If you are thinking about suicide, someone will talk with you right now.

The next few hours

You do not have to fix your life tonight. The only goal is to get through the next few hours with your options still open.

1. 1

   Tell one person.

   Out loud, to one human being: “I am thinking about killing myself.” A friend, a relative, a neighbour, a doctor, a helpline volunteer. Saying it is not a betrayal of anyone, and it does not commit you to anything.

2. 2

   Put distance between yourself and the means.

   Give away, lock up, or walk away from whatever you have been thinking of using. Ask someone to hold it for a while — medication, a weapon, keys, access to a place. Suicidal crises usually peak and pass within hours. Distance buys you those hours, and that is very often the whole difference.

3. 3

   Don't be alone with it.

   Go where other people are, or ask someone to come to you, or stay on a line with a volunteer. A room with another person in it is safer than a room without one, even if you say nothing.

4. 4

   Leave alcohol and drugs out of tonight.

   Both make the impulse louder and the pause between thought and action much shorter. This is not a moral point; it is the single most common factor in crises that turn into attempts.

5. 5

   Do the next small thing.

   Water. Something to eat. A shower. Cold air. Lying on the floor. None of this is a cure and nobody is pretending it is — it is a way of letting time pass while the peak comes down.

6. 6

   Set a time to decide again.

   “I am deciding nothing until tomorrow morning” is a real decision, and it is allowed to be the only one you make today. Then tomorrow morning, do it again.

Crisis lines, country by country

Everything listed here is free unless noted. Most are anonymous, and none of them require you to be certain you are “bad enough” to call.

Germany

Austria & Switzerland

United States & Canada

United Kingdom & Ireland

Australia & New Zealand

Everywhere else

Support for particular situations

A general crisis line will always take your call. But sometimes it helps enormously to reach someone who already knows the shape of what you are dealing with, and to whom you do not have to explain the basics.

If a crisis line is not something you can use

Some people avoid these numbers for reasons that deserve a straight answer rather than reassurance.

“I'm afraid they will send the police or have me committed.”

This fear is common and it is not irrational — but it is worth knowing how the services actually work, because the picture differs by country.

• Germany: TelefonSeelsorge describes its service as anonymous and free, and states that calls do not appear on your phone bill. Its volunteers listen and talk; they are not an emergency service and cannot dispatch one to you. Involuntary admission in Germany is a legal process involving a doctor and, beyond a very short period, a judge — it is not something a helpline sets in motion.
• United States: 988 counsellors work with your cooperation and try to resolve calls without emergency services; in a small minority of calls they do involve them without consent. If that risk is what stops you from reaching out at all, use a service with a published policy instead — see below.
• Trans Lifeline commits explicitly to no non-consensual active rescue: they state they will not call emergency services or law enforcement without your explicit request, even if you tell them you are in danger.

Warmlines and peer support

A warmline is not a crisis line. It is staffed by people who have been through mental health crises themselves, and it exists for the ordinary bad evening — loneliness, dread, the day before things get worse. You do not have to be at a breaking point to call, and that is the point of them.

• warmline.org
  — directory of peer-run warmlines across the United States, with hours.
• In Germany, look for a Krisendienst, an EX-IN peer counsellor, or the local Selbsthilfegruppe for depression —
  nakos.de
  keeps the national self-help directory.
• Online peer communities with active moderation, such as the Deutsche Depressionshilfe discussion forum, are a reasonable middle step when talking to a person is still too much.

Making a safety plan

A safety plan is a short written list you make while you are relatively well, so that the version of you in the middle of the night does not have to think clearly to know what to do. It is the most evidence-backed self-help tool in suicide prevention, and it takes about twenty minutes.

1. 1

   My warning signs

   The thoughts, feelings, situations and behaviours that tend to come before a crisis, in your own words. Withdrawing. Not answering messages. A particular sentence you start saying to yourself.

2. 2

   What I can do alone

   Things that have actually taken the edge off before, without needing anyone else — a walk, a specific playlist, a shower, a game, the dog.

3. 3

   People and places that distract me

   Company you do not have to explain yourself to. A café, a library, a friend you can sit next to in silence.

4. 4

   People I can ask for help

   Names and numbers, written out. Ask them in advance whether you may put them on this list — most people say yes, and are glad to have been asked.

5. 5

   Professionals and services

   Your doctor, your therapist, the local crisis service, the helpline numbers from this page, and the address of the nearest emergency department.

6. 6

   Making my environment safer

   What you will put out of reach, and who will hold it. Decide this now, while it is a calm administrative decision rather than a fight with yourself.

Apps and templates

• KrisenKompass — free German app from TelefonSeelsorge, built around exactly this plan.
• Stay Alive — free UK app from Grassroots Suicide Prevention, with a safety plan and a “life box” for photos and reasons to stay.
• MY3 — free US app following the Stanley & Brown safety plan, centred on three people you would contact.
• Virtual Hope Box — free, with distraction, relaxation and coping tools for the moment itself.
• Paper works just as well. A folded card in a wallet has saved lives that an unopened app did not.

Putting distance between yourself and the means

This deserves its own paragraph because it is the single most effective thing that can be done, and it is the thing people skip. The time between deciding and acting is often minutes. When the method is not to hand, that window passes, and the great majority of people who survive a suicidal crisis do not go on to die by suicide.

In practice it means: a friend or family member keeps your medication and hands out a few days at a time. Larger quantities are not kept in the house. A firearm is stored outside the home, with someone else, ideally with the ammunition separate. A key is given away. None of this is a judgement on you, and none of it has to be permanent — it is a lock on a door you would rather not be able to open at four in the morning.

If you are worried about someone else

You do not need training, and you are not expected to be their treatment. What helps is ordinary and unglamorous: ask, listen, stay, and help them get to someone who can do more than you can.

Ask directly

Ask the question in plain words: “Are you thinking about suicide?” Not “you're not thinking of doing anything stupid, are you?” — which asks for a no. Asking directly does not plant the idea. It is one of the most consistent findings in the field, and for many people it is the first time anyone has given them permission to say yes.

If the answer is yes, you have already done the hardest part. Stay calm, stay in the conversation, and ask how long it has been like this. You are not agreeing with them by listening.

Look after yourself too

Supporting someone through this is exhausting, and being the only person holding it is not sustainable for anyone. Every helpline on this page will also talk to you — that is an explicit part of what TelefonSeelsorge, Papyrus, the Suicide Call Back Service and the rest are for. Germany's Elterntelefon (0800 111 0 550) exists specifically for parents.

After an attempt

The weeks after a suicide attempt or a psychiatric discharge are a period of raised risk, and they are also the period where follow-up makes the clearest difference. This is worth knowing in advance, because it is not always explained well at the time.

• Ask for the follow-up appointment before discharge, not after. Ideally within a week. If you are supporting someone, ask on their behalf and write down what was agreed, including who to call if things slip before then.
• Make a safety plan with a professional while there is still someone to make it with, and go home to a house where the means have already been dealt with.
• Expect the conversations to be awkward. People often go quiet out of fear of saying the wrong thing, and the silence reads as rejection. If you are the friend: say something. “I don't know what to say, but I'm here” is enough.
• Attempt survivors —
  Live Through This
  collects portraits and stories of people who survived, and
  lifelineforattemptsurvivors.org
  is written by and for people who have been there. Reading someone else's ordinary life on the other side of it does something that advice does not.

If someone you love died by suicide

Grief after a suicide carries things ordinary grief does not: the unanswerable why, the guilt, other people's discomfort, and often a raised risk to your own health. Support from people who have been through the same thing helps in a way that general sympathy cannot.

Beyond the crisis

Helplines get people through a night. What changes the next year is usually treatment, and in most countries the hard part is the waiting list rather than the willingness.

Getting a therapy place in Germany

• Call 116 117 and ask the Terminservicestelle for a psychotherapeutische Sprechstunde. They are obliged to arrange one, and it is the official door into the system.
• In that first appointment you get a written recommendation (PTV 11). Keep it — it is what you need for everything that follows, including the Kostenerstattungsverfahren, where your Krankenkasse pays for a private therapist because no statutory place was available in time.
• Ring round practices yourself as well, during their telefonische Sprechzeiten. It is tedious and it works more often than the register suggests.
• Your GP can treat you, sign you off work, and refer you urgently. An acute crisis is a reason to be seen quickly, and saying the word “suicidal” out loud to them changes how fast things move.

While you are waiting

Waiting lists are not a verdict. Use the crisis lines on this page as often as you need them — they are not rationed, and calling twice in a week is not an imposition. Ask your GP about interim options. Look for a Selbsthilfegruppe through nakos.de. And treat the hopelessness itself with some suspicion: it is one of the symptoms, which means it is lying to you about the odds with the same confidence it lies about everything else.

Things that get in the way

“Other people have it worse.”

Nobody at a crisis line is running a comparison. There is no threshold of suffering you have to clear, and the volunteers would far rather talk to you on a Tuesday when it is merely bad than meet the emergency later.

“Talking about it will make it worse.”

The opposite is what the evidence shows. Being asked directly, and being able to answer honestly, reliably brings distress down rather than up — for the person asking and the person asked.

“This is a permanent decision I've thought through carefully.”

Almost everyone in a suicidal crisis is of two minds about it, right up to the end — which is why so many people reach out at the last moment, and why nearly everyone who survives goes on living. The clarity does not feel like ambivalence from the inside. It is worth giving that doubt more time than it is asking for.

“I don't know what to say.”

Then say that. “I don't know what to say, I just needed someone to pick up” is an entirely normal opening, and the person on the other end has heard it many times before. They will take it from there.

“Can I get help in English in Germany?”

English is not guaranteed on the German crisis lines, but it is often possible — TelefonSeelsorge (0800 111 0 111) is worth trying, and it costs you nothing to ask. If speaking in a second language while in distress feels impossible, the written services are usually easier: the chat and email counselling at telefonseelsorge.de, and krisenchat.de for under-25s. findahelpline.com also lets you filter helplines by language.

For ongoing therapy in English, many German cities have English-speaking therapists and the larger university towns usually have several. Ask your Krankenkasse directly — they hold lists — and see the section above on getting a therapy place, which applies to you regardless of the language you are treated in.

“Will it cost me anything, or show up on a bill?”

No. Every line on this page is free unless it says otherwise. TelefonSeelsorge states that its calls are free of charge and do not appear on your phone bill, and the Samaritans in the UK say the same about 116 123. You do not need credit on a prepaid phone to reach an emergency number, and you do not have to give your name to any of these services.