The first and most important step is to ask the question directly: “Are you thinking of suicide?” This can feel uncomfortable, but it opens the door to honesty, safety, and support. And even if you ask it often, it’s always uncomfortable but you know it’s important to ask directly.

But what happens after that question has been asked—and answered?

Especially, in the days, weeks, and months after a crisis, such as an ER visit or inpatient stay, many people trying to find recovery grow tired of being asked the same question every day–teenagers especially. Caregivers, parents, and partners often struggle to balance staying informed with respecting their loved one’s space.

Because this is not just stressful for the person who is struggling but the caregiver, too, especially in the days following the crisis. They often want to text, call, and ask constantly, but this can be unproductive, annoying, tiring, and humiliating for the person experiencing the difficult feelings of suicide.

This is where a safety maintenance plan can help

Instead of repeated direct questioning like, “Are you thinking of killing yourself?” Or “Are you thinking of suicide?” You and your loved one can define and agree on a compassionate way to communicate risk, like a shared safety scale or a code word/phrase that signals when someone is struggling. There is also a safety scale that is part of a safety plan, which is a validated tool for assessing this.

These tools preserve trust, reduce tension, and make it easier to keep an ongoing dialogue about suicide risk without making either person feel overwhelmed or smothered with frequent questioning.

Once you’ve asked the direct question and your loved one has moved past the immediate crisis, the next step is finding a way to check in regularly without exhausting or alienating them.

The Validated Safety Plan with a Safety Scale

Instead of asking “Are you suicidal?” every day, you and your loved one can use this structured scale to communicate risk in a way that feels less intrusive and more collaborative. Research supports this method as a reliable way to monitor changes in suicidal intensity while preserving trust and reducing tension.

By agreeing on what the different levels mean—and what action steps should be taken at each point—you create a shared language that makes staying connected and safe over time easier.

Below is an example of a safety scale.

The above is part of an overall research-validated safety plan. You can get your copy and the manual on how to create one.

• Get the research-validated Safety Plan with the Safety Scale here (PDF). O’Brien, K., Almeida, J., View, L., Schofield, M., Hall, W., Aguinaldo, L.D., Ryan, C.A., & Maneta, E. (2019). A safety and coping planning intervention for suicidal adolescents in acute psychiatric care. Cognitive and Behavioral Practice.
• See the website page and get the manual here.

Creating a Code Word or Phrase

For some families or relationships, a code word or phrase can work. This is a private signal that means “I’m feeling suicidal right now,” or “I’m feeling the darkness I get before I feel suicidal.” This can preserve privacy, too. It can be a phrase that only the person being supported and close family members are familiar with. But the important part is that the signal needs to be agreed upon and very clear.

Dr. Stacey Freedenthal talks about this in her book, “Loving Someone with Suicidal Thoughts.”

The phrase can be as simple or creative as you both decide. For example:

• “My brain feels itchy.”
• “My toenails are blue today.”
• It could be a two-word phrase like “stormy brain” or something offbeat like “purple heartbeat.”

The benefit of a code phrase is that it lowers the barrier to speaking up

Your loved one doesn’t have to explain everything in detail—they can just use the phrase, and you’ll immediately understand what it means.

Together, you should also decide what next steps the phrase triggers, whether that’s sitting down to talk, calling a therapist, or going to the ER. Setting expectations is important.

Both the safety scale and a code phrase work toward the same goal: giving your loved one a safe, less stressful way to communicate when they’re struggling. The caregiver needs to give the person struggling the autonomy to choose the words, and define the scale. It’s a way to give that person some of their power back since it’s likely they feel stripped of both their privacy and their self-confidence. The plan can also change and be altered over time, but all parties involved must establish this clearly.

This is part of a podcast transcript that is an example of how a family used a “code phrase” for a member of their family who struggled for a while with thoughts of suicide. It’s from Episode 12 of the podcast, “You don’t want a huge right?” I spoke with moms who had raised children who lived with autism.

[00:36:46] Kristen In our family, we developed a language, right? Once we did ask the question and once we heard the answer, we developed language that would help our kids be able to reach us immediately. And so that language for us was I don’t feel safe in my body right now. And we could get it by text, by phone, call by a teacher or by a therapist. We knew when we heard that that they needed immediate support.

[00:37:15] Anne Moss Yeah. And that’s called code word. So I loved that you all had that code word because it does get tiresome. And like, there is a young lady I work with, I mean, we’ve been communicating with her two years and she lives with chronic suicidality, which means that she will probably always have a certain level of suicidal ideation or suicidal thoughts in her life. And she has become friends. And I think it’s my toenails are blue today. And and, you know, allowing them to kind of help take that code phrase is kind of a way to also give them agency in the process of their mental health because we don’t want to do everything for them. But that asking for help. What I also love about that is that you’re saying it’s okay and this is a courageous step that you’re taking and you’re treating it that way. So therefore they have that formed in their mind. And then, this isn’t a step a coward takes this first step, someone who is courageous takes.

[00:38:32] Gwen And I would imagine it also shows them the partnership involved in that. By sharing those words, you are automatically partnering with the person, hearing them in order to help you. So I would imagine there’s a sense of community in that in that process.

[00:38:50] Anne Moss I love the way you said that because you’re basically saying you’re not alone without using the little phrase, you’re not alone. You’re making them feel less alone by partnering with them. And think about how much more powerful rather than saying, one, you’re not alone. Having them feel not alone. So that’s an excellent point. Thank you for highlighting that.

[00:39:19] Kristen I also think Anne Moss that it normalizes those feelings that they’re having. Right. So that it doesn’t become something that is bigger than them. It takes a little bit of the power away when you can just say those words and mom is not going to freak out. She just knows what it means. And then we’re going to walk through this series of of steps that we’ve discussed ahead of time. Jamison, for a long time, we had a safety plan for when he was having suicidal ideation and he pinned it to his wall by his bed and he knew who to call, what to say. If we weren’t available, he knew other resources to reach out to and he knew exactly what was going to happen. So it took a lot of the fear out of asking for help.

[00:40:10] Gwen And maybe even the fear out of the feelings themselves. Right. Those those suicidal feelings, I would imagine that’s terrifying.

[00:40:19] Anne Moss So scary. Imagine how frightening that is all by yourself. And the first point you made about allowing them to vent. Think about how much brain real estate it took up in their minds. But once they talk about it, it’s like a balloon losing air. You know, all of a sudden there’s more room in that brain and it’s not ruminating anymore and it’s not chewing on all of it.

Source: Episode 12 of the podcast, “You don’t want a huge right?”

More Resources:

• After Your Child’s Suicide Attempt
• How Can You Create a Mental Health Coping Card?

Related Articles and Videos:

• Article: “She’s Just Trying to Get Attention“
• Video: Child Says, ‘I Want to Die.’ Take it seriously?

My child has been suicidal. What do I do now?

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AnneMoss Rogers

AnneMoss Rogers is a leading wellness and suicide education expert and one of the top mental health speakers and suicide prevention speakers. Known for her powerful, motivational keynotes, AnneMoss combines her personal story of loss with proven strategies to help organizations build a wellness culture that drives results and saves lives.  She speaks at conferences, workplaces, K-12 schools, and universities, delivering impactful presentations that inspire change and promote mental health awareness.
AnneMoss does this work in memory of her son, Charles, who struggled with anxiety, depression, and addiction, and died by suicide at age 20 in 2015.