Recognizing hidden signs of suicide risk

According to provisional data from the Centers for Disease Control and Prevention, in 2024, more than 14 million people in the United States thought about suicide, and nearly 50,000 died by suicide.

Veronica Campbell, a licensed marriage and family therapist at Sharp Mesa Vista, says it is important to take someone seriously when they make direct statements about wanting to die or feeling completely hopeless. Those are clear warning signs, but others can be harder to notice.

“Someone who has been struggling with depression might suddenly appear unusually calm, relieved or even cheerful,” she says. “That shift can happen because they’ve made a decision and see an end ahead.”

Other subtle warning signs can include quietly taking care of paperwork, giving away possessions, showing little emotion or engagement, or making offhand remarks about wanting everything to stop.

Campbell recommends trusting your instincts and supporting someone even if they say they’re fine.

“Asking someone directly if they’re thinking about suicide does not put that idea in their mind,” she says. “Rather, it helps break through their isolation and creates a safe space for them to be honest with you.”

She adds that saying silver linings, like “look on the bright side,” can make a person feel misunderstood or guilty for struggling. Instead, validating their feelings and avoiding open-ended questions are often more supportive.

“Saying, ‘I hear how exhausted you are, and I'm right here with you,’ can go a long way,” says Campbell. “Rather than asking what they need, bring a meal or help them make their living space safer. Write down a list of trusted contacts and crisis numbers and keep checking in even after things seem to improve.”

How to help when someone is struggling

If you’re unsure about the next steps, Campbell recommends texting or calling the Suicide & Crisis Lifeline at 988. Mental health professionals answer the lifeline, and if appropriate, they can send a mobile crisis team to someone contemplating suicide.

If a loved one goes to the emergency room, keep in mind that the focus is on medical stabilization and safety, not punishment. Medical staff check vital signs and help decide what kind of treatment — whether inpatient or outpatient — is the best fit.

Inpatient treatment involves staying at the hospital, whereas outpatient treatment has the patient go home each day after a few hours.

While not all suicide attempts are impulsive, some decisions can be made quickly. “In clinical settings, that critical window can be less than an hour,” says Campbell.

Because that intense period is so short, restricting access to lethal means can save lives. Locking up medications, securing firearms and removing immediate risks can create an important buffer.

“If you can help someone safely endure the peak of that crisis, the urge can fade,” says Campbell. “Even one life lost to suicide is too many, and our efforts to help and show that we care can be monumental.”

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