New Delhi, Sept. 13 -- Suicide is often spoken about as though it is a decision. Clinically, it is more complicated. A person in a suicidal crisis may genuinely believe that death is the only way to end unbearable psychological pain. Yet that same person can feel very differently hours or days later.
That gap between the permanence of suicide and the temporary nature of many suicidal crises is one of the most important facts in suicide prevention.
September 10 is World Suicide Prevention Day. This year's theme, the final year of a three-year campaign, is "Changing the Narrative on Suicide", with a simple call to action: "Start the Conversation."
Perhaps that is where prevention begins.
When the mind becomes a tunnel
During an acute suicidal crisis, thinking can become dramatically narrowed. Psychiatrists call this cognitive constriction. The person may stop seeing multiple possibilities and become fixated on one solution. The future feels inaccessible. Problems that might normally seem manageable can suddenly feel impossible, and the ability to see consequences can become impaired.
Which is why telling someone to "think positively", reminding them how much they have to live for, or giving them a lecture about consequences may do little in the acute moment.
The immediate goal is simpler: Create time between the crisis and the action.
A crisis can change. The problem may not disappear, but the intensity of the urge can.
What does prevention actually look like?
It often begins with a question: "Are you thinking about suicide?"
There is a persistent myth that asking directly will put the idea into someone's head. Evidence does not support this. A calm, direct question can instead make it easier for someone to disclose what they are experiencing.
Then listen. You do not have to solve their marriage, examination, financial crisis, grief or depression at 2 a.m. You have to help them get through 2 a.m.
If the risk is immediate, do not leave the person alone. Reduce access to potentially lethal means. Involve someone they trust and seek urgent professional help. And stay connected afterwards.
Suicide prevention is not only about the crisis itself. The days and weeks afterwards matter too.
Can medication stop the crisis?
Ketamine and esketamine have attracted considerable attention because they can produce rapid antidepressant effects, sometimes within hours rather than the weeks associated with conventional antidepressants. But they should not be understood as magic emergency treatments. These medications require specialist assessment and supervision. In an acute crisis, safety, human contact and appropriate clinical care come first.
The numbers matter
India recorded 1,70,746 suicides in 2024. Student suicides reached 14,488, nearly 80 per cent higher than a decade earlier.
We cannot prevent every suicide by saying the right thing. But we can make the next ten minutes safer.
Ask directly.
Listen without judgement.
Bring in help.
Create time.
Sometimes suicide prevention is not about finding the perfect answer to someone's life. It is about making sure they are still here when the answer becomes visible.
Every life matters. You matter.
If you or someone you know is in immediate danger, seek emergency medical help. In India, you can also contact iCALL at 9152987821 or the Vandrevala Foundation at 1860 2662 345.
Published by HT Digital Content Services with permission from Millennium Post.