Spotting Suicidal Behavior & Suicide Prevention Myths

March 13, 2017

This week, we had the pleasure of speaking with Courtney Brown, the Hotline Director at San Francisco Suicide Prevention, who’s agreed to share her valuable experience with us. Since starting out as the organization’s volunteer hotline operator seven years ago, Courtney has found her life purpose in helping others. “Many people think that the work here would be really draining, but I’ve actually found the opposite to be true. Working here has given me more strength to continue living every day,” shared Courtney. “One of the things that all our callers have in common is their desire to help themselves, which is really beautiful and inspiring.”



While there are many possible signs of suicidal behavior, Courtney explains that the only way to find out if someone is suicidal is to ask them. “Perhaps the most helpful indication is when someone says things like, “I can’t see a reason to go on anymore,” or “I have no hope anymore, I don’t know why I’m here.” Statements like these are an invitation to discuss suicide without saying it directly. Many people will avoid the word “suicide” because of the stigma attached to it. They don’t want to scare others away or burden them,” says Courtney. “The right thing to do is to ask the person directly if they’re thinking about killing themselves.”

“If someone says they’re suicidal, my first response is to thank them for sharing their feelings because it’s really tough to be honest about it. The next step is to talk about what they’ve been going through and connect with them. The wrong step is to try to immediately tell them how good their life is or how great they are. That actually does the reverse of what’s intended. Instead of making them feel better, it makes them feel like there’s something wrong with them because they can’t be happy given their circumstances. It actually increases suicidality.” – Courtney Brown, Hotline Director at San Francisco Suicide Prevention.

“Instead, agree with them by saying something like, “You’re right, everything’s really hard right now, you’re going through a lot, and I want to support you through this.” You should also try to keep them safe. For example, ask them about any harmful medications or objects that they’ve thought of using to hurt themselves and try to restrict access to them.” While most people do not go through with their suicidal thoughts and just need someone to talk to, if you think someone is in immediate danger, do not leave them alone—stay there and call 911.



Myth #1: Only people with suicidal thoughts should call the suicide prevention hotline.

Contrary to popular belief, you don’t have to be suicidal to call the suicide hotline. “We want people to call us before they are in crisis to reduce the risk of getting there,” stresses Courtney Brown. Only 30% of the hotline’s callers are actually suicidal. The other 70% are going through other types of life crises like anxiety, major depressive or psychotic episodes. Some people call because they’re simply lonely. Even though they’re not in any danger of taking their own lives, they’re finding it difficult to wake up every day.”

Myth #2: If you call the hotline they will send the police to your door.

“People often assume that if they are suicidal, we’re just going to call the police on them. That’s definitely not true,” says Courtney. “Last year, approximately 65,000 called our hotline. We ended up having to send emergency services to about 50 of them. If somebody calls us and says, “I’m feeling suicidal, but I have no intentions of taking my own life or harming myself,” we’re not going to send anybody. We’re not going to try to fix your problems, we’re here to listen, and I can assure you, you will not be judged!”



A wide variety of support resources is available to troubled callers. “We definitely want to encourage people to get long-term care. That is ideal for all callers,” says Courtney Brown. “Additionally, modern technology offers 24/7 self-care options that complement standard therapy. Just like having a suicide hotline accessible in the middle of the night, when there’s no one else to talk to, having a resource where you can record your feelings is also very valuable.”

“Journaling makes you feel less like you’re a victim to your emotions. It helps you identify what you’re feeling and gives you an opportunity to figure out if you can change those feelings. A lot of people don’t know what makes them anxious or upset, and what helps them or makes them happy. A guided journaling tool like Therachat might be helpful for people with anxiety to figure out what their triggers are.” – Courtney Brown, Hotline Director

“When you journal without any sort of prompt, you’re feeding into whatever your stream of thought is. Especially if someone’s having a panic attack or an anxious episode–they might end up using the journaling to facilitate an anxiety spiral. Something a little more directive might be more helpful. To have a tool that reminds people to journal and redirects them would be hugely helpful,” says Courtney.

Visit San Francisco Suicide Prevention for more information and check out Therachat to learn more about journaling tools available to therapists and clients.

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  • Reply Amy April 11, 2017 at 5:23 am

    Here (Northeast) you have to be suicidal or in crisis when you call or they’ll get off the phone with you. And they almost always call the police to tales you to the hospital for an evaluation.

    • Reply Trish April 14, 2017 at 8:35 pm

      That’s really unfortunate. I can understand the mentality behind it because you want people to get help but forcing them to confront the police because they reached out is probably doing a lot more harm than it would good. Now if somebody says there are in the midst of deciding how to kill themselves that’s a different story. But if someone just calls to chat I think it would probably be better to allow them to otherwise less and less people are going to reach out the ones who are suicidal and who will actually commit suicide will do so quietly without ever letting anyone know.

    • Reply Anonymous April 16, 2017 at 9:41 pm

      That has been my experience too in the midwest. I know someone who literally told the crisis line that they weren’t suicidal and they still called the cops. Which is pretty traumatizing for someone who is already upset :/

    • Reply Beesy September 14, 2017 at 1:33 am

      Yep – I texted a crisis line and said I wasn’t going to kill myself just really down and needed to chat. Police came (in the middle of the night – 4 of them), ambulance, forced to go to the hospital, woke up my whole family….etc etc. Total nightmare. I am now a nervous wreck, afraid and sick all the time. Great help they provide.

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