Source: The Conversation (Au and NZ) – By Maddison Crethar, PhD Candidate, Youth Mental Health, University of the Sunshine Coast
Suicide is the leading cause of death among Australians aged 15 to 49. Approximately one in eight Australians have seriously considered suicide.
These numbers highlight why it’s crucial to understand the different ways suicidal thoughts – also known as suicidal ideation – can show up in everyday conversations.
Researchers once assumed people move along a single continuum from early thoughts to more concrete plans and actions. However, recent research suggests there are substages within this continuum, and people might flip-flop between different types of suicidal thoughts.
Suicidal thoughts can be active or passive. But what’s the difference, and how should we respond when we hear loved ones talking this way?
Passive versus active
Passive suicidal ideation involves thinking about death or not wanting to live, without intention to act and engage in suicidal behaviour.
These thoughts can sound like:
I don’t want to live, but I don’t want to die.
I wish I could fall asleep and never wake up.
My life is not worth living.
I don’t want to be here, but I don’t want to be dead.
I wish I could just disappear.
Everyone would be better off if I wasn’t around.
Active thoughts, in contrast, include thoughts about ending one’s life with some degree of intent or planning. These thoughts can sound like:
I’m having thoughts about how I would end my life.
I’m going to kill myself.
But the two categories are not always clear cut.
Researchers have tried to group related questions to reveal core themes of suicidal thinking but have struggled to articulate an exact distinction between passive and active ideation.
Research published in 2023 found some thoughts – such as “I wish I were dead” or “maybe I should kill myself” – may represent both active and passive ideation.
Passive and active thoughts often co-occur and each independently predicts suicide attempts.
Recognising the signs
These thoughts can be difficult to recognise – in yourself, or in a loved one.
People may not openly express them, or may not know how to put these thoughts into words and ask for help.
Regardless of whether thoughts are passive or active, certain patterns suggest increasing risk.
Warning signs include:
- thoughts becoming more frequent or intrusive
- increased hopelessness or despair
- creating plans to end one’s life or preparing to act, and
- engaging in risky behaviour.
There may also be behavioural changes, such as:
- shifts in sleep and eating habits
- withdrawing socially
- losing interest in hobbies
- irritability
- decreased academic or work performance, or
- a person putting their affairs in order.
More than two thirds of people who die by suicide do not engage with mental health professionals in the year prior to their death.
This underlines the crucial role of friends, family and peers.
What should I do if I hear someone talking this way?
First, thank the person for trusting you. Then get curious, listen more than you talk and identify patterns in what they are describing.
Ask about the frequency, intensity and controllability of their thoughts, and whether they are doing anything to prepare to act on them.
Asking about suicide does not put the idea in someone’s head.
Ask questions such as:
How long have you been having these thoughts?
When do these thoughts occur?
How would you rate the intensity of these thoughts?
Do you have a plan to act on these thoughts?
Importantly, passive thoughts are not “safer thoughts.”
They are often a warning sign the person is in significant distress and may move into more active planning if they do not receive support.
Talking about suicidal thoughts can reduce stigma and encourage people to get help.
The National Australian Suicide Prevention Strategy 2025–2035 recognises the importance of a whole-of-community response to suicide prevention, with specific emphasis on laypeople recognising and responding to suicidal distress.
The Black Dog Institute provides a four-step guide for suicide prevention that can help structure your response.
First, directly ask if they are having thoughts of suicide.
Second, listen and take what they are saying seriously, and check their safety to ensure there is nothing they can use to harm themselves.
Third, get help. If someone’s life is in immediate danger, call 000, call a helpline such as Lifeline (13 11 14), or take them to the emergency department; if they are not in immediate danger, help them make an appointment with a GP or psychologist or call a helpline.
Fourth, follow up and check on the person. Let them know you care about them and ask how often would be appropriate to check in with them.
Of course, suicide is complex. Warning signs are not always apparent in the moment. If you have lost someone to suicide, please know you are not responsible for their death. Their decision was shaped by many factors beyond just one person’s control.
No feeling is final
Crisis does eventually pass. While it may not feel possible in the moment, remind the person that things will not stay this way forever and that help is available.
Passive or active, thoughts of suicide are a sign of deep distress.
When we notice and respond with calm curiosity, compassion and practical support, we may help save a life.
If this article has raised issues for you, or if you’re concerned about someone you know, call Lifeline on 13 11 14.
Maddison Crethar reports financial support via an Australian government Research Training Program (RTP) Scholarship.
Daniel Hermens receives funding from the Commonwealth government’s Prioritising Mental Health Initiative and the Queensland Mental Health Commission.
– ref. ‘I wish I could fall asleep and never wake up’: even passive suicidal thoughts are a worry. Here’s how to respond – https://theconversation.com/i-wish-i-could-fall-asleep-and-never-wake-up-even-passive-suicidal-thoughts-are-a-worry-heres-how-to-respond-274741
