Not everyone thinks of killing themselves, but a distressing number of people do. Suicidal ideation, sometimes referred to as suicidal thoughts, is exactly what it sounds like: it's thinking about, perhaps making a plan, playing out in your mind what death by your own hand might be like.

Just because the term suggests that the action is not taken to its ultimate conclusion does not mean it is not to be taken seriously or that the person suffering is looking for attention.

What they may be looking for is someone to help them. And if you pay attention to the symptoms, you could be the one to help.

Those symptoms can range widely. Visible end-of-life preparations - giving away your property or possessions, saying farewell to friends and family, acquiring the means to the end such as a gun or lethal chemicals: these are perhaps the most obvious symptoms. Or you may observe an increase in risky behaviours like drug or alcohol use, even reckless driving.

Suicidal ideation (or suicide ideation) can be part of a bigger-picture mental health issue, like a depressive or bipolar disorder, which means that familiar symptoms and effects of those conditions can also be a factor: feelings of worthlessness, loss of interest in pleasurable activities, or isolation from others.

It is also possible that there may be no symptoms at all. Some people keep their feelings hidden, their behaviour controlled, and show no particular signs of any distress. You think they're ok and have no reason to doubt this.

In some instances, you might be concerned about someone's mental state simply from observing what life has thrown at them. Suicidal ideation can stem from a great many causes, but what those causes mostly have in common is a sense of having lost control of - or purpose in - life. Legal or financial troubles; loss of job, property, health, or a loved one: traumatic changes in life can often have traumatic consequences for our mental health.

And if your mental health is already fragile, then suicidal ideation can sometimes be an effect of your condition or occasionally the medication you are taking for relief. Depression, anxiety, bipolar disorder, schizophrenia, PTSD are just some of the mental health issues that can bring with them thoughts of suicide.

When it comes to paying attention and trying to help, the literature on suicidal ideation mostly agrees that in many cases paying attention is, in and of itself, the needed help.

There is a persistent but mistaken belief that you or I can push someone in the direction of suicide simply by mentioning it. There is no evidence that asking someone if they are feeling suicidal causes suicidal feelings. It's not a case of: 'Funny you asked, I was thinking I should spend more time working on a suicide plan.'

In fact, asking someone if they are feeling suicidal can show that you care about how they are feeling and offer an opportunity to talk about what may be a very difficult subject. Feeling suicidal - however that may be expressed - is a pretty clear sign that someone is