Suicide affects not just individuals and families but also entire communities. Raising awareness and promoting prevention efforts can help.
Asking someone if they are having suicidal thoughts and reducing access to lethal items (calling or texting 988, removing guns or medications) can save lives. So can helping connect them with a friend, family member, spiritual advisor or mental health professional and keeping in touch.
Risk factors
Suicide prevention involves reducing the risk factors and increasing the protective ones. Risk factors include a history of suicide attempts, mental health disorders (such as depression and bipolar disorder), family history of suicide, history of trauma, access to lethal items, and a desire to die. Protective factors include good problem-solving abilities, a strong sense of community, supportive relationships and spiritual beliefs that discourage suicide.
People who are at higher risk for suicide have poorer life skills, a greater number of adverse life events and a lower level of resilience to those challenges. These issues affect many populations, such as American Indians and Alaska Natives who experience the stress of prejudice and discrimination; gay, lesbian, and bisexual youth who struggle with family rejection and bullying; military service members who have higher rates of suicide due to frequent deployments and post-traumatic stress disorder; and rural residents who face financial difficulties such as fluctuating prices for commodities, lack of support services, and limited employment options.
Warning signs
Suicide prevention begins with the recognition of warning signs. Someone who is thinking about taking his or her own life will usually give clues, either verbally or behaviorally. These should be taken very seriously by those who are concerned.
These include dramatic mood changes, especially from being outgoing to being withdrawn; losing interest in everyday activities, such as eating or sleeping; neglecting appearance; showing big changes in social or recreational activities; becoming preoccupied with death or dying (writing poems or stories about it); and seeking access to lethal means. It is important to remove guns, pills or other lethal objects from the person’s reach and never leave a suicidal person alone.
It is also important to be there for the person and listen to him or her without judgment. Research has shown that being there can help keep the person safe and decrease suicide risk. The Interpersonal-Psychological Theory of Suicide identifies connectedness as one of the main protective factors against suicide.
Treatment
There are a variety of treatment options available for people with suicidal thoughts. Psychotherapy (talk therapy) can help people learn to solve problems, develop hope and motivation, and manage strong emotions. Problem-Solving Therapy is a popular evidence-based talk therapy that can help reduce suicidal thoughts and prevent suicide attempts.
Medications are also effective at reducing suicide risk. These include antidepressants and atypical antipsychotics. Behavioral activation therapies can teach people how to cope with painful life events and build coping skills. These programs usually involve weekly individual therapy sessions and group skills training classes.
Prevention methods that target the entire population can also be effective. These can include means restriction, responsible media coverage and general public education, as well as identification methods such as screening, gatekeeper training and primary care physician education. This type of universal intervention can also reduce barriers to help-seeking by increasing access to resources and lowering the stigma associated with mental illness.
Prevention
Approximately 703,000 people die of suicide around the world each year, and millions more attempt it. Each suicide is a tragedy that affects friends, family, and communities. Preventing suicide is a complex task that requires many different strategies. These include reducing risk factors, recognizing warning signs, and promoting hope. It is also important to build social connections and reduce isolation.
Health care organizations play a critical role in suicide prevention by screening, providing referrals, and monitoring risk. They can also provide education and training to help those at risk. In addition, they can support upstream comprehensive community-based suicide prevention efforts and work with people with lived experience.
PAHO supports the development of training programs for primary health care providers, non-psychiatric medical specialists, and humanitarian workers, including gatekeepers who are responsible for screening and referrals. These programs are evaluated on the basis of their effectiveness in preventing suicide attempts and their capacity to be scaled up at the city, county, state, and national levels.