A woman sits on a pier and looks out at the ocean.
The sharpest rise in suicide rates has occurred among men aged 45 to 64 and girls aged 10 to 14. (For Spectrum Health Beat)

Family, friends and acquaintances can play a key role in suicide prevention by being alert for signs and taking action to help someone who may be struggling, a mental health expert says.

Nearly 43,000 Americans commit suicide each year, according to the American Foundation for Suicide Prevention. For the past two decades, suicide rates have been rising in the United States, the federal Centers for Disease Control and Prevention says.

The sharpest rises in suicide rates have occurred among men aged 45 to 64 and girls aged 10 to 14, according to the CDC.

“There remains a lot of stigma associated with people who seek help for mental health, which prevents them from getting the assistance they need. We need to pay more attention to suicide prevention,” said William Zimmermann. He’s a clinician supervisor of New Jersey Hopeline, a suicide prevention hotline operated by Rutgers University’s Behavioral Health Care.

Many people mistakenly believe that suicides happen without warning. But most people who attempt suicide try to communicate their distress or suicide plans to someone, Zimmermann said in a Rutgers news release.

The problem is the suicide plans or thoughts may not be clearly stated, so asking direct questions about suicide can start the conversation and help-seeking process, he said.

Asking someone about suicide won’t put the idea in their head, Zimmermann said.

Warning signs of suicide attempts include increased substance abuse, anxiety, agitation, difficulty sleeping, dramatic mood changes, a feeling of hopelessness and being trapped, having no sense of purpose, social withdrawal, uncontrolled anger and reckless behavior.

If a person talks about wanting to hurt or kill themselves, threatens to hurt or kill themselves, or talks about looking for a method to kill themselves, get them immediate help or guidance by contacting a mental health professional or a suicide prevention hotline, Zimmermann said.

If you’re concerned about someone, ask them directly if they are thinking about suicide, Zimmermann said. He suggested saying things like: “I care about you. Some of the things you’ve said or done have made me wonder. Are you thinking about killing yourself?”

If they say they are considering suicide, don’t judge, don’t deny and don’t promise to keep it a secret, Zimmermann said. Get support for the person talking about suicide and for yourself, he said.