Knowledge is Key, Reacting to the Warning Signs of Suicide

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by Susan Ripley, MA CWLC-S; Director of Licensing                   

As we continue our blog series for National Suicide Prevention Week, we felt it was so important to discuss the warning signs that may be present when someone is considering suicide, as well as explore the actions that can best help someone in crisis, as well as those reactions that are not helpful.

Suicide claims more lives than HIV and homicide combined...but by knowing the warning signs and how to help someone in crisis, we may be able to make a difference for at least one person.

As someone who has worked in the mental health field, has a Master’s degree in Counseling and is certified in teaching suicide prevention as part of the QPR Institute, I am unfortunately not immune to the reach of suicide. I recently lost a nephew to suicide and experienced all the stages of grief that go along with this tragedy:

  • Denial - Not accepting that the tragedy happened
  • Anger - Resentment for causing his family pain
  • Bargaining - Making a deal with God asking for it be undone
  • Depression - Sadness and regret for my loss
  • Acceptance - Withdrawal and reflection of the loss 

I listened to my sister as she struggled with the heavy burden of wondering if she could have detected his pain and suffering and possibly done something to help him rise out of his despair.  All of his family and friends each reviewed their last contacts with my nephew, wondering if they should have known he was growing weary of trying to deal with the burdens that his mental health condition was causing him. In the end, we move through the stages of grief, maybe never fully reaching an ‘acceptance’ stage for many years.

The Scoope of the Problem in the US

According to the Suicide Prevention Resource Center, citing statistics from the CDC:

  • More than 38000 people died by suicide in 2010.
  • Over 4800 children, teens and young adults 24 years of age and younger die by suicide each year.  
  • Suicide is the second leading cause of death among 25 to 34-year olds.
  • Suicide is the third leading cause of death among 15 to 24-year olds.
  • Suicide among 45 to 54-year-olds is a growing problem; the rate of suicide is higher in this age group than in any other.
  • Although older adults engage in suicide attempts less than those in other age groups, they have a higher rate of death by suicide
  • Over the age of 65, there is one estimated suicide for every 4 attempted suicides compared to 1 suicide for every 100-200 attempts among youth and young adults ages 15-24.

Children in foster care are at higher risk for attempting or seriously considering suicide. As the parents and professionals tasked with keeping these children safe, it is so important that we educate ourselves on how to recognize the risk factors and know what to do with this knowledge. 

3 Steps to Suicide Prevention

The QPR Institute believes that suicide prevention can be reached in three easy steps: Question, Persuade, Refer.


Question the individual's desire or intent regarding suicide


Persuade the person to seek and accept help


Refer the person to appropriate resources.

According to the SPRC, youth that experienced trauma, abuse or neglect may also experience a deep sense of loss when removed from their parents, siblings and friends. These experiences of loss, isolation and lack of social support are all risk factors for suicide.  

Behaviors Indicating an Immediate Risk for Suicide 

  • Talking about wanting to die or to kill oneself
  • Looking for a way to kill oneself, such as searching online or obtaining a gun
  • Talking about feeling hopeless or having no reason to live

Other Signs That Someone May Become Suicidal

  • Withdrawing
  • Extreme mood swings
  • Increasing alcohol or drug use
  • Giving away prized possessions or a favorite pet away (indicating to us that they don’t plan on being around to enjoy these things)
  • Talking about being a burden to others (“You would be better off without me”, etc.)
  • Engaging in reckless behavior (drug use or other life threatening activities that most people would avoid as part of self-preservation)

In order to recognize the signs of suicidal behavior, you must remain close and keep your ears and eyes open for some of the signs named above.  Once you identify that someone is in crisis you must then work to get them help.

Helping Someone Who is at Risk

If you are concerned that someone close to you may be considering suicide, you should first let them know that you are there to listen to them…sometimes what seems like a minimal act to you such as staying close and asking questions brings a great relief to those in crisis. Don’t be afraid to ask questions. When asking the question, it is important that it is said in a direct, non-threatening way such as “Are you thinking about killing yourself?”  Or if that is too direct, you can start the conversation by asking, “Sometimes when people feel sad, they think about hurting themselves...have you ever had thoughts like that?”.  When asking these very important questions, it is so important that we do not minimize their feelings by asking in a condescending way that may make them afraid to talk, such as “You’re not thinking of killing yourself are you?” or “What do you have to be depressed about?”. 

In light of the recent suicide of comedian Robin Williams there have been many responses via social media that have not been reactions that were helpful. Someone shared their comment, “Nothing is THAT bad”, minimizing the despair that Robin Williams was feeling, as well as possibly causing others who are considering suicide to feel that no one would understand their struggle. There have been other responses I’ve seen or heard over the years that imply there is an ‘easy fix’ to suicidal feelings such as “go shopping”, which absolutely minimizes the extreme sadness one may be experiencing.   Leave the lines of communication open by letting them know that you care and asking in a caring way if they have thought about harming themselves.

If they admit that they have been considering harming themselves, the next step is to persuade them to accept help. Try to persuade them to seek immediate help, letting them know you will remain close while you help them reach out to a professional.  Know your resources – once you persuade them to accept help, you must know where to refer them.  There are many local and national resources that can help someone in a time of crisis. 


Tomorrow, we’ll wrap up our blog series by discussing how to survive suicide.  There are many long lasting effects from a suicide and it is important that we are able to help those around us as they survive.