Prevention Education

Suicide is when people direct violence at themselves with the intent to end their lives, and they die because of their actions. It’s best to avoid the use of terms like “committing suicide” or a “successful suicide” when referring to a death by suicide as these terms often carry negative connotations.

A suicide attempt is when people harm themselves with the intent to end their lives, but they do not die because of their actions.

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Suicide does not discriminate. People of all genders, ages, and ethnicities can be at risk.

The main risk factors for suicide are:

• A prior suicide attempt
• Depression and other mental health disorders
• Substance abuse disorder
• Family history of a mental health or substance abuse disorder
• Family history of suicide
• Family violence, including physical or sexual abuse
• Having guns or other firearms in the home
• Being in prison or jail
• Being exposed to others’ suicidal behavior, such as a family member, peer, or media figure
• Medical illness
• Being between the ages of 15 and 24 years or over age 60

Even among people who have risk factors for suicide, most do not attempt suicide. It remains difficult to predict who will act on suicidal thoughts.

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According to the Centers for Disease Control and Prevention (CDC), men are more likely to die by suicide than women, but women are more likely to attempt suicide. Men are more likely to use more lethal methods, such as firearms or suffocation. Women are more likely than men to attempt suicide by poisoning.

Looking for data and statistics? For the most recent statistics on suicide and more information about risk, please visit the CDC website at www.cdc.gov/ViolencePrevention/suicide/index.html

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Most people who have the risk factors for suicide will not kill themselves. However, the risk for suicidal behavior is complex. Research suggests that people who attempt suicide may react to events, think, and make decisions differently than those who do not attempt suicide. These differences happen more often if a person also has a disorder such as depression, substance abuse, anxiety, borderline personality disorder, and psychosis. Risk factors are important to keep in mind; however, someone who has warning signs of suicide may be in more danger and require immediate attention.

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The behaviors listed below may be signs that someone is thinking about suicide.

• Talking about wanting to die or wanting to kill themselves
• Talking about feeling empty, hopeless, or having no reason to live
• Planning or looking for a way to kill themselves, such as searching online, stockpiling pills, or newly acquiring potentially lethal items (e.g., firearms, ropes)
• Talking about great guilt or shame
• Talking about feeling trapped or feeling that there are no solutions
• Feeling unbearable pain, both physical or emotional
• Talking about being a burden to others
• Using alcohol or drugs more often
• Acting anxious or agitated
• Withdrawing from family and friends
• Changing eating and/or sleeping habits
• Showing rage or talking about seeking revenge
• Taking risks that could lead to death, such as reckless driving
• Talking or thinking about death often
• Displaying extreme mood swings, suddenly changing from very sad to very calm or happy
• Giving away important possessions
• Saying goodbye to friends and family
• Putting affairs in order, making a will

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If you or someone you know has warning signs or symptoms of suicide, particularly if there is a change in the behavior or a new behavior, get help as soon as possible.

Often, family and friends are the first to recognize the warning signs of suicide and can take the first step toward helping an at-risk individual find treatment with someone who specializes in diagnosing and treating mental health conditions. If someone is telling you that they are going to kill themselves, do not leave them alone. Do not promise anyone that you will keep their suicidal thoughts a secret. Make sure to tell a trusted friend or family member, or if you are a student, an adult with whom you feel comfortable. You can also contact the resources noted below.

 

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Health care providers can help prevent suicide when they understand the risk factors and use evidence-based treatments and therapies. In addition, The Joint Commission recommends screening all patients in all medical settings for suicide risk using validated, population and setting-specific tools.
Clinicians should be advised that it is no longer acceptable to “contract for safety” with patients. Safety planning for managing future suicidal thoughts and means restriction (removing or ensuring safe storage of potentially lethal items) have been proven to be effective ways of preventing suicide. Health care providers can find educational resources on the Zero Suicide website and news about the latest research on the NIMH website at www.nimh.nih.gov.

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• Knowing how to get help for a friend posting suicidal messages on social media can save a life. Many social media sites have a process to report suicidal content and get help for the person posting the message. In addition, many of the social media sites use their analytic capabilities to identify and help report suicidal posts. Each offers different options on how to respond if you see concerning posts about suicide. For example:
  • Facebook Suicide Prevention webpage can be found at facebook.com/help/594991777257121/ [use the search term “suicide” or “suicide prevention”].
  • Instagram uses automated tools in the app to provide resources, which can also be found online at https://help.instagram.com [use the search term, “suicide,” self-injury,” or “suicide prevention”]
  • Snapchat’s Support provides guidance at https://support.snapchat.com [use the search term, “suicide” or “suicide prevention”]  
  • Tumblr Counseling and Prevention Resources webpage can be found at https://tumblr.zendesk.com [use the search term “counseling” or “prevention,” then click on “Counseling and prevention resources”].
  • Twitter’s Best Practices in Dealing With Self-Harm and Suicide at https://support.twitter.com [use the search term “suicide,” “self-harm,” or “suicide prevention”].
  • YouTube’s Safety Center webpage can be found at https://support.google.com/youtube [use the search term “suicide and self injury”].

If you see messages or live streaming suicidal behavior on social media, call 911 or contact the toll-free National Suicide Prevention Lifeline at 1–800–273–TALK (8255), or text the Crisis Text Line (text HOME to 741741) available 24 hours a day, 7 days a week. Deaf and hard-of-hearing individuals can contact the Lifeline via TTY at 1–800–799–4889. All calls are confidential. This service is available to everyone. People—even strangers—have saved lives by being vigilant.

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Effective suicide intervention practices are based on research findings and tested to see how various programs benefit various specific groups of people.
The National Institute of Mental Health (NIMH) has supported research on strategies that have worked well for those who have mental health conditions related to suicide such as depression and anxiety.
Information obtained from the National Institute of Mental Health, 2018

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