“I just didn’t want to be alive anymore,” Meghan told Oprah. “And that was a very clear and real and frightening constant thought.” According to the National Institute of Mental Health, suicide is a leading cause of death in the United States. Additionally, suicidal thoughts are very common: 4.8% of adults ages 18 and over reported having serious suicidal thoughts in 2019. And the pandemic hasn’t helped anything—in August, the CDC reported that as many as 1 in 4 young adults between the ages of 18 to 24 had seriously considered suicide in the past 30 days. And yet, actually talking about suicide is still taboo. Sarah Harte, LICSW and Director at The Dorm, a mental health company that uses evidence-based clinical therapies to treat young adults, says Markle’s decision to go public with her experience is a huge step in the right direction for people all over the world who are navigating scary thoughts like this. “This is especially important as Meghan and Harry build an organization [Archewell] focusing on compassion and well being—they are showing with their own lives and their own stories, that it is OK (and very important) to be authentic in expressing feelings and allow an open dialogue about the challenges that so many of us face.” Despite the revelations in this barrier-breaking interview, it can still be tough to know exactly what to say when someone tells us they’re thinking about self-harm or suicide, and we’re often paralyzed by fear that we’ll say the wrong thing. Parade.com talked with mental health experts to better understand how to navigate this kind of situation.

Ask open-ended questions

When someone opens up about thoughts of harming themselves, it might be a natural instinct to change the subject in order to not “egg them on.” But according to Dr. Ziv Cohen, MD, a board-certified clinical and forensic psychiatrist and founder and medical director of Principium Psychiatry, it’s important to ask follow-up questions. For example, ask, ‘What are the thoughts you are having?’" says Dr. Cohen. “It’s also important to follow up with specifics, like, ‘What ways of killing yourself are you thinking about?’ Do not worry that you are putting ideas into the person’s mind—you are not. Asking specifics helps you understand how serious the person is and whether this is an emergency. If it is, call the national suicide hotline or 911.”

Encourage them to talk about it

Again, this might seem counterintuitive, but Harte echoes Dr. Cohen’s comment that by talking about it you won’t be “putting ideas in their head,” which is a fear many people have. “People report that talking about their suicidal thoughts offers relief and can effectively facilitate a path toward healing,” says Harte. It’s also a good idea to ask people if they’re OK unprompted. “There are no right and wrong ways to ask a friend or family member if they are OK—just start the conversation,” Harte suggests. “You could say, ‘I’ve noticed you’re not yourself lately’ or, ‘I’m worried about you, can we talk?’ or, ‘I hear you talking about being hopeless, have you been thinking about suicide?’”

Don’t brush them off

When someone opens up to you about suicidal thoughts, it’s important not to be dismissive of them. “Don’t say, ‘you’ll feel better tomorrow’ and forget about the conversation,” Dr. Cohen says. “Tell the person you’re concerned and that you want them to call you if the thoughts get worse so you can find a strategy together to stay safe and get better. Stay involved and seek the help of a professional early on.”

Make sure they get help

One important thing to note here is that it’s not enough to simply talk about it with the person—it’s also really important to connect them with the right resources so they can get the help they need. “If someone tells you that they are struggling with suicidal thoughts, it’s important to connect them with support. There are a variety of ways to access immediate support, including the National Suicide Hotline and the Crisis Text Line,” says Harte. “It is also important to help people get connected to longer-term professional help with a therapist and/or psychiatrist.” If you or someone you love is having suicidal thoughts, call the National Suicide Prevention Lifeline at 800-273-8255 or text HOME to 741741 for free 24/7 crisis counseling.  Next up, here are the 30 best mental health apps of 2021.

Sources

National Institute of Mental Health: “Suicide"Centers for Disease Control and Prevention: “Mental Health, Substance Use, and Suicidal Ideation During the COVID-19 Pandemic—United States, June 24–30, 2020"Sarah Harte, LICSW and Director at The DormDr. Ziv Cohen, MD, a board-certified clinical and forensic psychiatrist and founder and medical director of Principium Psychiatry What to Say When Someone Opens Up About Suicidal Thoughts - 16