September is Suicide Prevention Month, a time for Sacramento County Behavioral Health Services to remind our community that suicide can affect people of every age, background and circumstance. A person may be a child, teenager, adult or older adult; a friend, relative, co-worker, neighbor, student or veteran. No one needs to face a crisis alone, and each of us can help someone connect with support.
Suicide is rarely caused by one event. Health concerns, painful losses, relationship or financial stress, discrimination, trauma, substance use, isolation and barriers to care can combine in different ways. A past attempt and a sense of hopelessness are important risk factors, but risk factors do not predict with certainty who will attempt suicide. Connection, accessible care, coping skills and reasons for living can help protect people.
Hope is part of prevention
A suicidal crisis can make pain feel permanent and options seem out of reach. That feeling can change. With time, effective care, practical help and sustained connection, many people move through suicidal thoughts and build lives they value. Offer realistic hope: avoid promises or quick fixes, acknowledge the pain, and focus on the next safe step together.
- Recognize possible warning signs
- Pay particular attention when a behavior is new, increasing or connected to a painful event, loss or major change. Warning signs may include:
- Talking or writing about wanting to die, feeling hopeless, being trapped, having no reason to live or being a burden
- Looking for a way to die or making a plan
- Giving away valued belongings, saying goodbye or putting affairs in order
- Withdrawing from people or activities, or losing interest in usual routines
- Extreme mood changes, agitation, rage, anxiety, shame or unusual calm after severe distress
- Sleeping much more or less, or increasing alcohol or drug use
- Taking dangerous risks or behaving recklessly
One sign does not always mean a person is suicidal, and some people show few visible signs. If something feels different or concerning, check in. Any talk of suicide should be taken seriously.
What Can you do
The National Institute of Mental Health recommends five actions that anyone can use:
- Ask directly. Say, “Are you thinking about suicide?” Asking clearly does not put the idea in someone’s mind or increase suicidal behavior. It can open an honest conversation.
- Be there. Stay calm, listen without judgment and take the person seriously. Do not lecture, debate, minimize their pain or promise secrecy.
- Help keep them safe. Ask whether they have a plan and access to lethal means. If risk is immediate, stay with them and, when it can be done safely, reduce access to firearms, medications or other lethal means. Do not put yourself in danger.
- Help them connect. Call or text 988 together, contact a health or behavioral health professional, and involve a trusted person. Help with practical steps such as making an appointment or arranging transportation.
- Follow up. Reach out after the immediate crisis and after care begins. Specific, ongoing contact can reduce isolation and reinforce that the person matters.
Make the conversation age appropriate
Children
Use calm, concrete words: “Sometimes people feel so bad they think about dying. Have you had thoughts like that?” Ask about changes at home, school, with friends and online. A child who says they want to die or hurt themselves needs an immediate adult response. Stay with the child, secure potentially dangerous items, and contact a parent or caregiver and a health professional or 988. Do not ask a child to keep suicidal thoughts secret.
Teens and young adults
Be direct and respectful of privacy without promising confidentiality when safety is at risk. Ask about bullying, relationship loss, identity-based stress, school or work pressure, substance use and upsetting online content. Listen more than you speak, involve a trusted adult or professional, and collaborate on a safety plan. Do not dismiss comments as attention-seeking or assume social media posts are only jokes.
Adults
Check in after job or financial problems, relationship changes, legal trouble, serious illness, pain, caregiving strain, trauma or increased substance use. Use plain language, offer concrete help and follow through. A co-worker, friend or family member may need support connecting with care, taking time away from immediate stressors or making the environment safer.
Older adults
Do not treat hopelessness, withdrawal or talk of death as a normal part of aging. Ask about grief, loneliness, pain, disability, changes in independence, caregiving, sleep, medications and access to lethal means. Include the person in decisions, address hearing or communication needs, and connect them with medical care, behavioral health support and trusted community or family contacts.
Know when to get immediate help
If a person says they intend to act soon, has a plan and access to lethal means, has made an attempt, or cannot stay safe, do not leave them alone. Call 911 or go to the nearest emergency department. If it is safe to do so, remove access to lethal means while help is on the way.
For emotional distress, suicidal thoughts or concern about someone else, call or text 988 or chat at 988lifeline.org. The 988 Suicide & Crisis Lifeline is free, confidential and available 24 hours a day, seven days a week. Veterans may call 988 and press 1 or text 838255.
You do not need perfect words or all the answers. A direct question, a calm presence and help connecting to care can create time, safety and hope.