Suicide is an uncomfortable and scary topic, but one that we cannot afford to avoid or ignore.
The most significant things you can do when you believe someone is contemplating suicide is to have the conversation, ask appropriate questions, and take prompt action.
Each year 44,965 Americans die by suicide, a number that continues to increase annually. Suicide is the 10th leading cause of death in the U.S.
Factors That Can Contribute to Suicidal Ideation
Risk factors for suicide are characteristics or conditions that increase the chance that a person may try to take their life. Some people who have one or more of the major risk factors can become suicidal when coupled with stressful environmental factors.
Risk Factors
- Depression
- Schizophrenia
- Anxiety disorders
- substance abuse/dependence
- Previous suicide attempt
- A family history of attempted or completed suicide
- Borderline Personality Disorder
- Self-harming behaviors
Environmental Factors
- Highly stressful event: losing someone close or financial loss
- Prolonged stress due to unemployment, relationship conflict, harassment, or bullying
- Exposure to another person’s suicide
- Graphic or sensationalized accounts of suicide
Suicide Warning Signs
In contrast to longer-term risk factors, warning signs are indicators of more immediate suicide risk.
A person who is thinking about suicide may say so directly: “I’m going to kill myself.” More commonly, they may say something more indirect: “I just want the pain to end,” or “I can’t see any way out.”
Most of the time, people who commit suicide show one or more of these suicide warning signs before they take action:
- Talking about wanting to kill themselves, or saying they wish they were dead
- Looking for a way to kill themselves, such as hoarding medicine or buying a gun
- Talking about a specific suicide plan
- Feeling hopeless or having no reason to live
- Feeling trapped, desperate, or needing to escape from an intolerable situation
- Having the feeling of being a burden to others
- Feeling humiliated
- Losing interest in things, or losing the ability to experience pleasure
- Insomnia
- Becoming socially isolated and withdrawn from friends, family, and others
- Acting irritable or agitated
- Showing rage, or talking about seeking revenge for being victimized or rejected, whether or not the situations the person describes seem real
If you suspect someone may be at risk for suicide, take it seriously. According to the American Foundation for Suicide Prevention, 50% to 75% of all people who attempt suicide tell someone about their intention. If you have reason for concern you can ask questions, encourage professional help, and take action.
Suicide Intervention Plan
- Begin by telling the suicidal person you are concerned about them and that you care.
- Tell them specifically what they have said or done that makes you feel concerned about suicide.
- Don’t be afraid to ask whether the person is considering suicide, and whether they have a particular plan or method in mind. These questions will not push them toward suicide if they were not considering it.
- Ask if they are seeing a clinician or are taking medication so the treating person can be contacted.
- Do not try to argue someone out of suicide. Instead, let them know that you care, that they are not alone, and that they can get help. Avoid pleading and preaching to them with statements such as, “You have so much to live for,” or “Your suicide would hurt your family.”
- Actively encourage the person to see a physician or mental health professional immediately.
People considering suicide often believe they cannot be helped. If you can, assist them to identify a professional and schedule an appointment. If they will let you, go to the appointment with them.
High Risk Suicide Prevention Plan
- If the person is threatening, talking about, or making specific plans for suicide, this is a crisis requiring immediate attention. Do not leave the person alone.
- Remove any firearms, drugs, chemicals, or sharp objects that could be used for suicide from the area.
- Take the person to a walk-in clinic at a psychiatric hospital or a hospital emergency room.
- If these options are not available, call 911 or the National Suicide Prevention Lifeline at 1-800-273-TALK (8255) for assistance.
Ongoing Protective Approach
Protective factors for suicide are characteristics or conditions that may help to decrease a person’s suicide risk. By incorporating these into an ongoing suicide prevention plan, you can make sure a plan is in place if your loved one’s suicidal thoughts return.
Protective Factors
- Receiving effective mental health treatment
- Positive and healthy connections to family, peers, community, and social institutions such as religion that foster resilience
- The skills and ability to problem solve
Creating a Suicide Prevention Plan
The best approach is for the suicidal person to create a prevention plan with a mental health professional and a close family member or friend. The prevention plan evaluates their specific risk factors, environmental factors, and protective factors. They can identify the specific symptoms and behaviors that indicate suicidal thoughts are near, and outline plans of action to take in each different scenario.
The next time challenges arise that might predict suicidal behavior, your loved one will have a plan in place to keep themselves safe.