This article was written by the Grand Rising Behavioral Health clinical team and reviewed by licensed mental health professionals specializing in suicide prevention, trauma-informed care, DBT, and adult mental health. All clinical reviewers adhere to APA and DSM-5-TR guidelines, ensuring access to up-to-date, evidence-based guidance.

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Watching someone you care about struggle with suicidal thoughts is overwhelming. Knowing how to respond can change the outcome. 

This guide provides clear, practical steps for adults, from identifying warning signs and taking immediate action to understanding longer-term treatment options. 

You’ll also find guidance on supporting a loved one while protecting your own emotional health.

Warning Signs of Suicidal Thoughts in Adults

Spotting warning signs early is the first step in offering meaningful help. Signs can show up in behavior, mood, or how a person talks about themselves and their future.

Early recognition of suicidal ideation can save lives. Warning signs often appear as behavioral changes, emotional shifts, or verbal cues, sometimes subtly at first.

Watching for patterns, especially when several signs appear together, helps determine when immediate support is needed.

Behavioral Indicators of Suicidal Ideation

Behavioral changes are often the most visible early signs. These shifts may signal internal distress, hopelessness, or feelings of being overwhelmed.

• Social withdrawal: Pulling away from friends, family, or previously enjoyed activities.
• Loss of interest or motivation: Disengaging from hobbies, work, or daily routines.
• Sleep disturbances: Sleeping more or less than usual, frequent insomnia, or disrupted sleep patterns.
• Appetite changes: Noticeable weight loss or gain from reduced or increased eating.
• Increased substance use: More use of alcohol or drugs to cope.
• Risk-taking behaviors: Reckless driving, unsafe sexual activity, or impulsive actions.

Emotional and Psychological Warning Signs

Emotional indicators often reflect significant internal struggle and may appear before verbal expressions of suicidal thoughts.

• Persistent hopelessness or despair: Belief that circumstances will not improve.
• Chronic shame or self-blame: Feeling like a burden or believing others would be better off without them.
• Intense anxiety or agitation: Restlessness, panic, or inability to relax.
• Emotional numbness or emptiness: Feeling disconnected from emotions or surroundings.
• Sudden mood shifts: Moving from deep distress to a calm or “resolved” state may indicate increased risk.

Verbal Cues That Signal Elevated Risk

What someone says, directly or indirectly, can provide important insight into suicidal ideation.

• Statements such as “Life isn’t worth living,” “I’m tired of everything,” or “Everyone would be better off without me.”
• Talking about feeling trapped, having no purpose, or seeing no future.
• Expressing a desire to disappear, not wake up, or escape pain permanently.

Any expression of suicidal thoughts, whether vague or explicit, should be taken seriously. Asking direct, compassionate questions does not increase risk and can lead to life-saving support.

Need Professional Support Right Now?

If suicidal thoughts or emotional distress interfere with daily life, structured care can help. Grand Rising Behavioral Health offers evidence-based treatment in Massachusetts through Partial Hospitalization, Intensive Outpatient, and telehealth services. These programs help adults stabilize while staying connected to their lives.

Our clinicians specialize in DBT, EMDR, trauma-informed care, and crisis intervention. They create personalized plans to support safety, recovery, and long-term resilience.

Risk Factors That Increase Suicidal Thoughts in Adults

Certain factors raise the likelihood of suicidal thinking. Mental health conditions such as depression, anxiety, and bipolar disorder are common contributors. According to the CDC, approximately 49% of people who die by suicide have a known diagnosed mental health condition, while many others may struggle with undiagnosed or untreated symptoms that significantly heighten their risk (CDC, 2025).[1]

Major life stressors, such as relationship breakdowns, job or financial pressures, and unresolved trauma, also increase risk. Knowing these factors helps you identify who might need extra support.

Immediate Actions You Can Take to Help Someone Who Is Suicidal

When someone is in crisis, timely, compassionate action matters. Approach the situation with calm, curiosity, and a clear intent to keep them safe.

Use the 5 Key Suicide Prevention Steps Effectively

1. Ask Directly: Ask plainly and compassionately. For example, “Are you thinking about killing yourself?” Direct questions do not plant ideas; they open the door to help.
2. Listen Actively: Give your full attention. Let them tell their story without interruption. Reflect what you hear and acknowledge their pain.
3. Encourage Professional Help: Suggest contacting a mental health professional, primary care provider, or crisis service. Offer to help find a clinician or make an appointment.
4. Stay Connected: Keep in touch through calls, texts, or visits. Consistent contact reduces isolation and shows you are a steady source of support.
5. Create a Safety Plan: Work together to list warning signs, coping strategies, trusted contacts, and emergency steps. Remove or secure any means of harm when possible.

Contact Emergency Services or the 988 Lifeline

If the person expresses intent to harm themselves, has a plan, or appears unable to keep themselves safe, call emergency services or the 988 Suicide & Crisis Lifeline immediately. 

When you call, explain the current behaviors, any known plans or means, and any medical or mental health history so responders can act appropriately.

Long-Term Treatment Options for Adults with Suicidal Ideation in Massachusetts

Sustainable recovery often requires ongoing care that addresses the root causes of suicidal thoughts. Effective programs combine therapy, medication management, and skill-building in a structured setting.

How Partial Hospitalization and Intensive Outpatient Programs Help

Structured programs like PHP and IOP provide multi-disciplinary support without requiring full inpatient hospitalization. PHP offers several hours of daily treatment while allowing patients to sleep at home; IOP meets fewer hours each week but still delivers focused therapy, medication oversight, and group support. Both help stabilize symptoms and teach coping strategies for safer daily living.

Dialectical Behavior Therapy (DBT)

DBT is one of the most empirically supported psychotherapies for reducing suicidal behaviors and self-injury, particularly when emotion regulation and interpersonal skills are central challenges. 

Meta-analyses and clinical trials have found that DBT significantly lowers the frequency of suicide attempts, non-suicidal self-injury, and crisis service use compared with standard treatment, and helps patients stay engaged in therapy over time.[2]

Trauma-Focused Therapies (EMDR)

Eye Movement Desensitization and Reprocessing (EMDR) is widely used to help people process traumatic experiences that may underlie suicidal thinking. Trauma-focused care within broader suicide prevention strategies can reduce emotional distress and build resilience in adults with trauma histories.

Cognitive Behavioral Therapy (CBT)

CBT and related cognitive-behavioral approaches show strong evidence for reducing suicidal ideation and behavior by targeting negative thought patterns, maladaptive beliefs, and behavioral avoidance. 

Research has shown that CBT can moderately lower both suicide risk and self-harm recurrence, and it is widely recommended in clinical guidelines as a first-line psychotherapeutic intervention for adults at elevated suicide risk.[3]

Medication Management (SSRIs and Others)

Medications such as selective serotonin reuptake inhibitors (SSRIs) may be recommended when anxiety, depression, or other mood symptoms are present alongside suicidal thoughts. 

Although pharmacotherapy alone is rarely sufficient, combined treatment with therapy often yields better outcomes. 

Some evidence also supports other medications (e.g., lithium or ketamine in select cases) for reducing suicidal ideation in high-risk adults when used under clinical supervision.[4]

The table above summarizes common treatment pathways for adults thinking about suicide. Reviewing these options with a clinician helps you choose the right level of care for recovery and safety.

Supporting a Loved One Experiencing Suicidal Thoughts

Helping someone through suicidal thoughts calls for steady compassion, open communication, and realistic expectations. Your presence and patience can make a meaningful difference.

Use Communication Techniques That Build Trust and Understanding

Use open-ended questions, mirror what you hear, and validate their emotions without minimizing them. Say things like, “That sounds really hard,” or “I’m glad you told me.”

Avoid lecturing or quick fixes. Stay curious and compassionate, so they feel safe sharing what is true for them.

How to Practice Self-Care While Supporting Someone in Crisis

Supporting someone in crisis is emotionally demanding. Set boundaries, ask for help, and utilize your own support network or a professional counselor. Maintain routines that restore you, including sleep, proper nutrition, regular physical activity, and brief breaks, so you can remain present and effective for your loved one.

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Helping someone who is suicidal means recognizing warning signs, taking prompt, compassionate action, and connecting them to appropriate care. Your support matters, and so does looking after your own well-being as you help another person through a crisis.

Why Choose Grand Rising Behavioral Health

Choosing a treatment center for mental health treatment in Massachusetts requires trust. Our approach is based on clinical expertise, ethical care standards, and genuine compassion.

Evidence Based, Clinically Led Care

All treatment is designed and delivered by licensed mental health professionals trained in nationally recognized, research-backed therapies for suicide prevention and emotional regulation. These include DBT, EMDR, and CBT-informed approaches.

Right Level of Care

Our PHP and IOP programs provide intensive clinical support without inpatient hospitalization. Clients maintain family, work, and community connections as they heal.

Personalized Treatment Plans

We do not use templates or one-size-fits-all protocols. Each care plan is tailored, integrating therapy, skill development, lifestyle support, and medication management.

Trauma-Informed Environment

We prioritize psychological safety, respect, and dignity. Our small, supportive setting fosters trust, peer connection, and meaningful therapeutic relationships. These are key to lasting recovery.

With in-person and telehealth options, we ensure continuity of care and access at every stage of recovery. At Grand Rising, our focus goes beyond crisis stabilization. We help people rebuild hope, emotional strength, and a future worth living for.

Contact us today for a confidential consultation.

Frequently Asked Questions

What should I do if someone refuses to talk about their suicidal thoughts?

Respect boundaries, but show concern and keep the door open. Say you care and are available when they are ready to talk. Offer practical help, such as finding a clinician, calling a crisis line together, or attending an appointment. Ongoing presence and gentle invitations often help more than pressure.

How can I help someone who is experiencing a mental health crisis?

Prioritize immediate safety. Stay with the person if safe, remove obvious means of harm if possible, and listen without judgment. If they are in immediate danger, call emergency services or a crisis hotline.

After the immediate crisis, help them connect to professional care and community support.

What resources are available for someone struggling with suicidal thoughts?

Immediate support is available through the 988 Suicide & Crisis Lifeline, which provides 24/7 help from trained counselors. Local hospitals, community mental health centers, and private therapists offer assessment and treatment.

Peer support groups and verified online resources can also help. Encourage a mix of professional and community supports.

How can I recognize if my support is helping?

Progress can be gradual. Signs your support is helping include increased openness, returning to some daily activities, following through on appointments, using coping strategies, or expressing appreciation.

If safety remains a concern, continuing to connect them with clinical care is important.

What should I avoid saying to someone who is suicidal?

Avoid minimizing language or quick reassurances like “It’s not that bad” or “Just think positively.” These responses feel dismissive.

Do not lecture or offer platitudes. Instead, validate what they are feeling, acknowledge their pain, and ask how you can help right now.

How can I encourage someone to seek professional help?

Frame professional help as a practical step toward relief, not a sign of weakness. Offer to research options, make calls, or go with them to appointments.

Normalize therapy by sharing that many people find it helpful. Be patient. Encouragement combined with practical support often makes it easier to take the first step.

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Resources

1. Centers for Disease Control and Prevention. (2025, December 23). Suicidal thoughts & behavior. CDC. https://www.cdc.gov/mental-health/about-data/suicidal-thoughts-and-behavior.html
2. Linehan, M. M., Korslund, K. E., Harned, M. S., Gallop, R. J., Lungu, A., Neacsiu, A. D., McDavid, J., Comtois, K. A., Murray-Gregory, A. M., & et al. (2015). Dialectical behavior therapy for high suicide risk in individuals with borderline personality disorder: A randomized clinical trial and component analysis. JAMA Psychiatry, 72(5), 475–482. https://doi.org/10.1001/jamapsychiatry.2014.3039
3. Tong, F., Zhang, Y., & Jiao, Y. (2025). The efficacy of cognitive behavioral therapy on reducing suicidal symptoms among adults: A systematic review and meta-analysis. Frontiers in Psychology, 16, 1672957. https://doi.org/10.3389/fpsyg.2025.1672957
4. Abbar, M., Demattei, C., El-Hage, W., Llorca, P.-M., Samalin, L., Demaricourt, P., Gaillard, R., Courtet, P., Vaiva, G., Gorwood, P., Fabbro, P., & Jollant, F. (2022). Ketamine for the acute treatment of severe suicidal ideation: Double-blind, randomised placebo-controlled trial. BMJ, 376, e067194. https://doi.org/10.1136/bmj-2021-067194

Disclaimer

This content is for informational purposes only and does not replace professional medical or mental health care. If you or someone you know is experiencing suicidal thoughts or immediate danger, call 911 or the 988 Suicide & Crisis Lifeline right away.

Only a licensed mental health professional can provide a diagnosis or treatment. Do not delay seeking help because of this information.