Preventing Suicide

Suicide is a complex and devastating public health issue. Prevention strategies include means restriction, gatekeeper training, and suicide screening and education.

Warning signs of suicide include dramatic changes, withdrawal from friends/family, impulsive behavior, disinterest in appearance or hygiene, and/or a recurring depression. These symptoms should be taken seriously and acted upon immediately.

Identifying Suicide Attempters

Often, suicide attempters do not seek help for their risky behavior because they don’t know that help is available or are afraid that they won’t be helped. Gatekeepers like friends and family members, teachers, police officers and military commanders can identify risky behaviors and get people at-risk the help they need.

Behavioral changes that can indicate someone is planning to kill themselves include practicing or preparing for suicide, which may look like exhibiting unusual behaviors with guns, pills or other lethal items, according to SAMHSA. Other indicators can be a sudden life crisis such as the death of a loved one, a diagnosis of a serious illness, divorce, financial difficulties or a loss of a job.

Taking steps to keep someone safe can include asking if they are thinking of suicide and removing or disabling their access to lethal items. Studies have shown that increasing a person’s sense of connectedness and emotional support, as well as helping them get the mental health care they need, can help reduce suicide attempts.

Preventing Suicide Attempts

Like any other behavior, suicide results from a complex interplay of risk and protective factors. These can include a person’s history of mental health problems, exposure to violence and trauma, a person’s ability to withstand stress and cope, and the availability of effective treatments.

It’s important to know the warning signs and recognize that anyone can have thoughts about suicide. People can be helped by a range of prevention strategies, including personal safety planning, access to immediate help (like crisis centers or suicide hotlines), psychotherapy such as cognitive behavioral therapy and dialectical behavior therapy, and restricting access to lethal means (including medication).

A key factor in preventing suicide is feeling connected to others. This can be done by spending time with friends and family, attending religious or cultural events, and getting involved in your community. It’s also helpful to remove potential suicide methods from the home, such as by locking away pills or razors. Research has shown that providing psychoeducation and follow-up phone calls to at-risk people can reduce their suicidal thoughts and actions.

Getting Help for Suicide Attempters

A suicide attempt can be a traumatic experience. Even after they recover, many people struggle with flashbacks and PTSD symptoms like sleeplessness and physical tension.

It’s important to help the person find a safe and comfortable environment to talk about the event. This could include a therapist, a support group or a kaumatua or kuia. Often, people who have experienced suicide try to hide their feelings and don’t think they can trust anyone. But they need to know that it’s OK to let down those closest to them and that it is not their fault if they attempt or die from suicide.

Personalized safety planning—in which a health care provider helps the patient develop a plan to limit access to lethal means, identify resources and coping skills, and make sure someone knows where she is if she has suicidal thoughts—has been shown to reduce suicide attempts. It is also helpful to encourage the person to form a strong support network, including other survivors, and to participate in physical activity (like walking, jogging or swimming) that has been shown to reduce depression symptoms.

Supporting Suicide Attempters

People who survive a suicide attempt can benefit from ongoing support over the long haul. Talking openly and nonjudgmentally about the hard stuff in life, helping them create a safety plan and staying in contact with them can help. It’s important to remember, though, that they need to be able to access professional help themselves.

Supporting resilience and helping them regain a sense of control over their lives also is helpful. This is something that can be done by identifying positive aspects of their life and making sure they continue to do the things they enjoy.

Several strategies have been proven to reduce suicidal behavior. They include brief intervention strategies, limiting access to lethal means, community-based education and responsible media coverage, and identification methods such as gatekeeper training and primary care physician screening. However, a combination of strategies is likely to be most effective. Research on a range of societal and individual level interventions is needed.