The goal of preventing suicide is to prevent people from considering, attempting or dying by suicide. This requires strategies that work at the individual, systems and community level. These include gatekeeper training, screening and teaching warning signs. Other strategies include means restriction, responsible media coverage and public education campaigns.
Helping someone who is hurting themselves or thinking about suicide begins with knowing where to turn for assistance. Learn about local resources by calling 988 Suicide & Crisis Lifeline (opens external link).
Identifying People at Risk
Suicide is the 10th leading cause of death in the U.S. In 2022, more than 49,000 people took their own lives and millions attempted to. Life’s challenges can leave us feeling overwhelmed and unable to cope. A sudden loss or other traumatic event, financial problems, academic failures, or a diagnosis of mental illness can be the tipping point toward suicide.
Fortunately, there are things we can do to help someone who is at risk. These include asking them directly if they are thinking about killing themselves, connecting them to 988 Suicide & Crisis Lifeline and other community resources, and staying in touch with them after they experience a crisis or have been discharged from care.
One effective strategy that has been tested in emergency departments is the Safety Planning Intervention. It involves a collaborative effort between the individual and a health care professional to develop a personalized Safety Plan and offers strategies to manage and reduce depression and anxiety.
Reduce Access to Lethal Means
Triggered not only by mental illness and substance use but also by stress and other external events, suicide is a complex act. Putting time and distance between someone in crisis and a lethal means of suicide can save lives.
Suicide prevention includes work at the individual, systems and community levels. Interventions that reduce access to lethal means, such as reducing availability of firearms, are associated with lower suicide rates, but they must be combined with strategies directed at the individual such as identification and treatment.
Counseling to reduce access to lethal means (CALM) is one approach, and is associated with reductions in suicide rates. Programs that reduce access include distributing gun locks, removing medications from easy-to-open packages, erecting barriers at bridges or high risk areas, and eliminating items that can be used for hanging. Community-level interventions that increase social connectedness can also protect against suicide. These might include programs for specific populations or activities that promote a sense of belonging and support.
Providing Support
The best prevention strategies combine efforts to reduce risk factors and enhance protective factors. Protective factors include support networks and community connectedness, problem-solving skills, coping skills and resilience to adversity. Some interventions may help people build those skills, such as person-centered life skills training and therapeutic recreational therapy.
Providing people with access to help when they are at risk can reduce suicide attempts and deaths. This includes crisis services such as phone hotlines, walk-in crisis clinics and hospital-based psychiatric emergency care. It also includes a full continuum of care that connects people with ongoing treatment and support.
Some school-based interventions may reduce suicide rates, including the Stanley/Brown Safety Planning Intervention and a number of other brief preventive tools. This is often done in partnership with a mental health provider. These activities provide individuals with a plan to stay safe and they can invite others, such as a friend or family member, into that process. This is known as a collaborative approach.
Creating Safe Spaces
Community connectedness reduces the risk of suicide by providing a sense of belonging and emotional support. It can be achieved through social programs, activities, and connections with friends and neighbours. It can also be improved through reducing isolation, encouraging non-judgmental listening and supporting expression of feelings.
This research is being conducted across six sites using co-designed, participatory methods that empower stakeholders and build strong relationships between them. This includes people with lived experience as researchers and key partners on the research team, and the implementation of participatory evaluation tools to track ways of working.
We will use population health datasets to evaluate the impact of safe spaces on presentations for intentional self-harm and mental health-related EDs, as well as costs and data on the number of people supported by each site. We will also survey current and prospective safe space guests, and staff at the sites involved in the study. The survey will assess awareness, acceptability and reach of the model.