The Most Helpful Thing To Say To Someone In A Mental Health Crisis, Based On 75 Million Texts

by JR Thorpe
Ashley Batz/Bustle

Having conversations about suicidal thoughts is incredibly hard, and it can be very difficult to know how to ask about somebody's wellbeing in a sensitive, helpful way when they're in distress. New data from Crisis Text Line, which offers free 24/7 crisis support across the United States with crisis counselors, shows that there's some language that can be deeply effective if you want to ask about whether a person is experiencing suicidal thoughts.

The data, reported Rebecca Ruiz for Mashable, comes from analyzing 75 million text messages sent and received using Crisis Text Line since the organization began in 2013, and 400 transcripts of different exchanges between people in crisis and counselors. The study aimed to find out which approaches by counselors meant that texters felt comfortable, shared their thoughts, and felt less suicidal by the end of the conversation. Suicidal feelings are, in the vast majority of cases, temporary and will pass after a short period, according to HelpGuide. But being treated in a supportive way while someone is feeling them can be very helpful for easing their strength and helping them go away.

On average, 129 people die by suicide per day in the U.S., and it's the tenth leading cause of death in the country, according to statistics from the American Foundation for Suicide Prevention. It's likely that many of us will at some point either experience thoughts of suicide, or know somebody who experiences them. This is why it's crucial to know how to have a conversation about it.

According to the data from Crisis Text Line, using an "expression of care" while talking to somebody who might be suicidal is a good way to approach things, as opposed to being "blunt." "Expressions of care" involve couching your questions in a context of concern and love. Crisis Text Line notes that lines like "I want to check in on your safety" express care explicitly.

The examples of helpful questions given by Crisis Text Line also don't necessarily explicitly mention suicide. "Have you had any thoughts about death or dying" and "Have you had any thoughts about ending your life" are both viewed as good practice. By contrast, direct, "blunt" approaches that aren't cushioned by caring statements, like "Are you feeling suicidal?" or "Do you want to hurt yourself?" may not create as much support.

The right language, according to Crisis Text Line, creates real results. According to the data, 6 percent of people who encountered caring language while in a conversation with a counselor said they felt less suicidal afterwards, compared to 3 percent who talked to a counselor who used more direct language. The study has meant that Crisis Text Line now uses expressions of care in all of its calls, to help anybody who needs help to navigate their suicidal thoughts and get the support they need.

If somebody does tell you that they've been feeling suicidal, it's important to pay attention to your own response, Crisis Text Line also told Mashable. "When the receiving person can simply tolerate it, hold it in a way that doesn’t judge, and doesn’t jump in with a solution or quick fix, but receives it in a loving, compassionate way, that’s the ideal," said Crisis Text Line clinical advisory board member Dr. Christine Moutier, chief medical officer of the American Foundation for Suicide Prevention. My own therapist would answer my reporting of suicidal thoughts with a calm, "Thank you for telling me that," which banished any thoughts of shame or judgement immediately. Compassion is the aim of all conversations about suicide, and that can really help people who might be experiencing suicidal thoughts.

But experts also say that simply being available for someone in a time of crisis is important. “Never be afraid to ask" if someone is experiencing a mental health crisis, Melinda R. Paige, Ph.D., LPC, NCC, CPCS, assistant professor in clinical mental health counseling at Argosy University in Atlanta, previously told Bustle. "Typically, people think if I ask 'Are you OK?', it can be triggering, but it's not.”

The American Foundation for Suicide Prevention has a checklist for warning signs that somebody may be feeling suicidal, which is definitely worth checking out, particularly if you have concerns about somebody you know. Signs can range from talking explicitly about wanting to die or about being a burden to others to withdrawing, showing rage, demonstrating mood swings, or increasing the use of alcohol or drugs. If you're worried about somebody you know, you can have a conversation using these tips from Crisis Text Line.

With the right help, treatment and support from therapists and those around them, people who feel suicidal can increase their resilience and reduce the severity of their thoughts and behaviors. Language guidance is a good place to start.

If you or someone you know is experiencing suicidal thoughts, call the National Suicide Prevention Hotline at 1-800-273-8255 or text HOME to the Crisis Text Line at 741741. You can also reach out to the Trans Lifeline at 877-565-8860 or the Trevor Lifeline at 1-866-488-7386, or to your local suicide crisis center.