What resources are available for someone experiencing suicidal thoughts?

Resources for Someone Experiencing Suicidal Thoughts

The National Suicide Prevention Lifeline (988) is the primary resource for immediate crisis intervention for individuals experiencing suicidal thoughts, providing 24/7 support through trained counselors who can help develop safety plans and connect callers to additional mental health services. 1, 2

Immediate Crisis Resources

• The 988 Suicide and Crisis Lifeline (formerly known as the National Suicide Prevention Lifeline) provides 24/7 telephone-based crisis intervention services across the United States 2
• Crisis Text Line is available by texting HOME to 741741 for those who prefer text-based communication 1
• Specialized crisis lines exist for specific populations, including The Trevor Project for LGBTQ+ youth and Trans LifeLine for transgender individuals 1
• Local crisis centers often provide immediate telephone support and can connect individuals to local mental health resources 1

Effectiveness of Crisis Intervention Services

• Research shows that follow-up calls to suicidal individuals can significantly reduce perceived risk of future suicidal behavior, with 79.6% of followed clients reporting that intervention stopped them from killing themselves 3
• Crisis hotlines employ three essential principles: active engagement, active rescue, and collaboration between crisis and emergency services 4
• While early studies had methodological limitations regarding crisis hotline effectiveness, current evidence suggests they can be valuable when properly implemented 1
• Crisis hotlines are most effective when they include procedures to evaluate and refer identified individuals at risk to appropriate mental health services 1

Mental Health Professional Services

• Emergency department evaluation for those at imminent risk of suicide, with potential referral to inpatient psychiatric services when necessary 1
• Outpatient mental health treatment through psychiatrists, psychologists, or licensed therapists 1
• Partial hospitalization programs or intensive outpatient services for those requiring structured support but not full hospitalization 1
• In-home treatment or crisis stabilization interventions where available 1

Evidence-Based Treatment Approaches

• Dialectical Behavior Therapy (DBT) has strong evidence for reducing suicidal and self-directed violence, particularly among those with borderline personality disorder 1
• Crisis response planning, which involves collaborative identification of warning signs, self-management skills, social supports, and crisis resources 1
• Problem-solving therapy to improve coping with stressful life experiences through active problem solving 1
• Cognitive Behavioral Therapy (CBT) focused on addressing suicidal thoughts and behaviors 1

Safety Planning

• Safety planning should include identification of warning signs, coping strategies, healthy distractions, social supports, professional contacts, and means restriction 1
• Means restriction counseling is crucial, as many suicide attempts are impulsive (24% of attempts occur within 5 minutes of the decision) 1
• Families should be counseled on securing potential means of self-harm, including medications, knives, and especially firearms 1, 5
• For families with firearms, temporary relocation of weapons is recommended; if not possible, storing them unloaded in tamper-proof safes with ammunition stored separately 1

Barriers to Seeking Help

• Common barriers to contacting crisis services include belief that conversations won't be effective, fear of the conversation itself, and emotional concerns about discussing suicidal thoughts 6
• Gender differences exist in help-seeking behavior, with males at higher risk for suicide but less likely to reach out to crisis services 1, 6
• Brief interventions addressing specific barriers can potentially increase utilization of crisis services 6

Support for Family and Friends

• Third-party callers (family/friends concerned about someone) represent an important group of crisis line users, with counselors able to provide interventions and guidance 7
• Family members should be educated about warning signs, how to communicate with the person at risk, and when to seek emergency services 1, 5
• After a suicide, relatives, friends, and others close to the person may benefit from postvention services to facilitate grieving and reduce guilt 1

Pitfalls and Considerations

• Do not rely solely on "no-suicide contracts" as they have not been shown to prevent subsequent suicides; instead, focus on comprehensive safety planning 1
• Avoid dismissing self-harm thoughts even when no specific plan is present; continue thorough assessment and monitoring 5
• Be aware that some medications, particularly benzodiazepines, may increase risk in certain individuals through disinhibition effects 1, 5
• Don't assume crisis services alone are sufficient; they should be part of a continuum of care that includes appropriate follow-up 2, 3