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Concern about someone’s mental health does not always begin with an obvious crisis.
Maybe someone close to you has become harder to reach. A normally social family member has started isolating. A friend sounds increasingly hopeless. Someone who has been under significant stress begins drinking more, sleeping at unusual times, or making comments that leave you wondering whether they feel safe.
It is not always easy to know what these changes mean. It can be even harder to decide whether you should say something.
Understanding the warning signs of suicide does not allow you to know exactly what another person is thinking. What it can do is help you recognize signs of significant emotional distress, take concerning changes seriously, and know when it may be appropriate to ask directly about suicide or help someone reach professional support.
You do not have to be a clinician to express concern for someone you care about. At the same time, friends and family should not be expected to manage a suicide-related crisis on their own.
If You or Someone Else Needs Help Now
If you or someone you know is experiencing suicidal thoughts, severe emotional distress, a mental health crisis, or a substance use-related crisis, call or text 988 to reach the 988 Suicide & Crisis Lifeline.
The Lifeline connects people in the United States with trained crisis counselors 24 hours a day, seven days a week. You can also contact 988 if you are concerned about another person.
If there is immediate physical danger, a suicide attempt is occurring, or there is another medical emergency, call 911 or go to the nearest emergency department.
This article is educational and is not a substitute for evaluation or treatment from a licensed mental health or medical professional.
How to Help Someone Suicidal: What Are the Warning Signs of Suicide?
There is no single appearance, personality type, diagnosis, or behavior that identifies someone as suicidal.
Some people may directly say they want to die. Others communicate emotional pain in less obvious ways. Warning signs may appear in conversations, behavior, relationships, sleep, substance use, mood, or reactions to a significant loss or life change.
The 988 Suicide & Crisis Lifeline advises paying particular attention when concerning behaviors are new, increasing, or associated with a painful event, loss, or significant change.
A warning sign is not the same as a diagnosis. Seeing one sign does not prove that someone intends to attempt suicide.
The purpose of recognizing warning signs is to notice when someone may be struggling enough to need a conversation, additional support, or professional evaluation.
Listen Closely to What the Person Is Saying
Emotional pain sometimes becomes visible through language before other changes are easy to recognize.
Take comments seriously when someone frequently talks about:
- Not wanting to be alive.
- Wanting to die.
- Feeling that life has no purpose.
- Believing that nothing will improve.
- Feeling trapped by their circumstances.
- Experiencing emotional or physical pain that feels unbearable.
- Feeling like a burden to other people.
- Believing their family or friends would be better without them.
The tone of the statement does not necessarily tell you how serious the underlying distress may be.
A comment made during an argument, presented as a joke, or quickly taken back can still be worth checking on.
You do not have to determine whether someone “really means it” before responding with concern.
Changes in Behavior May Be Important
Sometimes the most noticeable sign is that a person simply does not seem like themselves.
Possible behavioral changes associated with suicide risk can include:
- Pulling away from friends or family.
- Becoming significantly more isolated.
- Sleeping much more or much less than usual.
- Appearing increasingly restless, anxious, or agitated.
- Acting more recklessly than is typical for them.
- Increasing alcohol or drug use.
- Showing unusually intense anger or rage.
- Experiencing pronounced changes in mood.
The 988 Lifeline includes these types of changes among potential suicide warning signs, particularly when they are new or escalating.
Context matters.
Someone who naturally prefers solitude may spend considerable time alone without it indicating a crisis. For another person, suddenly withdrawing from nearly every relationship could represent a meaningful change.
Rather than comparing someone with an idea of what emotional distress is “supposed” to look like, consider whether their behavior has changed from what is normal for them.
You do not need to determine which diagnosis might explain the change. Mental health assessment belongs with qualified professionals.
You can simply notice that something seems different and ask about it.
Emotional Changes Can Be Warning Signs Too
A person experiencing significant distress may begin to seem:
- Hopeless.
- Overwhelmed.
- Extremely anxious.
- Agitated.
- Emotionally disconnected.
- Increasingly isolated.
- Trapped by circumstances.
- Unable to imagine that life could become different.
Severe or unusual mood changes may also deserve attention.
These emotions do not automatically mean a person is suicidal. Many people experience anxiety, grief, depression, or emotional overwhelm without having suicidal thoughts.
But you do not need certainty before checking in.
A gentle opening may be enough:
“I’ve noticed you haven’t seemed like yourself lately. How have you been doing?”
Suicide Warning Signs and Risk Factors Are Different
People sometimes use the terms warning signs and risk factors as though they mean the same thing.
They do not.
A warning sign may indicate that someone is experiencing meaningful distress or possible suicide risk in the present.
A risk factor describes a characteristic or circumstance associated with greater vulnerability over time.
The 988 Lifeline notes that risk factors cannot, by themselves, cause or predict a suicide attempt.
Suicide is complex. It should not be explained by one breakup, relapse, diagnosis, financial problem, argument, traumatic experience, or other single event.
Likewise, having a mental health condition or another recognized risk factor does not mean that a person will attempt suicide.
Licensed clinicians assess suicide risk using multiple pieces of information about the individual and their circumstances.
Friends and relatives do not need to conduct their own clinical risk assessment. Their role can be much simpler: notice concerning changes, listen, ask questions, and help the person reach appropriate support.
What People Often Get Wrong About Suicide Warning Signs
Misconceptions about suicide can make people hesitate at the exact moment a conversation may be important.
“People who talk about suicide usually aren’t serious.”
Statements about suicide should be taken seriously.
Trying to decide whether someone is “being dramatic” or “looking for attention” can distract from the more important question: What is causing this person enough pain that they are talking this way?
A person communicating distress deserves to be heard.
“I shouldn’t bring up suicide unless I know for sure.”
You do not need proof before expressing concern.
If someone’s statements or behavior worry you, it is reasonable to ask how they are feeling. When suicide is a concern, you can also ask about it directly.
“Asking about suicide might put the idea in their head.”
Research does not support this common fear.
The National Institute of Mental Health states that asking someone directly whether they are thinking about suicide does not increase suicidal thoughts or suicidal behavior.
Direct language may make it easier for someone to tell you what they are experiencing.
“They told me they’re okay, so I should never bring it up again.”
One conversation may not resolve your concern.
If significant behavioral or emotional changes continue, another caring check-in may be appropriate.
Ongoing contact can also matter after someone has experienced a mental health crisis or returned home following treatment.
“I need to know exactly what to say.”
There is no perfect script.
Listening carefully, responding without judgment, and helping the person connect with qualified support are more important than finding flawless words.
How to Ask Someone If They Are Thinking About Suicide
It is understandable to feel uncomfortable asking a direct question about suicide.
You may worry about upsetting the person, embarrassing them, or saying the wrong thing.
Clear language is often more helpful than vague wording.
You might ask:
“You’ve been dealing with a lot lately, and I’m concerned about you. Have you been thinking about suicide?”
You could also say:
“When you say you don’t want to be here anymore, are you talking about ending your life?”
Or simply:
“I care about you, and I want to ask directly: Are you thinking about suicide?”
NIMH recommends asking directly when suicide is a concern. Research reviewed by the agency does not indicate that asking increases suicidal behavior or thoughts.
If the answer is yes, you do not need to become the person’s therapist.
You also do not need to perform your own suicide assessment.
Listen to what they tell you, take the disclosure seriously, and help connect them with a crisis counselor, clinician, or other appropriate professional support.
What Can Help During the Conversation?
When someone tells us they are hurting, the natural reaction is often to try to fix the problem immediately.
We may offer advice.
We may tell them how much their family loves them.
We may point out positive things in their life.
We may try to convince them that circumstances are not as bad as they seem.
Those responses often come from care. But someone experiencing intense emotional distress may first need to feel that another person is willing to hear what they are actually experiencing.
Consider responses such as:
“I’m glad you told me.”
“That sounds very difficult.”
“I want to understand what you’ve been going through.”
“I’m taking this seriously.”
“We can connect with someone who knows how to help with this.”
Try to avoid responses that minimize or dismiss the person’s experience, such as:
“Other people have it worse.”
“You have so much to be grateful for.”
“You wouldn’t actually do that.”
“Stop talking like that.”
“You’re just trying to get attention.”
You do not have to agree with someone’s interpretation of their circumstances to recognize that their emotional pain may feel overwhelming to them.
Five Evidence-Informed Ways to Help Someone Who May Be Suicidal
NIMH describes five practical suicide-prevention actions: Ask, Be There, Help Keep Them Safe, Help Them Connect, and Follow Up.
1. Ask Directly
When you are concerned about suicide, ask clearly.
Then give the person time to answer.
Resist the impulse to immediately reassure them, debate their feelings, or change the subject.
2. Be Present
Presence can look different depending on the situation.
It might mean listening in person, staying connected by phone, continuing a text conversation, or involving another trusted support person when appropriate.
Listening without judgment can help someone feel less alone with what they are experiencing.
Being present does not mean becoming solely responsible for another person’s safety. Professional help should be involved when indicated.
3. Focus on Safety
If the person appears to be in immediate danger, the priority is obtaining appropriate crisis or emergency assistance.
When it is safe to do so, remain connected or help another trusted person stay with them while appropriate help is arranged.
If an attempt is occurring or there is immediate physical danger or another medical emergency, call 911 or seek emergency medical care.
Do not put yourself in physical danger while attempting to assist someone else.
4. Help Them Connect With Support
Depending on the circumstances, appropriate support may include:
- The 988 Suicide & Crisis Lifeline.
- A psychiatrist.
- A therapist or counselor.
- A physician or other healthcare professional.
- An established mental health treatment program.
- A trusted family member or supportive friend.
- Another appropriate community behavioral health resource.
You can also contact 988 yourself because you are concerned about another person.
5. Follow Up
Care and connection can continue after an immediate crisis has passed.
NIMH notes that ongoing supportive contact following a suicide-related crisis or discharge from care can have an important role in suicide prevention.
A short message such as “I’ve been thinking about you. How are you doing today?” can communicate that the earlier conversation mattered and has not been forgotten.
When Should You Contact 988 Instead of 911?
Knowing which resource to use can be confusing, particularly when emotions are high.
Call or Text 988 for Mental Health and Crisis Support
The 988 Suicide & Crisis Lifeline offers support for suicidal thoughts and other forms of emotional or behavioral health distress.
A person does not need to wait until a situation becomes life-threatening before contacting 988.
988 can be appropriate when someone is struggling with emotional distress, anxiety, depression, loneliness, substance use concerns, relationship problems, trauma, or another mental health concern and needs crisis support.
Call 911 for Immediate Physical Danger or Medical Emergencies
Call 911 or seek emergency medical care when there is immediate danger to life, a suicide attempt is occurring, or another medical emergency requires an emergency response.
When a situation involves behavioral health distress but does not appear to be an immediate medical emergency, 988 can help connect the person with a trained crisis counselor.
When Mental Health and Substance Use Concerns Occur Together
Mental health symptoms and substance use sometimes overlap.
Someone experiencing depression may also begin drinking more heavily. Another person may use drugs while trying to cope with trauma, anxiety, or overwhelming emotions. A return to substance use after a period of recovery may occur alongside shame, isolation, relationship difficulties, or worsening psychiatric symptoms.
Increased alcohol or drug use is also included among the potential warning signs identified by the 988 Lifeline.
Substance use alone does not establish that someone is suicidal.
However, a significant increase in use—particularly when combined with hopelessness, withdrawal from relationships, suicidal statements, agitation, or other major changes—deserves careful attention.
People experiencing both mental health and substance use concerns may benefit from an assessment that considers both rather than treating each issue in isolation.
First City Mental Health Center provides treatment for adults experiencing mental health conditions as well as co-occurring mental health and substance use disorders in Kokomo, Indiana. Its current continuum includes residential mental health treatment, partial hospitalization, outpatient services, and additional substance-use treatment levels when clinically appropriate.
The appropriate type and intensity of treatment should be determined through professional assessment. Individual treatment needs and outcomes vary.
A Safety Note About Detox and Withdrawal
Stopping alcohol or certain drugs abruptly can carry significant withdrawal risks for people who have developed physical dependence.
In particular, withdrawal associated with alcohol or benzodiazepines can become medically serious and, in some cases, dangerous.
Home detox is not appropriate for everyone.
Whether supervised withdrawal management is needed depends on multiple factors, including the substance involved, pattern and duration of use, physical health, psychiatric symptoms, medications, previous withdrawal experiences, and other clinical considerations.
Anyone concerned about withdrawal should speak with a qualified healthcare professional.
Medical detox or another supervised level of withdrawal management may be necessary when clinically indicated.
This article should not be used as instructions for stopping substances or managing withdrawal at home.
September 2026: Suicide Prevention, Mental Health, and Recovery Awareness
September brings several national and international observances related to mental health, suicide prevention, treatment, substance use, and recovery.
Awareness events cannot replace professional care. However, they can encourage people to learn the warning signs, reduce stigma, discuss mental health more openly, and become familiar with available support.
National Suicide Prevention Month — September
September is widely observed as National Suicide Prevention Month.
It provides an opportunity for individuals, families, healthcare organizations, schools, workplaces, and communities to increase understanding of suicide prevention and encourage compassionate conversations about mental health.
For families, useful actions can be simple: learn common warning signs, save 988 as a crisis resource, check in when someone seems different, and become more comfortable asking direct questions when suicide is a concern.
National Suicide Prevention Week — September 6–12, 2026
In 2026, National Suicide Prevention Week falls from September 6 through September 12.
The week provides an opportunity to move beyond general awareness and learn practical ways to respond when someone is experiencing significant emotional distress.
988 Day — September 8
September 8 is 988 Day, a national SAMHSA initiative designed to increase awareness of the 988 Suicide & Crisis Lifeline.
The 2026 theme is “988 Reasons: Your reason is reason enough.”
SAMHSA emphasizes that a person does not have to wait for distress to become an extreme crisis before contacting 988.
World Suicide Prevention Day — September 10
World Suicide Prevention Day is observed September 10.
The World Health Organization identifies “Changing the Narrative on Suicide” as the 2024–2026 campaign theme, with “Start the Conversation” as its call to action.
The initiative encourages people and institutions to challenge harmful misconceptions, reduce stigma, and create environments in which people feel safer discussing suicide and asking for help.
That goal can begin at an individual level: noticing when someone is struggling, asking a clear question, listening without judgment, and helping the person connect with qualified support.
September Is National Recovery Month
September is also National Recovery Month, an observance that recognizes recovery from mental health and substance use conditions while promoting evidence-informed treatment, recovery supports, and the work of behavioral health professionals.
SAMHSA describes Recovery Month as a national observance held every September to support evidence-based treatment and recovery practices and recognize people, families, professionals, and communities involved in recovery.
The overlap between Recovery Month and Suicide Prevention Month is especially relevant in behavioral healthcare.
Mental health, substance use, suicide risk, treatment, and recovery frequently intersect. Comprehensive care considers the individual rather than assuming these concerns exist in separate categories.
National Addiction Professionals Day — September 20
National Addiction Professionals Day is observed on September 20.
Established by NAADAC, the observance recognizes professionals involved in addiction prevention, intervention, treatment, and recovery services.
Depending on the setting, those professionals may include counselors, therapists, nurses, physicians, case managers, peer-support professionals, and other members of multidisciplinary behavioral health teams.
When Is Professional Mental Health Support Appropriate?
A person does not need to reach a crisis before seeking mental health care.
Professional evaluation may be appropriate when emotional, behavioral, psychiatric, or substance use concerns:
- Continue becoming more intense.
- Interfere with work, school, relationships, sleep, or everyday responsibilities.
- Persist despite informal support.
- Include suicidal thoughts or statements.
- Occur alongside substantially increased alcohol or drug use.
- Continue returning after previous periods of stability or treatment.
- Make it difficult for the person to function or feel safe.
- Lead family members to believe that more structured support may be necessary.
A licensed mental health professional can assess symptoms in context and recommend an appropriate level of care.
For some people, outpatient therapy may be sufficient. Others may require a more structured treatment environment, such as partial hospitalization or residential mental health treatment.
The appropriate recommendation depends on the individual assessment.
When Comparing Mental Health Treatment Options, What Should You Look For?
When an immediate crisis has been stabilized, families may face a different question: What kind of ongoing treatment is appropriate?
Rather than evaluating a mental health program primarily by amenities or marketing language, consider its clinical structure.
Questions worth asking include:
- Is the facility appropriately licensed and accredited where applicable?
- Which licensed professionals provide psychiatric and medical oversight?
- How is an initial psychiatric or behavioral health assessment completed?
- Can the program address both mental health and substance use concerns when they occur together?
- What levels of care are available?
- How does the clinical team determine the appropriate level of care?
- Are treatment plans individualized?
- Is medication management available when clinically appropriate?
- Are individual and group therapy included?
- Is family or support-system involvement available when appropriate?
- How does the program respond if symptoms become more severe?
- How are transitions between levels of care managed?
- What continuing-care or discharge planning is provided?
First City Mental Health Center currently describes residential, partial hospitalization, and outpatient mental health programming, with multidisciplinary care involving psychiatrists, therapists, nurses, and other clinical staff.
No behavioral health program can guarantee a specific result.
Mental health treatment is individualized, and outcomes vary. A qualified assessment can help determine whether residential treatment, partial hospitalization, outpatient services, psychiatric care, therapy, substance use treatment, or another form of support is appropriate.
Frequently Asked Questions About Suicide Warning Signs
Does One Suicide Warning Sign Mean Someone Is Suicidal?
No.
One behavior or emotional change cannot confirm that someone is suicidal.
At the same time, you do not have to wait for several warning signs before checking in. One concerning statement or an important departure from someone’s usual behavior can be enough reason to ask how they are doing.
Is It Safe to Ask Someone Directly About Suicide?
Yes.
If you are concerned, a straightforward question such as “Have you been thinking about suicide?” can help begin a conversation.
NIMH reports that research does not show that asking directly about suicide increases suicidal thoughts or suicidal behavior.
What Should I Do If Someone Says They Are Thinking About Suicide?
Listen without judgment and take what the person tells you seriously.
Help them contact professional or crisis support. You can call or text 988 together, or you can contact 988 yourself because you are concerned about them.
If there is immediate physical danger, a suicide attempt is occurring, or there is another medical emergency, call 911 or seek emergency medical attention.
Can I Call 988 Because I Am Worried About Someone Else?
Yes.
You can contact 988 because you are concerned about a friend, family member, or another person who may need crisis support.
Is 988 Only for People Who Are Suicidal?
No.
988 can also support people experiencing emotional distress, mental health concerns, substance use difficulties, anxiety, depression, loneliness, trauma, relationship problems, or other behavioral health challenges.
SAMHSA’s 2026 988 Day campaign specifically emphasizes that people do not have to wait until they consider themselves to be in a severe crisis before reaching out.
Can Increased Drinking or Drug Use Be a Suicide Warning Sign?
It can be one potential warning sign.
The 988 Lifeline includes increasing alcohol or drug use among behaviors that may warrant concern, especially when the change is new, escalating, or occurring with other signs of emotional distress.
Substance use by itself does not prove someone is suicidal.
A licensed clinician can evaluate how substance use, psychiatric symptoms, medical concerns, and other factors interact.
What If I Responded Poorly When Someone First Opened Up?
You can return to the conversation.
You might say:
“I’ve been thinking about what you told me. I don’t think I responded as well as I wanted to, but I care about what you’re going through. Can we talk about it again?”
Supporting another person does not require a perfect first response.
You Do Not Have to Ignore a Change Because You Cannot Explain It
Recognizing suicide warning signs is not about learning how to diagnose another person.
It is about paying attention when something changes.
It means listening when someone tells you that life feels unbearable instead of automatically dismissing the statement.
It means being willing to ask a direct question when you are worried.
And it means recognizing when the situation requires more support than a friend or family member can reasonably provide.
If someone you care about seems to be struggling, begin with concern. Listen to what they tell you. Take suicide-related statements seriously. Help them connect with qualified support when needed.
For adults in Kokomo, Central Indiana, and surrounding communities who have moved beyond an immediate emergency but continue to need structured support for mental health or co-occurring concerns, First City Mental Health Center offers multiple levels of behavioral health treatment.
A professional assessment can help determine whether a particular service or level of care is appropriate. Treatment needs and outcomes vary from person to person.
If you or someone you know is experiencing suicidal thoughts, a mental health crisis, emotional distress, or a substance use-related crisis, call or text 988. If there is immediate physical danger or another medical emergency, call 911 or go to the nearest emergency department.
