctuated and slightly declined since then according to the US Centers for Disease Control and Prevention. Nearly 48,900 people in the US died by suicide in 2024, and more than 720,000 people worldwide end their lives every year, per the World Health Organization . Suicide is the third-leading cause of death globally among young people ages 15 to 29.

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Additionally, in the US in 2024 “an estimated 14.3 million adults seriously thought about suicide, 4.6 million planned a suicide attempt, and 2.2 million attempted suicide,” according to the CDC . Those numbers suggest there could be many opportunities to intervene, Moutier said.

Many people have difficulty reconciling how they can be simultaneously responsible for being supportive and not at fault for the outcome of someone still dying by suicide. That question leaves many bereaved individuals with painful inner conflict and guilt , as they wonder what they could have done differently to prevent their loved one’s death.

Moutier offers a nuanced answer. “Suicidal people have ambivalence and can be influenced towards hope and survival. There’s lots of research on that,” she said. There are also many anecdotal stories of people who were about to kill themselves but at the last minute thought something like, “If one person looks at me and smiles at me, I’m going to abandon this plan, keep on today and reconsider tomorrow.”

Some part of a person may be actually looking for hope or signals of connection, even if that desire doesn’t appear consciously. That’s why assuming that people who are suicidal are rigidly on that path to end their life isn’t always correct, Moutier added. But there isn’t one cause that leads somebody to suicide — so while you may try everything you can to help them, the person may still die by suicide.

“You can not be fully responsible for someone else, but still believe that we are connected,” Moutier added. “We look to each other, and we actually do all influence … those environmental and social connective features that are really impactful for mental health and, in some cases, suicide risk or protection.”

That’s why learning more about suicide is important.

Before you talk about suicide with someone, know that while you can give love and support, their situation requires professional help you likely aren’t trained to provide. But what can you do? Experts have some advice.

One of the most common myths preventing people from starting conversations about suicide is that talking about it will only make the person struggling at greater risk for taking their life, experts said.

That myth has been clearly debunked by several studies that found discussing suicide does not increase risk ; in fact, it sometimes decreases suicidal ideation and behavior, Moutier said. It can also help people open up and sometimes even take steps toward getting help.

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If you’re worried you might say the wrong thing, you can learn more below about having helpful conversations. And if, despite your best efforts, you still say something considered unhelpful, your loved one may actually appreciate your good intentions and allow room for you to try again.

If you think you’re not close enough with someone to ask what seem like intrusive questions, experts stressed that the matter of life or death is more important than social norms and potential offense.

On that note, never assume that someone has other people regularly checking in on them unless that person has said so, said Dr. Urszula Klich, a clinical psychologist in private practice in Atlanta. Even if that person has family and friends, that doesn’t mean they are being supported. That assumption can result in the bystander effect — everyone assumes someone else will step in, so no one does.

Spotting risk factors and warning signs of suicide can be difficult, and even experts can’t always predict who is at risk and whether and when those people will actually attempt to end their lives, clinical psychologist Dr. Justin Baker told CNN in a previous story .

People handle stressors differently, and there isn’t always a long timeframe during which someone is considering suicide and showing signs. Sometimes there are only 5 to 15 minutes between someone deciding to attempt suicide and doing it, Baker added.

Other times, a person who is suicidal and planning for a longer period of time will show behavioral and/or emotional changes, experts said. Below are some signs and risk factors, but for more detail, read this story .

Unusually reckless behavior that could lead to death, such as unsafe driving or excessive alcohol intake

Obsession with death or lethal means

Easy access to potentially lethal means

Loss of interest in activities or school

Practicing or preparing for suicide, which can look like exhibiting unusual behaviors with weapons, pills or other potentially lethal items

Giving away belongings

Emotional or mental signs

Personal history of suicidality

Mental and personality disorders, especially when paired with a lack of treatment

Experiences of abuse, neglect, severe physical illnesses, job or financial loss, relationship problems or loss, or other traumas and stressors

Mood swings (this includes anger and suddenly calm or cheeriness, since they may have privately decided to end their life and feel relieved by that)

Insufficient social support or a sense of isolation

Feeling like they have no reason to live

Comments that indicate feeling like they don’t belong or like a burden on people

Talking about feeling suicidal or wanting to die, by suicide or otherwise (even if someone jokes about this, checking in is still worthwhile)

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The American Foundation for Suicide Prevention has a play-by-play guide for discussing suicidality, which includes recommendations for specific phrases, questions to ask and next steps. The advice in this section is based on that guide and on insights from the experts CNN interviewed.

If you have noticed signs that someone may be struggling, you can try to set up a time to connect in person or over the phone. During that, you can start by simply asking them, “How are you doing for real?” If they don’t mention any issues, ask them about suicide directly.

You might say, “I care about you and I’ve noticed your mood has been different lately. I know your job loss has been really hard on you too. It makes me wonder if that ever makes you feel like ending your life?”

You can even use phrases like “killing yourself” — while that may sound harsh, plain language helps reduce stigma, unlike the phrase “committing suicide.” But phrasing the question as “You’re not having suicidal thoughts, are you?” can seem judgmental or like you’re not actually interested in talking, Moutier said.

If they confirm having suicidal thoughts or if they came to you without your asking, you might feel alarmed or like you need to lecture them on the impact their death would have on others, Roeske said. Or maybe you want to urge them to have gratitude and know that their situation could be worse, to realize they have so much to live for, or to believe that everything happens for a reason.

But experts say such responses can come off as insensitive, judgmental, dismissive and guilting. They can lead someone to feel more alone, which can further deter them from seeking connection or help. “When you bring it up matter-of-factly, and you respond matter-of-factly, that normalizes the person, it humanizes them,” Klich said.

Controlling your emotions and thoughts and listening more than you speak is the important thing, said Dr. Michael Roeske, clinical psychologist and senior director of the Newport Healthcare Center for Research and Innovation.

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That person just shared something incredibly private and important with you, and suicidal thoughts don’t always mean the person is in immediate danger, Moutier added. “Say, ‘Thank you for trusting me with that. I’d love to know more about what that’s like for you and when it comes up.’”

Try to validate their reasons for feeling suicidal without condoning suicide as a solution, Roeske said — such as by saying, “I’m so sorry that you’re dealing with this. That does sound really difficult.”

Ask them what they do and what helps when they have suicidal thoughts and if they have thoughts of a plan for attempting suicide — if they have a plan, they might need immediate help, so see steps for calling in emergency professional help in the last section of this story. Be curious about the details of their experiences and ask if they’re seeing a mental health professional. Ask how their hard times have affected other parts of their life, if at all — maybe they have been isolating or struggling to keep up with work.

Their answers can influence how you approach future talks or efforts to be supportive. Or even if there’s nothing you can do with the information, your exchange still might be useful if it makes the person consider what else could make them feel better or because the connection alone is helpful.

Reassure them that you care about their life, that you can get through it together and that nothing they told you changes how you feel about them. You can even offer to help them call their insurance or look online for a therapist or mental health treatment center , or just sit with them while they do it. If they’re nervous about any first in-person appointments, offer to take them to those sessions if that’s feasible for you.

After that initial conversation, knowing how and when to touch base over time can be difficult. Life gets busy, or maybe you care but don’t want to overstep.

If that person said they don’t have a plan and doesn’t bring up their suicidal thoughts again, that doesn’t mean they’re better. Again, ideation can turn into plans or attempts — another reason you should still check in regardless, maybe every few days. Not doing that can imply you’re actually not open to discussing the issue again. You can text, call or hang out in any setting, Moutier said. And don’t always limit the conversation to the person’s mental health — they’re still a whole, multifaceted person.

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You can also ask someone what would make them feel supported.

And if they have repeatedly been reluctant to seek professional help, trying to force them to most likely won’t be the most effective path toward them taking steps to get help, Moutier said.

If a person’s suicidality starts to transition from passive to more active, that’s when professional intervention is more critical, especially if they already have a history of attempting suicide, experts said — that’s also when you can increase your support if feasible for you. That shift can look like them going from passively wishing they wouldn’t wake up in the morning, to them feeling unsure that they can behave safely or them mentioning suicide methods or imminent plans. They might also show more warning signs, including sudden improvement in mood, Roeske said.

If you’re wondering how often it would be appropriate to touch base with someone who’s more urgently suicidal, daily or every other day is good, Moutier said. If they explicitly tell you about a plan, if you’re unsure that they’ll stay safe or if you’re overwhelmed, call 988 on their behalf or with them. Trained counselors can tell you what to do next or help the person cope or find local resources.

Sometimes people who are struggling may have been leaning on only one person in confidence. But involving others despite the individual’s wishes is appropriate if their condition is worsening, Roeske said. You can ask that person if they want to be included in your reach outs to their loved ones; and if not, proceed without them.

If you know someone is about to attempt suicide immediately or is actively harming themselves, call 911, Moutier said. Some cities have alternatives to the police that are trained to intervene in mental health emergencies, including nonprofit organizations and city government mental health departments. You can look for those online to know their phone numbers ahead of time.

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Finding yourself in the room during an imminent or ongoing attempt is rare, but if it happens, never put yourself in danger, Moutier said. You can try basic deescalation techniques as much as possible, she and Roeske added — including speaking in calm, low tones; creating distance between the person and the lethal means involved; and keeping the conversation going until help arrives.

When you’re supporting a loved one who’s suicidal over a long period of time, make sure you’re taking care of yourself too, experts said. Even if you understand their struggles, knowing they want to die and fearing they’ll follow through with that can be painful and anxiety-inducing.

Take moments for yourself, do things you enjoy and talk to a therapist if needed. Certain complicated emotions you might feel when a loved one wants to take their life, such as anger or rejection, are better navigated with a professional. The healthier you are, the better support you can be.

More mental health resources

If you live in the United States and are facing insurance or financial barriers, Mental Health America has guidance for finding more accessible care.

The United Kingdom-based charity Mind has various mental health helplines .

The International Association for Suicide Prevention and Befrienders Worldwide provide contact information for crisis centers around the world.

Australia’s Butterfly Foundation runs a call center (at 1800-33-4673) and online chat from 8 a.m. to midnight Australian Eastern Time every day.

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编者按：如果您或您认识的人正遭受自杀念头或心理健康问题的困扰，请拨打988自杀与危机生命线，联系受过专业训练的咨询师，或访问988生命线网站。国际预防自杀协会和Befrienders Worldwide提供世界各地危机中心的联系方式。

尽管人们对心理健康的认识不断提高，但自杀仍然常常被严重污名化，因此也常常以各种方式被掩盖。许多人会将自杀念头藏在心底，而家人在撰写讣告时也常常隐瞒自杀的死因。即使是想要提供帮助的亲朋好友，也可能不知道该如何下手。

“人们常常会找各种理由逃避现实，而不是走向他们所担心的人，我认为这其中有很多非常常见的原因，”美国预防自杀基金会首席医疗官克里斯汀·穆蒂埃博士说。

有些原因，例如认为有自杀念头是自私的，会加剧人们对自杀的歧视。另一些原因虽然出于好意，但却是错误的，例如担心谈论自杀会让事情变得更糟，或者是因为人们对自杀倾向（包括自杀念头、计划、尝试和死亡）缺乏了解。

据美国疾病控制与预防中心的数据显示，2000年至2018年间，美国的自杀率总体呈稳步上升趋势，此后虽有波动，但略有下降。世界卫生组织的数据显示，2024年美国约有48900人死于自杀，全球每年有超过72万人结束自己的生命。自杀是全球15至29岁年轻人死亡的第三大原因。

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研究表明，如果你的孩子出现社交退缩，就要警惕更严重的问题。

此外，据美国疾病控制与预防中心（CDC）估计，到2024年，美国“约有1430万成年人认真考虑过自杀，460万人计划过自杀，220万人尝试过自杀”。穆蒂埃表示，这些数字表明，我们有很多机会可以进行干预。

许多人难以理解，如何既能给予支持，又能不对自杀者的最终结局负责。这个问题让许多失去亲人的人内心充满痛苦的矛盾和愧疚，他们会不断反思自己是否还能做些什么来阻止亲人的死亡。

穆蒂埃给出了一个更为细致的答案。“有自杀倾向的人内心充满矛盾，他们很容易受到希望和求生念头的影响。这方面有很多研究，”她说。此外，还有许多轶事，讲述的是一些人原本打算自杀，但在最后一刻却想：“如果有人看着我微笑，我就放弃这个计划，继续过今天，明天再重新考虑。”

即使这种渴望并非有意识地表现出来，但人内心深处可能仍然在寻求希望或情感联结。穆蒂埃补充说，这就是为什么认为有自杀倾向的人就铁了心要结束生命并不总是正确的。但导致自杀的原因并非单一——所以，即使你竭尽所能地帮助他们，他们最终仍有可能选择自杀。

“你不可能对另一个人负全责，但仍然相信我们彼此相连，”穆蒂埃补充道。“我们互相仰望，而且我们确实都在影响……那些对心理健康，在某些情况下对自杀风险或预防具有重要影响的环境和社会联系因素。”

所以，多了解自杀问题很重要。

在与他人谈论自杀之前，请记住，虽然你可以给予他们爱和支持，但他们的情况需要专业的帮助，而你可能并没有接受过这方面的培训。那么，你能做些什么呢？专家们有一些建议。

专家表示，阻碍人们谈论自杀的最常见误解之一是，谈论自杀只会让正在经历痛苦的​​人面临更大的自杀风险。

穆蒂埃表示，多项研究已经明确驳斥了这种说法，研究发现讨论自杀并不会增加自杀风险；事实上，它有时还能降低自杀意念和行为。此外，它还能帮助人们敞开心扉，有时甚至促使他们采取行动寻求帮助。

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如果你担心自己会说错话，可以继续阅读以下内容，了解如何进行有效的沟通。即使你尽了最大努力，仍然可能说了一些不太中听的话，你的亲人或许会感激你的好意，并给你再次尝试的机会。

如果你认为你和某人关系不够亲密，不宜问一些看似冒犯的问题，专家强调，生死攸关的事情比社会规范和潜在的冒犯更重要。

亚特兰大私人执业临床心理学家乌尔苏拉·克利奇博士指出，除非当事人明确表示，否则永远不要想当然地认为有人会定期关心他们。即使当事人有家人和朋友，也不代表他们就能得到支持。这种想当然可能会导致旁观者效应——每个人都认为会有人出手相助，结果反而没有人真正行动。

临床心理学家贾斯汀·贝克博士在之前接受 CNN 采访时表示，发现自杀的风险因素和预警信号可能很困难，即使是专家也无法总是预测谁有风险，以及这些人是否以及何时会真正尝试结束自己的生命。

每个人应对压力的方式都不同，而且一个人考虑自杀并表现出自杀迹象的时间跨度也不总是很长。贝克补充说，有时从决定自杀到实际实施自杀，可能只有5到15分钟的时间。

专家表示，有时，有自杀倾向且计划较长时间的人会表现出行为和/或情绪上的变化。以下是一些迹象和风险因素，但更多详情请阅读这篇文章。

异常鲁莽的行为，例如不安全驾驶或过量饮酒，可能导致死亡。

对死亡或致命手段的痴迷

容易获得可能致命的手段

对活动或学校失去兴趣

自杀行为，包括练习或准备自杀，可能表现为使用武器、药物或其他潜在致命物品的异常行为。

赠送物品

情绪或心理迹象

个人自杀史

精神和人格障碍，尤其是在缺乏治疗的情况下。

遭受虐待、忽视、罹患严重疾病、失业或经济损失、人际关系问题或破裂，或其他创伤和压力事件

情绪波动（包括愤怒和突然平静或愉悦，因为他们可能已经私下决定结束自己的生命，并因此感到解脱）

社会支持不足或孤独感

感觉自己没有活着的理由

那些表达觉得自己格格不入或觉得自己是别人负担的言论

谈论有自杀倾向或想要死亡的想法，无论是自杀还是其他方式（即使有人对此开玩笑，关心一下仍然是值得的）。

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全球近12亿人患有精神障碍。而且这个数字还在不断增长。

美国预防自杀基金会提供了一份关于如何讨论自杀倾向的详细指南，其中包括一些关于具体措辞、提问方式和后续步骤的建议。本节中的建议基于该指南以及CNN采访的专家们的见解。

如果你发现有人似乎遇到了困难，可以尝试安排时间与他们见面或电话沟通。沟通时，你可以先简单地问问他们：“你最近过得怎么样？”如果他们没有提及任何问题，你可以直接询问他们是否有自杀倾向。

你可以说：“我很关心你，我注意到你最近的情绪不太好。我知道你失业对你打击很大。这让我不禁想，你有没有想过结束自己的生命？”

你甚至可以使用“自杀”这样的短语——虽然这听起来可能很刺耳，但直白的语言有助于减少污名化，这与“自杀身亡”的说法截然不同。但穆蒂埃表示，把问题问成“你没有自杀念头吧？”可能会显得带有评判性，或者让人觉得你根本不想和你谈。

如果他们证实自己有自杀念头，或者未经你允许就主动找你倾诉，你可能会感到担忧，或者觉得需要向他们讲解他们的死亡会对他人造成怎样的影响，罗伊斯克说。又或许，你想鼓励他们心怀感恩，明白自己的处境可能更糟，意识到自己还有很多值得珍惜的东西，或者相信一切的发生都有其原因。

但专家表示，这样的回应可能会显得冷漠、带有评判性、轻蔑且令人内疚。它们会让对方感到更加孤独，从而进一步阻碍他们寻求帮助或建立联系。“当你以平常心提出问题，并以平常心回应时，这会让对方感到被正常化，让他们更有人情味，”克利奇说道。

纽波特医疗保健研究与创新中心高级主任、临床心理学家迈克尔·罗斯克博士说，控制自己的情绪和想法，多听少说，这才是最重要的。

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那个人刚刚跟你分享了一些极其私密且重要的事情，而且有自杀念头并不总是意味着这个人处于迫在眉睫的危险之中，穆蒂埃补充道。“你可以说，‘谢谢你信任我，把这些告诉我。我很想更多地了解你的感受，以及你什么时候会想到这件事。’”

罗伊斯克说，要试着理解他们产生自杀念头的原因，但不要纵容自杀作为一种解决办法——比如可以说：“我很抱歉你正在经历这些。这听起来确实很艰难。”

询问他们有自杀念头时会做什么，什么方法对他们有帮助，以及他们是否有自杀计划——如果他们有计划，可能需要立即寻求帮助，请参阅本文最后一部分中关于如何联系紧急专业帮助的步骤。要对他们的经历细节感兴趣，并询问他们是否正在接受心理健康专家的帮助。询问他们的困境是否影响了生活的其他方面——例如，他们是否感到孤立无援，或者是否难以应付工作。

他们的回答可能会影响你未来如何与他们交谈或如何给予支持。即使你无法利用这些信息做什么，你们的交流仍然可能是有益的，因为它能让对方思考还有什么能让他们感觉好一些，或者仅仅是交流本身就很有帮助。

让他们知道你关心他们的生活，你们可以一起度过难关，而且无论他们说什么，你对他们的感觉都不会改变。你甚至可以主动提出帮他们联系保险公司，或者上网查找心理咨询师或心理健康治疗中心，或者只是陪着他们一起做这些事。如果他们对第一次面诊感到紧张，如果条件允许，你可以主动提出陪同他们一起去。

初次交谈之后，如何以及何时保持联系可能比较困难。生活会变得忙碌，或者你可能很关心她，但又不想越界。

如果对方说他们没有计划，也没有再提起自杀念头，这并不意味着他们的情况就好转了。再次强调，想法可能会发展成计划或行动——这也是为什么无论如何你都应该关心他们，也许每隔几天就关心一下。不这样做可能会让人觉得你其实并不想再讨论这个问题。穆蒂埃说，你可以发短信、打电话，或者在任何场合见面。而且不要总是把谈话内容局限于对方的心理健康——他们仍然是一个完整、多面的人。

奥尔加·亚斯特雷姆斯卡/iStockphoto/Getty Images

无论好坏，年轻人正在转向人工智能聊天机器人寻求情感支持。

你也可以问问别人，怎样才能让他们感到被支持。

穆蒂埃说，如果他们一直不愿寻求专业帮助，强迫他们寻求帮助很可能不是让他们采取措施获得帮助的最有效途径。

专家表示，如果一个人的自杀倾向开始从被动转变为主动，那么专业干预就显得尤为重要，特别是如果他们已有自杀未遂史——如果条件允许，此时你也可以加大支持力度。这种转变可能表现为：他们从被动地希望自己不要醒来，转变为不确定自己能否安全行事，或者提及自杀方法或即将实施的计划。罗伊斯克指出，他们也可能出现更多预警信号，例如情绪突然好转。

穆蒂埃表示，如果你想知道多久联系一次有严重自杀倾向的人比较合适，每天或隔天联系一次都行。如果他们明确告诉你他们的自杀计划，如果你不确定他们能否保证自身安全，或者如果你感到不知所措，请代表他们或与他们一起拨打988。受过专业训练的咨询师可以告诉你下一步该怎么做，或者帮助当事人应对困境，或找到当地的资源。

罗伊斯克表示，有时，一些身处困境的人可能只信任一个人。但如果他们的病情恶化，即使当事人不愿意，也应该让其他人参与进来。你可以询问当事人是否愿意参与你联系他们亲友的行动；如果他们不愿意，那就先不联系他们。

穆蒂埃说，如果你知道有人即将自杀或正在自残，请立即拨打911。一些城市设有除警察之外的其他机构，这些机构受过专门训练，可以介入精神健康紧急情况，包括非营利组织和市政府精神健康部门。你可以在网上查找这些机构的电话号码。

插图：康妮·陈（CNN）

只需两分钟的这种心理练习，你的大脑就能开始发生变化。

穆蒂埃说，在即将发生或正在进行的袭击中身处同一房间的情况虽然罕见，但如果真的发生了，千万不要让自己身处险境。她和罗斯克补充说，你可以尽可能尝试一些基本的缓和冲突的技巧，包括用平静低沉的语气说话；拉开对方与致命武器之间的距离；以及在救援人员到达之前保持对话。

专家表示，当你长期陪伴有自杀倾向的亲人时，一定要照顾好自己。即使你理解他们的挣扎，但知道他们想死，并担心他们会真的这么做，仍然会令人痛苦和焦虑。

给自己一些独处的时间，做自己喜欢的事情，如果需要的话，可以和心理咨询师谈谈。当亲人想要结束生命时，你可能会感到一些复杂的情绪，比如愤怒或被拒绝感，这些情绪最好在专业人士的帮助下进行处理。你的身心越健康，就能更好地给予他人支持。

更多心理健康资源

如果您居住在美国，并且面临保险或经济方面的障碍，美国心理健康协会 (Mental Health America) 可提供指导，帮助您找到更便捷的医疗服务。

总部位于英国的慈善机构 Mind 设有多个心理健康热线。

国际预防自杀协会和全球互助组织提供世界各地危机中心的联系信息。

澳大利亚蝴蝶基金会每天从澳大利亚东部时间早上 8 点到午夜开通呼叫中心（电话：1800-33-4673）和在线聊天服务。