First, take a deep breath. When someone tells you that they are thinking of suicide, different thoughts or emotions may came up for you. 

The best way to help is to show concern and compassion. You can say something like, “Things must be really hard for you to be feeling that way”. Let them know you are there to listen. Encourage them to share what they are feeling by asking open-ended questions. You can let them know that people sometimes feel like there is no answer to their pain, but that accessing help and supports can help them to feel better. 

If you are able to, tell them you can support them to find help. You can also work with them to brainstorm other members of their support team, who may be able to assit in finding help. 

Lastly, it is important to ask if they have a specific suicide plan, and access to the means in that plan. If they answer yes to both questions, do not leave them alone. The presence of a specific suicide plan may indicate that they are at a higher risk of suicide and may be in crisis. Help them to access more immediate care by calling a crisis service*, taking them to a doctor, mental health professional, or your local emergency department. If you believe they are in crisis, you can call 911.

*If you are located in Waterloo Region or Wellington County, the local crisis line is Here 24/7: 1-844-437-3247.

When someone is struggling with thoughts of suicide, we have an opportunity to listen. Thoughts of suicide may happen when someone has intense, emotional or psychological pain and cannot recognize or access other forms of help or solutions to this pain. People with lived experience often share that they did not want to die but were struggling to live, and in hindsight wished for the opportunity to talk openly about their struggles.  Changing the narrative around suicide and encouraging understanding can create spaces where individuals feel more comfortable in coming forward to seek help.  Professional help and support, including medication, therapy, as well as strong community-based relationships and connections are important, as they can support the individual and help them to develop coping mechanisms and potential solutions to their problems or pain. The best way to prevent a suicide is to encourage the person at risk to get the help and support that they need and deserve.

There can be many reasons why someone may refuse professional help. Some reasons might be:

• Feeling overwhelmed at the idea of talking to a doctor or mental professional
• Disagreements regarding the need for help
• Concerns about cost, privacy, or confidentiality
• Concerns about the cultural responsiveness or appropriateness of mental health care
• The presence of stigma regarding mental health and suicide

Understanding the reasons why someone might refuse professional support may allow you to try and address their concerns or fears. You can continue to tell them that you are concerned about them, and you can share information about community and professional resources. Let them know that you are there to listen, and offer help finding or getting to a doctor, mental health professional or hospital emergency room.

If you are concerned that the person will hurt themselves, help them to access more immediate care by calling a crisis service*, taking them to a doctor, mental health professional, or your local emergency department. If you believe they are in crisis, you can call 911.

*If you are located in Waterloo Region or Wellington County, the local crisis line is Here 24/7: 1-844-437-3247.

While, privacy is important,  your friend’s safety and their life is more important. A friend may want you to promise not to tell because they are embarrassed or ashamed of their thoughts of suicide. They may also be worried about what “getting help” means. However, if a friend is having thoughts of suicide, this is too heavy for anyone to carry alone. It is important to tell someone you trust about your friend and ask for their assistance in getting your friend professional help and support.

Self-harm or self-injury, often referred to as non-suicidal self-injury (NSSI), is when someone purposely injures or hurts themselves as a coping mechanism. Many people who self-harm are not suicidal and do not attempt suicide.

However, because of its nature, self-harm and self-injury are often signs that someone is struggling with deep, emotional pain. In some cases, self-harm and self-injury can be a warning sign that someone is at risk for suicide.    Whether or not they have thoughts of suicide, someone who is intentionally hurting themselves needs help. If you have a loved one who self-harms, encourage them to reach out for support and to seek help.

More information about non-suicidal self harm can be found at: Self-Injury Outreach and Support (sioutreach.org)

No, that is not true. Many people who die by suicide tell someone they plan to hurt themselves before they take their lives. When someone tells you they are thinking of suicide, they are giving you a precious opportunity to help before it’s too late. All mentions of suicide should be taken seriously.

To learn more about supporting others, visit: 

• How Do I Start the Conversation
• How Do I Connect Someone to Help?

Stigma and myths about suicide still exist. In the past, people who have thoughts of suicide or have died by suicide have been labelled as crazy, selfish, or as having a moral defect. As well, some people may believe that talking about suicide will encourage suicidal behaviours, or they might be concerned that they will say the wrong thing, making a person in distress feel worst.

As awareness and education about suicide continues, many people are becoming less fearful and more willing to listen to a person in distress with empathy and compassion.

Suicide can be prevented and everyone has a role to play. Recognizing the risk factors and warning signs of suicide can help to save lives. Equipped with information, even untrained people can intervene to get help for suicidal or at-risk family members, friends, or acquaintances. Some people seem to be more inclined and better equipped to observe and reach out to others in this way. These people are called “natural gatekeepers.” Research suggests that brief gatekeeper trainings may increase knowledge but may not be effective in actually helping at-risk individuals.

To learn more about suicide alertness and intervention trainings, visit: Home – LivingWorks

Some medications may contain a suicide risk warning because of potential side effects or interactions with other medications and substances, including alcohol and drugs. It is important to be honest with your prescriber about the medications you are taking, as well as any use or misuse of alcohol and drugs.

Before starting a new medication, it may be helpful to review any potential side effects with your care team, and where appropriate, work to co-develop a plan for safety. This could include letting trusted friends and family know about the medication(s) you are taking, potential side effects, and any warning signs of distress.

There are some suicide risk factors that may run in families or involve family history For example, having a family history of suicide and suicide loss may increase a person’s risk for suicide. It is thought that when a suicide has already occurred within a family, it may cause other family members to view suicide as an option for themselves. This is why participating in postvention activities following a death by suicide can be an important form of suicide prevention.

However, it is also important to remember that the presence of risk factors does not automatically mean that someone will experience suicidal thoughts or behaviours. To learn more about risk factors, protective factors, and warning signs for suicide, visit: Risk Factors, Protective Factors, and Warning Signs for Suicide

People do not start thinking about suicide just because someone asks them about it. Instead, asking about suicide can start an important conversation about how the person is feeling and what they are experiencing.

If you suspect a friend or loved one is suicidal, it is important to reach out and start a caring conversation. Tell them that you are worried and want to help them. You can ask whether they are considering suicide, and if they have a specific plan in mind- their answers to these questions can let you know how to support them. Your direct, non-judgmental questions can encourage them to share their thoughts and feelings.

If they are considering suicide and have a specific plan to die, this may indicate that they are at a higher risk and need immediate help and support. If you suspect that they are in crisis, call 911 and access emergency services.

The language that is used to describe suicide and suicide loss can impact those bereaved and work to challenge or reinforce, the stigma around suicide.

When discussing suicide and suicide loss, it is encouraged to:

• Use “died by suicide” or “death by suicide” instead of “committed suicide”.

• • The term ‘committed’ is stigmatizing as it implies someone is criminal or immoral or has committed an offence. Suicide is not a crime. It was decriminalized in 1972. Recent amendments to the Criminal Code of Canada (section 241) refer to ‘die by suicide’ rather than ‘committed suicide’. (Source: PHAC, 2018).

• Avoid referring to a suicide attempt as a “failed”, “incomplete”, or “unsuccessful”.
  • Suicide is a tragic outcome of many complex factors with lasting impacts; it is never about success or failure. It is not something to achieve or finish like a task or project. (Source: PHAC, 2018).

• Avoid asking specific questions about the death, including methods.
  • Discussing the specific methods used for suicide is recognized as unsafe. These questions may also cause further pain and difficulty for those who have been bereaved by suicide.

Many of us have felt stressed, and it’s normal to struggle with our mental health sometimes. The concern for someone’s safety and wellbeing arises when there are signs that an individual is struggling outside of what can be considered normal for them or persist for a longer time. In these cases, accessing mental health care through a qualified physician or clinician can be helpful.

Psychotherapy includes a broad range of treatments that can be effective in helping someone to manage thoughts of suicide. Finding a clinician that you feel comfortable with, and who uses approaches that feel like a fit for you will impact how effective your treatment will be.  

Before starting psychotherapy, it might be helpful to ask questions about a clinician’s experience with suicide and suicide ideation, and their preferred approaches. Remember, it’s okay to end a therapeutic relationship, and to seek different options for professional help if needed.