Rethink Mental Fitness
People will think of suicide for different reasons. If someone is exposed to a ‘risk factor’ it needs to be assumed that suicidal thoughts are more likely to happen.
A risk factor might include:
There are lots of studies about a possible link between antidepressants and feeling suicidal. But results are inconclusive. It is thought that risk may be higher during the first 28 days of starting antidepressants or reducing them. Someone taking medication should be monitored during these periods.
Someone taking antidepressants may be more likely to have suicidal thoughts and behaviours if they are under 25. It doesn’t mean that antidepressants shouldn’t be given for people under 25 but risks and benefits need to be thought about. If someone on medication talks about being suicidal it may be caused by the medication.
There are lots of reasons why someone may end their life. Some reasons are:
When someone feels suicidal, they may have some of the thoughts listed below.
Some people feel guilty for thinking about suicide if they have people who care about them. This can sometimes make the feelings of despair worse.
A change in someone’s personality and behaviour might be a sign that they are having suicidal thoughts. You may be the best judge of when someone you know is behaving differently.
Changes can include:
There are some indicators that suggest someone is more likely to attempt suicide. These include:
Signs that something is wrong can sometimes be more difficult to spot. Such as a cheeriness which may seem fake to you. Or they may joke about their emotions. Such as saying something quite alarming that is disguised as a joke. Don’t ignore your gut feeling if you are concerned about someone. Some people won’t be open about how they are feeling.
A lot of people try to seek help before attempting suicide by telling other people about their feelings. This could be a professional, friend or family member. If someone tells you about how they are feeling don’t ignore them.
If you think that someone may be feeling suicidal, encourage them to talk about how they are feeling.
You may feel uncomfortable talking about suicidal feelings. You may not know what to say. This is entirely normal and understandable.
It might help to:
Remember that you don’t need to find an answer, or even to completely understand why they feel the way they do. Listening to what they have to say will at least let them know you care.
If you are not sure that someone is feeling suicidal, ask:
These questions are direct. It is better to address the person’s feelings directly rather than avoiding the issue. Asking about suicide won’t make it more likely to happen.
When someone tells you that they are feeling suicidal your response may be to:
These responses are unlikely to be helpful. They may make someone feel:
Reassurance, respect and support can help someone to recover from a difficult time.
Talking about suicide can be a plea for help. Don’t assume that someone wont attempt to take their own life if they talk about suicide. Always take suicidal feelings seriously.
If you talk to someone about their feelings and it seems as though they want to end their life soon, try to keep them safe in the short term.
How do I keep them safe?
It is unlikely that you will be able to make their feelings go away, but you can help them by:
The removal of items will depend on what their immediate plan is to end their life. Examples include:
What’s a crisis plan?
A crisis plan is sometimes called a safety plan. Ideally a crisis plan should be made before someone is in crisis, but it is never too late to start.
If someone is being supported by a care coordinator, they should already have a crisis plan in place. You can ask them to show you their crisis plan. But it is their choice if they show you or not.
The aim of a crisis plan is to think about what support someone needs when they are in crisis. This may include:
Distraction techniques can include:
Remember to write down the names and numbers of people who would be able to help them.
There is no set way for how a crisis plan should look. There is a crisis plan template available in the factsheet for this section. Click on the download button at the top of the page to view it.
You can find more information about:
If someone is in immediate danger of taking their own life call emergency services on 999. Ask for an ambulance. Or take them to A&E at their local hospital.
Hospital staff will decide if they need to be admitted to hospital or not.
Give A&E staff as much information about the situation.
Crisis teams are sometimes called home treatment teams. They are part of NHS mental health services. They give short term support for people having a mental health crisis.
They are there to try and prevent people from needing to go to hospital. They should be available 24 hours a day, 7 days a week.
Access to the crisis team is different in different areas of the country. You may be able to contact them as a friend or family member. GPs, A&E and the police can also ask them to see someone.
If there isn’t a crisis team in the area you could contact the CMHT. They are part of the NHS.
They support and give treatment to people with mental health issues.
Call their GP if you know who they are. A GP may be able to offer support in a crisis. If the GP surgery is closed there will be a recorded message to tell you who to call.
NHS 111 can help if you have an urgent medical problem and you’re not sure what to do.
Dial 111 on your phone. It is a free service. They are open 24 hours a day, 7 days a week.
Crisis houses help people in crisis. They are an alternative to going into hospital. Usually people only stay in a crisis house from a couple of days up to a month. It is not a hospital but there will be healthcare professionals onsite. Usually a GP or other healthcare professional will refer someone. The NHS or charities usually run them.
They are not available in every area of the country. You can search online or check with local mental health teams to find out what is available in the local area.
Some charities offer emotional support services. They help by listening to someone’s concerns and giving them space and time to talk through how they feel. Emotional support services are not the same as counselling services.
You can find details of emotional support services at the bottom of this page.
Someone who has tried to take their own life or is showing suicidal behaviours will usually be taken to hospital. They will be kept safe and may be offered treatment.
They may be detained in hospital under the Mental Health Act. But this isn’t always necessary.
When will they be discharged from hospital?
Doctors will decide when someone is safe to leave hospital. If you don’t agree that someone is safe to leave, discuss your concerns with the hospital. Focus on risk. It may be helpful to think about the following questions:
What will happen when they are discharged from hospital?
If someone still needs a lot of support when they leave hospital you could ask them to be assessed for a package of care called ‘care programme approach’ (CPA). CPA are provided by NHS mental health teams. You can ask the hospital or GP to refer them to the mental health team.
CPA means that they will have a care plan and a care coordinator. The care plan will outline all of their needs. Their needs will be both NHS treatment and social care needs. The care plan will explain who is responsible for meeting each need.
Your relative should be placed under CPA if they have been detained in hospital under certain sections of the Mental Health Act such as section 3, or section 37.
They might be supported by the crisis team, community mental health team or GP.
If you think that they should be in hospital, ask for a Mental Health Act assessment.
It is best if the nearest relative (NR) asks for the assessment, but anyone can request one. NR is a legal term under the Mental Health Act. It is different to ‘next of kin.’ The nearest relative has certain rights.
What is a Mental Health Act Assessment?
A Mental Health Act assessment is an assessment to see if someone needs to go to hospital to be kept safe or treated against their will.
How do I ask for a Mental Health Act assessment?
If you are concerned that someone is a risk to themselves or other people you could try and get a Mental Health Act assessment by contacting an Approved Mental Health Professional (AMHP).
An AMHP works for social services but can often be found through the community mental health team (CMHT) or mental health crisis team.
The only way to give someone treatment who doesn’t want it is through the Mental Health Act. They will only be detained under the Mental Health Act if they are assessed as a high risk to themselves or other people.
There is no definition for what high risk means. It could include:
Think about the following questions:
Detaining someone in hospital can be a stressful process. It is usually the best option if someone can be encouraged to get the help for themselves, such as though their GP. Treatment available should be the same in hospital as in the community.
You can find more information about:
People with a mental illness are generally more likely to feel suicidal and attempt suicide.
Research shows that a person is more likely to attempt suicide if they have recently been discharged from a mental health hospital or unit.
What can someone do to try to stop suicidal thoughts from happening?
People manage their mental health in different ways. This is because different people find different things useful. Common examples of how people manage their mental health are:
You can find more information about:
Self-harm means that someone harms themselves on purpose. Self-harm isn’t a mental health condition, but it is often linked to mental distress.
Someone who self-harms don’t usually want to die. They may self-harm to deal with life, rather than a way of trying to end it.
But self-harm can increase the risk of suicide. Someone may accidentally end their life. Someone who self-harms should be taken seriously and offered help.
You can find more information about ‘Self-harm’ by clicking here.
If you know someone who talks about or has tried suicide, you might feel upset, frustrated, confused or scared. These are all normal responses.
Supporting a person who is suicidal can be stressful. And you are likely to need support yourself. You could try the following.
What is a carers assessment?
You have a right to have a carers assessment through the local authority if you need support as a carer. A carers assessment will work out what effect your caring role is having on your health. And what support you need. Such as practical support and emergency support.
To get a carer’s assessment you need to contact the local authority of the person you support.
It’s common for people to not consider themselves to be a carer. If you give someone lots of support, such as emotional support, you are a carer.
How do I get support from my peers?
You can get peer support through carer support services or carers groups. You can search for local groups in your area by using a search engine such as Google. Or you can call our advice service on 0300 5000 927. They will search for you.
You can find more information about:
The Samaritans give people confidential emotional support. In some areas they have local branches where you can go for support.
This is a national helpline. The offer emotional support and information for people affected by mental health problems.
Telephone: 0300 304 7000 (4.30pm – 10.30pm daily)
Textline: available through their website
CALM (The Campaign Against Living Miserably)
They raise awareness of suicide. Their helpline and webchat offers emotional support, advice and information to men and their families.
Telephone for outside London: 0800 58 58 58.
Telephone for inside London: 0808 802 5858.5pm – midnight, everyday.
Webchat: through the website
PAPYRUS (prevention of young suicide)
This is an organisation that aims to prevent suicide in young people. It can offer emotional support to people under 35 who are suicidal. They can also support people who are concerned about a young person who might be suicidal.
Aimed at people under 25. Their helpline is open between 4pm and 11pm, 7 days a week. They also run a crisis text service which is open 24 hours a day, 7 days a week.
Telephone: 0808 808 4994
E-mail: through the website.
Crisis text message service: Text THEMIX to 85258
Webchat: through the website. (4pm - 11pm, 7 days a week)
If you’re experiencing a personal crisis, are unable to cope and need support, text Shout to 85258. Shout can help with urgent issues such as suicidal thoughts, abuse or assault, self-harm, bullying and relationship challenges.
Text: Text Shout to 85258
Support line offers confidential emotional support by telephone, email and post. They try to help people find positive ways to cope and feel better about themselves.
Maytree is a national registered charity based in London. They provide a unique residential service for people in suicidal crisis so they can talk about their suicidal thoughts and behaviour. They offer a free 4 night, 5 day one-off stay to adults over the age of 18 from across the UK. Their aim is to provide a safe, confidential, non-medical environment for their guests.