Office Hours Recap: How can we ask about suicide directly, but sensitively?

Asking a person about suicide and about their thoughts or plans is a critical part of connecting with people. But sometimes it can feel hard to ask directly. What if the person feels attacked or confronted? What if they withdraw from the conversation completely?  

During our conversation at Office Hours, we brainstormed these strategies together. 

• Everything starts with connection. If you can connect with the person, and be the person they can talk to, it will be much easier to ask about suicide without a barrier coming down. With youth, that might mean being sensitive to the language they use and avoiding any phrasing that could seem condescending or overbearing. It might be helpful to restate things using the person’s phrasing.
• It’s ok to rephrase. A common question on standard instruments is “Have you had these thoughts with an intent to act?” But this phrasing can sometimes make the person feel like they are on the witness stand, answering to the suicide police. Instead, try to speak in a natural way. 
  • You could say, “I just wanted to ask you ... those thoughts you have, when they come, has that ever included, like, I really might do this someday?” The content is the same, but by rephrasing you can avoid sounding like a clinician or a lawyer, and instead just be a real person who wants to know because you care.
• Be calm, caring, and curious. Saying, “Can you help me understand a bit more about that?” makes the conversation feel more like a collaboration than an investigation.
• Ask about suicide in a way that normalises the experience. You could say, “With everything you have been through, it wouldn’t be unusual to have thoughts of death or dying or even of taking your own life. Have you had any thoughts like that?” 
• Ask without asking. Sometimes, just introducing a possibility is enough. You could say, “With everything you have been through, it wouldn’t be unusual to have thoughts of death or dying or even of taking your own life.” There is an implicit question here, and often a person will respond without you needing to push further.
  • If you do need to follow up, you might add “I’m curious what your experience is.”
• Be transparent when asking regularly. We know that some people can find it annoying to be asked about suicide frequently.  If you are meeting regularly with a person, be upfront that you will ask regularly about suicide and the reason why. 
  • “When we meet, I sometimes check on some of the same things. And that’s not because I’ve got a checklist I have to go through. It’s just that people actually change day to day, and I want to know how you are today.”

Note: This is one of the recaps from our monthly Office Hours sessions where SafeSide members can ask questions and share their experiences. Members also have access to Community of Practice with the full library of recaps, newsletters and resources.