Dear Dr. Wes and Samantha: If someone tells me that they have suicidal thoughts but are smart enough know it’s not the right thing to do, what should I do?

Samantha: Just because you believe your friend is “smart” enough not to act on suicidal thoughts does not mean you should not take the statements seriously. If this person decided to tell you, it may be an important cry for help. Even if you think this person will not actually commit suicide, even having suicidal thoughts indicates he or she is going through some major issues and needs help. Those feelings could escalate without it.

You shouldn’t be your friend’s only confidant during this challenging period of time. While you shouldn’t go telling everyone your friend’s private business, it is important to tell an adult, who may in turn tell your friend’s parents. Your friend may be angry with you at first but later will thank you for caring. That small act could well save this person’s life, so do so immediately. This adult will work to get your friend into counseling. Issues like suicidal thoughts are complex and can have roots in anything from chemical imbalances to family issues. Though it may be tempting to serve as the rescuer, a trained professional is really the most qualified person to help your friend.

I am also concerned about you. Dealing with a suicidal friend can be emotionally draining, and, if your friend were to attempt suicide, it would be emotionally devastating for you no matter what you have done to try to help. Don’t push yourself to the limit by being with this person constantly. It may be tempting to imagine that, if you just make sure this person is never alone, he or she will not be depressed and will not commit suicide. It cannot be your job to save this person. In fact, you probably are not the best person for this job.

You are, however, qualified to be a good friend. In addition to telling an adult, you certainly can express caring thoughts, and you should encourage your friend to speak with a counselor or other trusted adult. It also would be helpful if you could help your friend find suicide hot lines he or she can call at any hour.

Wes: The ratio of suicidal thoughts to actual behavior among teenagers is thankfully high. In other words, many or most teens will have what we refer to as “transient suicidal thoughts” over the course of their adolescence — meaning those feelings come and go. For a small handful these thoughts will go further to action, and for some those actions will be successful. The problem each of us faces in confronting this issue is as simple as it is agonizing: We cannot know which teenagers are just giving voice to their pain and which are stating an intent to harm themselves. Even trained professionals dread making a wrong decision in either direction. What if we make a mistake and someone hurts themselves or worse? So I have 18 years worth of empathy for the choices you face in this situation.

Fortunately, the question is a little more basic, just as Sam proposes. You don’t have to make the call as to whether your friend is at imminent risk or just talking through a tough situation. You just have to help this person access help so a qualified psychologist or social worker can figure it out. If you sit on this and something goes wrong, you’ll regret it forever. If you act on your concern and your friend ends up seeing a therapist and feels better, he or she will ultimately forgive you for butting in.

So the question becomes exactly how hard can and should you push the issue. I agree with all of Sam’s advice, though I’m not sure you can depend on just any adult for help on this. During the school year I’d send you straight to a school counselor or WRAP worker. You could even take the friend with you, suggesting you’ll go alone if he or she refuses. In the summer you have fewer options. Depending upon your friend’s family situation, it might be better to make a discreet phone call directly to the parents. If the family situation is problematic, it’s worth pointing out that Kansas teenagers 14 and up can access mental health services independently of their parents. Most therapists are going to want parents involved as a matter of liability and good practice in a case like this, but the older your friend, the less pressing that may be.

Just as Samantha suggests, you can only do what’s right. You can’t control the outcome. For now, the right thing to do is share your concerns with the parents or a professional. Do this calmly and be very clear that the friend has stated no intent, just feelings. Hopefully the family will be receptive to your kindness and work to help your friend get through whatever may be troubling him or her.

Thanks for caring about this person. I hope your friend will be able to see it that way, too.

— Dr. Wes Crenshaw is a board-certified family psychologist and director of the Family Therapy Institute Midwest. Samantha Schwartz is a senior at Lawrence High School. Opinions and advice given here are not meant as a substitute for psychological evaluation or therapy services. Send your questions about adolescent issues (limited to 200 words) to doubletake@ljworld.com. All correspondence is strictly confidential.