Expert guidance from Dr. Kerrie Smedley and Dauphin County ASPIRE
Suicide prevention can feel overwhelming, especially when someone you care about seems different, withdrawn, hopeless, or in mental, emotional, or physical pain. You may worry you will say the wrong thing. You may wonder whether asking about suicide will make things worse, whether you are qualified to help, or whether you will know what to do if someone says they are struggling.
Those fears are understandable. Suicide is a serious and tender topic. But silence does not protect people. Awareness, education, and compassionate action can help individuals, families, schools, workplaces, and communities recognize when someone may be at risk and connect them to support.
At Dauphin County ASPIRE, we believe suicide prevention starts with understanding. When we know the warning signs, risk factors, common myths, and first steps for helping someone in crisis, we are more prepared to respond with care instead of fear.
To help our community better understand these signs and steps, ASPIRE spoke with Dr. Kerrie Smedley, licensed psychologist and owner of Annville Psychological Services. Her guidance is featured in ASPIRE’s short video, Know the Signs. Be the Support, and informs the key takeaways in this article.
Watch the ASPIRE video: Dr. Kerrie Smedley explains suicide warning signs, risk factors, common myths, and how to help in a calm, practical, caring conversation.
If you or someone you know is in crisis, call or text 988 or chat at 988lifeline.org to reach the Suicide & Crisis Lifeline.
Meet Dr. Kerrie Smedley
Dr. Kerrie Smedley is a licensed psychologist and owner of Annville Psychological Services, where she practices alongside a team of clinicians serving youth and adults. Her work includes mental health care, suicide prevention, crisis intervention, and helping individuals and families access effective, compassionate care.
In her conversation with ASPIRE, Dr. Smedley offers an important reminder: suicide prevention is not only the responsibility of mental health professionals. Friends, family members, teachers, coworkers, coaches, neighbors, faith leaders, and community members can all play a role in helping someone move toward safety and support.
As Dr. Smedley explains, there are practical, intentional actions we can take that have the power to save lives. We may not always be able to predict with certainty who is at risk, but we can learn what to notice. We can ask direct and compassionate questions. We can listen. We can stay with someone in a hard moment. We can help connect them to professional support and crisis resources. There is no harm in asking the suicide question. That question will not put the thought of suicide in their mind.
That is the heart of suicide prevention. You do not have to have all the answers to make a difference.
It Matters How We Talk About Suicide
Many people still talk about suicide as if it were a simple choice or a decision made in isolation. In reality, thoughts of suicide are often connected to overwhelming emotional pain, mental health challenges, trauma, loss, isolation, substance use, chronic stress, or circumstances that make a person feel trapped and hopeless.
Most people who experience thoughts of suicide are not seeking death itself. They are often seeking relief from pain that feels unbearable or permanent. That distinction matters because it changes how we respond. Instead of judging, dismissing, or trying to talk someone out of what they are feeling, we can respond with empathy, understanding, and seriousness every time someone has serious thoughts of suicide.
Suicide can affect people across all ages, backgrounds, professions, families, and communities. It may affect teenagers and young adults, working professionals, parents and caregivers, veterans, older adults, students, and community leaders. There is no single “type” of person who experiences thoughts of suicide.
Someone who is struggling may still go to work. They may still care for their family. They may still show up for others. They may appear responsible, high-achieving, funny, helpful, or “put together” while privately carrying deep emotional pain.
That is why awareness matters. When we understand that thoughts of suicide can be hidden, we become more careful about assuming someone is okay simply because they seem to be functioning. We also become more prepared to notice meaningful changes and respond with care.
Recognizing Suicide Warning Signs
One of the first steps in suicide prevention is learning to recognize warning signs. Warning signs are signals that someone may be in immediate distress or moving toward a crisis. Some warning signs are direct and easier to recognize. Others are more subtle and require us to pay attention to changes in a person’s behavior, mood, language, or routine.
A person may talk about wanting to die, feeling like a burden, having no purpose, feeling trapped, or being unable to imagine a future. They may say they feel worthless or that other people would be better off without them. These statements should always be taken seriously, even if they are said quietly, indirectly, or in a way that sounds like a passing comment.
When Dr. Smedley talks about recognizing warning signs, she makes an important distinction… that a person may also begin verbalizing thoughts or plans, giving away prized possessions, or preparing for what happens after they are gone. These behaviors can be signs that the person is thinking seriously about suicide and needs immediate support.
Mood and behavior changes can also be important warning signs. A person may become more agitated, irritable, anxious, reckless, withdrawn, or emotionally numb. They may experience major mood swings or seem significantly different from how they usually are.
It can be tempting to explain these changes away. We may think someone is just stressed, tired, angry, or going through a difficult time in their life. Sometimes that may be true. But when changes are significant, persistent, or paired with concerning language about death, hopelessness, worthlessness, or being a burden, it is important to pay attention and ask more questions.
Subtle Signs Can Matter Too
Not every warning sign looks obvious from the outside. Some people openly express their pain, while others work hard to hide it. They may smile, keep plans, answer emails, attend meetings, take care of children, or maintain a normal-looking routine while feeling deeply distressed.
This is why Dr. Smedley encourages people to notice changes from a person’s usual baseline. Sometimes the clearest warning sign is not one specific sentence or behavior. Sometimes it is the feeling that someone is different from the person you know.
A person may become more reckless. Their attitude may shift. They may pull away from people, activities, or responsibilities that usually matter to them. Their sleep may change. Their mood may change. Their energy may change. They may seem disconnected, unusually calm, or suddenly relieved after a long period of depression.
That sudden relief can be confusing. While it may sometimes indicate improvement, it can also be a warning sign that the person has made a dangerous decision. A sudden sense of calm after severe emotional distress should not automatically be taken as proof that the crisis has passed.
Some people may also make indirect verbal statements such as, “I just want to go to sleep and not wake up,” or “I don’t want to be here anymore.” Those statements may not sound as direct as “I want to die,” but they can still signal serious emotional pain. Research shows that in fact, most people will say these in-direct types of statements instead of direct verbal threats of suicide.
One of the most useful questions we can ask ourselves is:
How is this different from the person I know?
That question helps us move beyond a checklist and pay attention to the individual. It reminds us that suicide prevention is not only about knowing general signs. It is also about noticing meaningful changes in the people around us.
Warning Signs and Risk Factors Are Not the Same
Many people use the terms “warning signs” and “risk factors” interchangeably, but they mean different things.
Warning signs are signals that someone may be in distress right now or moving toward a crisis. They often require immediate attention, especially when someone is talking about suicide, expressing hopelessness, giving away possessions, saying goodbye, or showing sudden and serious changes in mood or behavior.
Risk factors are broader experiences, histories, or circumstances that may increase a person’s vulnerability to thoughts of suicide or behaviors.
Risk factors do not always mean someone is in immediate danger, but they can help us understand when someone may need more support, connection, and care.
Decades of accumulated evidence have played a vital role in identifying broad risk factors. A previous suicide attempt is one of the strongest known risk factors. A family history of mental health challenges or suicide can also increase risk.
Other risk factors may include mental health conditions such as depression, bipolar disorder, anxiety disorders, PTSD, or substance use disorders. Trauma, abuse, violence, neglect, significant loss, chronic illness, chronic pain, financial stress, relationship stress, housing instability, and social isolation can also increase vulnerability.
Access to lethal means can increase danger during a crisis. This is why reducing access to means, when possible and safe, can be an important part of helping someone at risk.
Understanding risk factors is not about labeling people or assuming the worst. It is about being more aware of circumstances that may increase vulnerability. When risk factors are present and warning signs begin to appear, it may be time to reach out, ask directly, and help connect that person to support.
Common Myths About Suicide
One of the biggest barriers to suicide prevention is fear. People may be afraid to ask about suicide because they worry the question will make things worse. They may fear that saying the word “suicide” will put the idea into someone’s mind. This myth can keep people silent at the exact moment when a compassionate conversation may be most needed.
The insights provided by Dr. Smedley offer a vital perspective, reminding us that initiating an honest dialogue about suicide does not increase a person’s level of danger. Asking directly and compassionately can open the door to support. It can help a person feel heard, understood, and less alone. It can also create an opportunity to connect them with help.
Another common myth is that people who talk about suicide are “just seeking attention.” Any mention of suicide should be taken seriously. Even if someone’s words are unclear or indirect, they may be trying to communicate pain in the only way they can. A conversation that seems uncomfortable to us may be an important opening for them.
Some people also believe people who have thoughts of suicide always show obvious signs. In reality, some people hide their distress. They may continue functioning, working, caregiving, or socializing while privately struggling. This is why noticing changes from someone’s baseline can be so important.
Another myth is that once someone is suicidal, they will always feel that way. Suicidal crises are often temporary, even when they feel permanent to the person experiencing them. With treatment, support, safety, and connection, people can and do recover.
There is also a myth that once someone has made up their mind, nothing can be done. Dr. Smedley explains that people may experience ambivalence, confusion, and emotional pain. In those moments, intervention can make a difference. Listening, asking, staying present, reducing access to means when possible, and connecting someone to help can all be part of preventing a crisis from becoming fatal.
For anyone who wants to better understand what this can look like in real life, Dr. Smedley walks through it in the video. She explains why asking directly about suicide does not increase risk and can open the door to support.
Watch the video
What To Do If You Are Worried About Someone
Many people worry they won’t know what to say if they are concerned about someone. That fear is understandable. Suicide is a serious subject, and most people want to be helpful without causing harm.
The good news is that you do not need perfect words to begin. You can start by naming what you have noticed with care. You might say, “I’ve noticed you seem overwhelmed lately,” or “I’m concerned about you.” You might say, “You don’t seem like yourself,” or “How have you been doing?”
These questions do not have to be complicated. The goal is to create an opening. A simple, compassionate check-in can let someone know they are not invisible and that they do not have to carry what they are feeling alone.
If you are concerned that someone may be thinking about suicide, ask directly. You can say, “Are you thinking about suicide?” or “Has suicide crossed your mind?” The question may feel uncomfortable, but clarity can be kind. Asking directly gives the person permission to answer honestly, and it gives you a better understanding of what kind of help may be needed.
Dr. Smedley emphasizes that asking directly is something anyone can do. You do not have to be a mental health provider to ask a caring question. A family member, friend, coworker, teacher, coach, neighbor, or concerned community member can ask.
If the person says yes, stay calm and listen. Try not to panic, argue, shame, or rush immediately into fixing. It is natural to want to make the pain stop, but in that moment, the person may need to be heard before they can take the next step toward help.
Listening without judgment means allowing the person to say what they are thinking and feeling without dismissing, minimizing, or debating their emotions. You can ask follow-up questions. You can let them know you care. You can remind them that help is available and that they do not have to go through this alone.
When Immediate Help Is Needed
If someone has a suicide plan, access to lethal means, or appears to be in immediate danger, seek emergency assistance and crisis support right away. Stay with the person, or find someone who can, until help is available, as long as it is safe to do so.
You can call or text 988 or chat at 988lifeline.org to reach the Suicide & Crisis Lifeline. You do not have to be the person in crisis to contact 988. If you are worried about someone else, you can reach out for guidance.
Local crisis intervention services (Dauphin County Crisis (717) 232-7511), emergency departments, mental health professionals, physicians, therapists, and community support programs may also be part of the next step. If possible, offer practical support, such as sitting with the person while they call or text 988, helping schedule an appointment, or staying with them until another trusted person or professional support is available.
No one expects you to carry the situation alone. Helping someone connect to trained support is one of the most important things you can do.
For more Dauphin County resources, visit: https://www.dauphincoaspire.org/resources/
Suicide Prevention Starts with Human Connection
If there is one message worth taking from this article, it is that suicide prevention starts with human connection.
Most people do not need perfect words. They need someone who is willing to notice, listen, care, and take their pain seriously. They need someone willing to ask the hard question with compassion. They need someone willing to stay with them long enough to help connect them to support.
Every conversation matters. Every check-in matters. Every act of compassion matters.
By understanding warning signs, recognizing risk factors, challenging myths, and knowing how to respond, we create families, workplaces, schools, and communities where people feel supported instead of isolated.
There is reason for hope. There is help available. People can and do move through thoughts of suicide and crises with support, treatment, connection, and care.
To hear Dr. Kerrie Smedley’s full guidance, watch ASPIRE’s video, Know the Signs. Be the Support.
If you or someone you know is struggling or in crisis, call or text 988 or chat at 988lifeline.org to reach the Suicide & Crisis Lifeline.
For local suicide prevention training, education, and resources, visit our resources page here https://www.dauphincoaspire.org/resources/.