Suicidal thoughts - How to cope

Overview

• You can talk about how you’re feeling with someone you trust. Also, you can call an emotional support helpline like the Samaritans on 116 123.
• You can contact your local NHS urgent mental health helpline to get urgent support.
• You might also be able to get support from your GP, an NHS crisis team, or an NHS community mental health team.
• You can try to do activities you enjoy, which take your mind off what you’re thinking.
• If you feel you might harm yourself or try to take your own life you can:
  
  • call emergency services on 999, or
  • go to Accident and Emergency (A&E).
• You can make a crisis plan and a crisis box.

Helping myself

How can I help myself now?

When you’re feeling suicidal, it can feel overwhelming. It may feel like you have no other option than to act on these feelings. That there’s nothing that will make the thoughts or feelings go away. Or that it’s the only way the pain will stop.

Your feelings of pain are very real. But it’s important to know they can pass.

There are things you can do in this moment. It may feel like nothing will help. But there are things that you can do and you may feel differently after you’ve tried them. See below for more information.

You can try to get through this moment or this day rather than focusing too much on the future.

You may have felt like this before, and it may have passed. Try to remember that this feeling is temporary and it’s likely to pass.

You can try to change your immediate thoughts by doing something or thinking of something different. It doesn’t have to be a big change or take a lot of effort.

Have a look at the following ideas. You may find one or 2 things that help.

Don’t make a decision today

You don’t need to act on your thoughts right now.

You can try to focus on just getting through now, or today, and not the rest of your life.

You may have had these thoughts before, but you feel less able to cope today. You might find that you are more able to cope in a few days.

Get professional support

See further down this page for more information.

Talk to other people

It could be helpful for you to talk to someone about how you’re feeling. There are different people who can help. You could speak to friends, family or your GP.

Remember to be patient. Your friends and family may want to help but might not know how to straight away. If this happens, you should tell them what you want from them. You may want to talk about how you’re feeling, or you may want them to help you get professional help.

If you don’t want to talk to people you know, you could call an emotional support line. You can also use an emotional support app or use an online support group.

You can find details or emotional support lines and apps in the Useful contacts section at the bottom of this page.

Look at your crisis plan

You can follow your crisis plan if you have one. You may have made a crisis plan with the help of a health professional or made your own.

If you don’t have a crisis plan you can make one. You can start to think of some things which you will find helpful.

The last section before the contacts list will provide more information about how to make a crisis plan.

Look in your crisis box or hope book

A crisis box or a hope book is personal to you and can be filled with items that make you feel happier about life.

If you don’t have a crisis box, you can make one. The last section before the contacts list gives more information about how to make a crisis box.

Be around other people

You may find it too difficult to speak to anyone at the moment. That’s ok. Being around people can help to keep you safe, even if they don’t know how you’re feeling.

You could meet friends or family, go to a shopping centre, gym, coffee shop or park. Being around people can help to keep you safe, even if they don’t know how you’re feeling.

Be aware of your triggers

Triggers are things which might make you feel worse. Triggers are different for different people. You may find that certain music, photos or films make you feel worse. Try to stay away from these.

You could create a Wellness Action Plan to help you to be more self-aware. It can help you to identify triggers in your life which can make you unwell. It may help you to write down your triggers.

If you can understand what your triggers are, it can help you to be more in control of your feelings or stress levels.

You can share your Wellness Action Plan with your family or friends if you want to. Sometimes it is helpful to share your plan because it can help them to understand you more.

You can read more about wellness action plans here: www.mentalhealth-uk.org/blog/wellbeing-workplan.

You can see an example of a wellness action plan here: www.mhukcdn.s3.eu-west-2.amazonaws.com/wp-content/uploads/2021/04/26122110/MHUK-My-Wellbeing-plan.pdf.

Take care with drugs and alcohol

Alcohol affects the parts of your brain that controls judgement, concentration, behaviour and emotions. If you’re feeling low, drinking alcohol might bring on suicidal thoughts or make them worse.

Drugs affect the way you think and feel.

Different drugs have different effects. For example, cocaine can make you feel happy and more likely to take risks when you take it. But you may feel depressed after the effects stop.

Other drugs can cause hallucinations, confusion, and paranoia.

You may be more likely to take your own life if you take illegal drugs.

Go to a safe place

You can go to a place where you feel safe. Below is a list of places you could try.

• Your bedroom
• Friend or family member’s house
• Mental health centre
• Crisis centre
• Religious or spiritual centre
• Library
• Peer support group

Stay away from things you could use to harm yourself, such as razor blades or pills.

If you have a lot of medication, you can ask someone to keep it safe for you.

Ground yourself

When you are feeling suicidal, it can be helpful to do some exercises to calm your nervous system. Especially if you are feeling panicked, worried, or overwhelmed by your thoughts and feelings.

You can do some grounding exercises that use all your senses. This can help you to ‘be in the moment’ and to not focus too much on your thoughts.

Try a grounding exercise
Vision. Focus your attention on something beautiful or comforting. Like a meaningful photograph, piece of art, or a nice view.

Hearing. Listen to a favourite song, sit in nature and listen to the sounds, or sing.

Smell. Notice smells around you or find something you like the smell of. Like some soap, a type of food, or an essential oil.

Taste. Find something to taste and do it slowly and mindfully. Savour each moment. Notice the flavours, how it feels on your tongue, and what thoughts you have about it.

Touch. Stroke or feel something comforting. Get in a dressing gown or comfy blanket. Stroke a pet. Suck on some ice. Notice how the different sensations feels in your body.

Try another grounding exercise
Say out loud or think of:

• 5 things you can see,
• 4 things you can hear,
• 3 things you can touch,
• 2 things you can smell, and
• 1 thing you can taste.

Distract yourself

You might feel it is impossible not to focus on your suicidal thoughts or why you feel that way. If you focus on your thoughts, it might make them feel stronger and harder to cope with. So, you can try doing things that distract you. Think about what you enjoy doing.

Below are some things you could do as a distraction.

• Read a book or magazine.
• Watch a film or TV.
• Go to a museum.
• Draw or paint.
• Listen to music.
• Do some gardening.
• Exercise. Walk, run, swim, or whatever you enjoy.
• Play video games or other games or puzzles you enjoy.
• Singing or playing a musical instrument.
• Spend time with your pet.
• Set small goals to focus on. You could do the laundry, make a cake, or tidy or organise something.

You can find some more ideas of distraction techniques here:
www.papyrus-uk.org/wp-content/uploads/2018/10/Distraction-Techniques.pdf

Try to reframe your thinking

You can make a list of all the positive things about yourself and your life. It might be hard to think of these things right now, but it might help.

Think about your strengths and positive things other people have said about you. Regularly write down one thing you felt good about, something good you did, or something good someone did for you.

Try a reframing exercise
You may not feel like focusing on the positive. But it might help you to reframe your thinking. You could try one of the following exercises.

What went well. Write down 3 things that went well so far today. You might feel like nothing went well. But if you think you can always find things, however small. It might be as simple as ‘I got out of bed’, ‘I made breakfast’ or ‘I told someone I was not okay’.

Write down things you’re grateful for. Write down 3 things that you are grateful for in your life. For example, running water, a close friend, and a comfy bed. You could also write a letter of thanks to a loved one, saying how grateful you are. You can focus on the positive things they give you or others.

Reframe the negative. You may have a negative situation or experience you’re thinking about. You can write this down then think of 2 positives that have come from it. The negative thing might be ‘I’m feeling suicidal’. The 2 positive things might be:

• ‘I know I have people I can reach out to’, and
• ‘I’ve connected with others who have survived, so I know it’s possible.’

You can find more examples of positivity exercises at the link below, which some people find useful:
www.positivepsychology.com/positive-psychology-interventions

Problem solving

It can be helpful to think differently about your problems.

You can write down a problem you have and the things that might help to ease or solve that problem. You can ask someone to help if this feels too difficult.

This might help you to reframe the problems into manageable challenges. You could start with the small challenge and work your way up.

Exercise

Exercise can have a good effect on your mood and thinking. Exercise is thought to release dopamine and serotonin. These are ‘feel good’ hormones.

You can find out more about ‘Physical activity and mental health’ here:
www.rethink.org/advice-and-information/living-with-mental-illness/wellbeing-physical-health/physical-activity-and-mental-health

Mindfulness

Mindfulness is a type of meditation. It is when you focus on your mind and body. It is a way of paying attention to the present moment. When you practice mindfulness, you learn to be more aware of your thoughts and feelings. Once you are more aware of your thoughts and feelings, you can learn to deal with them better.

There is more information about getting started with mindfulness of the mindful.org website:
www.mindful.org/meditation/mindfulness-getting-started

Mindfulness usually benefits wellbeing. But if it’s not working for you, or is causing you difficulty, stop using it. You can try other relaxation technique or contact your GP for advice.

Breathing exercises

Breathing exercises can help make you feel calmer and reduce stress. Below are some exercises you can try.

Breathing exercises usually benefit wellbeing. But if they aren’t working for you, or are causing you difficulty, stop using them. You can try other relaxation technique or contact your GP for advice.

Slow breathing

• Sit or lie in a comfortable position.
• Keep your back straight and your shoulders back.
• Close your eyes and focus on your breathing.
• Think about how your breathing feels in your body.
• Can you feel it coming in through your nostrils?
• Can you feel it going down your throat, into your lungs?
• Slow down your breathing as much as you can.
• You may find it useful to count as you inhale and exhale.
• See if you can expand your exhale, to make it longer than your inhale. Can you feel your chest expanding? What about your belly?
• If you start to have upsetting thoughts, try bringing your focus back to your breathing.

Box breathing

• Sit or lie in a comfortable position.
• Put on some relaxing music if you want.
• Take one deep breath in and out.
• Breathe in for 4 seconds.
• Hold your breath for 4 seconds.
• Breathe out for 6 seconds.
• Hold your breath for 2 seconds.
• Repeat this cycle for 5-10 minutes.

4-5-8 method

• Start by sitting up straight in a comfortable position or lying down.
• Slowly breathe in through your nose for 4 seconds. If you can’t breathe in through your nose, use your mouth.
• Hold your breath for 5 seconds.
• Breathe out slowly for 8 seconds.
• Repeat this cycle 10 times, or as many times as you want. While you do it try to concentrate on your breathing. You can alter the second counts to suit you.

You can find more information on breathing exercises here:
www.nhs.uk/mental-health/self-help/guides-tools-and-activities/breathing-exercises-for-stress

Think about the people you love and care about

You may be thinking thoughts such as the following.

• ‘The world would be a better place without me.’
• ‘My family would be better off without me.’
• ‘No one would care if I’m not here.’
• ‘I’m a burden.’

These thoughts are common but people who love you won’t agree with them. You are important and unique, and you matter.

It’s important to know that many people have felt the way you feel, and have overcome it. They have gone on to live happy and joyful lives. And have often spoken out about how glad they are they didn’t ending their lives.

Ending your life is very final. There are no second chances. If you’re reading this now, this is your sign to know you’re not alone and to tell someone you’re not okay. This may be a loved one, a healthcare professional or someone else.

Remind yourself of your coping strategies

All of these different things you can do are called coping strategies. You might want to have a list of them in your crisis plan, crisis box, or hope book. You might also want to think about your own coping strategies and make a list of them.

You can find ideas of other coping strategies here:
www.papyrus-uk.org/wp-content/uploads/2018/10/Coping-Strategies.pdf.

See our webpage on Complementary and alternative treatments for more information.

Emotional support

How can I get emotional and peer support?

Where can I get emotional support?
Remember that however you feel there are people who will listen and who want to help.

You can family or friends know what you are going through if you want to. They may be able to offer support and help keep you safe. They may help you see your situation in a different way or think of other options.

You can get emotional support from other places. You could talk to:

• someone from an emotional support line,
• a teacher, tutor, or colleague, or
• a religious or spiritual leader.

Staff who work on emotional support lines are trained listeners. They will let you talk about your feelings and experiences without judging you or telling you what to do.

You can find details or emotional support lines and apps in the Useful contacts section at the bottom of this page.

Where can I get peer support?
Peer support groups are where people with similar issues share experiences with others and get mutual support.

You can search for local mental health support groups on the internet and below:

• Rethink Mental Illness: www.rethink.org/about-us/our-support-groups
• Local Minds: www.mind.org.uk/about-us/local-minds
• Andy’s Man Club (for men): www.andysmanclub.co.uk
• Men’s Sheds Association (for men): www.menssheds.org.uk

There are also online support services:

• Clic: www.clic-uk.org/
• Side by Side: www.sidebyside.mind.org.uk/
• 7 Cups: www.7cups.com
• Sane: www.sane.org.uk/what_we_do/support/supportforum
• Togetherall: www.togetherall.com/
• My Black Dog: www.myblackdog.co

These support groups are for people experiencing mental health issues. They are not crisis support groups.

Professional support

How can I get professional support?

There can be a difference between what are known as ‘passive’ and ‘active’ suicidal thoughts.

Passive suicidal thoughts are when you have thoughts of killing yourself, but don’t have a plan to end your life.

Active suicidal thoughts are when you’re thinking about and planning to end your life.

Depending on how you’re feeling you may need different types of professional support.

You can listen to your gut feeling and if you think your safety is in danger, it’s best to act immediately. You’ll not be wasting anyone’s time as a mental health emergency is as seriously as a physical health one.

You have the following options.

NHS urgent mental health helplines

These local helplines are usually available 24 hours a day 7 days a week. You can call them for advice and support.

They can assess what is happening and direct you to the best services and support for your situation.

To find your local helpline go to:
www.nhs.uk/service-search/mental-health/find-an-urgent-mental-health-helpline.

Emergency services and Accident and Emergency (A&E)

You can go to Accident and Emergency (A&E) department at your local hospital if you think your safety is at risk.

Staff at A&E can assess you and may arrange for a mental health professional to see you. They will decide on the best next steps, which can include:

• outpatient help and support from mental health professionals at the hospital,
• help from an NHS crisis team in the community, or
• going into a mental health ward in hospital.

You can search for your loved local A&E here:
www.nhs.uk/Service-Search/other-services/Accident%20and%20emergency%20services/LocationSearch/428

NHS emergency services (999)

If you think your safety is at risk, you can contact the emergency services on 999. They may contact mental health services such as the crisis team or send an ambulance.

Your GP

GP practices usually keep some appointments free for urgent issues. You might be seen by a GP or a mental health professional, like a community psychiatric nurse (CPN). They can refer them to the local crisis team if necessary.

GPs are experienced in dealing with mental health problems, so you should try to be open about how you’re feeling.

You might be offered medication, access to talking therapies or more specialist support and treatment. Your GP should refer you to your local NHS crisis team if you live with depression and are a high risk of suicide, self-harm or self-neglect.

You might be able to get an appointment on the weekend or in the evening. Outside of normal surgery hours you can still phone the GP surgery, but you will usually be directed to an out-of-hours service or to NHS 111.

Out-of-hours services vary across the country. You could be:

• given another phone number to call, or
• directed to another service, such as a walk-in centre in large towns and cities.

For more information see our webpages on the following:

• GPs – What to expect from your doctor
• Talking therapies
• NHS mental health teams

NHS crisis team

Crisis teams support people who are having a mental health crisis in the community. You usually need to be referred to the team by a mental health or social care professional.

If you are supported by a crisis team, or have been in the past, then you can contact them if you need urgent help.

Crisis teams are sometimes called crisis resolution teams or home treatment teams.

NHS community mental health teams (CMHTs)

Community mental health teams (CMHTs) support people who have complex or serious mental health problems in the community. They’re usually only available during office hours on weekdays. You usually need to be referred to the team by a mental health or social care professional.

If you’re being supported by your local CMHT you can contact your care coordinator other key contact. If they are not there, talk to whoever is on duty that day.

Other services

Other services are provided in some areas by the NHS and other providers, such as charities. These local services can include:

• crisis houses that provide short-term accommodation for people experiencing a mental health crisis,
• crisis cafés that provide a safe, welcoming place where people can go if they are feeling emotionally distressed or are in a mental health crisis, and
• crisis helplines that provide emotional and sometimes practical support, and

Rethink Mental Illness provide some of these services in some areas. You can click the ‘Help in your area’ link on our website to search:
www.rethink.org

You can search online for local crisis services and your local NHS urgent mental health helpline should know about them too:
www.nhs.uk/service-search/mental-health/find-an-urgent-mental-health-helpline.

Longer-term support for your mental health

See our webpage on Worried about your mental health - How to get treatment and support for more information.

Crisis plan and crisis box

How do I make a crisis plan or crisis box?

Crisis plan

The aim of a crisis plan is to think about what support you need when you are in crisis. They are sometimes called a safety plans.

The plan should be made before you are in crisis, but it is never too late to start. You can ask someone to help you to make a crisis plan such as a friend or support worker.

You could make a list of things that you could do to help yourself.

You can write down the names and numbers of people who would be able to help you.

There is no set way for how a crisis plan should look. There is a crisis plan template at the end of this factsheet which you can use.

You should keep your plan in a safe place, and you can change it as you need to.

You can look online for templates of crisis plans. You can find advice on how to make a suicide safety plan on the Papyrus website here: www.papyrus-uk.org/hopelink

You can find more templates and guidance on how to fill one in, on the Staying Safe website here:
www.stayingsafe.net/home.

Crisis box

A crisis box has many different names such as a ‘happy box’, a ‘self-soothe box’, or a ‘hope box.’ You can call it whatever you like. It should be personal to you.

Creating a crisis box can be a good distraction or self-care activity.

The idea of a crisis box is that it is filled with items that make you feel better. You can use it when you feel anxious, stressed, or suicidal.

You can fill it with anything, such as:

• your favourite CD or USB with music you like,
• something to distract you, like a puzzle or colouring book,
• reminders of positive things you have learnt in therapy sessions,
• a copy of your crisis plan,
• photographs of people you love and who make you happy, and
• your favourite sweets.

If you don’t know what to put in your box, you can look online for ideas. It can be helpful to have a mixture of items, that use all 5 of your senses.

The charity Papyrus has more information about crisis boxes. Click the below link for more information:

www.papyrus-uk.org/wp-content/uploads/2018/09/HOPEBOX-resource.pdf

You may also like to create a hope book. This could be a scrap book with pages covering different things you like. And that make you feel good. Papyrus has more information about their ‘HOPEBOOK’ below.

www.papyrus-uk.org/wp-content/uploads/2018/10/HOPEBOOK.pdf

Useful contacts

Emotional support lines

Samaritans
A charity that offers emotional support for people who are distressed. Local branches offer telephone support and sometimes face to face support. The Samaritans helpline is available 24 hours a day, 7 days a week

Phone: 116 123
Address: Chris, Freepost RSRB-KKBY-CYJK, PO Box 9090, Stirling, FK8 2SA
Email: jo@samaritans.org
Website: www.samaritans.org

ASSISTline
National helpline offering supportive listening service to anyone throughout the UK with thoughts of suicide or thoughts of self-harm. They are open 24/7 for those aged 18 or over.

Phone: 0800 689 5652
Website: www.spuk.org.uk/national-suicide-prevention-helpline-uk

Shout
A charity that provides text support if you’re experiencing a personal crisis and are unable to cope.

Text: text shout to 85258
Text (young people): text YM to 85258

PAPYRUS
Charity that offers emotional support to people under 35 who are suicidal. They can also support people who are concerned about someone under 35 who might be suicidal.

Phone: 0800 068 41 41
Text: 07786 209697
Email: pat@papyrus-uk.org
Website: www.papyrus-uk.org

C.A.L.M. (Campaign Against Living Miserably)
CALM is leading a movement against suicide. They offer accredited confidential, anonymous and free support, information and signposting. The provide this to people anywhere in the UK through their helpline and webchat service.

Phone: 0800 58 58 58
Webchat: www.thecalmzone.net/help/webchat
Website: www.thecalmzone.net

Sane
Work with anyone affected by mental illness, including families, friends and carers. They provide a helpline and a free text-based support service called Textcare. And an online supportive forum community where anyone can share their experiences of mental health.

Phone: 0300 304 7000
Textcare: www.sane.org.uk/what_we_do/support/textcare
Support Forum: www.sane.org.uk/what_we_do/support/supportforum
Website: www.sane.org.uk

SupportLine
Support line offers confidential emotional support by telephone, email and post.

Phone: 01708 765200
Address: SupportLine, PO Box 2860, Romford, Essex RM7 1JA
E-mail: info@supportline.org.uk
Website: www.supportline.org.uk

The Mix
If you’re under 25 and need help but don’t know where to turn, call the Mix for free. They’ll explore your situation with you and find organisations that may be able to help you further.

Phone: 0808 808 4994
Crisis support: text THEMIX to 85258 for crisis support - www.themix.org.uk/get-support/speak-to-our-team/crisis-messenger
E-mail: www.themix.org.uk/get-support/speak-to-our-team/email-us
Telephone Counselling: www.themix.org.uk/get-support/speak-to-our-team/the-mix-counselling-service
Webchat: 1 to 1 chat service: www.themix.org.uk/get-support/speak-to-our-team
Website: www.themix.org.uk

Emotional support lines for LGBT+ people

Switchboard
Switchboard gives practical and emotional support for people in the LGBT+ community.

Phone: 0300 330 0630
E-mail: chris@switchboard.lgbt
Webchat: through the website
Website: www.switchboard.lgbt

Emotional support lines for people who’ve experienced childhood abuse

NAPAC
Support adult survivors of childhood abuse.

Phone: 0808 801 0331
E-mail: through the website: www.napac.org.uk/contact
Address: NAPAC, CAN Mezzanine, 7-14 Great Dover St, London, SE1 4YR
Website: www.napac.org.uk

Emotional support lines for ex-service personnel

Combat Stress
Charity that offers support to ex-service personnel who are experiencing problems with their mental health. And their families.

Phone for veterans and their families: 0800 138 1619
Phone for serving personnel and their families: 0800 323 4444
Helpline text:07537 404719
Address: Tyrwhitt House, Oaklawn Road, Surrey, KT22 0BX
Email: helpline@combatstress.org.uk
Website: www.combatstress.org.uk

Apps

Stay Alive
The Stay Alive app is a suicide prevention resource for the UK. It has useful information and tools to help you stay safe in crisis. You can use it if you are having thoughts of suicide. Or if you are concerned about someone else who may be considering suicide.

Website: www.prevent-suicide.org.uk/find-help-now/stay-alive-app

Headspace
Headspace is designed to help you to manage your mental health. You can access the app for free, you will have access to basic packages. You will have to pay a subscription to access more content.

E-mail: help@headspace.com
Website: www.headspace.com

Smiling Mind
Free meditation app.

Website: www.smilingmind.com.au/smiling-mind-app

Residential support

Maytree
Maytree is a national registered charity based in London. They provide a unique residential service for people in suicidal crisis so they can talk about their suicidal thoughts and behaviour. They offer a free 4-night, 5-day, one-off stay to adults over the age of 18 from across the UK. Their aim is to provide a safe, confidential, non-medical environment for their guests

Telephone: 020 7263 7070
Address: 72 Moray Road, Finsbury Park, London, N4 3LG
Email: maytree@maytree.org.uk
Website: www.maytree.org.uk

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You can access a fully referenced version of this information by downloading the PDF factsheet by using the link at the top of this page.

© Rethink Mental Illness 2022

Last updated October 2022
Next update October 2025

Version number 9