Founder
Dr. Roland Segal is a leading psychiatrist with extensive experience and is the Managing Partner and MD Psychiatrist at Legacy Recovery Center. After earning his medical degree from the University of Arizona, College of Medicine, he completed general psychiatry training at Banner Good Samaritan Medical Center in Phoenix, Arizona, and advanced his expertise through a forensic psychiatry fellowship at USC’s Keck School of Medicine.
With over a decade of diverse experience in clinical, administrative, and forensic psychiatry, Dr. Segal is double board-certified in General and Forensic Psychiatry. His previous roles include Chief Medical Officer at Valley Hospital in Phoenix, Arizona, and president of the Arizona Psychiatric Society. He has also served as the legislative committee chair and contributed to numerous state and national boards, committees, and organizations. Additionally, Dr. Segal teaches as a clinical assistant professor of psychiatry at the University of Arizona, College of Medicine, mentoring medical students and residents.
Dr. Segal acts as an expert psychiatry consultant for multiple superior and regional courts, including those in Maricopa and Yuma counties, Salt River, as well as city governments like Phoenix, Lake Havasu, and Mesa. He also consults for prominent organizations such as the United States Postal Service, Social Security Administration, Immigration Health Services, and the U.S. Departments of Justice and Homeland Security.
Guided by principles of objectivity, ethics, mindfulness, and cultural awareness, Dr. Segal remains dedicated to providing compassionate, inclusive psychiatric care, impacting lives across Arizona and beyond.
Recognizing the warning signs of suicide and knowing how to respond can save lives. Suicidal thoughts often show up through changes in what a person says, feels, and does, and asking directly about suicide, plus connecting someone to immediate support can save a life.
Suicide is complex and determined by multiple combinations of factors, such as mental illness, substance misuse, chronic illness, trauma, painful losses, exposure to violence, and social isolation [1]. In this article, I outline the warning signs and actions someone can take to help.
Warning Signs of Suicide
There is a wide range of signs to be aware of. Of course, an individual contemplating suicide may only show some of these [1] [2] [3] [4].
Verbal Cues
- Talking about wanting to die or kill themselves
- Expressing feelings of hopelessness or having no reason to live
- Talking about being a burden to others
- Talking about feeling trapped or in unbearable pain
- Talking about feeling hopeless or having no reason to live
- Talking about great guilt or shame
- Being a burden to others
- Saying goodbye or making arrangements
Behavioral Changes
- Withdrawing from social contact and isolating themselves
- Giving away prized possessions
- Increased use of alcohol or drugs
- Searching for ways to die online or obtaining means
- Acting anxious, agitated, recklessly, or engaging in risky activities
- Sudden calmness after a period of depression (may indicate a decision has been made)
- Has trouble eating or sleeping
- Sleeping too little or too much
- Exhibits drastic changes in behavior
- Withdraws from friends or social activities
- Loses interest in school, work, or hobbies
- Prepares for death by writing a will and making final arrangements
- Gives away prized possessions
- Has attempted suicide before
- Takes unnecessary risks
- Has recently experienced serious losses
- Loses interest in his or her personal appearance
- Increases alcohol or drug use
- Chronic illness or serious physical health conditions
Emotional Signs
- Severe mood swings
- Overwhelming guilt, shame, or humiliation
- Intense anxiety, agitation, or rage
- Loss of interest in previously enjoyed activities
- Displaying extreme mood swings.
- Seems preoccupied with death and dying
- Empty, hopeless, trapped, or having no reason to live
- Extremely sad
- Unbearable emotional or physical pain
Situational Factors
- Recent traumatic event or loss
- Chronic pain or terminal illness diagnosis
- History of suicide attempts
- Family history of suicide
How To Help If You Notice Warning Signs
If you think someone is suicidal, do not leave them alone. Take all signs of behavior related to suicide seriously.
If someone talks about suicide plans or behaves in a way that suggests the person is thinking of suicide, do not play it down or ignore the situation. Many people who kill themselves have expressed the intention at some point [4].
You’re not responsible for preventing a suicide. But you can take action to help the person see that other options are available to stay safe and get treatment.
- Ask directly: “Are you thinking about suicide?” Asking won’t plant the idea
- Listen without judgment: Allow them to express their feelings
- Take it seriously: Don’t dismiss or minimize their pain
- Stay with them: If there’s immediate danger, don’t leave them alone
How To Ask and Listen
- Asking directly, “Are you thinking about suicide?” in a calm, nonjudgmental way often provides relief. It doesn’t increase risk. By gently asking how long they’ve felt this way and what has kept them going you can better understand the severity and any ambivalence they may feel about following through.
- Listen more than you talk: Let them express what they are feeling or thinking. Don’t minimize, argue, or immediately try to “fix” it. Avoid clichés such as “cheer up,” and “others have it worse”. Don’t shame by saying (“you shouldn’t feel that way”. This may increase their isolation.
Next Steps
- Remove possible means: Such as access to firearms, medications, or other potential means.
- Connect to help:
- National Suicide Prevention Lifeline: 988 (in the U.S.)
- Crisis Text Line: Text “HOME” to 741741
- Encourage contacting a mental health professional
- Follow up: Check in regularly after the crisis has passed
- Encourage professional help: Offer to help make an appointment or accompany them to a suicide counselor or doctor.
Create A Safety Plan
Work together to create a simple safety plan, including:
- Personal warning signs
- Coping strategies
- People and places that feel safe
- Phone numbers for trusted supports and crisis services.
- Remove or safely store medications, weapons, and other lethal means.
Integrated Mental Health Support at Legacy Recovery Center
Legacy Recovery Center is a highly rated, premier addiction and mental health treatment center in Arizona. Legacy is owned and operated by two psychiatrists with over 40 years of combined experience, as well as a robust therapeutic team.
We’re unique among residential treatment centers thanks to our ability to help people suffering from mental health and/or substance abuse issues. Our expert psychiatric team is equipped to treat multiple issues concurrently, focusing on your specific needs.
Sources
[1] SAMHSA. 2024. Warning Signs of Suicide.
[2] American Psychological Association. 2024. Suicide warning signs.
[3] National Institute of Mental Health. 2025. Warning Signs of Suicide.
[4] Mayo Clinic. 2023. Suicide: What to do when someone is thinking about suicide
