What to say

Start with something specific you have noticed rather than a general enquiry. “How are you?” invites “fine.” An observation does not.

• “You have seemed really flat the last few weeks. What’s going on?”
• “I noticed you have stopped coming to things. I’m not judging — I just wanted to check in.”
• “That sounds genuinely awful. I’m glad you told me.”
• “I don’t know what to say, but I’m not going anywhere.”

That last one matters. Not knowing what to say is fine, and saying so out loud is better than retreating because you have not found the perfect sentence.

If you are worried about suicide, ask

Plainly, without euphemism: “Are you thinking about killing yourself?” or “Are you having thoughts of ending your life?”

Vague versions — “you’re not thinking of doing anything stupid, are you?” — signal that you would rather hear no, and people oblige. Ask the direct question and then be quiet long enough for a real answer.

If the answer is yes, do not react with panic or with a lecture. “Thank you for telling me” is a good next sentence. Then find out whether they are safe right now and get someone professional involved.

What not to say

Most unhelpful responses come from wanting to make the feeling stop, which is a decent instinct that produces bad results.

• “Others have it worse.” Adds guilt to despair.
• “You have so much to live for.” Reads as an argument, and someone who is suicidal will feel they are losing it.
• “Have you tried exercising / going outside?” Reasonable advice at the wrong moment sounds like dismissal.
• “You’re scaring me.” Understandable, and it makes them responsible for managing your feelings.
• “Just snap out of it.” Depression is not a decision.
• Jumping straight to solutions. Being heard has to come first, and often it is the whole of what was needed.

Signs worth paying attention to

Not every low mood is a crisis. Changes that persist for a couple of weeks and are out of character are the ones that matter.

• Withdrawing from people and from things they used to care about
• Sleeping far more or far less than usual
• Increased drinking or substance use
• Talking about being a burden, being trapped, or having no way out
• Giving away possessions that matter to them, or unexplained tidying of affairs
• A sudden lift in mood after a long depressive stretch — this one is counterintuitive and worth knowing about, because it can follow a decision rather than a recovery
• Marked agitation alongside hopelessness

When it is an emergency

Call 911 if someone has already harmed themselves, is unresponsive, or is in immediate danger. Do not leave them alone.

Call or text 988 if you are worried and it is not an immediate emergency. The Suicide & Crisis Lifeline takes calls about someone else, so you can use it to work out what to do rather than deciding alone. Counsellors will talk through the situation with you.

If someone tells you they are having suicidal thoughts and is willing to stay safe for now, two things help. Stay with them or arrange for someone else to. And help reduce their access to anything they could use to hurt themselves — a practical step that has good evidence behind it, and one that is easier to raise as “can we put that somewhere else for a while” than as a confrontation.

Then get a professional involved rather than carrying it yourself.

Helping them get actual care

“You should see someone” is where most well-meant conversations stop, and it is where they most often fail. The gap between agreeing to get help and having an appointment is where people give up.

Concrete beats general:

• Do the searching with them, on the spot, on your phone.
• Offer to sit with them while they call. Making the first call is disproportionately hard when you are depressed.
• Offer to be there for the appointment if they want that — and note that a family member’s observations are genuinely useful at a first psychiatric evaluation.
• Follow up afterwards. Ask how it went. People frequently attend once and stop.

If they do not know what to expect, what happens at a first psychiatry appointment is worth sending them — not knowing is one of the biggest reasons people postpone.

You are not their treatment

This part gets left out and it matters.

You are not responsible for keeping another adult alive, and you cannot be someone’s only support without eventually running out. Supporting a person through a mental health crisis is genuinely draining, and people who take on too much often disappear entirely a few months later — which is worse for everyone than a sustainable amount of support would have been.

Keep your own life running. Tell someone you trust what you are carrying. And you can call 988 for yourself, as a person supporting someone else. That is a legitimate use of it.

Formal training, if you want it

Mental Health First Aid is an eight-hour certification course teaching a structured approach to recognizing and responding to mental health crises, widely used in workplaces, schools, and community organizations. Many local health departments run sessions at low or no cost. It is genuinely useful if you are in a role where this comes up often.

It is not a prerequisite for helping someone you care about. Asking directly and staying present covers most of what actually helps.

Frequently asked questions

Will asking about suicide make it more likely?

No. Asking directly does not increase risk or introduce the idea. It opens a conversation the person is often already having alone.

What if they get angry with me?

It happens, and it is usually about being seen rather than about you. Do not press in that moment. Say you are there, and come back to it.

What if they refuse help?

You cannot compel an adult into treatment except in narrow emergency circumstances. What you can do is stay in contact, keep the offer open, and reduce immediate risk. Many people accept help later that they refused at first.

Should I call 988 or 911?

911 for immediate danger or a medical emergency. 988 for everything short of that, including working out which of the two you need.

Can I call 988 about someone else?

Yes. Family and friends calling on someone else’s behalf is a common and appropriate use.

How do I bring it up without making it weird?

Lead with something you noticed and keep it low-key. “You’ve seemed off lately, everything alright?” is enough. The awkwardness is almost always yours, not theirs.

Help them take the next step

Samz Mental Health provides online psychiatric evaluation with a board-certified psychiatric nurse practitioner across nine states. No referral required, and appointments are usually available quickly.

Book an Evaluation