How to support someone experiencing suicidal thoughts

When someone you know talks about having suicidal thoughts it can be a scary experience. Your first response might be to say something like, ‘Don’t be so silly’ or ‘Stop talking like that’. Some people may worry that talking about it will make things worse, but there is no evidence to suggest this is true.

It’s a brave step for someone to open up about such feelings, so, what’s the best way to respond?

The Samaritans have a useful acronym that gives pointers on how to manage a difficult conversation – they call it SHUSH active listening: 

  • Show you care (focus on the person, give them your full attention, maintain some eye contact, put your mobile phone away)
  • Have patience (they may not be ready to open up fully – keep an open and empathic stance, letting them know you’re there to talk whenever they’re ready)
  • Use open questions (open questions usually start with ‘when, how, where, etc. They give the talker space to explore and expand)
  • Say it back (this reflection of what they’ve said shows them you’re listening, allows them to feel heard, and makes sure you have understood correctly)
  • Have courage (it’s difficult to listen to someone with these thoughts. Don’t worry if they don’t want to open up fully – you’ve made the first step and just being heard will usually be beneficial for the person)

Asking direct questions is useful to ascertain the level of risk. You could ask what plans, if any, they have, and ask them how ‘real’ this feels to them – what’s the likelihood on a scale of 0-10 that they would act on the plans, and when? 

“Try to remain non-judgemental and try not to shame or blame the person having these thoughts. ”

Quite often the thoughts are of ‘escape’ rather than actually wanting to die – which is why deeper exploration is useful in understanding what they really want. They may want the emotional pain to stop but may not really want to give up their entire future. Talking through their feelings can help them to see this more clearly. 

The next step is to explore what further help they might need or want, and to encourage them to seek professional help. Some options would include contacting their GP or a therapist or a counsellor. If the situation is acute, calling the Samaritans for free (116 123) or emailing, is an obvious choice. 

If someone is in immediate danger, the quickest way to get help is to call an ambulance on 999.

Don’t forget to take care of yourself – supporting someone having these thoughts can be exhausting and emotionally draining. 

By Maxine Freshwater, Therapist at Emotionalskills

Thursday 10th October is World Mental Health Day 2019. This year, the main theme is “suicide prevention”.

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