Call or text 988 for the Suicide and Crisis Lifeline.

988 is a national three-digit line in the United States for any mental health crisis, including thoughts of suicide. It is free, confidential, and available 24 hours a day. You do not need to be in immediate danger to call. You can call for a friend or family member. You can call for yourself. Calls can be made in many languages, and the line includes specialized routing for veterans (press 1), Spanish speakers (press 2), and LGBTQ+ youth and young adults (press 3). Text and chat options are available for people who cannot or do not want to speak on the phone.

988 replaced the older 1-800-273-TALK number in 2022. It is operated by a national network of more than 200 local crisis centers, coordinated by the Substance Abuse and Mental Health Services Administration (SAMHSA) and Vibrant Emotional Health.

A trained counselor answers, usually within seconds. They will ask your first name (you can use any name) and a few questions about what is going on. They listen without judgment. They do not call the police unless there is an immediate, identifiable threat to life that cannot be addressed any other way; the vast majority of calls are resolved on the line.

Most calls end with a person feeling more grounded, a plan for the next few hours, and a referral to follow-up care. The counselor can stay on the line as long as needed. There is no time limit and no script you have to follow.

At a hospital, you will be triaged at the front and then evaluated, often by a social worker or a mental health clinician on the psychiatric consult team. The team will ask about the thoughts you are having, what has been going on, what makes you safer, what does not, and whether you have access to lethal means. They will also check for medical issues that can present like or contribute to a mental health crisis (thyroid, infection, sleep deprivation, substances).

Sometimes the visit ends with going home with a written safety plan, a same-week or next-day follow-up, and updated medications. Sometimes it ends with a short voluntary inpatient stay for stabilization. In a smaller number of situations, an involuntary hold may be used when a person is at acute risk and cannot consent to care; the criteria and the length of these holds are set by state law.

Either outcome is care, not punishment. Going to an emergency department for a mental health crisis is the same kind of action as going for chest pain.

Ask directly. Asking about suicide does not plant the idea. It opens a door. "Are you thinking about suicide?" is a complete, respectful question. Other ways to ask: "Are you thinking about hurting yourself?" "Are you safe right now?" "Do you have a plan?"

Listen without arguing. Resist the urge to fix or to minimize. Stay present. If you can, stay with the person. Help them connect to 988, to their clinician, or to an emergency department. If you are not sure what to say, say that. "I am worried about you. I want to listen. I am not going anywhere."

1. If there is immediate danger to the person or to others, call 911. Tell the dispatcher this is a mental health crisis and ask for crisis-trained responders if your area has them.
2. If there is no immediate danger but the person is unsafe, call or text 988 together, or drive them to the nearest emergency department. Do not leave the person alone.
3. Reduce access to lethal means. Move firearms out of the home. Move medications to a locked container or to another household. Limit access to the specific method the person has been thinking about.
4. Stay calm and stay nearby. Sit at the same level. Slow your speech. Do not argue with the thoughts. Do not promise secrecy.
5. Keep them company until a clinician, 988 counselor, or emergency department takes over. The most dangerous moments are usually short, and presence helps.

Reducing access to lethal means is one of the strongest interventions we have. Most suicide attempts are impulsive. Most are decided on within an hour of acting. Most people who survive an attempt do not go on to die by suicide. Putting time and distance between a person and a method reduces both the chance of an attempt and the chance that an attempt will be fatal.

Firearms

A firearm is the most lethal common method, and access is one of the most modifiable risk factors. Off-site storage with family, a friend, a range, or a local gun shop is the cleanest option. Many states have temporary storage options through law enforcement or licensed dealers. Where off-site storage is not possible, a gun safe with the ammunition stored separately and the keys held by someone else reduces immediate access. The Counseling on Access to Lethal Means (CALM) training is widely used by clinicians to guide these conversations.

Medications

Lockboxes, smaller pharmacy fills, and a family member holding the prescription all add time and distance. For acetaminophen and over-the-counter sleep aids, smaller package sizes meaningfully reduce risk. For prescription opioids and benzodiazepines, the same applies, with the additional step of asking the prescriber whether the dose can be lowered or the medication can be changed.

Other means

Limit access where possible to the specific method a person has thought about. These conversations are practical, not moral. A clinician can help walk through what is realistic for a given household.

A safety plan, made with a clinician, is one of the most useful tools in this work. The Stanley-Brown Safety Planning Intervention has six steps: warning signs, internal coping strategies, people and settings for distraction, people you can ask for help, professionals and agencies, and steps to make the environment safer. Safety plans have evidence in research for reducing suicide attempts and improving engagement in care after a crisis (Stanley et al., JAMA Psychiatry, 2018). They take 20 to 30 minutes to build with a clinician. The full template is available from the Suicide Prevention Resource Center.

How to help a partner with depression. When should I see a doctor for depression? Safety plan template (printable). Save-to-device safety plan. Support person checklist. Support person guide. Suicidal thoughts in depression. Safety plan (glossary). Passive suicidal thoughts (glossary). Active suicidal thoughts (glossary). Treatment. How to find a therapist.

• Centers for Disease Control and Prevention. Suicide Data and Statistics. 2023.
• Substance Abuse and Mental Health Services Administration. 988 Suicide and Crisis Lifeline. 2024.
• Stanley B, Brown GK. Safety Planning Intervention: A Brief Intervention to Mitigate Suicide Risk. Cognitive and Behavioral Practice. 2012.
• 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.
• Mann JJ, et al. Improving suicide prevention through evidence-based strategies: a systematic review. Am J Psychiatry. 2021.
• National Action Alliance for Suicide Prevention. Safe Messaging Guidelines.
• Suicide Prevention Resource Center. Counseling on Access to Lethal Means (CALM).