Suicide is preventable, but it takes an entire community working together. People can help by learning the warning signs and supporting those in need.
Remove guns, drugs and other potentially lethal means of suicide from the home. Provide mental health resources and help with a safety plan. Encourage and facilitate help-seeking by removing barriers such as stigma and transportation issues.
Risk Factors
Suicide is a complex and multifactorial phenomenon, and the relative strength of risk factors varies by age, gender and across domains. The available evidence underscores the need to develop innovative public health strategies, which must be integrated at local and national levels.
A comprehensive approach to suicide prevention should involve all sectors of society, including education, labour, business, justice, law, defence, politics, and health. This includes helping people at risk to identify protective factors and reduce their access to lethal means of self-harm.
The evidence suggests that many risk factors are modifiable and can be targeted by innovative public health interventions. These include improving liaison between physical and mental health services, and targeting high-risk groups (eg those in contact with the criminal justice system or owing substantial unsecured debt). The risk of suicide is also higher among males than females and varies by country of origin, particularly for those from Asian countries. This is partly due to differences in the prevalence of psychiatric disorders and methods of suicide, as well as cultural and economic contexts.
Interventions
In addition to strengthening protective factors, focusing on life skills can help people deal with adversity and cope with stressors. These skills include critical thinking and managing stress, dealing with emotions, and communicating. Using mobile apps and skills training programs can help individuals build these abilities and become resilient.
Identifying people who are at risk of suicide requires knowledge of warning signs and knowing what to do when someone shows these signs. Training can improve this knowledge, for example, by teaching gatekeepers what to look for. For example, a school counselor who attended project SOAR, a mandatory 8-hour course, correctly identified warning signs such as depression, previous suicide attempts, low self-esteem, and recent relationship breakups 87 percent of the time or better.
There are many suicide prevention interventions, and some have multiple rigorous studies. Some, like brief contact interventions and care coordination, have been shown to reduce suicide attempts. However, the evidence is limited on other strategies such as safety planning intervention and reducing access to lethal means.
Resilience
Some individuals are naturally resilient, but resilience is also a skill that can be learned. Psychotherapy, such as cognitive behavioral therapy, is a good way to help individuals develop the skills needed to be resilient.
Resilient people possess a variety of effective coping strategies, which allow them to weather difficult emotional storms without falling into despair. Enhanced problem-solving abilities allow them to recognize and utilize potential solutions, such as reaching out to friends for support or reading books about other people who have survived similar circumstances.
In addition, resilient individuals are able to take their time when processing stressful events. This can help prevent a person from acting on impulse and taking risks that can lead to a recurrence of depression or other mental health problems. For example, if a Service Member forgets an important meeting because they are stuck in traffic, they will likely apologize and reschedule the appointment rather than get angry, stress out or even think they are a terrible person.
Prevention
Identifying people at risk and making timely referrals to treatment can save lives. A variety of identification methods have been shown to be effective, including screening, gatekeeper training and primary care physician education. In addition, responsible media coverage that does not link suicide to external events such as divorce, job loss or school failure can help prevent stigma and encourage those considering self-destructive behavior to seek help.
Keeping people safe includes reducing access to lethal items and disabling them if necessary. It also includes asking if someone is thinking of killing themselves, although this may be difficult to do. It is important to be able to discuss these thoughts in a supportive and caring manner.
Supportive social programs that increase a sense of belonging and foster emotionally supportive relationships can protect individuals from suicide despite a high level of risk. For example, the My 3 downloadable app recommended by the National Suicide Prevention Lifeline helps patients create a safety plan that lists people to contact, coping strategies and resources.