Instead of asking “How are you?” try this instead

Of course, most of the time nobody is being dishonest. “How are you?” has simply become less of a question than a social ritual, rather like saying “Nice to see you.” Nobody expects you to stop in the supermarket and provide an honest assessment of your marriage, finances, and current state of mind before reaching the dairy aisle.

The trouble is that we can fall into the same habit with the people we love, asking “How are you?” and accepting “Fine, thanks!” without stopping to wonder if that's actually true.

September is National Suicide Prevention Month in the United States, an annual opportunity to talk more openly about suicide, how to recognize when someone may be struggling, and where to find help. One part of prevention is something considerably less clinical: connection.

The CDC identifies support from family and friends and feeling connected to others among the factors that can help protect against suicide.

That doesn't mean a good conversation can somehow prevent every tragedy, nor that we should start treating every quiet friend as a potential emergency. Suicide is complex and rarely has a single cause. But perhaps it does give us a reason to think about how well we make room for the people around us to tell us when life isn't quite as “fine” as they say it is.

Sometimes simply asking the question again is enough. A quick “How are you?” followed, a little later, by “No, but how are you really doing?” tells someone that the first answer wasn't merely a conversational box to tick.

Specific questions can be even better. If a friend has recently lost a parent, asking: “How are you coping now everyone's gone home?” gives them somewhere to begin. Someone struggling at work might find: “Is Sunday night still the worst bit?” easier to answer than an enormous question about their mental health. With a teenager: “What's been taking up most space in your head lately?” might get you further than yet another: “Everything OK?”

There is no magic wording. What matters is the message beneath the question: I noticed. I remembered. You don't have to give me the easy answer. And then, crucially, don't be frightened of the difficult one.

It's tempting, when somebody finally admits that things are bad, to rush in with reassurance. We point out everything they have going for them, suggest solutions or instinctively tell them that things will get better. All of that usually comes from love, but sometimes the more useful response is to resist fixing anything for five minutes and find out what the person is actually trying to tell us.

That might mean asking another question, tolerating an uncomfortable silence or simply saying: “Tell me more.” Listening without judgment is one of the steps recommended by the National Institute of Mental Health when supporting someone experiencing suicidal thoughts, and ongoing contact matters, too. Sometimes the important conversation isn't the first one, but the message two days later that says: “I've been thinking about what you told me. How are things today?”

There is, however, an important point at which delicacy isn't helpful. If someone talks about wanting to die, feeling hopeless or trapped, being a burden, or says something else that makes you genuinely concerned about suicide, ask them directly: “Are you thinking about suicide?”

It can feel frighteningly blunt, particularly when every instinct is telling us not to put such a terrible idea into someone's head. But research does not support that fear. NIMH states clearly that asking someone about suicide does not increase suicidal thoughts or behavior; instead, the question can open a conversation and help identify someone who needs support.

From there, our job isn't to become somebody's therapist. NIMH recommends helping the person connect with appropriate support, which might include a mental health professional, trusted family member, spiritual advisor or the 988 Suicide and Crisis Lifeline, and helping them stay safe if there is immediate danger. Following up afterward is important too.

For Christians, none of this feels entirely separate from the ordinary business of loving our neighbor. Attention is one of the quieter forms that love takes. It remembers that someone had a difficult appointment on Tuesday, notices when the person who usually makes everyone laugh has gone rather quiet, and occasionally asks a question without already having one eye on the next thing that needs doing.

Perhaps that's a useful little challenge for National Suicide Prevention Month. We don't need to spend September interrogating everybody we know about their emotional wellbeing, and I'm certainly not surrendering my British right to insist I'm “absolutely fine” while visibly falling apart.

But with the people who matter, every now and then we can ask a better question -- and make it clear that this time, they don't have to say they're fine.