How to identify and address suicidal thoughts

Suicide is the act of taking one’s own life, and it is one of the leading causes of death in the United States. From year to year, this public health crisis takes the lives of thousands of people. In fact, in 2022 alone, nearly 50,000 people in the U.S. died by suicide.

However, the number of people who have had suicidal ideations, which is a very broad term used to describe thoughts about suicide or suicide attempts, is far higher. According to the Centers for Disease Control and Prevention (CDC), an estimated 12.3 million American adults seriously thought about suicide; 3.5 million planned a suicide attempt; and 1.7 million attempted suicide in 2021.

This is why, experts say, it’s crucial to recognize that suicide is preventable. Understanding what suicidal ideation is and how to support someone who is dealing with suicidal thoughts can save lives.

Common signs of suicide

According to Dr. Brian Miller, medical director of Behavioral Health Services at Sharp Grossmont Hospital, people who have thoughts of suicide may or may not have a plan to attempt it. For some people, they may simply need to work through their thoughts and emotions with a trusted individual. For others, they might be in crisis and are at immediate risk of suicide.

Some signs that a person may be thinking about suicide, include:

• Increasing their use of alcohol or drugs

• Sleeping too little or too much

• Withdrawing or exhibiting signs of isolation

• Showing loss of interest in living or feeling hopeless

• Searching for means of suicide online

• Giving away personal possessions

• Texting people “goodbye”

Additionally, there are risk factors that can influence suicidal thoughts and suicide as a whole. These include having previous suicide attempts, a family history of suicide, lack of access to mental health care, and access to lethal means, including firearms or drugs.

Most people who are considering suicide will talk about it or show one or more behaviors before attempting suicide, Dr. Miller says. Being aware and not neglecting these signs can provide an opportunity for intervention and prevention.

"Suicide can occur impulsively and without much consideration," Dr. Miller says. “Simply providing support and listening may alter the course someone has started. Don't feel pressure to have all the answers, just being available can be enough.”

Taking steps to save a life

Suicide isn’t an easy topic to talk about, but such loss has significant effects on individuals, families and communities. This is why starting the conversation about suicide is so vital.

If you notice any signs of suicidal ideation, take immediate action with the at-risk person, Dr. Miller advises. It’s especially important to talk with them, show them they aren’t alone, and get them the help they need so it doesn’t reach a point of crisis.

“It can be upsetting and distressful to bring up suicide with someone you care about, but it’s critically important to do so when you have concerns about safety,” says Dr. Miller. "You may find out that things are being managed appropriately, and you will, at least, be identified as someone they could turn to if needed.”

Jennifer Rivera, manager of Behavioral Health Services at Sharp Grossmont, agrees. She adds that if you don’t feel comfortable speaking to the person at risk for suicide, immediate intervention could mean contacting a spouse, parent or counselor.

Rivera offers the following tips for helping someone who may be at risk for suicide:

• Give the individual your undivided attention and address them face-to-face. Body language and facial expression can be indicative of severe depression.
  

• Ask open-ended questions that lead with observations. For example, you might say, “I noticed you haven’t been attending class or answering phone calls or texts. I know your mom passed away last week. How are you feeling? How much sleep are you getting at night or during the day? What do you need to get through this difficult time?”
  

• Then ask directly, “Are you having thoughts about ending your life?” You might also ask if they are feeling impulsive or considering doing things that are risky. This can include reckless driving, using illicit drugs, drinking and driving, or consuming more medication then prescribed.
  

• Keep the individual safe by reducing their access to lethal means, such as firearms.
  

• Help them connect with the 988 Suicide & Crisis Lifeline by calling or texting 988 or by texting the Crisis Text Line number, 741741. You can also help connect them with people they trust, such as a family member, friend, spiritual advisor or mental health professional.

Lastly, it’s important to stay in touch with the individual after a crisis, Rivera says. By following up with them to see how they are doing, you show that you care about them and that they aren’t alone in their journey.

"Being aware and not neglecting the warning signs of suicide can provide an opportunity for intervention and prevention,” says Dr. Miller. “And it may help save someone’s life.”

If you or a loved one is in crisis, call 911 or the 988 Suicide & Crisis Lifeline, which is available 24 hours a day by calling or texting 988 from anywhere in the country. For additional assistance, mental health professionals at Sharp can help.