Supporting someone with suicidal thoughts: what the latest research says

A 2023 review of 110 studies, covering nearly 250,000 people who had survived a suicide attempt, found about one in five made another attempt during follow-up [1]. Most did not, but the studies followed people for different lengths of time. This is not an estimate of what happens over a whole lifetime.

A separate 2014 review of 177 studies of people seen in hospital after self-harm, including suicide attempts, found about one in six had self-harmed again within a year and about one in five within five years [2]. Those estimates came from different groups of studies, so they do not show exactly when most repeat episodes happened. Deaths by suicide continued to occur years after the original hospital visit. These figures cannot predict what will happen to one person. Support is worth keeping up after the immediate crisis has passed.

A 2024 review of 34 studies linked repeat attempts with earlier attempts, continuing suicidal thoughts, alcohol or drug problems, and past trauma [3]. These are associations across groups, not a way to predict one person's future. NICE tells professionals not to use risk scores to predict suicide [4], so being told someone is "low risk" shouldn't stop you saying what you're seeing. If thoughts are continuing or drinking or drug use is worrying you, you can talk with them and pass concerns to the service involved. If you do not know which service that is, our urgent help page explains where to turn.

The national inquiry into suicide among people in mental health care reported in February 2026, using UK data from 2013 to 2023. It identified the first week or two after leaving a mental health ward as a particularly high-risk time; risk does not end after the first follow-up contact [5]. England's suicide prevention action plan gives NHS England the job of making sure people get good-quality follow-up within 72 hours of discharge [6], and NICE says carers should know the likely discharge date well in advance [7]. Before they come home, you could ask:

> "When will someone be in touch after they're home, and who do we ring if things get worse before then?"

Tell the team what you're noticing, too. NICE says families can give staff information even when the person hasn't agreed to share theirs [4].

A March 2026 review included 36 trials with 9,552 adults after a suicide attempt. It studied brief interventions, such as safety planning or brief therapy, and follow-up through letters, postcards or calls. Across the 23 studies measuring repeat attempts, these approaches reduced the odds of another attempt by 28%, with moderate certainty in the evidence [8]. That is a relative change in odds, not 28 fewer attempts in every 100 people. Results varied between studies.

These were structured programmes from services. The finding does not tell us the effect of a relative's or friend's calls and visits, or make them a replacement for clinical follow-up. Ask what support the service will offer, when it will start and how long it will continue.

A safety plan is a short written plan, usually made with a clinician, listing the person's warning signs, what helps and who to contact. A review of six studies with 3,536 people found safety-planning interventions reduced the relative risk of suicidal behaviour by about 43%, but found no clear reduction in suicidal thoughts [9]. This was evidence about interventions involving a plan, not proof that a document alone keeps someone safe.

NICE says the plan should be made with family and carers where appropriate, kept by the person, and shared as they decide [4]. A separate 2023 review of 15 studies in under-18s found promising but limited evidence and called for more support for parents and carers [10]. Those findings concern young people, rather than establishing how well plans work for adults.

Ask whether there's a plan and whether they'd like you to have a copy or a role in it. When things are calmer, ask whether it still fits. A review found no evidence that asking about suicide increased suicidal behaviour or distress [11], so it is reasonable to ask plainly how they are feeling.

A 2023 review of 26 trials, with 3,155 people treated in emergency psychiatric settings after an attempt, found CBT reduced repeat attempts compared with regular case management, roughly halving the odds on moderate-quality evidence [12]. It was the only therapy with a statistically clear benefit against that comparator in this review. That does not prove it is the only therapy that works or that it is better for every person. NICE recommends therapy informed by CBT for adults after self-harm, usually 4 to 10 sessions, with more if needed [4].

A 2019 review of 18 controlled trials found DBT, which teaches skills for managing intense emotions, reduced a combined measure of suicide attempts and self-injury by a small to moderate amount [13]. It did not establish a separate reduction in each outcome. A small US trial of family-based CBT with 42 teenagers found fewer suicide attempts over three months [14]; it cannot establish lasting benefit for adults. If therapy hasn't been offered, ask about treatment aimed at the suicidal thoughts and behaviour themselves.

A 2022 review of 21 studies of relatives and friends supporting someone after an attempt, or with suicidal thoughts, found fear, constant watchfulness, family strain, and a lot of anxiety and low mood. Carers wanted to be involved in care and planning, to get clear guidance before the person left hospital, and to be listened to without judgement [15]. A 2024 review of 11 studies found much the same, along with loneliness and a sense of being overlooked by professionals [16]. If you feel shut out, ask the team plainly what they can tell you, what you can tell them, and what the plan is for home.

Support for families and other close supporters has been studied far less: a 2022 review found seven studies of generally poor quality, though carers valued the help and some outcomes improved [17]. In a 2024 trial with 84 relatives of men at risk of suicide, a four-part online course improved knowledge, confidence about helping and low mood among people who completed follow-up [18]. It did not clearly reduce burden or distress, and did not measure how well participants actually helped someone. It is a promising small study, not proof that training makes you responsible for preventing an attempt.

In the UK, the Zero Suicide Alliance offers a free online suicide awareness course for anyone aged 16 or over [19]. A 2025 Australian study interviewed nine young people aged 17 to 30 whose relative had attempted suicide. They described watchfulness, guilt and putting off help for themselves [20]. These interviews cannot tell us how common those experiences are, but they are a reason to check how other supporters are coping too. Samaritans will talk to you, on 116 123 [21].

A review of 1,125 trials across nearly 50 years found small average treatment effects on suicidal thoughts and self-injury [22]. An average cannot tell you how much one person may benefit. Help is worth seeking, but nobody, including professionals, can guarantee another person's safety. Family and friends cannot be expected to do that either.

A free app from Grassroots Suicide Prevention for people having suicidal thoughts and those worried about someone [23]. It includes a safety plan, reasons for living, personal photos or recordings, and a directory of help [24]. If they'd like to use it, you could help them put their plan in it. The app does not replace professional support or urgent help.

It can be used without an account. Creating an account allows personal content to sync between devices, so check its privacy information before choosing what to save [24].

Free short-term therapy for men aged 18 and over in suicidal crisis, including after a recent attempt. Centres are in Liverpool, London, Newcastle and Birmingham, with a pilot service in Darlington. The catchment covers London and the surrounding area, the North East, the North West and the West Midlands.

Men must be able to attend and engage in talking therapy, have stable accommodation during treatment, and be registered with a GP or eligible to register; James' Place can help with registration. It is not for men currently receiving treatment from a crisis or community mental health team for a severe, long-lasting condition. Men can refer themselves, or a friend or relative can refer them with their consent. Check the current criteria with the service if you're unsure [25].

A service evaluation found that distress fell among men with measurements before and after treatment. It had no untreated comparison group, so it cannot establish how much of that change was caused by the therapy [26].

Next check due: 3 November 2026. Details to check: Centres, catchments and referral criteria.

If someone dies by suicide, the Support After Suicide Partnership lists bereavement services and helplines, and points to AtaLoss for finding local groups [27]. Its guide Help is at Hand is free to download [28].