Death by suicide: What are the signs? How can I reach out? What you can do to help save a life

Death by suicide is the biggest killer of men under forty-five, and the fourth leading cause of death among 15–29-year-olds. We read the statistics and news headlines, or remember the boy in the year above at school, but what can we do to help?

According to Samaritans, ‘only a third of people who die by suicide have been in contact with specialist mental health services in the year before their death’, so to get people the help they need, firstly, it’s important to recognise the signs of someone considering suicide.

Some signs according to SAVE, Suicide Awareness Voices of Education used by Samaritans:

Talking about suicide – Any conversation on dying or self-harm.

Self-destructive behaviour – Increased alcohol or drug use, reckless driving, unsafe sex, taking risks like they have a death wish.

No hope for the future – Feeling that things will never get better, that “there's no way out.”

Preoccupation with death – Unusual focus on death, dying, or violence through writing.

Self-loathing – Feelings of worthlessness, guilt, shame, and self-hatred, like a burden that “everyone would be better off” without.

Withdrawing from others – A desire to be left alone.

Seeking out lethal means – Access to objects that could be used in a suicide attempt.

Sudden sense of calm – A sudden sense of happiness after being depressed can mean that they have decided to attempt suicide.

Getting affairs in order – Making a will, giving away possessions, and making arrangements for family.

Saying goodbye – Unusual visits or calls to family and friends, saying goodbye as if they won't be seen again.

Samaritans say that ‘a suicidal person can’t see any way of finding relief except through death.’ There are many complexities that make people feel trapped, but we can introduce help and relief to them by starting the conversation.

Ways to reach out, according to Samaritans

Provide a supportive presence free or judgement – Create a safe space for them to feel, express themselves or sit in silence and know that they are cared for.

Listen – It is usually better to listen and respond with open questions rather than advice or opinions.

The idea is not to make them feel guilty, but to let them know they are not worthless – That they contribute meaningfully to the lives of others. Avoid expressions that centre around their actions, such as ‘I’ll be so upset if you die.’

Let them know that you value them – If it feels appropriate, using your own words like, ‘you’re important to me.’

Take the person seriously – Evidence shows that asking someone if they’re suicidal can protect them. By being direct, you give them permission to tell you how they feel and let them know that they’re not a burden. You’re allowing them to share their pain, not putting ideas in their head.

In my experience, honesty about my own darkest times and thoughts have encouraged others to talk about theirs. Acknowledging that you don’t have to be alone to feel lonely can go a long way. According to Samaritans, ‘it’s important to be persistent’, and persistence can be following up on medication, encouraging positive lifestyle changes and being supportive and available even after a crisis point. Another way to be helpful is by making a safety plan to navigate suicidal feelings and urges, where the person has ownership of the plan, but you support them.

Safety plan, suggested by Samaritans

Identify signs that someone might be nearing a crisis – Such as, in the past, they might have experienced patterns of thinking, physical sensations or specific mental images just before a crisis.

Internal coping strategies – Things that the person can try on their own, like removing themselves from a situation or looking at soothing resources, images, or messages.

Use friends and family to distract from suicidal thoughts – Like a place where the person who is struggling can go.

Writing down which friends and family can help them navigate a crisis – A list of trusted people to turn to who can help make sure that there’s always someone there.

A list of mental health professionals and agencies to call.

Make it harder for the person to harm themselves - Removing things that could be used for suicide or self-harm.

There is no ultimate prevention of suicide, but by understanding the people that we care about, we are more able to help them. It is a strength to care about others, so be proactive, don’t just say ‘you can call me anytime’ like a manager saying, ‘my door is always open’, but show them that you care for the long haul. I am twenty-three years old, and six people I know have died by suicide. But the more we incorporate suicide into our language, psyche, and awareness that it could happen be anyone we know, the more lives we can save.

If you need help or would like to learn more, here are some sources below:

Where to get help

Samaritans: call 116 123, 24/7 operative.

CALM: call 0800 585858 (available every day from 5PM to midnight).

Papyrus UK: call 0800 068 4141 (9am to midnight).

Call 999: or the local emergency number.

Reading sources:

Suicide Prevention: https://www.helpguide.org/articles/suicide-prevention/suicide-prevention.htm

Why more men than women die from suicide: https://www.bbc.com/future/article/20190313-why-more-men-kill-themselves-than-women

Gender and Suicide: https://media.samaritans.org/documents/ResearchBriefingGenderSuicide_2021_v7.pd