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This post is for anyone who has ever been concerned for a loved one's mental health, worried they may be at-risk of suicide, and felt too uncomfortable to ask.

We are all coming out of an era where mental health and mental illness were not commonly discussed topics.

If you're in your mid 30s like me or around there, then you were raised by parents whose education and understanding of mental health was likely naught. This of course has an impact on our knowledge of and comfort with mental health issues.

Many of us were not taught that it's ok to feel and express the spectrum of emotions, which can consequently send the message that having significant struggles, such as contemplating ending one's life, is unacceptable and shameful.

This creates multiple barriers to suicide prevention.

Perhaps most obvious, if we feel ashamed of our struggles we are unlikely to reach out for help, which is hugely isolating and problematic.

Further, this ongoing stigma creates deficits in our collective ability to help our fellow humans (who, as mentioned, are challenged to reach out); when we are not comfortable with a full range of emotional and mental experiences, we lack capacity to sit with each other through such difficulties.

Certainly, we have come a long way in the fight against stigma. Systems to support people with mental health difficulties have become more accessible (albeit, systemic issues are pervasive - but that is a topic for another day); many schools now prioritize and teach social-emotional skills, which will contribute to greater acceptance and consequential support for mental health and mental illness issues; and research is providing us with more and more understanding of wellness and lack there of, which allows us to improve our interventions and normalize these human experiences.

Still, despite these advances, according to the World Health Organization, "More than 700,000 people die by suicide every year, which is one person every 40 seconds."

Given that death by suicide is majorly preventable, these numbers highlight the need to improve our ability to assess risk, intervene, and prevent suicidal acts.

Don't get me wrong, I am not saying everyone should be responsible for undertaking a full-blown suicide risk assessment and safety plan when they are concerned about someone's risk for suicide. Yes, there are tons of trainings out there and the more people with this skillset the better. But, at the very least, as a society we need to get more comfortable asking the important question: Are you feeling suicidal? So we can then connect people in need with the appropriate resources.

If there is one thing I have come to learn in over 10 years of suicide risk assessment and intervention it's that people don't want to ask if someone is having thoughts of suicide. Even when they are genuinely concerned and deeply care.

I get it.

It's a scary AF question to ask.

And as humans, we have a tendency to avoid what makes us feel uncomfortable and afraid. This is a highly effective survival mechanism that has been with us for millions of years. When we avoid what makes us afraid and uncomfortable we increase our chance of survival. This mechanism is not helpful, however, when our safety is not truly at risk, but the safety of others is and we are otherwise in a position to help them. Potentially to save a life.

If we can become consciously aware of our urge to avoid the discomfort then we are in a better position to make choices about our actions. Rather than operating automatically on the primitive survival mechanism of avoidance, we get to choose. We can label our discomfort, acknowledge our fear, and make a rational decision.

My intention here is not to shame anyone who may have avoided asking the question, "are you feeling suicidal?" But rather, to create greater comfort with asking so you are more prepared next time. I hope I have made it clear that many factors contribute to an avoidance of asking and that we can actively navigate these factors for better outcomes.

To increase comfort with asking, I recommend practicing.

Through practice we create brain pathways that enhance our ability to do something, build confidence, and create more comfort in the action. You can start by using your imagination, allowing yourself to experience success by imagining a comfortable outcome. Perhaps the person you ask in your imagination is not having thoughts of suicide and they respond by thanking you for being concerned. You can take this practice a step further by roleplaying with friends and colleagues, or imagining a scenario where the person does need support for thoughts of suicide. And so on. Remember, you’re in control of your imagination and this practice is meant to help you gain confidence.

Further, by learning skills of empathy, active listening, and distress tolerance we increase our comfort with and capacity for sitting with others through their difficulties.

Offering an in-depth guide on distress tolerance, empathy, and active listening is beyond the scope of this post.

In brief, distress tolerance involves soothing our activated nervous system, which can be done through grounding, deep breathing, and other calming strategies; active listening means paying attention to what someone is telling you with the intention of understanding, not necessarily responding or problem solving; and empathy involves understanding someone's feelings and experiences through their lens.

When we are able to do these things we offer the person struggling a safe space to share and a sense of supportive connection. From there we are in well-positioned to connect them to appropriate resources for proper risk-assessment and prevention planning.

Bottom line: Asking if someone is having thoughts of suicide can save lives. If you are concerned about someone and feel unable to ask, please phone a crisis line in your region to get more guidance. Your local crisis line can also provide information about support programs in your area, and/or training in suicide risk-assessment and intervention.

There are many resources available to prevent suicide.

Get Comfortable Being Uncomfortable: Asking if Someone is Suicidal Saves Lives