Suicidal ideation refers to thinking about or planning suicide. These thoughts can range from fleeting considerations to extensive planning. While not everyone with suicidal ideation will attempt suicide, it is a sign that someone is suffering and needs support. Education is vital for understanding this complex mental health issue.

Many people have misconceptions about suicide and make unfair judgements about those experiencing suicidal crises. In reality, suicidal ideation is usually a symptom indicating extreme emotional or psychological distress. There are almost always underlying issues that need to be addressed through counseling, medication, lifestyle changes, or other treatment.

Risk factors for suicidal ideation

Certain factors can increase someone’s risk of contemplating suicide. These include:

• Mental health conditions like depression, bipolar disorder, schizophrenia, PTSD, anxiety disorders, and substance abuse. Around 90% of people who die by suicide have a diagnosable condition.
• A family history of suicide or mental illness. Genetics and early childhood environments may play a role.
• Trauma from physical or sexual abuse, disaster, violence, or loss of a loved one.
• Chronic pain, illness, and other health problems.
• Social isolation, bullying, discrimination, relationship conflicts, unemployment, financial stress, and other life challenges.
• Impulsivity and aggression. Some personality traits affect how a person copes with difficulties.
• Access to lethal means, especially guns.
• A previous suicide attempt. This is the strongest predictor of future attempts.
• Exposure to another person’s suicide, or to graphic or sensationalised accounts of suicide.
• Cultural and religious beliefs, such as the perception that suicide is a noble resolution of a personal dilemma.

Warning signs of suicide risk

Many suicidal people show one or more warning signs, especially if the behavior represents a change from their normal way of being. Signals to look out for include:

• Talking about wanting to die, feeling hopeless or trapped, having no reason to live, or being a burden to others.
• Making a specific suicide plan or acquiring means such as a firearm or stockpiling pills.
• Giving away possessions, tying up loose ends, or saying goodbye to loved ones.
• Sudden mood improvements after a period of depression, which may indicate the person feels relief at having made a decision.
• Withdrawal from social activities, hobbies, work, or school.
• Significant personality changes, serious mood swings, or increasing use of alcohol or drugs.
• Aggression, rage, extreme mood swings, or reckless behaviours.
• Struggling to sleep or sleeping all the time; drastic changes in eating habits.
• Visiting or calling people to say goodbye.
• Self-loathing comments, expressions of guilt or shame, or a fixation on death in conversation, creative works, social media posts.

Responding to suicidal threats and behaviour

If you notice any of these red flags in a friend, loved one, student, patient, or coworker, take action. Start by talking to them in private about your concerns. Don’t be afraid to ask directly if they are having suicidal thoughts. Raising the issue will not give them ideas. The most helpful thing you can do is listen without judgment.

Take all threats seriously – never assume the person is only seeking attention. Remind them that with help, the crisis will pass, problems can be solved, and they will feel better in time. Don’t try to minimise their feelings or offer simple solutions. Instead, let them know they have options and that you care.

You can point them to resources like crisis hotlines, counselors, clergy, mental health professionals, or a hospital emergency room. If the risk seems imminent, stay with the person until help is available. Call 911 or the National Suicide Prevention Lifeline at 1-800-273-TALK (8255) if you cannot safety monitor the situation.

With support, compassion, and access to treatment, many people can overcome suicidal thinking. But providing this help requires understanding how complex and multi-faceted the problem is. Educating ourselves and others is the first step.

Promoting education and awareness

There are many ways we can foster greater knowledge about suicide risk and prevention:

• Share articles, videos, infographics, and other educational materials from reputable health organizations. Avoid stigmatizing language.
• Support mental health education campaigns like the National Alliance on Mental Illness’s Better to Know initiative.
• Participate in awareness events like the American Foundation for Suicide Prevention’s Out of the Darkness Walks.
• Advocate for suicide prevention training for teachers, counselors, clergy, first responders, and health providers.
• Correct misinformation on social media and in news reports that could promote contagion.
• Learn the warning signs and risk factors so you can recognize people in crisis.
• Become trained in mental health first aid, psychological CPR, or suicide intervention skills.
• Stay informed on research related to suicide risk assessment, treatment, and prevention.
• If you have struggled with suicidal thoughts in the past, consider telling your story to help others feel less alone.
• Promoting education and expanding the public conversation on suicide leads to increased understanding, more people getting much-needed help, and ultimately lives saved. We all have a role to play.

Studies show public awareness campaigns can reduce suicide rates. For example, after Austria started a national suicide prevention program in the 1980s, overall rates decreased by 7% over two decades. Education enables healthier attitudes, lowers stigma barriers, and connects more people with life-saving resources. Each life lost to suicide is a tragedy—but through knowledge, hope and help, many more can be spared.

Valerie Hopewell is a freelance mental health writer.