Words, behaviours and patterns that should concern you

Concerns about self-harm or suicide are often indirect. They can appear as explicit statements, vague remarks, changes in behaviour, repeated contacts, or reports from someone else.

Direct and indirect wording

Some phrases are explicit: "I want to die", "I have taken an overdose" or "I am going to kill myself". Others are less clear but still worrying, especially when the person seems distressed, isolated, recently bereaved, intoxicated, has self-harmed, has access to means, or suddenly changes their tone.

• "I cannot do this anymore."
• "There is no point booking anything."
• "I have taken something."
• "I need help before I hurt myself."
• "I will not be here tomorrow."
• "Please tell the doctor I am sorry."

Behaviour and context can add urgency

Reception staff may notice a person sounding flat, panicked, intoxicated, confused or detached. They may cancel appointments repeatedly, stop collecting medication, send goodbye messages, give away possessions, or withdraw after repeated distress.

Do not interpret any single sign in isolation. Record what was said or reported, note any pattern, and escalate through your local urgent process if the information suggests immediate or serious risk.

Third-party reports matter

Information from relatives, friends, carers, schools, police, ambulance services or other professionals can be important. Callers may be upset or uncertain and may ask for information you cannot give. Even so, you can receive their report and pass the facts to the appropriate clinician.

Third-party reports

Exact words matter; vague summaries can hide urgent risk.