‘I wish I could fall asleep and never wake up’: even passive suicidal thoughts are a worry. Here’s how to respond

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.