Talking about suicide: Advice for communities, friends, and families

A high school student in our community died last month, likely by suicide, though no one has officially identified the cause of death or released the student’s name to the larger school community. The principal and district superintendent sent emails shortly after the incident. They offered additional mental health support and lamented the loss, imploring us to take care of each other. This sudden, traumatic death is otherwise shrouded in silence.

There are likely many reasons for this. Suicide comes with a stigma that complicates the already fraught anguish of grief. The family may prefer to mourn in private. In addition, school officials or others may worry that talking about the cause of death more directly will result in more deaths by suicide.

This article discusses youth suicide statistics, recommended practices for discussing suicide as a community, and how to speak to a potentially suicidal person about their feelings and plans.

If you or someone you know is in crisis, the National Suicide Prevention Lifeline is a free, 24/7 service that can provide you with support, information, and local resources.

Dial 988 to get help

Rising suicide rates

Rates of suicide for children, teens, and young adults rose 60% between 2008 and 2018. It is the second-leading cause of death for young folks between the ages of 15 and 24. The reasons for this are not fully known and likely stem from a complicated mix of psychological, societal, historical, and environmental factors.

Who is most at risk?

A young person’s risk for suicide depends in part on the group(s) they belong to. LGTBQI+ youth, those who were or are involved in the child welfare or juvenile justice systems, members of the armed services, and Native American and Alaskan Native youths all have higher suicide rates.

Although rates are also high among American White teens and young adults, the rates of suicide among Black youth in the U.S. is rising rapidly. In addition, suicide is the leading cause of death for Asian American youth between the ages of 15 and 24. A 2019 study reported that 1 out of 10 Latina teens surveyed had attempted suicide the previous year.

Among teens, girls are more likely to report suicidal ideation, while boys are more likely to die by suicide. According to research, adolescent boys who are higher risk for suicide (for example, those who are depressed) are also more likely to have transient, perhaps intense, periods of suicidal ideation. This puts them at a higher risk for making impulsive attempts using highly fatal means. This impulsivity, combined with other factors, may also be related to the attempts of Black teens.

Out of these groups, transgender teens are the most at risk. Not only do an estimated 82% of transgender youth consider suicide, over half of those surveyed report suicide attempts. This higher risk is most likely due to the stigma around being trans, which is often intensified by public policies that discriminate against transgender and gay people.

Limiting access to means prevents suicide

Limiting access to the ways folks take their own lives is a public health imperative. When people cannot easily complete an impulsive action, they often are able to ride out the urge to do something potentially fatal. One example of limiting means is to make firearms more difficult to acquire. Another is to install protective barriers on high buildings and bridges. On an individual scale, limiting access to medications or putting guns in a safe helps keep folks safe. In addition, educating teens about these ephemeral periods of intense suicidal ideation, with a focus on their temporary nature and on ways to cope, can help.

What happens when we don’t talk about suicide as a community?

Silence around suicide is confusing. It denies and erases reality. Without a shared acknowledgment or some larger ritual to mark a death, the community’s grief becomes divided and compartmentalized. There is no communal way to process the loss. What does it mean when something cannot be spoken, when grief and pain are not given full, official space to be expressed? The implicit, likely unintended lesson is that suicide and the struggles beneath it must stay unspoken. The feelings we cannot express or acknowledge grow in the dark. Without the space to mourn, grief goes underground. It can show up in confusing, and perhaps unhealthy, ways. And those who are grappling with hopelessness, who already feel burdensome, may remain silent. This silence can be dangerous.

Many of us are afraid to discuss suicide directly, particularly with struggling friends, kids, or family members. We worry that just bringing it up will plant the idea in impressionable, suffering minds. However, talking directly and factually about a person’s suicide or about the topic in general does not cause folks to be suicidal. Open and nonjudgmental discussions about suicide do not encourage suicidal actions. In fact, providing space to talk about it often decreases suicidal thoughts, helping depressed and hopeless people feel less alone.

Ways to talk about suicide collectively

How we talk about suicide collectively, particularly in the media or in large settings, does matter. The American Foundation for Suicide Prevention has guidelines for reporting on suicide. They suggest covering the topic carefully and briefly, with non-sensationalist reporting that includes information on the potential warning signs for suicide and how to get help. Providing information about suicide as a public health issue, as well as including hopeful stories of recovery, are also among their recommendations.

In general, it is good to speak honestly about what happened. Focus on potential underlying reasons for the person’s decision (for example, he was depressed or had mental illness). At the same time, remind people that there are alternative ways to handle these struggles. Give grieving folks and communities a safe space to process their emotions, remember the person who is gone, and get support.

Talking with friends or family members about suicide

Talking about suicide directly opens up space to prevent it. Approaching the topic with compassion, checking in with our friends, kids, and family members, and making it more difficult to access fatal means are all helpful. Having greater access to mental health care and social support are also important, though challenging as psychotherapists and hospitals are often at capacity.

To help you start these discussions, I’ve included lists of potential warning signs and risk factors, common thoughts and feelings for those considering suicide, and what you can do to help. These lists are based on information from the American Foundation for Suicide Prevention and Crisis Support Services of Alameda County.

Recognize the warning signs

The more warning signs a person shows, the greater their risk. Not everyone will show these warning signs. If you are a parent, don’t wait for these signs to emerge. Check in with your teen regularly about how they are doing. Listen without judgment, and be vulnerable about your own feelings. Talk to them about how intense emotions may appear suddenly and that the feelings will pass. Encourage them to talk to you or someone else they trust if they do experience suicidal thoughts and feelings.

For more information, look at Jason Reid’s article on talking to teens about suicide, as well as the American Academy of Pediatrics article on things parents can do to prevent suicide.

• Talking about wanting to die
• Looking for a way to kill oneself
• Feelings of hopelessness or purposelessness
• Talking about feeling trapped or being in unbearable pain
• Feeling like a burden
• Increasing use of alcohol or drugs
• Acting anxious, agitated, or behaving recklessly
• Previous attempts
• Sleeping too little or too much
• Withdrawing or feeling isolated
• Showing rage or talking about seeking revenge
• Displaying extreme mood swings

Common feelings in suicidal crisis

• The pain feels permanent
• It’s hard to think clearly
• Making decisions is impossible
• Feels like there is no way out
• Unable to sleep, eat, or work
• Depression feels like it will never fade
• Seems impossible to make the sadness go away
• Can’t see a future without pain
• Feel worthless
• Can’t get anyone’s attention
• Can’t seem to get control

How to help

• Talk openly, directly, and matter of factly about suicide
• Listen without judgment
• Allow expressions of feelings, accepting those feelings as they are
• Show interest and support and be available
• Keep any feelings of shock to yourself
• Do not keep it a secret
• Seek support for yourself and for them
• Offer hope that alternatives are available without glib reassurance that everything will be fine
• Take action by removing means, such as guns or stockpiled pills
• Get help from persons or agencies specializing in crisis intervention and suicide prevention (such as the Suicide Prevention Lifeline at 800-273–TALK (8255) or 988)
• If the person is actively suicidal, take them to an emergency room or consult with a medical or mental health professional

(Post updated for inclusivity and clarity 10/30/2022)