Ask a Question, Save a Life
If you or someone you know is at risk of suicide or experiencing a mental health crisis, call or text the Suicide and Crisis Lifeline at 988. Trained crisis counselors are available 24/7/365. 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.
Every September, I find myself in the same spot: In front of my laptop, a blog deadline breathing down my neck, arguing with myself about the need for an updated Suicide Prevention Blog. Can’t I just repost the same one from last year? Honestly who would notice…the data isn’t that different…But. As is the case every year, here I sit, writing a revised version with the latest statistics, research, and resources. Why do I waffle, knowing full well that I always write it anew? Well. Because, no matter how many blogs I write or trainings I deliver, suicide is still a topic that hurts. It’s hard. And sad. And scary. And (as is the case for many of us) personal. It’s a topic that, in many ways, would be far easier to avoid. And yet, I write. And you read. Because all of us know that, even against the backdrop of fear and discomfort, the cost of not writing, reading, and talking about suicide 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 US have attempted suicide. So…I’d say pretty high.
As is always the case, this blog is not exhaustive (resources abound at the bottom of the page!). Rather, it was written with the hope of giving us all a starting point, because suicide prevention is not solely the job of mental health therapists or emergency response teams. While such support 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. With that in mind, let’s read on for information and action steps that will leave us better equipped to do our part in preventing suicide.
Suicide in Recent Years*
There is no question that suicide is, and has been for some time, a major public health issue. From 2000-2018, suicide rates in the United States increased 37%. Though suicide rates declined 5% from 2018-2020, the aftermath of the pandemic saw suicide rates nearly return to their peak. In the U.S. alone, 2021 yielded 1.7 million suicide attempts from adults and over 48,000 deaths by suicide. These staggering numbers equate to roughly one suicide attempt every 19 seconds, one death by suicide every 11 minutes, and 131 deaths by suicide every day in America alone.
A few more noteworthy 2021 statistics on suicide in the United States include:
- Suicide was one of the top three causes of death for those aged 10-34, with suicide rates for this group having risen 52% since 2000
- By state, Colorado has the sixth highest suicide rate in the country at 22.8 (per 100,000 deaths, and up from 2020) compared to the national average of 14.1
- 9% of high school students reported having made at least one suicide attempt in the previous 12 months
- Suicide by firearm was most common, accounting for 55% of all suicides
Armed with a clearer picture of this complex, multifaceted public health issue, we turn to action steps for suicide prevention.
Suicide Prevention
It is our collective responsibility to be proactive when it comes to suicide prevention. After all, September is Suicide Prevention – not Intervention – Awareness Month. Various organizations have crafted detailed community-level plans aimed at enhancing affordable access to physical and mental healthcare, alleviating pain, building hope, strengthening connections, and restricting access to lethal means in order to mitigate conditions that increase suicide risk. Beyond that, there are also a number of simple actions we can take on an individual level to enhance resilience, improve overall well-being, and 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 who 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 Healthy Connections: People who report a network of supportive relationships with their friends, family, and community are less likely to experience suicidal thoughts and exhibit self-harming behaviors.
- Normalize Discussion Around Mental Health: As many as 90% of people who die by suicide experience 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.
Create Protective Environments: While it is impossible for us to create environments completely free of lethal means, we can certainly make it more difficult for individuals to access materials they can use to end their lives. Ensuring firearms and medications are appropriately secured is imperative.
Risk Factors & Warning Signs
Possibly the most impactful action we can take in preventing suicide is to be able and willing to identify and support persons at risk. Though any individual can be at risk of suicide, and while suicide is rarely caused by a single circumstance or event, there are a range of factors that can increase the risk of a suicide attempt. Such individual factors include:
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- Previous Suicide Attempts: A prior suicide attempt is one of – if not the – 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.
- 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 or family member or the loss of a job or financial stability are at an increased risk.
- Personal Demographics
- Gender: Though women are more likely to attempt suicide, males are approximately 4x more likely to die by suicide.
- Race/Ethnicity: The highest suicide rates are among non-Hispanic American Indian/Alaskan Native (AI/AN; 28.1) and non-Hispanic White (17.4) populations, with suicide rates increasing significantly among non-Hispanic AI/AN (+26%) and non-Hispanic Black people (+19.2%) between 2018-2021.
- Age: Adults aged 75 and older have one of the highest suicide rates (20.3), and adults aged 35-64 account for nearly 47% of all suicides in the US.
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- Veteran Status: Veterans have an adjusted suicide rate that is 57.3% higher than the non-veteran US adult population.
- LGBTQ+: Young people who identify as LGBTQ+ are 5x more likely to attempt suicide than their straight peers, with evidence for greater risk in bisexual youth, transgender and nonbinary youth, and LGBTQ youth of color.^
Regardless of the presence or absence of risk factors, few suicide attempts happen without indication; nearly all individuals considering suicide exhibit warning signs.** While these signs can be explicit (talking or posting about suicide, seeking access to lethal means, making plans for suicide, etc.), a number are less direct, such as:
- Isolation or withdrawal from family, friends, and community
- Feeling like a burden, trapped, or in unbearable pain
- Sudden and/or significant changes in sleep patterns or substance use
- Extreme mood swings or changes in mood (increased anger, rage, anxiety)
- Expressing feelings of hopelessness or helplessness
- Apparent loss of interest in activities previously enjoyed
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 988.
Taking Action
Now, the crucial question: If we suspect an individual is struggling with suicidal thoughts, what do we do? 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, 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 988 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.
Remember…
Though suicide is an intimidating topic, it is preventable. If we, on the community and individual level, take all suicidal threats seriously and are willing and able to quickly and appropriately respond to mental health crises, 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 any readers who may be struggling, know that you are not alone. I know it can be scary, and I also know that it gets a bit less scary once you find the courage to reach out for support. I know you can do it, just as I know that you are loved, you are needed, and you are enough just as you are. I, personally, am very, very glad you are here.
Katie
*All statistics are taken from the Centers for Disease Control and Prevention’s most recently published data on suicide.
^It is worth noting that LGBTQ+ youth are not inherently prone to suicide risk because of their sexuality or gender identity, but rather placed at higher risk because of how they are mistreated and stigmatized in society. [Data: The Trevor Project]
**Though many warning signs of suicide overlap with symptoms of depression, individuals do not have to be struggling with depression to be at risk of suicide
Resources
Mental Health Emergency
Suicide Prevention Training
Suicide Facts & Figures
