american foundation for suicide prevention

A lot of people in the United States live with suicidal thoughts.

One study suggested that about 15% of Americans will have suicidal thoughts in their lifetime. About 40,000 Americans die by suicide each year.

I could tell you more statistics too, like how more than half of those are by firearm or how men are three and a half times more likely to die by suicide than women. I can tell you a lot of statistics. And those statistics are important. But for most of us, they're just numbers.

But when it's not just numbers — when it's your dad, spouse, or someone you love who you think is in danger — what the heck are you supposed to do?

This is a situation that, unfortunately, some of us might have to deal with one day. And it can be incredibly scary.

But there are things we can do and words we can say that situation. Dr. Christine Moutier, chief medical officer for the American Foundation for Suicide Prevention, gave me a few tips for how to start that conversation:

1. Trust your gut.

There are some definite warning signs and risk factors for suicide, such as the person saying they feel they have no reason to live or if they've made suicide attempts before. But there can be subtler clues as well, such as giving away prized possessions or withdrawing from friends and family. So if something sets off your radar, it's important to act on that.

"If your gut is telling you something, trust it," said Moutier.

2. Be the one to take action.

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Let's say it was your dad who you were worried about. It's natural to want to wait and talk with the rest of the family before reaching out to him. But unfortunately, what sometimes happens is that while everyone is talking about how Dad needs help, nobody is actually talking to Dad.

Instead, Moutier said, you should act as if you're the only person who has noticed. Be the person who reaches out.

3. Don't worry about being the "right" person.

Sometimes we might feel like it's not our place to bring up our worries. Continuing the Dad example, we might think, "Oh, well, he's much closer to Mom than he is to me." But people can be really good at hiding things.

Again, you should act as if you're the only person who has noticed. Because you might be.

4. Set up a heart-to-heart.

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When you're ready to talk to the person, schedule a private conversation. It doesn't have to be dramatic. Even just a basic "I'd like to talk to you about something" or an "I just want to check in and see how things are going" can work.

The idea is to make sure they know it can be a private, personal conversation.

5. Once the conversation is started, say what made you worried.

Be direct about what tweaked your radar. "You've been drinking more lately, and talking a lot about feeling overwhelmed and trapped. How are things going? What's on your mind?"

"That lets the person know there's a reason that you're concerned and you're not hiding information from them," said Moutier. "You're being very direct."

It's OK to not bring up many specifics or your worries about suicide just yet. Leave it open-ended and let them talk about what's on their mind.

6. Then just listen.

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Your goal right now is to just understand what they're going through. Though it might be tempting to offer solutions, people who are seriously in trouble have likely already spent a lot of time and mental energy trying to figure out their problems. What they need right now is a release valve, not a life coach.

7. If you're still worried — even a little bit — ask directly about suicide.

At this point, they may or may not have already talked about suicidal thoughts. But if there's even a shadow of a doubt in your mind, it's OK to ask about it.

When you do, be direct. Calm, yes, but direct. Something like: "When you’re feeling this way, does it ever get to the point where you’re thinking of ending your life?”

8. Seriously. Be direct.

Sometimes we feel afraid of saying something blunt. We might be afraid the person will get mad or that we might plant the idea in the person's head or somehow make the situation worse.

"In fact, the research shows that it actually does quite the opposite," said Moutier. "For people who are having suicidal thoughts, it's almost like this sense of relief to be able to discuss what's been on their mind."

9. If it turns out they are experiencing thoughts about suicide, help them get help.

The veteran population is disproportionately affected by suicide too. Photo from iStock.

A lot of suicidal people might be afraid of the stigma surrounding suicidal thoughts, or they might feel like they're too far gone to help. But sometimes all a person needs is someone else to give them permission.

So open up the dialogue. Something as simple as "I'd think the world of you if you made an appointment with a doctor" might be enough to get them started.

10. If you think they are in immediate danger, try to keep them safe and call someone.

Sometimes a person may be having suicidal thoughts but no definite plan or means.

But if the person actually does have both a plan and the means to carry out that plan, you may be beyond judgment calls. In that case, stay with them, try to remove anything that could be dangerous like firearms or pills, and call either 911 or a suicide helpline. (By the way, they can also talk to you on behalf of someone else.)

11. Whether they're suicidal or not, try to follow up with them later.

It can never hurt to just check in and see how they're doing.

12. Finally, take care of yourself.

As you're taking care of someone else, it's important to also be taking good care of yourself. Make sure you have your own emotional support network and, if needed, talk to a professional yourself.

Talking to someone who you think is suicidal might be scary.

But it can also be a win-win. If nothing else, you get a heart-to-heart with a friend or coworker, and you'll show them you're there to support them. And if it's serious, you might help save a life.