Objectives
By the end of this module you will be able to:
- Recognize warning signs that a person may be thinking about suicide.
- Ask directly and calmly about suicide.
- Use the GGN Lantern Crisis Steps to stay with a person and connect them to 988 or 911.
- Know what to do after a crisis conversation, including caring for yourself.
Lesson
Why this module matters for grief
Grief can bring thoughts about death. Some grieving people say they want to "be with" or "join" the person who died. Often this is longing, not a plan to die. But sometimes it is suicidal thinking. You cannot tell the difference by guessing. You can only know by asking.
Warning signs
The 988 Suicide & Crisis Lifeline and the U.S. National Institute of Mental Health describe warning signs such as:
- Talking about wanting to die, or about killing oneself.
- Talking about feeling hopeless, trapped, in unbearable pain, or being a burden to others.
- Looking for ways to end one's life, such as searching online or getting a weapon or pills.
- Withdrawing from friends and family, saying goodbye, or giving away important possessions.
- Increasing use of alcohol or drugs.
- Extreme mood swings, agitation, sleeping too little or too much, or acting recklessly.
A sudden calm after a long period of deep distress can sometimes be a warning sign as well, especially alongside other signs.
Asking directly
Asking someone whether they are thinking about suicide does not put the idea in their head. Researchers who reviewed the evidence (Dazzi and colleagues, 2014, Psychological Medicine) found no evidence that asking increases suicidal thoughts. Asking clearly tells the person that you can handle the answer.
Use plain words, and avoid hinting:
- "Sometimes when people are grieving this hard, they think about ending their life. Are you thinking about suicide?"
- "When you say you want to be with her, do you mean you're thinking about killing yourself?"
Avoid asking in a way that invites "no," such as "You're not thinking of doing anything stupid, are you?"
The GGN Lantern Crisis Steps
| Step | What you do |
|---|---|
| 1. Stay close | Stay with the person, in person or on the phone. Keep your voice calm and slow. If there is immediate danger, do not leave them alone. |
| 2. Ask plainly | Ask directly about suicide. If they say yes, ask whether they have thought about how, and whether they have access to the means. Listen without arguing or judging. |
| 3. Call together | If there is immediate danger, such as a weapon in hand, an overdose, or an attempt in progress, call 911. Otherwise, call or text 988 together, or chat at 988lifeline.org. Offer to dial and to stay on the line. Veterans can dial 988 then press 1. |
| 4. Make space safer | If it is safe to do so, help put time and distance between the person and the means they mentioned, such as firearms or stockpiled medications, often with help from another trusted person. Never put yourself in danger. |
| 5. Keep company | Help the person identify trusted people who can be with them. Agree on when you will next check in, and follow through. Encourage follow-up with a doctor or licensed mental health professional. |
Other crisis supports
- Crisis Text Line: text HOME to 741741 (United States) for free, 24/7 text support with a trained crisis counselor.
- Outside the United States: use your local emergency number and national crisis line.
What not to do
- Do not promise to keep suicidal thoughts a secret. You can say, "I care about you too much to keep this to myself."
- Do not argue about whether life is worth living, lecture, or debate faith.
- Do not leave someone alone if they are in immediate danger.
- Do not try to physically restrain a person or put yourself at risk. Call 911.
After the conversation
Crisis conversations are hard on helpers. Afterward, talk with someone you trust, rest, eat, and notice your own feelings. You can call or text 988 yourself for support as a concerned friend or family member. You did not have to have perfect words. Staying, asking, and calling are what matter.
GGN practiceSaying the Hard Words (about 10 minutes, alone or with a partner)
This practice builds the ability to ask about suicide calmly. Saying the words out loud in a calm moment makes them easier to say when it matters. Sit somewhere private. Take a slow breath and feel your feet on the floor. Read this sentence out loud, slowly: "Sometimes when people are grieving this hard, they think about ending their life. Are you thinking about suicide?" Notice how it felt to say it. Read it again, a little more steadily. Now say it in your own words. Keep the word "suicide" or "killing yourself" so the question is clear. Practice a follow-up: "Thank you for telling me. I'm going to stay with you. Let's call 988 together." Practice what you would say if they asked you to keep it secret: "I care about you too much to keep this to myself. Let's get support together." Finish by putting 988 in your phone contacts as "988 Lifeline," if you have not already. Notes: If this practice brings up your own thoughts of suicide, please stop and call or text 988 now, or call 911 if you are in immediate danger.
Fictional storyFictional Story 5.1: Ana and her aunt
Ana's aunt Pilar, 62, lost her husband last winter. On the phone, Pilar says she has been sorting his things and giving his tools to the neighbors. She adds, "I've had a good life. I'm ready to go be with him. I've got his pills saved up." Then she changes the subject to the weather. Questions to consider:
- Which warning signs do you hear?
- What could Ana say next?
- What are Ana's next steps?
Discussion: Pilar is giving away possessions, talking about being ready to die and be with her husband, and mentions saved pills. Ana should stay on the phone, keep her voice calm, and ask directly: "Tía, when you say you're ready to go be with him, are you thinking about killing yourself?" If Pilar says yes or will not say, Ana can call or text 988 for guidance, connect Pilar with 988, or call 911 if Pilar is in immediate danger or may have taken the pills. Ana can ask a nearby relative or neighbor to go to Pilar and help put the pills somewhere out of reach, and should follow up the next day.
Reflection Prompts
- What feelings come up for you when you imagine asking someone if they are thinking about suicide?
- Who could you turn to for support after a hard crisis conversation?
- What is one thing you will do this week to be ready, such as saving 988 in your phone?