The official National Suicide Prevention Month is September, but really, every month is a good month to prevent suicide. Suicide is the 10th leading cause of death in the United States in general, and the second leading cause of death in the world for people aged 15-24 years old. In 2017 there were 1.4 million suicide attempts (over 3,800 a day) and 47,173 Americans died by suicide (129 a day). Depression affects 20-25% of American adults every year and only half receive treatment. Importantly, of those who receive treatment, 80-90% are treated successfully with therapy and/or medication (with both together being the most effective). Worldwide, there are almost 800,000 deaths by suicide every year, which is roughly one death every 40 seconds. News agencies across the nation report an increase in mental health issues such as depression, anxiety, and substance abuse following COVID-19, though experts note we are a couple of years away from having retrospective data on exactly how COVID-19 will impact the suicide rate.
Suicide most often occurs when stressors and health issues converge and result in hopelessness and despair. Depression is the most common disorder associated with suicide, especially when it goes undiagnosed or untreated. Anxiety, bipolar, schizophrenia, conduct disorder, and substance abuse also increase the risk for suicide. Other health risk factors for suicide are serious physical health problems including pain and traumatic brain injury. Environmental risk facts include access to lethal means including firearms and weapons, prolonged stressed such as unemployment, relationships problems, harassment or bullying, and bearing witness to someone else’s suicide or sensationalized accounts of suicide. If a person has a family history of suicide, has attempted suicide before, or has a history of childhood abuse, neglect, or trauma, their risk for suicide increases.
Know the warning signs of suicide. Sometimes they are obvious – someone talks about killing themselves, you find they’ve been searching online for methods of suicide, or they’ve acquired a means (e.g. buying a gun when they have not had an interest before). Other signs are more subtle or not obviously connected to suicidality: increased use of substances; withdrawal from activities; connecting with people to apologize, forgive, or say goodbye; seeking revenge or feeling rage; aggression; anxiety; fatigue; inadequate or excessive sleep; loss of interest and low mood, or feeling trapped, overwhelmed, and hopeless. Sometimes there are dramatic mood changes or reckless behavior. Sometimes someone who has been depressed suddenly feels better and appears lighter, relieved. This might be a sign they have made a decision to commit suicide. Sometimes, unfortunately, there are no signs at all.
How do you help someone who is suicidal? The best way is to be direct. Ask the person: Are you having thoughts of suicide? Do you plan to kill yourself? Have you decided when you’d do it? Do you have what you need to carry out your plan? If they have a plan and the means, call 911 immediately. Sometimes people fear that mentioning suicide will put the idea into someone’s head. This is not true. You are much more likely to help someone feel better if they were feeling desperately alone. People might also be afraid of offending the person. Err on the side of safety – it’s better to offend someone than to miss an opportunity to save a life.
Next, listen nonjudgmentally. Whether you’re waiting for the police to arrive, or they are not in crisis but are willing to talk, encourage them to talk about what they’re thinking and feeling. Accept what they’re saying even if it’s hard to hear. People considering suicide feel alone, and just being heard can lessen that. Empathize with them – imagine what it might be like to be them. Don’t challenge what they’re saying in an effort to change it. Just listen.
Then give reassurance and information. Reassurance can be the hope a suicidal person needs to push through this moment to the other side of feeling suicidal. Tell them that there is help out there, that feeling suicidal is often connected to something that is treatable, like depression. Offer to help them get connected with a professional who can help them. Psychiatrists are medical specialists in the field of mental health who can assess and prescribe medication. Therapists (could be psychologists, social workers, LPCs, LMFTs, etc.) are professionals who specialize in “talk therapy.” Studies show the best help for most serious mental health issues, including suicidality, is both medication and therapy at the same time. Encourage the person considering suicide to reach out to connect with healthy people in their lives. Ask them who has been helpful in the past when they’ve felt this way, who do they trust and love? They need to tap into their social support system as much as they can right now.
Remember to practice self-care for yourself after a crisis situation. It can be shocking and draining to find yourself suddenly on the front lines of trying to save a life. Reach out to your own support system after such an event. To bolster your knowledge and skills, take a mental health first aid course (https://www.mentalhealthfirstaid.org/). It’s a good idea to memorize the National Suicide Prevention hotline or have it in your Contacts list: 1-800-273-8255.