Suicidal thoughts

How to support someone

Suicide is when someone purposely ends their own life. This factsheet
looks at why someone might think about suicide and how you can help
them.

 People might think about suicide for different reasons.

 If you are worried that someone may be thinking about suicide, talk
to them. Ask them about how they are feeling and offer to help.
 Talking to someone about their suicidal thoughts does not make
them more likely to end their life.
 You can help someone who is feeling suicidal by listening to them
without judging them and trying to help them think about other
options.
 You may need to get crisis help from mental health services or the
emergency services.
 Helping someone with suicidal thoughts is likely to have a big
impact on you. Find out what support is available to you.
 If someone does try to end their life, this is not your fault.

This factsheet covers:

1. What makes someone think of suicide?

2. What are the warning signs that someone feels suicidal?
3. How can I help someone who is feeling suicidal?
4. What services can help someone who is feeling suicidal?
5. Are people with mental illness more likely to feel suicidal?
6. Are self-harm and suicide linked?
7. How can I get support?
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1. What makes someone think of suicide?

There is rarely a single thing that makes someone want to end their own
life. Experts believe that a number of complex issues can make someone
feel this way. 1

If someone is thinking about suicide, they often feel nothing will help with
the problems that are making them feel suicidal.

Certain things can make someone more likely to think about suicide.
These might include:

 difficult life events – such as having a traumatic childhood or

experiencing physical or emotional abuse,2
 something upsetting or life-changing happening such as a
relationship ending or a loved one dying,3
 misusing drugs or alcohol,
 living alone or having little social contact with other people,
 having a mental health condition such as depression,
schizophrenia or personality disorder,4
 having a physical health condition, especially if this causes
pain or serious disability,
 problems with work or money. 5

Why do people choose to end their lives?

A person may choose to end their lives to:

 escape what they feels is an impossible situation,

 relieve unbearable thoughts or feelings,
 relieve physical pain or incapacity.

What kind of thoughts might someone have?

When someone feels suicidal, they may have some of the thoughts listed
below.

 I have let myself and other people down.

 What is the point in living?
 I will never find a way out of my problem.
 I have lost everything.
 Things will never get better for me.
 Nobody cares about me.

Some people might feel confused why they want to take their own life.
Some people may definitely want to die while some people may not care if
they live or die.

Some people feel guilty for thinking about suicide if they have people who
care about them.

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2. What are the warning signs?

A change in someone’s personality and behaviour might be a sign that

they are having suicidal thoughts. You may be the best judge of when
someone you know is behaving differently.

Changes can include:

 becoming anxious, irritable or confrontational.

 having mood swings.
 acting recklessly.
 sleeping too much or too little.
 preferring not to be around other people.
 having more problems with work or studies.
 saying negative things about themselves.

There are some signs that suggest someone is more likely to try suicide.
These include:6

 threatening to hurt or kill themselves,

 talking or writing about death, dying or suicide, or
 actively looking for ways to end their life, such as stockpiling
medication.

It is rare for someone to be certain that they want to end their own life.
Most people will be undecided about suicide, seeing some ‘pros’ and
‘cons’ of living and dying.

A lot of people try to seek help before attempting suicide by telling other
people about their feelings or by self-harming to show people that they are
in emotional pain.

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3. How can I help someone who is feeling suicidal?

If you think that someone may be feeling suicidal, encourage them to talk
about how they are feeling.

Remember that you don’t need to find an answer, or even to completely

understand why they feel the way they do. Listening to what they have to
say will at least let them know you care.

It might help to:

 let the person know that you care about them and that they are not
alone,
 make sure someone is with them if they are in immediate danger,
 try to get professional help for the person feeling suicidal and
support for yourself.

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You could reassure the person that they will not feel this way forever and
that they can get help, including help from a doctor.

If you are not sure that someone is feeling suicidal, you could ask:

 “Are you thinking about suicide?” or

 “Are you having thoughts of ending your life?”

These questions might seem direct but it is better to address the person’s
feelings directly than to skirt around the issue. Most people do not have
this sort of conversation every day and so you may feel uncomfortable and
unsure of what to say. This is entirely normal and understandable.
However, you can help by being calm, supportive and non-judgemental.

Try to see the world as the person sees it. Try to do this without judging,
criticising or blaming them.

What won’t help someone who is feeling suicidal?

When someone tells you that they are feeling suicidal you may feel like
trying to cheer the person up or telling them that they have no reason to
feel like that. These are understandable responses but may not help that
much.

Someone who wants to end their life will not want:

 to feel rejected by friends, family or colleagues,

 people to change the subject when they are talking about how they
feel,
 to be told that they are wrong or silly,
 to be patronised, criticised or analysed,
 to be told to cheer up or ‘snap out of it’,7
 to be told that they should be grateful for having such a good life.

Reassurance, respect and support can help a person recover at this

difficult time.

What if someone is saying they want to end their life now?

Talking about suicide can be a plea for help. Don’t assume that because
someone has talked about suicide they won’t try to take their own life. You
should always take this seriously.

If you talk to someone about their feelings and it seems as though they
want to end their life soon, try to keep them safe in the short term. It is
unlikely that you will be able to make their feelings go away, but you can
help by making them see that there are some things worth living for.

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It might help to: 8

 be supportive and accept what they are telling you,

 ask whether they are thinking about ending their life now or
soon,
 try and get a better understanding of why,
 ask about their reasons for living and dying and listen to their
answers. Try to explore their reasons for living in more detail,
 ask whether they have tried to kill themselves before,
 ask if they have a plan for how they would do it in the future,
 try to make them safe and be open to making reasonable
steps to help them,
 follow up any commitments that you agree to.

If you live with the person, you could also try to remove things from the
house that they could use to take their own life. The kind of thing you
could try to remove depends on the person’s immediate plan for taking
their own life. They could include sharp objects and knives, cleaning
products, medicines and belts. If the person is in crisis, do not leave them
alone.

Section 4 goes into more detail about how to get professional help for
someone.

You can find out more about how to get someone help in the following
factsheets:

 Worried about someone’s mental health?

 Getting help in a crisis

You can download these at www.rethink.org. Or call 0121 522 7007 and
ask for the information to be sent to you.

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4. What services can help someone who is feeling suicidal?

Crisis and home treatment teams

Crisis teams are sometimes also called home treatment teams. They are
part of mental health services. They are help people who are having a
mental health crisis. They should be available 24 hours a day, seven days
a week and are an alternative to going into hospital.

How someone gets help from a crisis team varies between different areas
of the country. You may be able to contact them as a friend or family
member. GPs, Accident and Emergency departments (A & E) and the
police can also ask them to see someone.

You can get more information in our ‘Crisis Teams’ factsheet available
from www.rethink.org. You can also get a hard copy by calling us on 0121
522 7007.
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Accident and Emergency department
If someone is feeling suicidal, you could try and them to a local hospital
that has an Accident and Emergency department (A&E). Staff can speak
to them about how they are feeling and ‘triage staff’ will decide if they need
to be admitted to hospital or not.

You can give A&E staff as much information as possible so they can make
the right decision.

Emergency services
If you think that someone is in urgent danger, is going to try and take their
life immediately or has already tried, call 999.

Other services
 Crisis houses help people in crisis and are an alternative to going
into hospital. Usually people only stay in a crisis house from a
couple of days up to a month. The NHS, charities and other
services run them. They are not available in every area of the
country but you can check what there is locally through the local
crisis team or doing a search online.

 Emotional support services help by listening to someone’s concerns

and giving them space and time to talk through how they feel.
Details of emotional support services are at the end of this
factsheet.

What happens next?

Hospital

When someone is feeling suicidal and has tried to take their own life or
plans to, usually they will be taken to hospital. Sometimes they might be
treated at home or visited regularly by the crisis or home treatment team.

After someone has been in hospital, going back home can be difficult and
someone may still need a lot of support.

Links between services

There should be good links between Accident and Emergency

departments (A&E) and mental health services. However, these links are
not always good enough. 9

A&E do not always pass details onto the local crisis team. If they don’t,
then you can contact the crisis team instead.

Letting someone who is suicidal leave hospital

Doctors should carry out a risk assessment when thinking about

discharging someone from hospital. This might look at whether someone
is feeling suicidal and is thinking about ending their life. Carers should also
be part of this decision if possible.
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Getting more help from mental health services

Some people get passed back to their GP with no other support.

If this happens, the GP should think about asking for help from the local
mental health services such as the Community Mental Health Team
(CMHT). This sort of team can give more specialist help.

The person you are supporting could get help under the ‘Care Programme
Approach’ (CPA) if they meet the criteria. CPA is used to organise many
people’s care who are under mental health services and who have
complex needs.

You can find more information about CMHTs and CPA at www.rethink.org,
or call 0121 522 7007 and ask for the information to be sent to you.

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5. Are people with mental illnesses at greater risk of suicide?

People with mental illnesses are generally more likely to feel suicidal and
try to take their own lives than people who do not have mental illnesses. 10
Research also shows that a person could be more likely to try to end their
own life if they have recently been discharged from a mental health
hospital or unit. 11 At this time, it is important someone gets the right
support.

Making sure that someone attends appointments with health services and
has a care plan in place is important to keep someone well and prevent
them feeling suicidal.

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6. Self-harm and suicide

Self-harm is when someone deliberately tries to harm or injure

themselves. Someone may do this more than once.

There are different views on whether someone trying to take their own life
is the same as self-harm.

People do not normally self-harm to take their own life. Instead, people
can self harm to deal with emotional pain, punish themselves or express
distress to other people. 12

If the person you care for self-harms, they may do this privately and may
not want to talk openly about it. You can try to talk to them about why they
do it. Let them know that you do not judge them and are there to talk if
they need to. If they refuse to stop self-harming then you may be able to
persuade them to do it safely, or to try safer alternative methods. It is
unlikely that they will stop altogether just because you have asked them
to.

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You can get more information in our ‘Self-harm‘ factsheet which you
can download at www.rethink.org.

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7. How can I get support?

If you know someone who talks about or has tried suicide, you might feel
upset, frustrated, confused or scared. These are all normal responses.

Supporting a person who is suicidal is likely to be a stressful time in your

life, and a time when you are likely to need support yourself. You could:

 talk to friends and family,

 talk to someone on an emotional support helpline (see our useful
contacts),
 talk to your own doctor,
 join a support group for carers, friends and family,
 take some time out to concentrate on yourself.

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You can use emotional support telephone services if you want to talk to
someone about how you are feeling. You could tell the person you care for
about these services. You may want to talk to someone about the effect
the situation is having on you.

Samaritans
The Samaritans give people telephone, letter and email emotional and
practical support. Their volunteers are trained in supporting people who
feel suicidal but are able to provide a listening ear to anyone that needs it,
whether or not they are suicidal.

Telephone: 116 123 (UK) (24 hours)

Address: PO Box RSRB-KKBY-CYJK, P.O. Box 90 90, Stirling FK8 2SA
Email: [email protected]
Website: www.samaritans.org

Saneline
This is a national helpline offering emotional support and information for
people affected by mental health problems.

Telephone: 0300 304 7000 (4.30pm – 10.30pm daily)

Email: use their online form www.sane.org.uk/resources/contact_us
Website: www.sane.org.uk

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Support Line
Support line offers confidential emotional support to adults and children by
telephone, email and post. They try to help people find positive ways to
cope, feel strong on this inside and feel better about themselves.

Telephone: 01708 765200 (hours vary)

Address: SupportLine, PO Box 2860, Romford, Essex RM7 1JA
Email: [email protected]
Website: www.supportline.org.uk

CALM (The Campaign Against Living Miserably)

This is an organisation that raises awareness of depression in young men
between 15 and 35. It has a free helpline offering support, advice and
information to young men who need someone to talk to.

Telephone: Outside London 0800 58 58 58. Inside London 0808 802

5858 (5pm – midnight, everyday)
Webchat: via the website
Website: www.thecalmzone.net

Maytree
This is a London-based charity supporting people who feel suicidal. They
offer different services including a place where people can stay for a few
nights and have someone to talk to. It is not a medical service. They have
trained volunteers for people to speak to as well as time for rest and
relaxation. People can only stay there once.

Telephone: 020 7263 7070

Address: 72 Moray Road, Finsbury Park, London, N4 3LG
Email: [email protected]
Website: http://www.maytree.org.uk/

PAPYRUS (prevention of young suicide)

This is an organisation that aims to prevent suicide in young people. It can
offer advice if you are worried about a young person who might be
suicidal.

Telephone: 0800 068 4141

Text: 07786 209697
Email: [email protected]
Web: www.papyrus-uk.org

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 Top
1
NHS Choices. Suicide – Causes. 2016 ]
2
World Health Organisation. Preventing Suicide: A global imperative.
2014.http://apps.who.int/iris/bitstream/10665/131056/1/9789241564779_e
ng.pdf [Accessed March 2016]
3
As note 1
4
Arsenault-Lapierre et al. Psychiatric diagnoses in 3275 suicides: a meta-
analysis. BMC Psychiatry. 2004; 4: 37. Published online 2004 Nov 4.
Available online at http://www.ncbi.nlm.nih.gov/pmc/articles/PMC534107/
[Accessed February 2016]
5
World Health Organisation. Preventing suicide: A resource for general
physicians. 2000:P8-10. www.who.int/mental_health/media/en/56.pdf
[Accessed March 2016]
6
NHS Choices. Suicide Warning signs.
www.nhs.uk/Conditions/Suicide/Pages/warning-signs.aspx [Accessed
February 2016]
7
World Health Organisation. Preventing suicide: A resource at work.
2006: pg19
http://apps.who.int/iris/bitstream/10665/43502/1/9241594381_eng.pdf
[Accessed February 2016]
8
Ramsey, R.F. Suicide Intervention Handbook 10th Ed. Calgary :Living
Works; 2004, pgs 63-70.
9
The College of Emergency Medicine. Mental health in emergency
departments. (2013) pg 11-12 www.rcpsych.ac.uk/pdf/CEM6883-Mental-
Health-in-EDs---toolkit-(FINAL-FEB-2013)-rev1.pdf ]Accessed February
2016]
10
See references 1 and 4
11
Crawford, M.J. Suicide following discharge from inpatient psychiatric
care. Advances in psychiatric treatment, 2004:10; 434-438. Available from
http://apt.rcpsych.org/content/10/6/434.full.pdf+html [Accessed February
2016]
12
Royal College of Psychiatrists. Self-harm, Suicide and Risk: helping
people who self-harm. London: RCPsych; 2010 pg 22-23.

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© Rethink Mental Illness 2014
Last updated March 2016
Next update March 2019

This factsheet is available

in large print.

Last updated 01/10/2010