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Intervention

I'm worried about someone

Safety First

The first thing to consider is whether you need emergency services. E.g. if the person has told you they have taken an overdose, they need an ambulance right away. Call 999. The physical safety of the suicidal person is the most important thing to consider before moving into any further intervention.

Stay Calm

If you've become aware that someone you know is having thoughts of suicide, first things first, take a breath. Maybe you just have a worry, maybe someone has said something to you that might mean they are feeling suicidal or maybe someone has told you clearly that they are having thoughts of taking their own life. However you've become aware of this, you are dealing with a very difficult thing and it is completely normal to be feeling stressed or anxious. However, it is important that you stay calm.

Ask the Question

This can be hard and uncomfortable, but it is rare for someone to say clearly and directly that they are feeling suicidal. They are more likely to say things like:

"I can't do this anymore"

"I don't want to be here"

"I'm thinking of ending it all"

"It won't matter soon"

However, it may not even be this explicit so if you have any concern that suicide might be on a persons mind, ask clearly:

"Are you thinking about taking your own life?"

"Have you been thinking about suicide?"

"Sometimes when people are dealing with what you've been dealing with/feeling how you're feeling, they start to think about suicide. I'm wondering if that's something you've been thinking about?"

There is a myth that asking someone about suicide will put the idea in their head if it wasn't there already. This is untrue and several studies have shown that when people who are feeling suicidal are asked about suicidality, they are less likely to progress towards an attempt. There are also several studies showing that when people who are not suicidal are asked about suicide, they do not develop thoughts of suicide. Asking is safe, asking is encouraged, asking could save a life.

Let them tell you their story

You've asked the question and been told they are having suicidal thoughts. You've stayed calm, patient and compassionate and the person now knows that suicide is a safe topic to discuss with you. If it is safe to do so and the person doesn't need immediate help. Allow them the time and space to tell you what has brought them to thinking about suicide. Create a safe, non-judgemental space where the person feels heard and understood. Empathise with their situation but avoid phrases like "I understand" or "I know what you're going through", these ring false because we can't fully know or understand another person's experience.

See the Language Matters section for common mistakes and suggested alternatives when talking about suicide.

Establish Risk Level

Once you have given the person a chance to be heard and understood. You can begin to get a sense of where the current risk level lies. If you are in need of support with this, please make use of advice from CAMHS or your own Mental Health and Wellbeing services.

Planning - We can ask if they have put any thought into how or when they would attempt to end their live.

Isolation - We can ask if anyone else but us knows how they are feeling and if they would be open to you sharing it with others together. (In many situations, especially in schools, this information will need to be shared with home but if the young person can agree, this is preferable).

Access to Methods - once we know how they had thought about ending their live we can ask if they have access to what they would need. (Medications, sharps, rope, high open windows etc.)

Co-creating a Safety Plan

It's important to remember that the goal here is not to keep the person safe forever. It's only to keep the person safe right now or until you can get them to the right service or support. What do they need right now to keep themselves safe for the next hours, days, weeks? Can they do this alone or do they need help? Who could help? (this is where you can explore their support network). A template safety plan can be found below but a plan can be in the form of a discussion and doesn't always need to be written down.

Suicide-Safety-Plan-A5-Booklet-English-2024.pdf

Support Access to Appropriate Mental Health Support

Part of any intervention around suicide risk should be supporting that person to access appropriate mental health support. This can come in many different forms and should be guided by the person's wishes as much as possible. The person might feel that their existing family and friend support network, once the people in it are aware of their struggles, is enough. They might want to access counselling, therapy or another support via the Single Point of Access

Considering a CAMHS Referral

A referral to Child and Adolescent Mental Health Services (CAMHS) may be appropriate in some cases, but it is not always necessary. The level of intervention should be guided by the young person’s level of risk, their ability to manage their thoughts safely, and the support available within their environment.

If a young person acknowledges having thoughts of suicide but:

Feels they are unlikely to act on them,
Has not developed a plan or means to carry it out, or
Describes these thoughts as fleeting or hypothetical rather than an intention to harm themselves,

then specialist mental health services may not be immediately required. In such cases, appropriate school-based support, monitoring, and early intervention strategies may be sufficient.

However, if there is any doubt about risk level, staff should seek advice and guidance either from CAMHS directly or from within the school’s safeguarding and mental health support structure.

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