What Real Support Looks Like After Someone Says “I’m Not Okay”

“I’m not okay.”

These words might arrive in the middle of a long conversation, or they can come through a text message late at night.

In other cases, the message feels even more frightening:

• “I don’t want to be here anymore.”
• “I don’t think I can do this.”
• Or, after you find the courage to ask directly, “Are you thinking about suicide?”, the answer is simply: “Yes.”

What happens next matters.

When someone we love tells us they are struggling with suicidal thoughts or experiencing a mental health crisis, our instinct is often to do something immediately—to find the right words, fix the problem, convince them that life will get better, or somehow make the pain disappear.

But real support often begins somewhere much simpler:

• Stay.
• Listen.
• Take them seriously.
• Get help.

You do not have to become someone’s therapist or crisis counselor to make a difference. You have to be willing to stay connected while helping them reach someone who knows what to do next.

First, Pay Attention to How You Show Up

Hearing that someone you love is thinking about suicide can be frightening.

Your mind may immediately race:

• How serious is this?
• What do I say?
• What if I make it worse?
• What am I supposed to do?

You may feel afraid, angry, helpless, confused, or desperate to tell them all the reasons they shouldn’t feel this way.

Those reactions are human. But before responding, try to steady yourself.

Not because your emotions don’t matter. They do. But in this moment, the person in front of you needs to know that you can hear what they are telling you.

Slow down. Listen.

Your job is not to solve everything in the next five minutes. Your first job is to communicate:

• I hear you.
• I’m taking this seriously.
• You don’t have to figure out what comes next by yourself.

During our conversation about suicide prevention, River’s Bend Director of Business Development and Suicide Prevention Specialist Leah Bogdanski made an important distinction: if you don’t feel equipped to manage a crisis conversation yourself, you can still help.

Sitting beside someone while calling a professional together allows you to make that vital connection. Furthermore, staying with them while a trained specialist guides the next steps ensures they don’t feel abandoned.

While knowing every answer isn’t required, simply avoiding leaving the person to figure things out alone makes all the difference.

What Do You Say After Someone Tells You They’re Thinking About Suicide?

This is where fear can make well-intentioned people say things that aren’t particularly helpful.

Try to avoid responses such as:

• “Why would you think that?”
• “But you have so much to live for.”
• “Think about your family.”
• “You don’t really mean that.”
• “Things aren’t that bad.”
• “You just need to stay positive.”

Those responses often come from love. We desperately want the person to see what we see.

But someone who has just trusted us with something deeply painful may hear something very different: You shouldn’t feel this way.

Leah encourages people to acknowledge what the person has shared instead. You might say:

• “That’s a really hard place to be. I’m sorry you’re going through this.”
• “I’m glad you told me.”
• “I’m here with you.”
• “You don’t have to handle this alone.”
• “I’m concerned about you. What can we do together to make sure you stay safe right now?”

That response does two important things: it doesn’t argue with the person’s experience, and it makes clear that you are going to help them take the next step.

Listen Before You Try to Fix

When someone tells us they are hurting, our natural instinct is often to make the pain go away.

We often try to offer quick solutions or point out everything they have going for them. Reassuring them that tomorrow will be better comes naturally, as does reminding them how many people love them.

But this may not be the moment for solutions.

It may be the moment to listen.

Good support in that moment can be remarkably simple:

• Give the person your full attention.
• Let them finish what they are trying to say.
• Acknowledge that what they are experiencing sounds painful.
• Resist the urge to immediately correct their thinking or offer solutions.
• Ask what would help them feel safer right now.¹,³
• Let them know you will help connect them with additional support.

Listening does not mean agreeing with someone’s belief that nothing can improve. It means allowing them to tell the truth about what they are experiencing without immediately correcting, judging, or minimizing it.

Sometimes one of the most meaningful things we can give another person is our full attention.

Your Presence Matters More Than You May Realize

When the problem feels enormous, simply being present can feel inadequate.

It isn’t.

Connection is an important part of suicide prevention. Someone who is struggling may already feel isolated, burdensome, hopeless, or disconnected from the people around them. Having another person notice, listen, take their words seriously, and remain with them interrupts that isolation.

Leah returned repeatedly to the importance of human connection during our conversation.

Technology gives us more ways than ever to communicate, but Leah pointed out that being present with another person allows us to notice things a screen may not reveal:

• A change in someone’s demeanor
• Shaking hands
• Withdrawal
• Changes in appearance
• The expression on someone’s face when you ask how they are really doing
• The sense that the person sitting across from you simply isn’t okay

When we know what to look for, we can pay attention differently.

Support doesn’t require a perfect speech. Sometimes it starts with sitting beside someone and making sure they aren’t alone.

If They Ask You Not to Tell Anyone

This can be one of the hardest moments for a friend, parent, sibling, coworker, or other trusted person.

Someone tells you they are thinking about suicide.

Then they say:

“Please don’t tell anyone.”

You may feel caught between protecting their trust and protecting their safety.

Leah is remarkably clear about which one takes priority.

The person may:

• Become angry with you for involving someone else.
• Feel betrayed.
• Tell you that you broke their trust.
• Even tell you they hate you in that moment.

Leah’s response is worth remembering:

“It’s okay that they’re angry in that moment. It’s okay that they hate you in that moment. You’re saving somebody.”

She has also seen what can happen after the crisis passes. The perspective can become: They cared enough about me to get me the help I needed.

Real support doesn’t always mean doing what someone wants us to do in the moment. Sometimes it means caring enough to do what helps keep them safe.

Get Help—You Don’t Have to Become the Expert

If someone tells you they are thinking about suicide, take them seriously and connect them with appropriate help.

Remember what you do not have to do:

• You do not have to conduct your own clinical assessment.
• You do not have to determine their level of suicide risk.
• You do not have to diagnose what is happening.
• You do not have to know which behavioral health program they need.
• You do not have to carry the responsibility alone.

Your role is to help create the connection to someone who can guide the next step.

The 988 Suicide & Crisis Lifeline is available 24 hours a day by calling or texting 988. You can contact 988 when you are experiencing a crisis yourself or when you are concerned about someone else and need guidance about what to do.

Depending on the situation, additional crisis evaluation or emergency medical care may be necessary. If there is an immediate life-threatening emergency, call 911 or seek emergency medical care.

Leah described the role of the person providing support very simply: sometimes you are the person who stays beside someone while you bring in the people who are trained to help.

That is not handing the person off.

That is helping.

Parents: Your Child Needs a Safe Place to Tell the Truth

For parents, discovering that your child is struggling can bring another layer of emotion.

Fear can quickly become interrogation:

• Why didn’t you tell me?
• How long has this been happening?
• What happened?
• Why would you feel this way?

There will be time to understand more.

First, make home a place where the truth can be spoken.

Leah talked about the fear parents sometimes have that discussing suicide—or asking a child directly about suicide—could somehow put the idea into their head.²

Her message is the opposite: talk about it.

For parents, that can mean:

• Notice when something about your child’s behavior or mood has changed.
• Ask directly when you are concerned.
• Listen before trying to explain away what they feel.
• Take statements about suicide seriously.
• Bring in professional help rather than trying to manage the situation within the family alone.
• Continue showing up after the immediate crisis has passed. ³,⁴

Your child does not need you to have a clinical degree.

They need to know that telling you the truth will lead to support.

Keep Showing Up After the Crisis

Real support doesn’t end with the crisis call, emergency evaluation, hospitalization, or first therapy appointment.

There is an afterward.

And support afterward can look surprisingly ordinary:

• Send the text tomorrow.
• Ask how the appointment went.
• Sit with them in the waiting room.
• Offer a ride to treatment.
• Learn about their treatment when they want you involved.
• Invite them to do something ordinary.
• Check in again next week.
• Remember the difficult anniversary they mentioned.
• Don’t assume that because someone appears better, they no longer need connection.

Recovery isn’t always linear, and meaningful support often happens in ordinary moments long after the immediate crisis has passed. ⁴

Leah’s emphasis on human connection is especially important here.

You don’t have to constantly ask someone about their mental health. Sometimes support looks like coffee, a walk, dinner, a phone call, a ride to an appointment, or simply sitting together without needing to fix anything.

Keep being part of their life.

Families Shouldn’t Have to Navigate What Comes Next Alone

After an immediate crisis begins to stabilize, families often encounter another difficult question:

What happens now?

Depending on the person’s needs, the next step could include:

• Inpatient or crisis stabilization services
• A Partial Hospitalization Program (PHP)
• An Intensive Outpatient Program (IOP)
• Psychiatric services
• Individual or family therapy
• Substance use treatment
• Recovery programming
• Another specialized community resource

The appropriate level of care can also change throughout recovery.

Trying to understand all of that while your family is already frightened and exhausted can feel overwhelming.

Leah works with individuals, families, healthcare professionals, hospitals, schools, treatment organizations, and community partners to help connect people with appropriate behavioral healthcare resources throughout Michigan.

Sometimes River’s Bend may be the right place for care.

Sometimes a hospital, crisis service, or another community organization is the better first step.

And someone who begins treatment elsewhere may later benefit from River’s Bend as they stabilize and transition to another level of care.

Leah described River’s Bend’s philosophy simply:

If we can help, we’ll make the connection. If we can’t, we’ll help find the resources that can.

The goal isn’t to make every person a River’s Bend client.

The goal is to help people get the care they need.

Real Support Is Not One Person Saving Another

There is a dangerous expectation we can place on ourselves when someone we love is struggling:

It’s my job to save them.

It isn’t.

Real support is not one heroic person carrying someone else through a mental health crisis. It is building a circle around them that might include:

• Family and friends
• Therapists and other clinicians
• Crisis professionals
• Physicians and psychiatric providers
• Schools or other trusted community supports
• Treatment programs
• Community resources
• People who know the person
• People who know the behavioral healthcare system

Your role may simply be to make sure that circle begins to form.

Ask. Listen. Stay. Connect. Follow up.

And remember Leah’s simplest message:

If you’re worried, ask the question.

Then, if the answer tells you someone needs help, don’t leave them alone with the answer.

Help them take the next step.

Help Is Available

If you or someone you know is experiencing suicidal thoughts, emotional distress, or a mental health crisis, call or text 988 to reach the 988 Suicide & Crisis Lifeline. In the event of an immediate life-threatening emergency, call 911 or seek emergency medical care.

Those in Michigan who are unsure which behavioral healthcare resource or level of care is appropriate can also reach out to Leah Bogdanski at River’s Bend.

You don’t have to know which program, provider, or level of care is right before you call.

Sometimes River’s Bend will be the answer. Sometimes one of our community partners will be. And sometimes River’s Bend can become part of the journey later, when the person is ready for a different level of care.

What matters first is getting the person you care about connected to help.

Real talk. Compassionate support. People who are willing to stay.

References

1. DeCou, C. R., & Schumann, M. E. (2018). On the Iatrogenic Risk of Assessing Suicidality: A Meta-Analysis. Suicide and Life-Threatening Behavior, 48(5), 531–543. DOI / publication

2. Nuij, C., van Ballegooijen, W., de Beurs, D., et al. (2021). Safety planning-type interventions for suicide prevention: meta-analysis. British Journal of Psychiatry, 219(2), 419–426. DOI / publication

3. Stanley, B., Brown, G. K., Brenner, L. A., et al. (2018). Comparison of the Safety Planning Intervention With Follow-up vs Usual Care of Suicidal Patients Treated in the Emergency Department. JAMA Psychiatry, 75(9), 894–900. DOI / publication

4. Skopp, N. A., Smolenski, D. J., Bush, N. E., et al. (2023). Caring contacts for suicide prevention: A systematic review and meta-analysis. Psychological Services, 20(1), 74–83. DOI / publication