Help now, without having to explain yourself first.

Asking someone directly about suicide does not plant the idea — it usually brings relief and opens a conversation.

• Ask plainly: 'Are you thinking about suicide?' Then listen without fixing, arguing or minimising.
• Do not promise secrecy. Keeping them safe matters more than keeping their confidence.
• If the risk is immediate, do not leave them alone. Stay until help arrives.
• Help them make the call, or make it with them. Offer to go with them to a clinic or emergency unit.
• Reduce access to means — medication, alcohol, firearms — even if it feels intrusive.
• Follow up in the days and weeks afterwards. Risk stays high after a crisis has passed.

A suicide attempt is a medical emergency, even if the person appears physically unharmed.

• Get medical attention first. Some methods cause harm that only becomes apparent hours later.
• Ask for a psychiatric assessment before discharge — emergency units can arrange this.
• Leave with a written safety plan and a concrete follow-up appointment, not just a phone number.
• The period immediately after an attempt carries the highest risk of another. Support matters most now.
• Family and carers need support too. Ask the treating team what to watch for at home.

Self-harm is usually a way of managing unbearable feelings rather than a bid for attention — and it is a sign of distress that deserves care.

• It is not attention-seeking, and it is not the same as a suicide attempt — but it does raise future risk.
• It should never be dismissed as a phase, especially in teenagers.
• Therapy helps. Dialectical behaviour therapy (DBT) has the strongest evidence base.
• Replace, rather than simply remove, the coping strategy — the underlying distress still needs somewhere to go.
• Seek urgent help if wounds are serious, or if the intent behind the self-harm is unclear.

Psychosis means a loss of contact with reality — hallucinations, delusions or severely disorganised thinking. It is treatable, and early treatment improves outcomes.

• Speak calmly and in short sentences. Do not argue about the delusion or try to win the point.
• Reduce stimulation: a quiet room, fewer people, less noise.
• Do not leave them alone if they are frightened, disoriented or at risk.
• Contact a doctor, clinic or emergency unit as soon as possible. Do not wait for it to pass.
• If there is a risk of harm to themselves or anyone else, call 10111.

Some mental-health situations cannot wait for a routine appointment. These are the signs to act on immediately.

• Thoughts of harming yourself or another person, or a specific plan.
• Hallucinations, delusions or severe confusion accompanied by distress or agitation.
• Not eating or drinking, or being unable to meet basic needs such as washing or taking medication.
• Severe agitation, or medication side effects that feel dangerous or uncontrollable.
• Where to go: your nearest hospital emergency unit. Call 10111 for police, or 112 from a cellphone.

A written safety plan, shared with someone you trust, is far more useful in a crisis than one you keep in your head.

• Warning signs — the thoughts, feelings and situations that come first for you.
• Coping strategies that have helped before, and how to make them easier to reach.
• People and places that help you feel safe, with names and numbers written down.
• Contacts: one trusted person, one professional, and at least one crisis line.
• Making your environment safer — medication, alcohol, means — ideally with someone helping you.
• Review it when you are well, not only when you are struggling.

All the numbers below are free to call. You do not need to be in immediate danger to use them.

• SADAG Suicide Crisis Helpline — 0800 567 567 (24/7)
• SADAG Substance Use Line — 0800 12 13 14 (24/7)
• Lifeline South Africa — 0861 322 322 (24/7)
• Childline South Africa — 116 (24/7)
• GBV Command Centre — 0800 428 428 (24/7)
• Emergency services — 10111, or 112 from a cellphone