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How to talk with loved ones about suicidal thoughts: a tough but necessary conversation

Suicide is the second leading cause of death in persons age 10-34. Studies show that approximately 15 percent of adolescents have thought about suicide within the past year. Rates in adults tend to be lower, at about 5 percent. Luckily, not every thought leads to suicidal actions, but that leaves the difficult question of when to be very worried verses just concerned.

Start the conversation

For most people, talking about suicide is very uncomfortable - especially when speaking with loved ones. However, research shows that talking about these thoughts is the most important step to ensure safety. It is important to stay calm when discussing suicide with loved ones.  Any sort of strong emotional response, blaming or creating feelings of guilt, or belittling these thoughts will likely decrease the person’s willingness to open up. Instead, focus on mostly listening and gathering information and express only emotions of support. A good place to start is usually asking, “Do you ever have thoughts of hurting yourself or killing yourself?”

Make a plan of action

Suicidal thoughts vary in terms of risk. The risk varies from vague thoughts of one's own death to having severe suicidal thoughts with a plan and intent to carry out that plan. Interviews with suicide survivors have shown that the majority of suicide attempts were not planned out for more than an hour before the event. It is important, therefore, that if you are concerned about a loved one, make sure they have a safety plan. An example of a safety plan might look something like this:

  • Try distraction by watching a movie, listening to music, or reading
  • Call or text a person of support in your life
  • Meet with a loved one
  • Call the National Suicide Lifeline: 1-800-273-TALK(8255)
  • Go to the Emergency Department or call 911

A safety plan is often needed when suicidal thoughts occur and a person starts thinking of a way in which they might hurt or kill themselves. The more realistic their plan, the higher the risk. Some individuals might need to be hospitalized to ensure their own safety until their intense suicidal thoughts subside. Severe suicidal thoughts are no different than a severe allergic reaction, severe asthma attack, or heart attack and should be taken just as seriously.

Be proactive

Try to ensure those you love know they can talk to you if they are having suicidal thoughts by being open and supportive about their mental health. You can be proactive by mitigating risks of suicide such as keeping firearms locked in a safe and separate from ammunition (or not in the home at all), and securing medications. Have the National Suicide Crisis Line in an obvious place where anyone can access it. South Tahoe High School and Middle School student identification cards have this number on them. For parents of teenagers, please try to stay involved and know what your kids are up to and how they are feeling. If someone confides in you but won’t take action, making sure they are getting help is the right thing to do.

I hope this advice can make an emotional and difficult topic a bit easier to speak about. Suicide is a preventable death, and people have much more power to make a difference than they might believe.

A few resources:
National Suicide Prevention Lifeline- 1-800-273-TALK(8255)
1-888-628-9454 (Spanish/Español)

El Dorado County Mental Health Crisis Line- 530-544-2219
Crisis Text Line- text HOME to 741741

Suicide Prevention Network- spnawareness.org


Dr. Tracy Protell is a Board-certified Adult Psychiatrist, Child and Adolescent Psychiatrist, and a Pediatrician at Barton Psychiatry.