How to Ask the Question: Are You Thinking About Suicide?

When someone shows warning signs of suicide, those around them are often at a loss: What should I do? What should I say? A critically important starting point is to simply ask the question: “Are you thinking about suicide?”

It’s a myth that asking this question will somehow plant a seed in someone’s mind. In fact, it shows that someone saw and someone cares.

“People may already have had the thought and you asking the question, research tells us, often provides relief,” said Thomas Otten, Vice President of Behavioral Health. “Asking the question gives the person an open door to respond honestly.”

The risk of suicide is too serious to ignore. Consider these statistics:

• Suicide remains a leading cause of death in the United States, with a 4% increase between 2020 and 2021.
• It’s the 10^th leading cause of death in South Dakota, but it was the No. 1 cause of death for people ages 10–29 in 2021.
• Provisional data from the Centers for Disease Control and Prevention shows that in 2022, almost 50,000 suicide deaths happened in the U.S.
• In 2021, South Dakota Department of Health reported 198 suicide deaths — the highest number since tracking began. It was an increase of 48% compared to the numbers one decade ago.

The devastation left in the wake of suicide leaves no question that prevention is critical.

Understand the Warning Signs of Suicide

It’s important that we all are informed about the warning signs of suicide. Knowledge allows us to recognize when someone is at risk and then support them in getting help.

Warning signs of suicide include, but aren’t limited to:

• Expressions of hopelessness or feeling trapped
• Talks about feeling empty or having no reason to live
• Increase in drug and alcohol use
• Loss of interest in things they used to enjoy

Other significant events, such as going through a current crisis like divorce, job loss, legal issues or financial problems, can lead to thoughts of self-destruction. Suicidal thoughts change fast, so asking the question isn’t a one-time thing. If you’re concerned about someone, stop and ask the question.

How to Ask If Someone Is Considering Suicide

Approaching a person you’re concerned about can be difficult and should be handled sensitively. Allow these tips to guide you through the process:

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• Be compassionate.
• Allow the individual to express themselves in full.
• Actively listen.
• Reaffirm that their concerns and pain are valid — and they are worthy of help and recovery.
• Be courageous and ask the question: “Are you thinking about suicide?”

If the person answers “yes,” be sure to help them take the following steps:

• Remove means of self-harm. “Suicidal thoughts are fluid,” said Otten. “Even a person who received help and denied having thoughts of suicide could begin to have suicidal thoughts at a later time. They can remain at risk of an impulsive attempt.”

Because of the high impulsivity of suicide, it’s important to modify our environment to increase safety. It’s recommended to immediately remove firearms, medication and other means of self-harm from the living space of someone struggling with their mental health.

• Create a plan for help — together. The individual should get help as soon as possible. Remain with the person until they can be evaluated. You can contact 988 from anywhere, at any time. Professionals will walk you through the crisis.
• Praise the person for their courage.

“It’s courageous to admit you’re struggling with suicidal thoughts,” said Otten. Praise the individual for the courageous choice they made in sharing honest thoughts with you.

What to Avoid When Talking About Suicide

• Don’t minimize their pain or lecture them about things they should be grateful for. This can be very invalidating and lead to isolation as it may reinforce the distorted belief that “No one understands.”
• Don’t try to fix them. “You wouldn’t fix someone having severe chest pain all by yourself,” said Otten. “Leave the evaluation and treatment to the professionals. It’s your role to connect the individual to an expert.”
• Make sure you follow up. A person who’s receiving help will appreciate your support. Along the journey, continue to check in and share your support.

“We need everyone to help in this fight,” said Otten. “Everyone can make a difference; if you’re willing to ask the question, you can, too.”