A friend recently attempted suicide. What can I do to prevent it from trying again?

A dear friend of mine recently attempted suicide. Luckily she survived, but I'm very concerned about what prompted her to attempt suicide, and also the possibility of her trying again.

She has been in pain for some time and has already mentioned suicide. As a social and caring person with many friends, she was open about her sadness and we tried to support her. She has also been in therapy and takes medication for depression (it should be added that she mentioned suicide before taking medication, so suicidal thoughts are not a side effect). Unfortunately, none of that seemed to work. So what to do?

I'm so sorry to hear about your friend, and vicariously for you, as it can be very difficult to support someone through this. I consulted Samaritans, and Lucia, a listening volunteer, helped me answer your questions. She suggested some areas you could talk about with your friend: “There is obviously a lot of emotional pain. I would start by asking him, is there a trigger or life event that triggered this? You can also say something like, "I'm very worried about the pain and injury, how can I help you?"

Your friend may not not know what the trigger was, or it may take time for him to figure out how or if you can help him. Lucia wanted to emphasize that you shouldn't be afraid to ask if your friend is feeling suicidal again. I think we dread mentioning the word, like we do while doing it, but it's important to have these conversations.

"Although we try not to not make people feel guilty, I would ask if there is anything your friend might be missing in life. I would use the word 'could', not 'could', because 'could' sounds very definitive,” adds Lucia.

You can also ask her if there is something she could change that might make things better for her. Maybe something like: "Do you really not want to be here, or do you want to be free from emotional pain?"

Try not to be shocked by anything your friend says. Instead, just be there with them. You can also recommend contacting the Samaritans. But as Lucia said, sometimes when people are in this space it can take a lot of energy. You can do a "third party referral" where you call or email the Samaritans and ask them to contact your friend. If you did it over the phone, the Samaritan volunteer will talk to you and make sure you, too, are okay. Whether you tell your friend you did is up to you, the Samaritans will call them anyway (but they won't leave a message if the phone goes to voicemail).

My advice is to ask your friend to make a safety plan with you, when she feels like she's at a crisis point. It could be: Step one, call a friend (maybe you?); Second step, call another friend, etc. Also, if your friend has been on medication for a while, might a visit to the GP be necessary?

Both Lucia and I would like to point out that you seem very nice and caring, but you are not responsible for your friend, even with all the support you can offer, you may never be able to solve the problems. Lucia suggested you do it, saying to your friend, “I hear what you're saying, I'm very sad you've come to this. If you want to talk things over, I can be there for you, or just sit quietly with you. I can get you help if you're open to it, but it's your decision. It's hard to accept. But it's also important that you have boundaries and take care of yourself.

If you've been affected by this issue, you can learn more at samaritans.org ; young people can find out more at papyrus-uk.org.

Each week, Annalisa Barbieri addresses a family-related issue sent by a reader . If you would like advice from Annalisa on a family matter, please send your concern to ask.annalisa@theguardian.com. Annalisa regrets not being able to enter into personal correspondence. Submissions are subject to our terms and conditions.

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