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Risk Factors and Warning Signs

Risk Factors and Warning Signs

Risk Factors and Warning Signs

Risk Factors and Warning Signs

What leads to suicide?

There’s no single cause for suicide. Suicide most often occurs when stressors exceed current coping abilities of someone suffering from a mental health condition. Depression is the most common condition associated with suicide, and it is often undiagnosed or untreated. Conditions like depression, anxiety and substance problems, especially when unaddressed, increase risk for suicide. Yet it’s important to note that most people who actively manage their mental health conditions lead fulfilling lives.

Suicide Warning Signs

Something to look out for when concerned that a person may be suicidal is a change in behavior or the presence of entirely new behaviors. This is of sharpest concern if the new or changed behavior is related to a painful event, loss, or change. Most people who take their lives exhibit one or more warning signs, either through what they say or what they do.

// Talk // 

If a person talks about:

Being a burden to others
Feeling trapped
Experiencing unbearable pain
Having no reason to live
Killing themselves

// Behavior // 

Specific things to look out for include:

Increased use of alcohol or drugs
Looking for a way to kill themselves, 
such as searching online for materials or means
Acting recklessly
Withdrawing from activities
Isolating from family and friends
Sleeping too much or too little
Visiting or calling people to say goodbye
Giving away prized possessions

// Mood //

People who are considering suicide often display one or more
of the following moods:

Loss of interest

// Health Factors //

Mental health conditions
Bipolar disorder
Borderline or antisocial personality disorder
Conduct disorder
Psychotic disorders, or psychotic symptoms in the context of any disorder
Anxiety disorders
Substance abuse disorders
Serious or chronic health condition and/or pain

// Environmental Factors //

Stressful life events which may include a death, divorce or job loss

Prolonged stress factors which may include harassment, bullying, relationship problems and unemployment

Access to lethal means including firearms and drugs

Exposure to another person’s suicide or graphic or sensationalized accounts of suicide

// Historical Factors //

Previous suicide attempts

Family history of suicide attempts




Find the Words

Find the Words

Find the Words

Find the Words

1. Start the Conversation

Before starting a conversation with someone you are concerned about, be sure to have suicide crisis resources on hand.

"I've noticed that you've mentioned feeling hopeless a lot lately…"

Mention the signs that prompted you to ask about suicide. This makes it clear that you are not asking "out of the blue," and makes it more difficult for the person to deny that something is bothering them.

"Sometimes when people feel like that, they are thinking about suicide. Are you thinking about suicide?"

Ask directly about suicide. Talking about suicide does NOT put the idea in someone's head and usually they are relieved. Asking directly and using the word "suicide" establishes that you and the person at risk are talking about the same thing and lets the person know that you are willing to talk about suicide.

"Are you thinking about ending your life?"

You may phrase the question in a different way. If they answer "yes" to your direct question about suicide stay calm, and don't leave the person alone until further help is obtained. Call 911 or the National Suicide Prevention Lifeline at 1-800-273-8255.

2. Listen, express concern, reassure

"I can imagine how tough this must be for you. I understand when you say that you aren't sure if you want to live or die. But have you always wanted to die? Well, maybe there's a chance you won't feel this way forever. I can help."

Listen to the reasons the person has for both living and dying. Validate that they are considering both options and underscore that living is an option for them.

"I'm deeply concerned about you and I want you to know that help is available to get you through this."

Let the person know you care. Letting them know that you take their situation seriously, and you are genuinely concerned about them, will go a long way in your effort to support them.

3. Create a Safety Plan

"Do you have any weapons or prescription medications in the house?"

Ask the person if they have access to any lethal means (weapons, medications, etc.) and help remove them from the vicinity. (Another friend, family member or law enforcement agent may be needed to assist with this.)

Do not put yourself in danger; if you are concerned about your own safety, call 911.

"Is there someone you can call if you think you may act on your thoughts of suicide?"

Create a safety plan together. Ask the person what will help keep them safe until they meet with a professional.

“Will you promise me that you will not drink or at least have someone monitor your drinking until we can get you help?"

Ask the person if they will refrain from using alcohol and other drugs or agree to have someone monitor their use.

"Please promise me that you will not harm yourself or act on any thoughts of suicide until you meet with a professional."

Get a verbal commitment that the person will not act upon thoughts of suicide until they have met with a professional.

4. Get Help

"I understand if it feels awkward to go see a counselor. But there is a phone number we can call to talk to somebody. Maybe they can help?"

Provide the person with the resources you have come prepared with. Call the National Suicide Prevention Lifeline anytime at 1-800-273-8255.

If you feel the situation is critical, take the person to a nearby Emergency Room or walk-in psychiatric crisis clinic or call 9-1-1.

5. What not to say

"You're not thinking about suicide, are you?" OR, "You're not thinking about doing something stupid, are you?"

Don't ask in a way that indicates you want "No" for an answer.

"Fine! If you want to be selfish and kill yourself then go right ahead! See if I care."

Don't tell the person to do it. You may want to shout in frustration or anger, but this is the most dangerous thing you can say.

Don't Say: "Don't worry, I won't tell anyone. Your secret is safe with me."

Don't promise secrecy. The person may say that they don't want you to tell anyone that they are suicidal.

Say this instead: "I care about you too much to keep a secret like this. You need help and I am here to help you get it."

You may be concerned that they will be upset with you, but when someone's life is at risk, it is more important to ensure their safety.




Create a Safety Plan

How to Reach Out

Create a Safety Plan

How to Reach Out


You are not alone in helping someone in crisis. There are many resources available to assess, treat and intervene. Crisis lines, counselors, intervention programs and more are available to you, as well as to the person experiencing the emotional crisis. National Suicide Prevention Lifeline, 1-800-273-8255 This free, 24-hour hotline is available to anyone in suicidal crisis or emotional distress. Press 1 for Veterans assistance. Para español, oprima 2.


There are several excellent trainings available to the public that teach the knowledge and skills to be an effective "gatekeeper" for people who are thinking about suicide. A gatekeeper is someone who is able and willing to help someone thinking about suicide get professional help.

  • Applied Suicide Intervention Skills Training (ASIST) is a workshop for anyone who want to feel more comfortable, confident and competent in helping to prevent the immediate risk of suicide. To learn more about ASIST, visit To find a workshop, email

  • safeTALK is a three hour training that prepares anyone over the age of 15 to identify persons with thoughts of suicide and connect them to suicide first aid resources. To learn more about safeTALK, visit To find a workshop, email

  • QPR stands for Question, Persuade, and Refer — Just as people trained in CPR and the Heimlich Maneuver help save thousands of lives each year, people trained in QPR learn how to recognize the warning signs of a suicide crisis and how to question, persuade, and refer someone to help. To learn more about this one-hour training, visit


If you are bereaved by a suicide death, you may be in search of support for yourself and other loved ones. There are resources available online and in many communities that are specifically for people who have lost a loved one to suicide.

American Foundation for Suicide Prevention (AFSP)  
The AFSP's Suicide Survivors Outreach Program has trained volunteers who conduct personal visits to newly bereaved family. They also provide information about support groups and other local resources. Visit the website to find out how to request an outreach visit.

Suicide Awareness Voices of Education (SAVE) 
SAVE provides a variety of resources and educational materials for coping with a loss to suicide including information on grief, finding comfort, and what to say to children.

American Association of Suicidology (AAS)
AAS provides a variety of resources and educational materials for bereaved family and friends including locating a support group and how to facilitate your own survivor support group.


After A Suicide...

After a Suicide

After A Suicide...

After a Suicide

Find best practices for community response to a death by suicide including media recommendations for reporting on suicide.

Postvention is defined as actions taken after a death by suicide. This section contains many best practice resources and information for use in a variety of environments to ensure careful and sensitive care for families and communities impacted by a death by suicide.

Community Postvention Goals

1.     Reduce the risk of further suicidal behavior

2.     Avoid glorifying or sensationalizing the suicide

3.     Avoid vilifying the decedent

4.     Identify youth who may represent a high-risk for suicidal behavior

5.     Connect at-risk youth with mental health resources

6.     Identify/alter environmental factors that may be influencing the process of contagion

7.     Provide long-term surveillance and analysis

Postvention in the Community 

Due to the inherent vulnerability of many youth in response to suicidal behavior displayed by others, it is important that every school and community have a postvention response plan in place. Too often a school has found itself caught in a wildfire of suicidal behavior resulting in preventable deaths, injuries due to attempts and lives that are forever altered. Prevention is the key, and incorporating suicide prevention programs is the first level of preventative measures. Once suicide behavior has occurred, postvention protocols should be implemented immediately to prevent imitative suicide behavior among at-risk youth and other individuals in the community.