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MixedNuts comments on How would you talk a stranger off the ledge? - Less Wrong Discussion
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That's probably an accurate model, but ouch. What is one supposed to do when one is feeling absolutely awful, in need of help, and somewhat suicidal but one is aware one most likely won't go through with it? Even recognizing that's what's going on hurts - "How dare I compare my puny problem I won't even kill myself over to those of actual, important, real suicidal people? I'm just a whiny teenager, this is disgusting, I should kill mys- oh wait". (Obviously, I've been there.) And cries for help less extreme that suicide threats... don't actually get answered with much help, which may explain why such threats are so frequent.
I think it is very useful to have at least one moderately wise person you can freely communicate with. But it can be difficult to find one, because in our society extended families are torn apart and teenagers have to spend most of their time in Matrix (a.k.a. school) among their equally unexperienced peers, with a few overburdened and burned out teachers. There are psychologists, of course, but to visit one is really bad for signalling. Thus a sick environment is created, where it is socially more acceptable to say "I will kill myself" than "I have some problem that I don't know how to solve; may I have your attention for a few minutes, please?" :-(
I want to take the word "attention" out, shoot it, and hang it with its own bowels. Yes, someone to talk to is usually necessary. But what's really hard to find is people who will actually help. Like, look up psychologists or cook you meals if you're anorexic or take care of you while you're chained to the wall weaning off heroin.
In my experience, there are two pieces to this.
First, find friends who actually give a crap about me, who want me to be happy and fulfilled, who are willing to listen to me talk if I want to talk, who care what happens to me. (Professional therapists can also serve this role, if nobody else is available. That's not to say it's the only role they serve, merely to say that they can serve this role.) This is the most valuable piece; without it not much else works.
Second, simply describe my current state. For example: "I feel awful. I've been thinking about killing myself, and though I don't expect I'll ever actually do it, I suspect that the suicidal ideation is itself a bad sign. I don't seem to enjoy anything, I'm either sad or indifferent most of the time, despite there not really being anything in particular to be sad about, and I can't imagine it ever getting any better than this. I need help and I don't know how to seek it out, and I'm afraid that even admitting to this will cause people to think poorly of me."
Of course, it's all easier said than done.