Speaking Openly About Suicide: A Talkspace Therapist Roundtable

Suicide hotline numbers

Since 1999, suicide rates in the US have increased by more than 25%, a harrowing statistic that points to a growing public health emergency. With the loss of two bright stars in a single week — iconic fashion designer Kate Spade, and celebrity chef, author, and television personality Anthony Bourdain — to suicide, we wanted to bring together three Talkspace therapists to discuss and answer questions about one of the most taboo topics in Western Culture.

We remind you that there is no shame in asking for help and if you’re in crisis or know someone who is, don’t wait. The National Suicide Prevention Lifeline is available 24/7 –– call them: 1-800-273- TALK (8255) or contact the Crisis Text Line by texting TALK to 741-741.

What should you do if you’re worried that someone is going to harm themself?

Dr. Rachel O’Neill — LCSW-R, New York, Talkspace therapist

The Suicide Prevention Lifeline, through their #BeThe1 campaign offers 5 steps to help individuals who may be at risk for harming themselves. These are:

1) Ask
2) Keep them Safe
3) Be there
4) Help them Connect (with crisis resources)
5) Follow-up. More information is available here:

Jill Daino

If you are worried about someone, do not hesitate to reach out and be direct. Tiptoeing around the subject of suicide or self-harm helps no one. Expressing your concern in a compassionate, genuine, nonjudgmental way can make all the difference. It’s vital to directly ask the person if they have felt like they might hurt themselves and offer to go with them to get help — to a therapist or, if urgent, to an emergency room — so they know they are not alone.

If you are worried about someone who doesn’t live near you, call 911 and explain your concerns so a safety check can be made. Also if it is a child or teenager who is worried about a friend, help them understand that they should not keep this secret. They should reach out to a trusted adult for guidance and additional support — a parent, a teacher, guidance counselor — kids and teens should not try to carry this burden for their friend alone.

Cynthia V. Catchings

As individuals, friends, and family members, we can offer resources, company, and support. Having information to contact a suicide hotline is also very helpful. We have to keep in mind that only mental health professionals, and those advocates trained to assist in these cases, have the right tools to assist. Our company and support might help a person to feel more comfortable to make the call. Putting our heart out there and letting the person know how much we care is also a great way to help.

What keeps most people from getting help?

Dr. Rachel O’Neill

There are a lot of reasons why people don’t ask for help. Some people are worried that it makes them seem “crazy” or sick. Others don’t know where to go about looking for help. Still others are worried that perhaps they (or their problems) are beyond helping.

Jill Daino

While each situation is unique, it is common for people to not get help because they have reached a point where they feel nothing is going to help and that it just doesn’t matter. It may also be that they have struggled on and off for years and yet don’t see the possibility of change or improvement. For many people there is also still the stigma of admitting they have thoughts of self-harm or suicide. These thoughts and feelings are held privately; it becomes such an isolating experience that the person may no longer be able to see their way clearly. These issues still provokes judgments from many people — we have to work to change that.

Cynthia V. Catchings

Embarrassment, fear, lack of resources, the thought that we are the one only ones feeling that way, and stigma are some of the main reasons that keep most people from getting help.

What are some warning signs to look out for regarding suicide?

Dr. Rachel O’Neill

Threatening to hurt or kill one’s self. Talking or writing about death. Feeling like there’s no reason for living. Feeling no sense of hope that things will get better, which leads to anxiety or agitation, and then withdrawing from friends, family, or obligations. Dramatic mood changes are also sometimes a warning sign.

Cynthia V. Catchings

Excessive sadness, withdrawal, talking about wanting to die or to kill oneself, looking for a way to kill oneself, sharing that they are feeling hopeless or have no reason to live. Also, talking about feeling trapped, feeling unbearable pain, or about being a burden to others, and wanting to give their belongings away.

Are there specific conditions that put someone more at risk?

Dr. Rachel O’Neill

Anyone can be at risk for suicide but things like depression, anxiety, recent medical concerns or conditions, and substance use could all elevate an individual’s risk of suicide.

Cynthia V. Catchings

Abuse, neglect, ending a relationship, financial issues, and medical and mental health issues are common issues that put someone more at risk of suicide.

If someone won’t seek help, what can you do to best be supportive of them until they’re ready?

Jill Daino

If someone won’t seek help, as a friend you can continue to be direct and nonjudgmental encouraging them to reach out for help. Being supportive, while at the same time helping them to understand the importance of getting proper care from trained therapists is incredibly important. Reaching out and validating their struggle, while at the same time explaining that, while it may not seem possible now, things can change and improve. Suicide is a permanent decision to situations that are temporary.

Cynthia V. Catchings

Be present! Be caring! Be proactive and do not promise something you can’t offer.

How is it possible for really high functioning people with lots of resources to still not get the help they need?

Cynthia V. Catchings

Stigma and fear can be strong factors that prevent someone from asking for help. Sometimes we can have the resources, the support, and the means but the depression might be so strong that it is very difficult for someone to even think about possible solutions.

What can we do to reduce the stigma and amplify the conversation about getting help for suicidal ideation?

Dr. Rachel O’Neill

Talk about mental health treatment. Encourage counseling. Encourage wellness. Encourage people to take care of their mental health just as we encourage them to take care of their physical health.

Cynthia V. Catchings

To reduce the stigma I like to use a very simple example. I tell people that if we suffer from diabetes or the flu, we go see the doctor and we take our medications and adjust our lifestyle. In the same way, if we suffer from depression or any other issue that exacerbates our condition, or causes suicidal ideation, we have to see a therapist and talk to them. And if a prescription is needed, we have to be open to start the treatment.

By publicizing high-profile suicides, are we glamorizing or putting others at risk for increased suicidal ideations?

Dr. Rachel O’Neill

Yes, the American Association of Suicidology (AAS) warns of the potential for a contagion effect, i.e., “Copycat suicide” in the aftermath of a highly publicized death by suicide. The AAS offers these guidelines for responsible reporting of suicide.

Cynthia V. Catchings

I think that it actually does the opposite. I think that it opens our eyes to how much mental health services are needed, how much more we have to do to educate and help everyone in our communities.