Crisis Support Guide

A crisis may build over time or emerge suddenly. A person might be visibly distressed, unusually withdrawn, agitated or quiet. Appearance alone cannot tell you whether they are safe.

Reasons to ask

• Talk of suicide, hopelessness, unbearable pain or feeling like a burden.
• Unusual goodbyes, giving away valued possessions or a concerning change in behaviour.
• Something the person says that leaves you worried about their immediate safety.

These are not a checklist for predicting suicide. The absence of a sign does not establish safety, and a change in mood does not tell you someone's intentions. Describe what you have noticed and ask how they are doing.

If you are concerned, ask plainly: "Are you thinking about suicide?" Research reviewed by Dazzi and colleagues did not find evidence that asking induces suicidal thoughts. That does not mean a conversation can establish someone's level of risk on its own.

Make room for the answer

• Listen without debating their reasons or comparing their pain with someone else's.
• You might say, "I am glad you told me. Let us find support together."
• Avoid guilt, shame and promises of absolute secrecy. Explain that you may need help to respond to an immediate safety concern.
• Ask what would make the next few minutes safer. You do not need to demand personal details or know the perfect phrase.

If their answer or the situation concerns you, involve a crisis service or qualified professional. Do not rely on a promise not to act as proof of safety.

An attempt, serious injury, suspected overdose, loss of consciousness or an immediate threat needs emergency help. Use your local emergency number. If you are unsure what to do, seek urgent professional guidance rather than trying to make a clinical assessment yourself.

While arranging help

• Stay with the person or keep contact if it is safe for you to do so. Bring in another trusted person or professional; do not take sole responsibility.
• Tell responders what you know about the immediate situation and location. Follow their instructions.
• Create distance from a dangerous situation where possible. Do not confront someone holding a weapon or put yourself at risk trying to remove it.
• Ask a professional about safely reducing access to potentially harmful items. Do not alter prescribed medication on your own.

For a concern without immediate danger, contact a crisis service together if the person is willing. You can also seek guidance when you are worried about someone else. Outside Canada, use a service appropriate to the person's location.

Offer a specific, manageable way to connect: sit nearby while they call, help them contact an existing clinician, or arrange an appointment or safe transport with qualified guidance. Do not assume they can navigate a complicated system while overwhelmed.

Check what is workable

• Is the service open, affordable and appropriate for their location and needs?
• Would a call, text, interpreter or another accessibility support help?
• Who else can share the support, with the person's agreement where possible?

A collaborative safety plan can be developed with a qualified professional. Stanley and colleagues' 2018 study examined safety planning plus follow-up in US Veterans Affairs emergency departments. It was a cohort comparison, not a randomized trial. Its findings do not establish that completing a website worksheet alone prevents suicide.

After a crisis, ask what kind of contact would be useful. An agreed check-in, help with an appointment or an ordinary shared activity may be more useful than insisting on a detailed account of what happened.

• Keep agreed contact where you can, and be honest about when you are unavailable.
• Help the person reconnect with professional care and other trusted supports.
• If immediate concerns return, seek urgent help again. A previous plan does not remove the need to respond.
• Consider support for yourself too. Caring does not require unlimited availability or personal risk.

You can offer steady care and practical help. The outcome is not yours to guarantee.