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Suicide and crisis terms

Active suicidal thoughts

Shariq Refai, MD, MBA, board-certified psychiatrist and the reviewer of this article.

Reviewed by Shariq Refai, MD, MBA·Updated March 15, 2026·About 3 minutes

About this term

Sources

  • CDC. Suicide Data and Statistics. 2023.
  • SAMHSA. Key Substance Use and Mental Health Indicators. 2022.
  • Posner K, et al. The Columbia-Suicide Severity Rating Scale. Am J Psychiatry. 2011.
  • Stanley B, et al. Comparison of the Safety Planning Intervention with follow-up vs usual care of suicidal patients treated in the emergency department. JAMA Psychiatry. 2018.

Primary source: 988 Suicide and Crisis Lifeline.

Frequently asked questions

What are active suicidal thoughts?
Active suicidal thoughts include intent to act, a plan, or steps toward acting (acquiring means, choosing a time or place). They're distinguished from passive thoughts (wishes to be dead without intent or a plan) and are a clinical emergency.
What should I do if I'm having active suicidal thoughts?
Call or text 988, call 911, or go to the nearest emergency department now. If you're with someone, tell them. Reduce access to lethal means immediately, especially firearms and stockpiled medication. You don't have to be certain you'd act to ask for help.
How do clinicians assess active suicidal thoughts?
A clinical assessment covers intent, a plan, access to means, timing, prior attempts, protective factors, and reasons for living. Validated tools such as the Columbia Suicide Severity Rating Scale (C-SSRS) help structure the conversation. The result guides whether to treat in the community, intensify outpatient care, or hospitalize.
How can I help someone with active suicidal thoughts?
Stay with them. Help them connect to 988 or to their clinician. If they're in immediate danger, call 911. Reduce access to lethal means. Don't promise secrecy. Asking directly about suicide doesn't plant the idea and is the first step in keeping someone safe.

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Last reviewed March 15, 2026.

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