Suicide is one of the leading causes of death among adults in the United States, and rates have risen over the last two decades in many age groups. Most people who die by suicide have shown signs, though not always to the people best positioned to notice, and not always in the ways depicted in film. Knowing what to look for, what to say, and where to point someone is a form of civic literacy that ordinary adults can carry.
What follows is not a substitute for professional care. It is a plain guide for the people around someone who may be struggling.
What increases risk
Suicide is almost always the result of many factors converging, not a single trigger. Known risk factors, drawn from research summarized by organizations including the National Institute of Mental Health and the American Foundation for Suicide Prevention, include:
- Prior suicide attempts.
- Depression, bipolar disorder, PTSD, substance use disorders, and certain other mental illnesses, particularly when untreated.
- Recent loss: relationship, job, financial, health, status.
- Chronic pain or serious physical illness.
- Social isolation and disconnection.
- Access to lethal means during a period of acute risk.
- Family history of suicide.
Risk is not destiny. Many people with several risk factors never attempt suicide. Protective factors, especially strong connection to at least one other person, effective treatment, and reasons for living, matter.
Warning signs worth taking seriously
Signs that a specific person may be in acute risk include talking about wanting to die or being a burden; withdrawing from friends and activities; giving away possessions; sudden calm after a period of depression; increased substance use; and expressions of hopelessness or feeling trapped.
The presence of these signs does not confirm a person is suicidal. Their appearance does mean it is reasonable, and often necessary, to ask.
Asking someone directly about suicide does not plant the idea. It often reduces the isolation of carrying it.
How to ask, and what to do
Evidence and clinical consensus support asking directly, calmly, and without euphemism. "Are you thinking about suicide?" is a better question than "You're not thinking of doing anything, are you?" Direct questions communicate that the topic is not too big to discuss.
If the answer is yes:
- Listen more than you talk. You do not need to fix it in the conversation. Being heard matters.
- Take it seriously. Do not minimize, argue, or promise secrecy you cannot keep.
- Reduce access to lethal means. This is one of the most evidence-supported prevention strategies. Removing or securing firearms and lethal medications during a period of crisis meaningfully reduces risk. Ask directly; help arrange safe storage.
- Connect them to help. In the US, the 988 Suicide and Crisis Lifeline offers 24/7 free, confidential support by call, text, or chat. Many other countries have equivalent services; a quick search for your country plus "crisis line" will locate them. Local emergency services remain appropriate for immediate danger.
- Follow up. A brief check-in a day or two later is not intrusive. It is protective. Research on caring contacts, simple non-demanding messages after a crisis, shows real reductions in future risk.
You do not need to be a clinician to be useful. You need to be present and willing to stay in the conversation.
After a loss
Suicide loss is a distinctive kind of grief, marked by shock, guilt, and unanswered questions. Survivors are themselves at elevated risk. Specialized support groups exist and help. If you have lost someone, be gentle with yourself and consider working with a clinician familiar with suicide bereavement.
Coverage and conversation also matter. Safe messaging guidelines, developed by suicide prevention organizations and journalists, recommend focusing on prevention, hope, and resources rather than detailed circumstances. Individuals following the same instinct in personal conversations help reduce contagion risk.
The bottom line
Suicide prevention is not the exclusive work of clinicians. Ordinary adults, informed and willing to ask, are part of what keeps people alive. Learn the warning signs, ask directly when you are concerned, help reduce access to lethal means during crises, and know how to connect someone to 988 or a local equivalent. Small acts of connection are not small.