Let’s demonstrate how to help a suicidal friend with a case example:

In the moment

The goal is to help your Veteran get through the worst of the feelings they are going through in the moment.

• If they’re giving signals that all they want is distraction, that’s fine: distract.
• Are they giving signals that they want to talk about the pain? Talk about it—don’t try to minimize or skirt around it. Listen, accept it, sit with it.
• You don’t need to analyze or solve the problem—and when they’re drunk or high they’re not in a planning mode. Help them through by talking until they’re not so upset by the feeling and start to calm down.
• When a person sobs or rants or just talks through how one really feel, it can be surprisingly effective. It may not solve the problem, but can add some peace that helps clear a path for next steps.

In the next day or two

• Find a quiet time when they are in a good place (e.g., sober, calmer) to talk over the situation, especially if this has been a repeating pattern.
• Tell them you’re glad they shared their suicidal feelings. Let them know you care and want to help and that most people who become suicidal recover.
• DON’T argue that they shouldn’t be suicidal, guilt-trip them about how they should be grateful, or lecture them about snapping out of it. Acknowledge that they’re feeling a lot of pain.
• Ask what they think could help lessen the pain.
  • It might be therapy, or if they’ve tried therapy and it hasn’t helped, perhaps give another therapist or medication a try. Often it’s a matter of finding the right match.
  • Or perhaps a support group, or a 12-step program. You don’t need to be expert in this stuff. Either you or they could call 988 to learn about options.
  • Other steps could also be helpful, like joining some positive social activity regularly (e.g., running club, book group, volunteer carpentry for a shelter), getting a pet, avoiding social situations they know are bad for them, etc.
• Don’t forget to make a plan for the guns and medications at home.
• Make an emergency plan—what if what they’ve been doing doesn’t work? What if calling you or someone else doesn’t “talk them off the ledge”? Find out now—not in the crisis—if there’s a local person you can call who could go over to their home in an emergency to provide support.
• Would they be willing to have you get 988 (the mental health hotline) on the line? Would they trust the police in an emergency?
• Remember to check in with yourself throughout this process. If at any time it feels too much, it may be helpful to reach out to others in your Veteran’s network to help you.

Longer term

• Check in with them from time to time. That’s a concrete way to show you care.
• Sometimes the check-ins can be about nothing – sports scores, a good Netflix series, whatever – but sometimes check in directly about the pain. “How is it going with sometimes feeling suicidal? Has that continued?” If yes, ask if it’s getting worse, how often it happens, how long it lasts, whether they feel they can control it or if the thoughts sometimes control them.
• If things seem to be getting worse—especially if they feel they can’t always control the suicidal thoughts and they want to act on them, urge them again to try treatment or to consider changing providers or treatment approach if they are already in care.
• Remember to check in with yourself throughout this process. If at any time it feels too much, reach out to others in your own social network for support, or call/text 988.