Preventing Suicide

Preventing suicide involves a broad array of treatment and prevention strategies. These include psychotherapy, pharmacotherapy and safety planning, along with education and access to care.

Learn about the warning signs of suicide and how to help a friend or family member. Also, know what to do after a suicidal crisis has passed.

Prevention Strategies

Many risk factors for suicide are complex and multifactorial and can include a combination of biological, psychological, interpersonal, and environmental influences that interact over time. Preventing suicide requires multiple community-based efforts to address all these factors.

Prevention strategies focus on reducing access to lethal means, identifying people at risk and connecting them to treatment, and improving support and connections for individuals struggling with suicidal thoughts or behaviors. These strategies can be applied at the local level and require commitment and cooperation from diverse sectors of society including education, health care, law enforcement, business, and government.

Research on the effectiveness of these strategies is limited by small sample sizes, a lack of replication studies, and variable methods of identification and assessment of suicide risk. In addition, many suicide prevention efforts are targeted at specific groups like those with psychiatric illnesses or a history of previous attempts. Further, some interventions have not been tested during the period of greatest suicide risk.

Protective Strategies

Suicide risk factors include mental health conditions, economic stressors, impulsivity, and exposure to trauma. Protective strategies include supportive relationships, access to mental health care, community connectedness, and healthy coping and well-being practices.

Family and friends are often the first to recognize warning signs of suicide and can help loved ones find treatment if needed. This is why it’s so important to know the warning signs and to talk openly about them with someone you trust, such as a doctor or a crisis line support group.

Universal screening is a powerful tool to identify people at risk for suicide. For example, one study found that a simple three-question screener for suicide in emergency room settings could double the number of people identified as being at risk. Similarly, measures that reduce access to lethal means can dramatically lower suicide rates. For example, storing firearms unloaded and locked with keys or combinations inaccessible to children or other unauthorized users significantly reduces the risk of tragedy during a suicide attempt.

Identifying People at Risk

Suicide rates are much higher in certain groups of people, such as American Indian/Alaska Native and non-Hispanic White Americans. The rate of suicide also varies by age, gender, and occupation. Men are more likely to commit suicide than women. Firearms are more commonly used in suicides than other methods of self-harm.

Identifying patients who are at risk can help to prevent suicide. Universal screening in emergency rooms can double the number of adults who receive mental health care and reduce the number of those who attempt to die by suicide.

Providers can educate themselves about the warning signs of suicide and teach their colleagues and staff how to recognize them. They can also help a patient to develop a crisis plan and make sure that any lethal means are safely locked away. Staying connected and following up with people at risk has also been shown to decrease suicide rates. These interventions can be delivered by primary care providers and other clinicians, community organizations, and local governments.

Reducing Access to Lethal Means

Increasing the distance between someone with suicidal thoughts and their means of suicide can be a powerful preventive strategy. This can be achieved by reducing availability of lethal substances, equipment or locations (eg, by dispensing gun locks, limiting the amount of medication in packages, erecting barriers on bridges and high risk areas, and removing items that can be used for hanging such as ligatures) or by encouraging clinicians to discuss the safety of firearms with their patients.

It is important to note that there are limits to this strategy, including the possibility that restricting access to one method could be offset by the emergence of a different method (eg, as occurred with domestic gas and carbon monoxide in the 1970s and 2000s). In addition, many people who die by suicide do not report having any intention of using any specific means of death, and so restrictions on all methods would be unlikely to have large population effects.