When someone close to you is having suicidal thoughts, ask them if they need help. Asking doesn’t increase the risk of suicide and shows you care.
A variety of approaches show promise in preventing suicide, including gatekeeper training and screening, teaching warning signs, and means restriction. However, randomized trials are rare and scalability is an issue.
1. Identify People at Risk
A key to suicide prevention is identifying people who are at risk. Talking about or thinking about suicide is a warning sign that needs to be taken seriously. Whether someone is considering suicide or has attempted it, they should seek help immediately.
A variety of warning signs can indicate a person is at risk, including being preoccupied with death or dying, mood swings and a change in behavior, withdrawing from social interactions, giving away personal belongings, making preparations like writing a will or buying lethal means like guns or pills. Other risk factors include a history of mental illness, being around someone who has committed suicide, having family or friends with mental health problems, experiencing a major life crisis, such as the death of a loved one, academic failures or financial difficulties.
Research shows that limiting access to lethal means and providing support after an attempt can decrease suicide rates. Some groups are at higher risk of suicide, such as veterans and those living in rural areas.
2. Reduce Access to Lethal Means
The most effective suicide prevention strategy is to limit access to lethal means. Whether by banning acutely toxic highly hazardous pesticides, restricting firearms, installing barriers in places where suicides often occur or limiting access to ligature points, making it harder to obtain and use these methods of self-harm reduces deaths by suicide.
A person attempting suicide will often change their mind or choose a less lethal method when they are no longer close to the means of taking their own life. This is one reason it is important for families and communities to talk about suicide openly, learn the warning signs of depression and other mental disorders, and work together to break the stigma around mental health problems and suicide. This is also why it’s important to promote safe storage of medications and firearms, as well as providing crisis response training and implementing collaborative assessment and management. Those who have experienced a tragedy or major loss, abuse, trauma or traumatic loss are particularly at risk.
3. Build Life Skills
People with caring relationships, access to mental health services and other sources of support are less likely to engage in suicidal behaviors than those who do not. Asking someone if they are at risk and helping them find help can reduce suicide thoughts.
A person experiencing suicidal thoughts should never be left alone. Encourage them to call a suicide support service, go with them to their GP or hospital and make sure they stay connected with family, friends and community. Help them to understand that their thoughts and feelings are temporary and that there is hope for recovery.
Schools are a unique setting for suicide prevention. All school staff should receive training in identifying warning signs and how to respond to a suicide crisis. ACT on FACTS Training (two-hour online training) is available for teachers, school counselors, social workers and mental health professionals. Applied Suicide Intervention Skills Training (ASIST) is a more in-depth two day training for all caregiving groups.
4. Build Resilience
Research has shown that resilience can protect people from suicide, even in the presence of risk factors. Resilient individuals are more likely to be connected with supportive relationships and mental health professionals, and have a stronger belief that they can cope with difficult times.
Building resilience involves teaching individuals life skills like critical thinking, stress management and coping, as well as helping them develop positive self-concept and optimism. It also involves encouraging them to pursue meaningful goals and activities that promote wellness, and providing support when they experience distress.
Many things can cause a person to feel overwhelmed and depressed, including stress, family problems, work pressures and relationship issues. To help someone build resilience, you can teach them strategies to reduce their stress levels, such as relaxation techniques, distraction exercises, grounding and mindfulness. You can also encourage them to try the 15-minute rule when they start having suicidal thoughts – distract themselves for 15 minutes and then check in with themselves.