Resources

We See Your Signs® is an independent music platform amplifying mental‑health and suicide‑prevention messages

Our Resources

Crisis Text Line: Text HOME to 741741
PsychologyToday.com (Find a Therapist)
MentalHealth.gov

AFSP

2morrow Needs You

San Diego Chapter

Community education
survivor outreach
Annual Out of the Darkness walk
afsp.org/san-diego
info@afsp.org
(202) 449-3600afsp.org

NAMI San Diego & Imperial

San Diego Youth Services

San Diego County Suicide Prevention Council (CHIP)

Mental Health America of San Diego County (MHASD)

Didi Hirsch Suicide Prevention Center (LA County, statewide reach)

Music Therapy for Veterans

MTFV provides a variety of trauma
conscious sound and frequency
based wellness options for optimal healing
health and resiliency
musictherapyforveterans.org
(619) 246-2993
info@musictherapyforveterans.org

Progressive Conversation Starters for Suicide Concern

Mental health professionals often recommend starting with gentle, non-threatening openers, then gradually
moving toward more direct, safety-checking questions if concern deepens. The idea is to create safety, trust,
and openness without making the person feel interrogated or cornered.

1. General Wellbeing (soft openers)

How are you?
Are you okay?
How have you been sleeping/eating lately?
What’s been the best part of your day this week?
What’s been hardest for you lately?
(Purpose: Opens the door without pressure, lets them choose their level of disclosure.)

2. Emotional Awareness (building deeper trust)

What emotions did you feel today?
What’s been weighing on you the most?
Who or what has been on your mind?
What are you avoiding right now?
What are you afraid of?
(Purpose: Moves from surface check-in to emotional expression. You’re showing it’s safe to name hard feelings.)

3. Meaning & Values (exploring inner conflict)

What values did you honor… or stray from today?
Who are you when no one’s watching?
What is your heart longing for?
If you weren’t afraid, what would you do?
What else could this situation mean?
(Purpose: Encourages reflection on identity, purpose, and resilience, while still giving space for disclosure.)

4. Signs of Strain (gentle risk exploration)

What’s been taking up most of your energy?
Do you ever feel like you’re carrying more than you can handle?
Have you felt like things won’t get better?
What keeps you going on the hardest days?
Do you feel like you have the support you need right now?
(Purpose: Signals that you’re ready to hear struggle. Begins leaning toward safety questions without jumping too fast.)

5. Direct Safety Check (if risk is suspected)

How to Use This Progression

Start where they are : If they’re already very down, you might move faster through the early stages.

Mirror their pace: If they give short or vague answers, stay soft. If they open up, lean in with empathy.

Normalize: Phrases like “a lot of people feel this way” or “thank you for trusting me” reduce stigma.

Safety net: If they say “yes” to suicidal thoughts: listen calmly, avoid judgment, and connect them to
988 or professional help immediately.

Bibliography: Evidence for Suicide Conversation Starters

This reference list provides research and validated tools supporting the use of progressive conversation starters and
direct safety questions when suicide risk is suspected.

Asking about suicide does not increase suicidal ideation—may reduce it.

Psychological Medicine – Cambridge University Press
https://www.cambridge.org/core/journals/psychological-medicine/article/does-asking-about-suicide-and-relatedbehaviours-induce-suicidal-ideation-what-is-the-evidence/FCAEE9E5BC840D76CF10AEBECD921AC9
Systematic review: Asking about suicide is safe, not harmful.

PubMed – Dazzi et al. (2014)
https://pubmed.ncbi.nlm.nih.gov/24998511/
Meta-analysis: No evidence that asking about suicide causes distress or suicidal ideation.

PubMed – Blades et al. (2018)
https://pubmed.ncbi.nlm.nih.gov/30014862/
Ask Suicide-Screening Questions (ASQ) Toolkit – validated for youth & adults.

National Institute of Mental Health (NIMH)
https://www.nimh.nih.gov/research/research-conducted-at-nimh/asq-toolkit-materials
Universal suicide screening in hospitals reduces later suicide attempts.

The Pew Charitable Trusts
https://www.pew.org/en/research-and-analysis/fact-sheets/2022/08/02/a-few-simple-questions-can-help-preventsuicide
Open questions improve GP conversations about self-harm and distress.

National Institute for Health and Care Research (NIHR)
https://evidence.nihr.ac.uk/alert/open-questions-improve-gp-conversations-self-harm/
Guidelines: Suicide risk assessment and asking directly about intent.

Centre for Addiction and Mental Health (CAMH)
https://www.camh.ca/en/professionals/treating-conditions-and-disorders/suicide-risk/suicide—detecting-andassessing-suicidality
VA Suicide Risk Assessment Guide – guidance for clinical questioning.

U.S. Department of Veterans Affairs
https://www.mentalhealth.va.gov/docs/suicide_risk_assessment_guide.doc
Columbia-Suicide Severity Rating Scale (C-SSRS).

Validated clinical tool
https://en.wikipedia.org/wiki/Columbia_Suicide_Severity_Rating_Scale
Suicide Behaviors Questionnaire-Revised (SBQ-R) – validated self-report tool for teens.

Validated screening tool
https://en.wikipedia.org/wiki/Suicide_Behaviors_Questionnaire-Revised
Overview of suicide risk assessment tools.

Wikipedia summary
https://en.wikipedia.org/wiki/Assessment_of_suicide_risk
U.S. Surgeon General’s National Strategy recommends screening.

Wikipedia – Suicide prevention
https://en.wikipedia.org/wiki/Suicide_prevention