Suicide Prevention Month: What to Watch For, What to Say, and How to Get Help

By Stephanie Winter, DNP, FNP-C, ENP-C, PMHNP-BC — board-certified psychiatric nurse practitioner and owner, Anchor Psychiatric Group. Medically reviewed by Thomas Winter, MD.

If you or someone you know is in crisis right now, you don’t have to finish this article first. Call or text 988 (Suicide & Crisis Lifeline, available 24/7), text HOME to 741741 (Crisis Text Line), or go to your nearest emergency room. Veterans can reach the Veterans Crisis Line by calling 988 and pressing 1.

September is Suicide Prevention Month, which exists because most people don’t know what to look for, what to say, or how much of a difference it makes when someone does. This isn’t a topic anyone finds easy to bring up. It’s also one of the few areas of medicine where a straightforward conversation, asked plainly and without judgment, has been shown to help.

The numbers, briefly

In 2024, more than 48,000 people died by suicide in the United States. Far more thought seriously about it: an estimated 14.3 million adults, with 4.6 million going as far as making a plan and 2.2 million making an attempt.

A common assumption is that this is mainly a crisis among teenagers. The data tells a different story: adults 80 and older have the highest suicide rate of any age group, and men die by suicide at nearly four times the rate of women. Suicide touches every age, and the people most at risk aren’t always who you’d expect.

Warning signs that get missed

The signs most people are taught to watch for (talking openly about wanting to die, giving away possessions) are real, but they tend to show up late. The subtler ones often show up earlier, and get explained away as something else entirely:

• Insomnia, or waking consistently in the early hours of the morning. This isn’t just “stress” for a lot of people. Research has found sleep disruption to be an independent risk marker on its own, separate from the depression it often gets folded into.
• A sudden burst of agitation or irritability in someone who’s usually even-tempered. This gets read as a bad mood or a stressful week far more often than it gets read as a warning sign, especially in men.
• Reconnecting with people they’d drifted from, or resolving old conflicts, out of nowhere. It can look like personal growth. It can also be someone quietly closing loops.
• Talking about their life in the past tense: “it was a good run,” “I’ve had a good life,” phrased almost like a retrospective rather than a life still in progress.
• Self-deprecating comments about being a burden that get delivered as jokes, dismissed by everyone in the room, including sometimes the person saying them.
• Going quiet about the future: no longer talking about upcoming plans, vaguely declining things weeks out, or losing interest in goals they’d been genuinely invested in.
• New carelessness about physical safety. Driving faster, skipping precautions they used to take seriously, a general “it doesn’t matter what happens to me” quality to how they move through the day.
• Physical complaints with no clear cause: fatigue, headaches, stomach issues, that show up alongside a mood change rather than a physical illness.

Any one of these on its own isn’t necessarily a red flag. Several together, or a combination with direct or indirect talk about death or suicide, is worth taking seriously.

Why asking directly helps, not hurts

A common fear is that asking someone directly, “are you thinking about suicide,” will plant the idea or push them further. Research consistently shows the opposite: asking directly does not increase risk, and it often opens the door to a conversation the person didn’t feel able to start on their own.

You don’t need the perfect words. Listening without judgment, taking what they say seriously, and helping them connect to care matters more than saying the right thing.

Treatment works

Suicidal thoughts are treatable, not a fixed trait. Therapy approaches developed specifically for suicidal ideation, along with medication when it’s appropriate, make a measurable difference. A collaborative safety plan built with a provider, and temporarily reducing access to whatever means someone might use during an acute crisis, are both evidence-based steps that save lives. Follow-up care in the weeks after a crisis or hospitalization matters enormously, since that window is when risk is often highest.

How this works at Anchor

Anchor Psychiatric Group provides ongoing psychiatric evaluation, medication management, and coordinated care via telehealth, including safety planning as part of a treatment plan. We are not a crisis or emergency service. If you or someone you know is in immediate danger, call 911 or 988, or go to the nearest emergency room first. Ongoing care is exactly where we come in after that.

The bottom line

Suicide is preventable, and reaching out, for yourself or for someone you’re worried about, is never an overreaction. If this month is the reason you finally bring it up with someone, or finally get yourself an appointment, that’s exactly what it’s for.

[Request an appointment] or call 602-241-2828.

If you or someone you know is in crisis: call or text 988 (Suicide & Crisis Lifeline, 24/7), text HOME to 741741 (Crisis Text Line), or go to your nearest emergency room. Veterans: call 988 and press 1.

Educational content only; not medical advice or a substitute for a qualified clinician’s evaluation.