Are you wondering about the difference between passive and active suicidal thoughts? Maybe you, a close friend, or a family member is struggling with thoughts of suicide. What should you do?

This blog is for educational purposes only. If you or someone you know is feeling suicidal, please call the National Suicide Prevention Lifeline at 800-273-8255 or visit the nearest emergency room. 

Let’s start with defining the two categories of suicidal thoughts: active suicidal thoughts and passive suicidal thoughts. Then we’ll move on to what to do to address each of these types of suicidal thoughts.

Passive Suicidal Thoughts

Passive suicidal thoughts occur when an individual no longer has the motivation to live, but does not have a plan to take their life. Passive suicidal thoughts sound like “I just wish I could go to sleep and not wake up,” “I wish I could just wander into a fog and just disappear,” or “I wish that the world just ended tomorrow.”

Treatment for Passive Suicidal Thoughts

Passive suicidal ideation is a severe mental health concern and should be taken seriously. The level of treatment depends on the person, their support system, and their state of mind. We recommend that anyone experiencing these thoughts be evaluated by a mental health professional.

An important question to ask someone having passive suicidal thoughts is “Can you commit to stay safe for the next 24 hours?” If the answer is yes, we recommend setting the person up with a mental health assessment, therapy, and intensive treatment within those 24 hours. If the answer is no, we recommend immediately taking the person to the emergency room or a nearby psychiatric hospital for evaluation and inpatient hospitalization.

Active Suicidal Thoughts

Active suicidal thoughts differ from passive in that not only does the person no longer have the motivation to live, they have a plan to end their life. Active suicidal ideations sound like “It would be so easy to end my life by ___.”

Treatment for Active Suicidal Thoughts

Those who have a plan to end their life and have a means to carry out their plan are at a high risk for suicide and should be hospitalized. While the person is hospitalized, the support system should create a safety plan to make sure that the suicidal person has the environment and support they need to maintain a high standard of safety.

In an inpatient treatment setting, the person will be evaluated by psychiatrists, attend individual therapy, participate in group therapy, be taught coping skills, be given tools to change their environment and safety plan, and possibly be given medications to help stabilize their mood.

An Example of an Inpatient Stay for Suicidal Ideation

Here’s an example of a typical experience of a patient at our psychiatric hospital, Salt Lake Behavioral Health, when someone comes in reporting thoughts of suicide.

John comes in for a free mental health assessment a few days after he was laid off from work. He states “I’m just feeling so hopeless, I just want to end it all. My life is a mess. This evening I took out my father’s gun and I was just holding it and staring at it. It would be so easy to end my life. I don’t want to, but I just want this pain to end.” 

John is experiencing active suicidal ideation and he has the means to complete suicide. Although he says he does not want to, he clearly is at risk for acting on his desire to end the pain. The mental health evaluator recommends he stay in the hospital for a few days to receive treatment, and John agrees. A family member brings John the clothing he needs for a few days, and John is moved into a bedroom in a wing of the hospital. 

A psychiatrist meets with John and diagnoses him with Major Depressive Disorder and recommends he try medication while under observation. John talks with a therapist who teaches him strategies for managing a crisis. John and the therapist also discuss and process why he is experiencing the thoughts and feelings he is having. They have a family therapy session where John creates a safety plan with his family. John and his family agree to remove all the firearms from the home. 

John attends group therapy with others who are experiencing similar thoughts. He learns about his mental health challenges from the instructor as well as from the experiences of others with the same disorder. John learns about what triggers him and he learns coping strategies he can implement if he has suicidal feelings again. 

John meets with the psychiatrist several more times to talk about his experience on the medication. John reports having a positive response to the medication. 

After four to six days, John is discharged with a supply of medication, several coping skills to help prevent him from going into crisis, an appointment with an outpatient program that he will attend three times a week, educational information about his diagnosis, a safety plan, and resources for additional support.

All Suicidal Thoughts Should be Taken Seriously

Remember, if you or someone you know is experiencing suicidal thoughts, seek professional help. We hope this blog has answered some of your questions about the difference between passive and active suicidal thoughts. 

Get a No Cost Mental Health Assessment

If you or a loved one is experiencing suicidal thoughts of any kind, they can come to Salt Lake Behavioral Health for a no cost mental health assessment. Just call 801-264-6000.