Talking openly about suicide does not raise the risk. Experts explain the warning signs, what to say and what to avoid.

Suicide is still surrounded by stigma, so many people hide their suicidal thoughts. Friends and relatives who want to help often hold back because they fear saying the wrong thing.

The World Health Organization says more than 720,000 people die by suicide every year. Among young people aged 15 to 29, it is the third-leading cause of death worldwide.

Talking About It Does Not Make Things Worse

The biggest myth is that asking about suicide puts the idea in someone’s head. Dr Christine Moutier, chief medical officer of the American Foundation for Suicide Prevention, says studies have disproved this. Talking about it does not raise risk. In some cases, it lowers suicidal thoughts and behaviour, and it can help people open up and seek help.

Many people stay silent because of stigma. Some see suicidal thoughts as selfish, while others simply fear making things worse. Whatever the reason, experts say you should not wait. If you are not close to the person, remember that a life matters more than social awkwardness.

Also, do not assume that someone else is already checking in. Clinical psychologist Dr Urszula Klich warns that everyone often assumes this, and so nobody steps in. And if you say the wrong thing, the person may still value your good intentions and let you try again.

Warning Signs to Watch For

Even experts cannot always predict who is at risk or when. Some people show changes over a long period, while for others the window is very short. That is why any worry is worth acting on.

Changes in behaviour may include:

• Heavy use of alcohol or drugs
• Unusually reckless behaviour, such as unsafe driving
• A strong focus on death
• Loss of interest in activities, work or school
• Giving away belongings
• Unusual behaviour around items that could cause harm

Changes in feelings and circumstances may include:

• Hopelessness, or feeling there is no reason to live
• Mood swings, including sudden calm or cheerfulness after a low period
• Isolation and a lack of support
• A past history of suicidal thoughts
• Untreated mental health conditions
• Major stress, such as abuse, serious illness, job or money loss, or the end of a relationship

Things the person says may include:

• Feeling like a burden or that they do not belong
• Talking about wanting to die, even as a joke. It is still worth checking in.

How to Start the Conversation

Pick a time to connect in person or by phone. Begin with a simple question, such as “How are you doing, for real?”

If they do not mention any problems, ask directly. For example: “I care about you, and I’ve noticed your mood has changed lately. Are you thinking about ending your life?”

Plain words like “killing yourself” can sound harsh, but they help reduce stigma. Say “died by suicide” instead of “committed suicide.” Avoid questions such as “You’re not suicidal, are you?” Moutier says they sound judgmental, as if you do not really want to talk.

What to Do Once They Open Up

Stay calm, and listen more than you speak. Dr Michael Roeske, a clinical psychologist, says this matters most. Responding in a matter-of-fact way helps the person feel normal and human, according to Klich.

You may feel alarmed. Even so, try not to lecture the person about how their death would hurt others. Do not tell them to be grateful, that things could be worse, that they have so much to live for, or that everything happens for a reason. Experts say these replies sound dismissive and guilt-inducing, and they can leave the person feeling more alone.

Know What You Can and Cannot Do

You can offer love and support, but someone in this situation needs professional help that you are probably not trained to give. Encourage them to see a doctor or mental health professional.

People with suicidal thoughts are often torn, according to Moutier. A kind word or a sign of connection can push them towards hope. Still, there is no single cause of suicide. You can do everything you can and the person may still die. You cannot be fully responsible for another person’s life, but you can stay connected to them.

Where to Get Help

If someone is in immediate danger, call your local emergency number or take them to the nearest hospital, and do not leave them alone.

The International Association for Suicide Prevention and Befrienders Worldwide list crisis centres around the world. In the United States, you can dial 988 to reach the Suicide & Crisis Lifeline.