If you or someone you know is at risk of suicide or experiencing a mental health crisis, call 911 or the National Suicide Prevention Lifeline at 1-800-273-8255. Please note that the content of this blog may be triggering; if you need to step away, or read it with the support of a loved one, please do so.

Generally speaking, I quite enjoy writing blogs for our club. I love the process of selecting and researching topics (often to a greater extent than is needed), and distilling information into digestible and impactful pieces. To be entirely transparent, though, this blog was not particularly enjoyable to write. Suicide, while massively important, is a tough topic; it isn’t one that people itch to discuss. It’s uncomfortable. It’s scary. For many of us, it’s personal. I know that is the case for me, which is why – no matter how many times I write on suicide – it still hurts. It’s still hard. The cost of not writing, reading, and talking about it, though, is far too high. Just how high, you ask? Well. In the time it has taken you to read this far, two individuals in the United States have attempted suicide. So…I’d say pretty high.

As with most of my blogs, this is by no means exhaustive; if you’re looking for more information, check out the resources list at the bottom of the page. This blog was written to give us all a starting point; to help us feel a bit more confident and equipped to do our part in supporting those at risk of suicide. As you read, know that suicide prevention is not solely the job of counselors, therapists, or emergency response teams. While seeking support from such practitioners is an integral part of suicide prevention, so are all of us; every person who interacts with other people is in a position to save a life.

Suicide By the Numbers*

This blog is primarily devoted to equipping us with knowledge and action steps for suicide prevention, risk identification, and management. First, though, it is crucial for us to have an understanding of the widespread and active threat that suicide poses. As hard as it may be, I implore you not to skip this short section. Have the courage to look at these numbers and see them not just as facts and figures, but as people in your life. In doing so, I hope that we will all feel more accountable to the individual roles we play in suicide prevention.

Suicide is a large and growing public health concern not only in the United States, but all over the world. In the U.S alone, 2019 yielded 1.4 million suicide attempts and 47,500 deaths by suicide, making suicide the 10th overall leading cause of death in the country. In our every day, these staggering numbers equate to roughly one suicide attempt every 23 seconds, one death by suicide every 11 minutes, and 130 deaths by suicide every day in America alone. A few equally alarming facts include that:

• Suicide rates have increased nearly 35% since 1999
• Suicide is the 2nd leading cause of death for those aged 10-34 (behind unintentional injury)
• By state, Colorado has the fifth highest suicide rate in the country

While a quick search will yield dozens of more statistics on suicide, these numbers alone make clear the very real threat that suicide poses, specifically to children, adolescents, and young adults in our state.

Suicide Prevention

Suicide is a worldwide pandemic, and it’s our collective responsibility to be proactive when it comes to suicide prevention. After all, September is Suicide Prevention – not intervention – Awareness Month. While various organizations have crafted detailed community-level plans to reverse the upward trend of suicide rates, there are also a number of simple actions we can take on an individual level to better protect our loved ones:

• Teach Problem Solving Skills: People who are able to effectively solve problems and resolve conflict in a non-violent way are at a lower risk of suicide.
• Develop Healthy Coping Strategies: Individuals that can confidently, consistently, and effectively implement a variety of healthy coping skills (exercising, listening to music, talking with a friend, meditating, praying, writing, drawing, etc.) better manage stress and experience lower rates of suicidal thoughts and behaviors.
• Promote Connection: People who report a network of supportive relationships, and feel a greater degree of connection to their friends, family, and community, are less likely to experience suicidal thoughts and exhibit self-harming behaviors.
• Normalize Discussion Around Mental Health: 90% of people who die by suicide experienced adverse mental health symptoms. Individuals who regard mental health as stigmatic are far less likely to actively attend to their mental health and seek out support when needed, placing them at a greater risk of suicide.
• Ensure Availability of Physical and Mental Health Care: People who have easy and reliable access to physical and mental health care report lower rates of suicidal thoughts and exhibit less suicidal behaviors.

Risk Factors & Warning Signs

In addition to taking preventative action, we must also be able to identify individuals struggling with suicidal thoughts or engaging in suicidal behavior. Though any individual – regardless of age, socioeconomic status, race, gender, etc. – can experience suicidal thoughts, there are a handful of factors that place specific individuals at particular risk. Such factors include:

• Previous Suicide Attempts: A prior suicide attempt is the single most important risk factor for suicide in the general population.
• Diagnosed Mental Illness: Though a diagnosable mental illness is not a prerequisite for suicidal thoughts or behaviors, 46% of people who die by suicide have a diagnosable mental health condition (including substance use disorders).
• History of Trauma or Abuse: Individuals who have experienced violence, neglect, bullying, or any form of abuse are at a greater risk of suicide.
• Recent Tragedy or Loss: People who have recently experienced the death of a friend, family member, or other notable individual (by suicide or other causes) are at an increased risk of experiencing suicidal thoughts or engaging in self-harming behaviors.
• Personal Demographics
  • Gender: Though women are more likely to attempt suicide, males are 4x more likely to die by suicide.
  • Race/Ethnicity: The highest suicide rates are among American Indian/Alaskan Native and non-Hispanic White populations.
  • LGBTQ+: Young people who identify as LGBQ+ are 4x more likely to attempt suicide than their straight peers, while transgender individuals are 12x more likely to attempt suicide than the general population.

Bearing these factors in mind, our next goal is to be able to identify warning signs of suicide. Despite how it may appear, few suicide attempts happen without indication; often, we are simply not aware or attentive enough to recognize the warning signs of suicide. While these signs can be explicit (talking about suicide or self-harm, making comments like “I wish I wasn’t here”, a preoccupation with dying or death, etc.), a number are less direct, such as:

• Withdrawal from family, friends, and community
• Sudden and/or significant changes in sleep patterns, eating habits, alcohol/drug use, mood, or personality
• Apparent loss of interest in activities previously enjoyed
• Feelings of helplessness or hopelessness
• Aggressive, impulsive, or reckless behavior

Though some of these warning signs overlap with symptoms of depression, remember that individuals need not be struggling with depression to be at risk of suicide. Beyond these warning signs, specific behaviors such as buying a weapon, collecting pills, saying goodbye, giving away possessions, or making final arrangements should be considered an emergency. If you see an individual engaging in such behaviors, call 911 or a mental health provider.

Taking Action

Now comes the crucial question: If we suspect an individual is struggling with suicidal thoughts, what do we do? First and foremost, the best way to find out if someone is contemplating suicide is to ask them directly: Are you thinking about suicide? Do you have a plan? Contrary to popular belief, research has repeatedly shown that asking at-risk individuals if they are suicidal does NOT increase suicide risk. In fact, doing so serves to show the person that they are cared for and may reduce suicidal thoughts. If you suspect someone is struggling, start a conversation; it, alone, could save a life.

If an individual is experiencing suicidal thoughts, but lacks a plan or is not in immediate danger, take action to reduce their access to lethal means, listen, show support, and connect them with a mental health professional. Alternatively, if an individual has made a previous suicide attempt, has a plan in place, or appears to be an imminent threat of harm to themselves, the situation should be considered an emergency. In such cases, the behavior of an at-risk individual can be unpredictable and change dramatically without warning. To support an individual amidst a mental health crisis:

• Have someone call 911, or another emergency response resource, and stay with the individual.
• Remove lethal means from the individual if it is safe to do so. Be sure to ask permission before attempting to touch the person.
• Maintain a calm voice and avoid overreacting. If you are in a group, have one person speak up at a time.
• Do not argue, threaten, or debate if suicide is right or wrong.
• Express support and concern. The at-risk individual’s struggles may be compounded by feelings of vulnerability, guilt, and shame in the moment. Be compassionate.
• Ask simple and direct questions about how you can help; offer options instead of attempting to take control of the situation.
• Engage in active listening through nonverbal attending behaviors, reflections, and summarizations of what the individual is sharing. Make them feel heard.
• Do not leave the individual alone until emergency assistance arrives.

After ensuring an individual is connected with appropriate resources, be sure to follow-up with them. Whether it be with a text, call, or coffee date, checking in demonstrates to the individual that you are a present source of support in their lives. Doing so will not only show that you care, but also foster greater feelings of connection, which we know to reduce future suicide risk.

Though suicide is an intimidating topic, it is preventable. If we, on the community and individual level, ensure to take all suicidal threats seriously and are willing and able to quickly and appropriately respond to mental health crisis situations, we can save countless lives. If you have one take away from this blog, let it be the knowledge that if you – a single person – pay attention, and are willing to ask a single question, you can save a life.

And finally, for those of you reading this who may be struggling, know that you are not alone. Have the courage to reach out. You are seen, you are loved, and you are enough just as you are. I, personally, am very, very glad you are here.

*All statistics are based on the data from the Center for Disease Control’s 2019 WISQARS Fatal Injury Data Visualization Tool

Resources:

National Suicide Prevention Lifeline

• Suicide Hotline: 1-800-273-8255

Suicide Prevention Training – Question, Persuade, Refer Institute

National Alliance on Mental Illness

• Suicide Prevention Awareness Month
• Navigating a Mental Health Crisis

Center for Disease Control and Prevention – Suicide Facts, Prevention

Child Mind Institute – Suicide & Self-Harm

National Institute on Mental Health – Suicide Statistics