Suicide prevention: the basics

The 988 Lifeline connects you with a trained counselor any time of day or night, every day of the year. Conversations are free and confidential. You can call 988, text 988, or chat online at chat.988lifeline.org.

You don’t need to be suicidal to reach out. 988 is for anyone in emotional distress, and for anyone worried about someone else. Text and chat are also available in Spanish.

What happens when you reach out

• A trained counselor listens without judging
• They help you work through what is happening right now
• They can help you make a plan to stay safe
• They can connect you with local support

If talking out loud feels too hard, texting can be easier. Text HOME to 741741 from anywhere in the United States, at any time. A trained volunteer crisis counselor will text back. It is free and confidential, though normal message and data rates may apply.

Veterans, service members, National Guard and Reserve members, and the family and friends who support them can call 988 and press 1, text 838255, or chat online. It is free, confidential and open 24/7. You don’t need to be enrolled in VA benefits or health care.

The Trevor Project offers crisis support for LGBTQ+ young people 24/7, every day of the year. It is free and confidential. You can call 1-866-488-7386, text START to 678-678 (message and data rates may apply), or chat on their website.

If you or someone else is in immediate danger, call 911 or go to the nearest emergency room. If you are worried about someone, do not leave them alone while you get help.

Find A Helpline lists free, confidential helplines in more than 175 countries, by phone, text or chat. If a life is in immediate danger, call your local emergency number.

Pay attention when someone talks, posts or texts about wanting to die or about feeling hopeless. Sometimes it is said as a joke or in passing. Take it seriously anyway.

It might sound like

• “I just want it all to stop.”
• “Everyone would be better off without me.”
• “I can’t see a way out.”
• “There’s no point anymore.”
• “I can’t take this pain much longer.”
• “I won’t be a problem for you much longer.”

Changes in behaviour can be a sign that someone is struggling more than they are saying. These are most worrying when they are new or follow a painful event.

Look out for

• Withdrawing from friends, family and activities
• Saying goodbye to people, or giving away prized things
• Looking for ways to end their life, or making a plan
• Drinking or using drugs more
• Sleeping much more or much less
• Taking dangerous risks
• Acting aggressively or seeming very tired

Strong, painful feelings often sit underneath suicidal thoughts. Someone may seem deeply sad, anxious, angry or numb.

Look out for

• Depression, anxiety or losing interest in things
• Feeling empty, hopeless or trapped
• Shame, humiliation or intense guilt
• Irritability, agitation, anger or rage
• Big mood swings
• Sudden relief or calm that doesn’t seem to have a clear reason

A sudden lift in mood after a very dark time can be real recovery. But sometimes it can mean a person has stopped fighting their thoughts. If something feels off, check in.

Depression and other mental health conditions, alcohol or drug problems, serious physical illness, chronic pain and brain injuries can all raise risk. This is one reason getting care for these conditions is so important.

Stressful events like a breakup, divorce, money crisis, job loss or the death of someone close can raise risk, especially when other risks are present. Ongoing harassment, bullying, discrimination and loneliness also weigh heavily.

Having easy access to firearms or other dangerous means also raises risk. Being exposed to someone else’s suicide, or to sensational coverage of it, can too.

A past suicide attempt is one of the strongest risk factors. A family history of suicide, and childhood abuse, neglect or trauma, also raise risk.

In the U.S., suicide rates are highest among American Indian and Alaska Native people. Veterans, people in rural areas, and people in jobs like mining and construction also have higher rates. Lesbian, gay and bisexual young people are more likely to have suicidal thoughts and behaviours than their peers.

This is not because of who people are. It is often linked to things like discrimination, isolation, trauma and harder access to care.

Protective factors are the things that help keep people safe, even during hard times. They are where families, friends and communities can make a real difference.

What helps protect people

• Strong connections to family, friends and community
• Easy access to mental health and health care
• Problem-solving and coping skills
• Limited access to firearms and other dangerous means
• Beliefs and communities that encourage connection, purpose and asking for help

For teens, feeling connected at school and having parents or carers who know what is going on in their lives were linked with lower suicide risk in a large CDC survey.

In 2023, 6,398 U.S. veterans died by suicide. The suicide rate among veterans was about twice as high as among non-veteran adults, and suicide was the second leading cause of death for veterans under 45.

Support that fits

• The Veterans Crisis Line: call 988 and press 1, or text 838255. You don’t need to be enrolled in VA care
• Peer support from other veterans who understand military life
• Telehealth, which helps when providers are far away
• Family members can learn the VA’s S.A.V.E. steps: Signs, Ask, Validate, Encourage and expedite help

Adults ages 35 to 64 account for almost half of all suicides in the U.S., and suicide is the 6th leading cause of death in this age group. In 2024, the suicide rate for men ages 45–64 was 29.6 per 100,000, and the highest rate among women was also in the 45–64 age group (8.1 per 100,000).

Midlife can stack up pressures: work, money, divorce, caring for children and ageing parents at once, and health changes. Many people in this stage are used to being the one others lean on, which can make asking for help feel harder.

Adults ages 80 to 84 have the highest suicide rates of any age group. In 2024, men 75 and older had a rate of 40.1 per 100,000, the highest of any group of men.

Loss of a partner, loneliness, chronic pain, illness and feeling like a burden can all weigh heavily in later life. Help works at every age.

What helps

• Regular visits and calls, especially after a loss
• Asking gently and directly if you are worried
• Helping them stay involved in things that give life meaning
• Telling their doctor about changes in mood or talk of being a burden

CDC finds that suicide rates increase as population density goes down. Big cities have the lowest rates and the most rural areas have the highest.

Rural prevention programs focus on safe firearm storage, and telehealth helps bring care closer where providers are scarce. Long distances to care and worries about privacy in a small town can also make reaching out harder.

Non-Hispanic American Indian and Alaska Native people have the highest suicide rates in the U.S., and suicide is the 8th leading cause of death in these communities. CDC points to social conditions such as discrimination, economic hardship and barriers to care.

Tribal health organizations are leading prevention work shaped by their own communities and cultures.

Many communities draw strength from culture, language, ceremony, family and community ties. Support works best when it respects and builds on these.

In 2023, about 1 in 5 lesbian, gay or bisexual high school students reported a suicide attempt in the past year, more than three times the rate of heterosexual students.

This comes from rejection, bullying and stigma, not from being LGBTQ+. Accepting families, supportive schools and connection with peers make a real difference.

A 2022 study found that adults with disabilities were 2 to 3 times more likely to report suicidal thoughts than adults without disabilities.

Isolation, pain, discrimination and care that isn’t accessible can all add up. Support that is built with disabled people, not just for them, helps most.

988 can be reached by videophone in American Sign Language, and interpreters are available. See the “Neurodiversity: the basics” guide.

In 2021, industries with the highest suicide rates included mining, construction, arts and entertainment, and farming, fishing and forestry. CDC says the workplace is an important place for suicide prevention.

What helps at work

• Leaders who talk openly about mental health
• Training crews and staff to notice signs and ask
• Sharing 988 and any employee support program often
• A plan for supporting coworkers after a loss

Watch for changes that last for weeks, not days. A teen who stops seeing friends, sleeps all the time or stops caring about things they loved may be hurting. Respond with curiosity and warmth instead of arguing or lecturing.

Try saying

• “You haven’t seemed like yourself lately. I’m here, no matter what.”
• “Sometimes when people feel this low, they think about suicide. Have you had thoughts like that?”
• “Thank you for telling me. We’ll figure this out together.”

In a large CDC survey, teens who felt connected at school, and whose parents or carers usually knew where they were and who they were with, had lower rates of suicidal thoughts and attempts. Staying involved is not about spying. It is about warm, ongoing interest in their life.

Everyday ways to stay close

• Know their friends and ask about their day
• Eat together when you can
• Encourage clubs, teams or activities where they belong
• Talk about how social media makes them feel

Pediatricians advise removing firearms from the home if possible, or storing them locked and unloaded, with ammunition locked separately. They also advise locking up alcohol and other items that could be dangerous during a crisis.

If you are worried, contact your child’s primary care provider, a therapist or a school counselor. If they are in immediate danger, call 911 or go to an emergency department. You can call or text 988 together any time, or for advice yourself.

Teens can talk to their doctor privately, and that time stays confidential unless someone’s safety is at immediate risk. If a doctor learns a teen is at risk, they will involve parents, and the teen usually gets a say in how that conversation happens.

Changes in sleep can be a warning sign, and good sleep helps teens handle stress. Experts recommend 60 minutes of physical activity a day for adolescents. Help them set a realistic pace and break big tasks into smaller ones.

This is one of the most important facts in suicide prevention. Studies show that asking someone directly whether they are thinking about suicide does not cause or increase suicidal thoughts. Asking can be the best way to find out if someone is at risk.

A review of research found no increase in suicidal thoughts when people were asked about them. Talking openly may even reduce them, because the person feels seen and less alone.

Talking about wanting to die is a recognised warning sign. Someone who talks about suicide is telling you they are hurting. Thinking “they won’t really do it” is a misconception that can stop people from getting help.

Most people considering suicide don’t actually want to die. They feel they can’t keep living with the pain they are in. That is why helping them see other options, and easing the pain, can save a life.

Many suicidal crises are brief. When dangerous means are harder to reach, suicides often go down, and people usually do not simply switch to another way. Putting time and distance between a person and danger saves lives.

About 9 in 10 people who survive a suicide attempt do not go on to die by suicide later. Help and time really do make a difference.

Mental health conditions raise risk, but suicidal thoughts can also come with extreme distress such as grief, a crisis or ongoing pain. A person can have generally good mental health and still feel unable to cope for a time.

Suicidal thoughts can come and go, but they do not have to be permanent. Many people who have been through a suicidal crisis, or survived an attempt, go on to heal with time and support.

1. Ask: “Are you thinking about suicide?”
2. Be there: listen, and do what you say you’ll do
3. Help keep them safe: put time and distance between them and anything dangerous
4. Help them connect: to 988, a professional, and people who care
5. Follow up: a text, a call or a visit in the days after

Asking directly does not increase suicidal thoughts. Talking openly may even reduce them, because the person feels seen and less alone.

A safety plan is a short list of steps to follow when suicidal thoughts or a crisis shows up: warning signs, ways to cope, people to contact, crisis lines including 988, and ways to make surroundings safer. It is written ahead of time, ideally with someone trusted or a professional.

In a study across nine VA emergency departments, people who made a safety plan and got follow-up calls were about half as likely to have suicidal behaviour over the next six months.

Many suicidal crises are brief. When dangerous means, such as firearms, are harder to reach, suicides often go down, and people usually do not simply switch to another way. Safe storage buys time for the crisis to pass.

Save 988 in your phone, and share it with friends and family. 988 is for anyone in emotional distress, and for anyone worried about someone else. You can call, text or chat at 988lifeline.org.

One well-known program, QPR, stands for Question, Persuade, Refer. In about 1 to 2 hours, people learn the warning signs, common myths, how to ask the suicide question directly, how to listen and encourage someone to accept help, and how to connect them to resources.

QPR describes itself as an emergency response by ordinary citizens, not treatment. Studies of it found gains in knowledge about suicide, confidence and skills. It is used with teens, adults and older adults, and by school staff, health workers, faith leaders and police.

Other trainings, such as Mental Health First Aid, and the VA’s free S.A.V.E. training for people who support veterans, teach similar skills.

Students who feel connected at school have lower rates of suicidal thoughts and attempts. Schools can train staff to spot and refer students at risk, teach coping and problem-solving skills, and make sure every student has at least one trusted adult.

Adults spend much of their lives at work, and CDC calls the workplace an important opportunity for suicide prevention, especially in industries with higher rates.

What workplaces can do

• Train managers and peers to notice and ask
• Share 988 and support programs in break rooms, chats and pay slips
• Make it normal to take time off for mental health appointments
• Have a plan for supporting staff after a suicide loss

Beliefs and communities that encourage connection, purpose and asking for help are protective. Faith leaders are among the people gatekeeper programs train, because people often turn to them first.

Ideas for congregations

• Speak about mental health and suicide with compassion from the pulpit or in groups
• Make sure people know that asking for help is not a lack of faith
• Welcome and include families who have lost someone to suicide
• Keep a list of local mental health services and 988 handy

Coaches, club leaders and group organisers often notice when someone changes. A simple check-in, and knowing how to ask about suicide, can make these spaces part of suicide prevention.