If this topic makes you uncomfortable, that discomfort is understandable. Suicide is still one of the most silenced and stigmatized subjects in mental health. People worry that talking about it will make things worse, that bringing it up will plant an idea that wasn’t there, that naming it will somehow cause harm.

The research is clear on this point: asking someone if they are thinking about suicide does not increase suicide risk. It reduces it. Direct, compassionate conversation creates connection, reduces isolation and often provides the opening a person in crisis has been waiting for. Silence, on the other hand, leaves people alone with the weight of something they believe they cannot say.

September is Suicide Prevention Month and World Suicide Prevention Day falls today on September 10. We are writing this because we believe the mental health field, and the people we serve, are best served by honest, direct information rather than careful avoidance. If you or someone you love is struggling, please know: help is available and reaching out is the right thing to do.

The Scope of the Problem

Suicide is the second leading cause of death among Americans aged 10 to 34 and the 11th leading cause of death overall. In 2023, more than 49,000 people in the United States died by suicide, more than 130 people every day. For every death by suicide, there are many more attempts and many more people experiencing suicidal thoughts without acting on them.

These are not abstract statistics. They represent people who were suffering and who did not have access to the support that might have changed the outcome. The mental health system has significant gaps in availability, affordability, and cultural responsiveness. People wait months for appointments. They cannot afford care. They do not see themselves reflected in the providers available to them. These are system problems that require system-level change, and in the meantime, they require those of us who have access to good care to use it.

Warning Signs: What to Listen & Watch For

Suicidal ideation rarely arrives without signs. The challenge is that the signs are often subtle or are interpreted as something else: moodiness, withdrawal, stress. Knowing what to look for can make the difference.

• Talking about death or suicide: Statements like “I wish I weren’t here,” “Everyone would be better off without me,” or “I don’t want to be a burden” should always be taken seriously, never dismissed as drama
• Giving away possessions: A person who is saying goodbye may begin giving away things that matter to them
• Sudden calm after a period of distress: Sometimes a person who has made a decision experiences a sudden quieting which is often mistaken for improvement
• Withdrawal from relationships: Pulling away from family and friends, especially from people they are usually close to
• Increased alcohol or substance use: Self-medication of unbearable emotional pain
• Expressing hopelessness: The belief that nothing will ever change, that the pain will never end, that there is no path forward
• Significant behavioral changes: Reckless behavior, sleep changes, neglect of responsibilities or self-care that is out of character

How to Talk to Someone You’re Worried About

The most important thing you can do if you are worried about someone is to ask directly. Not “Are you okay?” which invites “Fine.” But something real: “I’ve noticed you seem really down lately. Are you having thoughts of suicide?”

You may be afraid of asking. You may be afraid of the answer. But asking says: I see you. I am not afraid of this. You can tell me the truth. That message alone can matter enormously to someone who has been managing something unspeakable in silence.

If someone says yes: stay with them. Listen without judgment. Do not minimize or try to fix. Help them access support by calling or texting 988 (the Suicide and Crisis Lifeline), taking them to an emergency room if the risk feels immediate, or helping them connect with a mental health provider.

If someone says no: believe them and stay connected. Keep checking in. The fact that you asked has already opened a door.

Mental Health Treatment Reduces Suicide Risk

The most powerful thing the research tells us is this: mental health treatment works. Depression, which is the most common underlying condition in suicide, is one of the most treatable conditions in all of medicine. People who receive appropriate clinical care like therapy, medication, or both see significant improvement in the overwhelming majority of cases.

At Evolve Psychological Services, our depression therapy and adult psychotherapy services address the underlying conditions that contribute to suicidal ideation with genuine clinical skill and compassion. Our child and teen therapy includes evidence-based approaches specifically effective for adolescent depression and anxiety. And our trauma specialists offer EMDR and Brainspotting for those whose suicidal thoughts are rooted in unprocessed traumatic experience.

If You Are Struggling Right Now

You are not alone and this pain is not permanent. Please reach out:

• 988 Suicide and Crisis Lifeline: call or text 988, available 24/7
• Crisis Text Line: text HOME to 741741
• Emergency services: call 911 or go to your nearest emergency room if the risk feels immediate

And when you are ready for ongoing support, please contact us. We are here.

Now Offering Thrizer: Making Out-of-Network Benefits Simple

We now offer Thrizer for psychotherapy clients with out-of-network benefits: pay only your estimated reduced responsibility (if plan is eligible), once your deductible is met, at the time of service and Thrizer handles the rest for a small fee: automatic claim submission & reimbursement direct to your bank. Visit our Fees & Insurance page to check your eligibility using the Thrizer widget, no phone call needed.

If You’re Struggling, Please Reach Out. We Are Here.

At Evolve Psychological Services in Montclair, NJ, we offer compassionate, evidence-based therapy for depression, anxiety, trauma, and the experiences that can lead to suicidal ideation. You do not have to be in crisis to come to us and you do not have to face this alone. We serve adults, teens, and children in person across Essex County and virtually throughout NJ, NY, and PsyPact states.

Call or text us at (973) 891-0793 or reach us through our secure online contact form. If you are in immediate crisis, please call or text 988 or call 911. Healing is possible. We would be honored to be part of your path toward it.