Ask; persuade; refer – three words that can make a difference if you think that someone you know may be suicidal. Known as the APR approach, according to suicide prevention and bereavement charity, Pieta, it can help us help a loved one or friend who is in crisis.

Today, on World Suicide Prevention Day (WSPD), we want to share the APR approach with you as it ties in well with the theme of this year’s WSPD, which is, Creating Hope Through Action.

World Suicide Prevention Day is a global public-health day for raising awareness and understanding about suicide prevention, and mobilising local and international support for action.

Since the outbreak of the Covid-19 pandemic 18 months ago, the stresses and strains of life became more and more challenging as lockdowns and restrictions curtailed life as we knew it.

Our mental health has suffered, and Pieta reported increased calls to and demand on its service as a result.

In 2020, the service delivered over 52,000 hours of intervention and bereavement counselling; its crisis helpline service was open 24 hours a day and received over 70,000 texts and calls from people all across Ireland; and more than 600 households were supported after the death of a loved one by suicide.

According to the charity, “most people who talk about suicide do not want to die, they simply want to stop the pain they feel”.

If you know someone who may be struggling, then the APR approach can help.

Here is what Pieta advises.


If the person is opening up to you, engage them in a non-judgemental manner with empathy and don’t be afraid to ask them directly if they are struggling with thoughts of suicide or self-harming behaviour.

  • Ask them directly: “Are you thinking about suicide or wanting to kill yourself?”
  • Don’t ask: “Do you want to hurt yourself?” Self-harming is not the same as suicide;
  • Don’t be afraid. It’s understandable that you might be worried that mentioning suicide to someone you love who is in distress could encourage the idea. But that is a myth. The reality is that talking to them openly and honestly is one of the best things you can do;
  • Listening is one of the most powerful tools we have.

Calmly and gently try to persuade the person to seek help or to allow you to assist them in getting help.

  • Do say: “Will you go with me to get help?” or “Will you let me assist you to get help?”
  • Or ask them to agree not to act on their suicidal thoughts until you’ve arranged help for them. If you can’t persuade them to seek help in person straight away, remember that Pieta’s crisis helpline is open 24 hours a day.

As quickly as you can, refer or guide the person you are concerned about to Pieta, or your doctor, or local mental health service.

  • If you can, make the call with them or travel with them to the appointment.

Thoughts of suicide – warning signs

If you are concerned about a friend or family member who may be in distress, there are warning signs to watch out for.

According to Pieta, here are some of the key signs:

What to listen for
  • Talking or writing about hurting themselves, dying or saying that they want to die;
  • Talking about ways to die or having a suicide plan;
  • Saying that they are ‘trapped’ or have no options in their life;
  • Saying they have no purpose in their lives, that they feel hopeless.
What to look for
  • Engaging in self-harm or reckless, risk taking behaviour;
  • Giving items away or saying goodbye to people;
  • Becoming more inward looking and withdrawing from family and friends;
  • Changes in their sleep patterns – too much or too little sleep;
  • Extreme emotions or dramatic changes in mood;
  • Increasing their use of drugs or alcohol.
Useful contacts

Freefone 1800 247 247
Text HELP to 51444
Call 0818 111 126

Call 116 123
Email [email protected] (response time 24 hours)