The Tool Desk
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Why you cannot separate the two by wording
A person may describe distress indirectly, ask for help, or speak plainly about wanting to die. None of those forms of wording proves or rules out suicidal thoughts. The National Institute of Mental Health (NIMH) says suicidal thoughts or actions are signs of extreme distress and indicators that someone needs help. Treat what they say as a reason to respond with care, not as a test of sincerity.
Warning signs can guide a conversation, but they cannot diagnose someone or tell you with certainty what they intend to do. Your role is to ask, listen, and connect them with support—not to assess or label their risk.
Ask directly and listen without judgment
You might say: “I care about you, and I want to understand. Are you thinking about suicide?” NIMH also gives the example, “Are you thinking of killing yourself?” Its guidance says asking directly does not increase suicidal thoughts or behavior. See NIMH’s five action steps and its frequently asked questions about suicide.
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Give the person room to answer. Listen without arguing, judging, or rushing to solve everything. You can ask what would help right now and whether they would be willing to contact someone they trust or a professional with you.
Notice warning signs, without treating them as a verdict
Possible warning signs include:
- Talking about wanting to die, feeling hopeless or trapped, or experiencing unbearable emotional or physical pain.
- Saying they feel like a burden, withdrawing from others, saying goodbye, giving away important possessions, or putting affairs in order.
- Taking dangerous risks, having extreme mood changes, using more alcohol or drugs, or changes in eating or sleeping.
NIMH advises seeking help as soon as possible, especially when signs are new or have increased. The 988 Suicide & Crisis Lifeline also highlights signs that are new or worsening, or that appear alongside a painful event, loss, or change. These signs do not establish a person’s intent; use them as prompts to check in and help them reach support. See NIMH’s warning signs of suicide and the 988 Lifeline’s warning signs guidance.
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What to do when someone tells you they may be suicidal
NIMH’s five action steps are Ask, Be There, Help Keep Them Safe, Help Them Connect, and Follow Up. Put them into practice in a way that fits the immediate situation:
- Ask: Ask directly whether they are thinking about suicide. Stay calm and listen to their answer.
- Be there: Offer your presence and listen without judgment. Do not promise to keep suicidal thoughts secret; WHO guidance advises against promising secrecy.
- Help keep them safe: If there is immediate danger, stay with them and involve appropriate help. NIMH recommends reducing access to highly lethal items or places when possible.
- Help them connect: Offer to contact a trusted person, crisis service, or mental health professional together.
- Follow up: Check in afterward and keep supporting their connection to help.
Do not try to act as their therapist. A safety plan or crisis response plan—made with appropriate support and spelling out what to do and how to get help when suicidal thoughts arise—can help reduce the risk of acting on those thoughts, according to NIMH.
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When to contact crisis or emergency services
In the United States, call or text 988, or use chat at 988lifeline.org, for suicidal crisis or emotional distress. If the situation is life-threatening, call 911. If someone says they are going to kill themselves, NIMH advises not leaving them alone; involve emergency help when needed. These numbers are U.S.-specific. Outside the United States, contact local crisis and emergency services.
Independent reader supportYour contribution helps us test, update, and keep practical guides available for everyone.Where a friend’s role ends and clinical assessment begins
Friends and relatives can ask directly, listen, and help someone connect with care. Screening and clinical assessment are different tasks. NIMH’s ASQ Toolkit is designed for medical settings; its guidance says a positive screen should be followed by a brief suicide safety assessment conducted by a trained clinician. A checklist of signs—or a conversation with a friend—does not replace that professional follow-up.
Quick Recap
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