It’s extremely hard to talk about mental health. There’s an unfair stigma.

An estimated 26% of Americans 18 and older suffer from a diagnosable mental disorder. The conversation around mental health and suicide needs to change.

One caring conversation really can make all the difference. Recognize the risk factors that make it more likely that someone might consider suicide: mental health disorders, substance abuse, hopelessness, impulsive behavior, history of trauma or abuse, major physical illness, previous suicide attempts, job or financial loss, loss of relationship, lack of social support or sense of isolation, stigma associated with asking for help, and lack of healthcare are some risks.

Don’t ignore warning signs, especially if the behavior is new, has increased or is related to a painful event: Talking about wanting to die, looking for ways to kill themselves, talking about feeling hopeless, feeling trapped or being a burden, increased use of alcohol or drugs, acting anxious or agitated, behaving recklessly, sleeping too much or too little, isolating themselves, showing rage or talking about revenge and extreme mood swings.

n Ask — are you thinking about suicide?

n Keep them safe — find things to establish immediate safety.

n Be there — be present either physically or on the phone.

n Help them connect — connect them with community resources.

n Follow up to see how they’re doing.