Why Asking the Hard Question “Are You Thinking About Suicide?” Matters More Than We Think

As we raise Suicide Prevention Awareness in this Month of September, a time when individuals globally reflect on the reality of suicide, encourage conversations about mental health, and highlight strategies that help prevent loss of life. One of the most powerful tools we have is a simple question: “Are you thinking about suicide?” Asking this question directly can create a turning point for someone in despair.

What is suicidal ideation

Suicidal ideation refers to when a person thinks about ending their life. These thoughts may be passive so that a person simply wishes not to wake up or rarely considers death. Or the thoughts may be more active including planning or imagining ways to die. Suicidal ideation is a serious signal of distress and should always be met with care, compassion and prompt support.

Signs to observe before you ask

You do not need to wait until a full crisis to speak up. There are signs that suggest someone may be struggling enough that asking the question could be necessary. Some of these signs include:

• Talking about hopelessness or saying life does not have meaning
• Expressing that they are a burden or that people would be better off without them
• Major changes in behaviour such as withdrawing from friends or activities, or sudden silence or isolation
• Dramatic shifts in mood for example very sad for a long time or a person seeming calm after a period of distress
• Increased use of substances or risky behaviour
• Giving things away, or creating what seem like final arrangements

Not all these signs may be present and people may show different combinations. You do not need to wait until you feel sure. If you observe several signs, it may be time to ask.

What research says about asking directly

There is a persistent myth that asking someone if they are thinking about suicide will somehow encourage suicidal thoughts. However research does not support that myth. For example a systematic review by Dazzi and colleagues (2014) found that asking about suicide and related behaviours in research or clinical settings did not increase suicidal ideation in either adults or adolescents. In many cases it led to improvements in mental health among people seeking help.

Another study embedded two suicide questions within adolescent health screening that showed a reduction in suicide attempts among students compared to those without such screening. This demonstrates that directly addressing suicide as part of routine care or conversation can reduce harm.

Globally, more than 720,000 people die by suicide annually. Suicide is the third leading cause of death among people aged 15 to 29. About seventy three percent of those deaths occur in low and middle income countries.

Why asking “Are you thinking about suicide?” matters

• Creates space for truth: When you ask directly, you signal that you care enough to notice the pain. That signal can relieve isolation.
• Reduces silence and stigma: Many people carry suicidal thoughts in secret because they fear judgement. A direct question breaks the taboo and lets them know they might not be alone.
• Leads to earlier help: People who are asked tend to open up sooner and access help earlier. This reduces the risk of acting on thoughts.
• Does not increase risk: As above, the evidence shows that asking does not make suicidal ideation worse. It can actually help reduce distress.

How to ask the question

Wait for a private moment where the person feels relatively safe. Use a calm voice and express concern, for example:

• “I’ve noticed you have been going through a lot lately. Are you thinking about suicide?”
• “Sometimes when people feel hopeless they wonder about ending their life. Are you feeling like that now?”

Tips when asking:

• Listen without judgement
• Let them talk as much as they need to
• Avoid telling them what to do; focus on letting them know you care and that help is possible

What to do after they respond

If the person says yes or seems unsure:

• Stay with them if possible until further help arrives
• Encourage them to connect with a mental health professional, counselor or trusted person
• Help them find resources and support in their community (www.smacwellbeing.org)
• Remove or reduce access to means of harm if you can safely do so
• Follow up later to reaffirm support

Getting help in Nigeria

If you or someone you know is struggling with suicidal thoughts in Nigeria here are three helplines you can reach out to:

1. SURPIN Nigeria (Suicide Research and Prevention Initiative)

https://lifeline-international.com

2. Mentally Aware Nigeria Initiative (MANI)

https://mentallyaware.org

3. SMAC Wellbeing

SMAC Wellbeing recognizes, relates, responds, and refers.

www.smacwellbeing.org

These helplines provide confidential, compassionate support. If someone is in immediate danger please call local emergency services.

Essentially, asking someone “Are you thinking about suicide?” is not easy but it is often essential. Research shows that asking such questions does not harm and often helps. Recognizing warning signs and speaking with honesty and kindness can open the way to healing.

Every life has value. Sometimes the question you ask could be the one that changes a life.

References

• Dazzi T, Gribble R, Wessely S, Fear NT. Does asking about suicide and related behaviours induce suicidal ideation? What is the evidence? Psychological Medicine. 2014.
• Suicide and Suicide Risk in Adolescents | Pediatrics. Embedding suicide questions in screening reduced attempts among students.
• World Health Organization. Suicide fact sheet.
• Nigerian Mental Health Helplines – Mentally Aware Nigeria Initiative
• Suicide Research and Prevention Initiative (SURPIN)